Advanced prostate cancer (stage IV) newly diagnosed

[nereabg]

Hi! My father is 81 year old and has been diagnosed with advanced prostate cancer in october 2017. One bone met and one lymph node affected. PSA 4.48. He underwent brachytherapy in april 2015 and the psa fell to 1.27 but started rising in october (2.88). Gleason 7 (3+4). The doctor has prescribed him triptolerin and doesn´t want to treat him with radiation (too old). Concerned about the evolution. First psa and testosterone control at the end of January.

[Litlerny]

Best wishes to your father. I’m a patient, not a doctor, and would never second guess a medical professional. You might inquire about abiraterone with prednisone if his insurance will cover it. I’ve also heard that some oncology practices are referring their patients to radiation oncologists to “zap” single bone mets. Others prescribe Xofigo for the bone issues. A lot depends on your father’s general health other than the prostate cancer, what his insurance and/or Medicare will cover, and what is likely to help him the most with the fewest side effects. Even at 81 there are secondary treatments tat should benefit him and give him better quality of life. Heck, I golf with a guy who is 81. Good luck, and God bless you both.

[nereabg in reply to Litlerny]

Thank you very much. The doctor told us that abiraterone was an option if the tumor turns out to be castration-resistant. The general health of my father is quite good and he has no pain (yet), only urinary problems specially at night.

[Dr_WHO]

Sorry that you are here, but it is a great group. You may want to review the results from the Stampede and Latitude trials which are showing great promise. In short, they use a combination of two hormonal therapies, Lupron and Zytiga, at the same time. Listed below are some references.

cancernetwork.com/asco-pros...

ascopost.com/News/55700

The next reference focuses on options for treating bone mets

cancer.org/cancer/prostate-...

Moving away from giving you information, please know that everyone here is pulling for your father and your whole family. It is a fact that cancer effects everyone, not just the ones that have it. Some of the strongest people I know are the caregivers. Your family will never be alone. As the song states “people like us we have to stick together “. Well your family just got a lot bigger.

[nereabg in reply to Dr_WHO]

Sure it´s a great group I have been answered immediately. Thank you very much for the references and your support. The doctor says that Zytiga is the next option if the tumor turns out to be castration-resistant but not at the same time with triptolerin. I have read that it can be good to combinate both at the same time... we will see in the next psa control...

I am here to give my support back to you.

[Dr_WHO in reply to nereabg]

😀😀😀

[Hidden]

Love, Love, Love, and compassion, that’s what he needs! My father had it also. I was long distance and didn’t see him during that time.. He died a few yrs later from asthma.I now know what he went thru and I feel bad now because I really didn’t nderstand at that time what he was going thru.. Instead of getting a check myself at 40 because of his history. I waited until 53 and I couldn’t pee, to visit the doc. I thought that at the worst, I’d need prostate out some day.EGO didn’t know that it could could be worse than that,, Comfort your father, that’s all that we can do.. He is fortunate to have you as his daughter..

[nereabg in reply to Hidden]

Thank you, we try to give all our love to him. Sorry about your father, prostate cancer is very common in men and the risk increases with age. It´s good that you are having controls. The doctors are reluctant to remove the prostate they usually don´t do it after age 60.... Best wishes to you.

[eggraj8]

The current plan seems reasonable to me. By control of testosterone the cancer can contained. I would suggest you see how he responds to that before anything more. Several years of good life may be gotten with just the ADT therapy. Best wishes

[nereabg in reply to eggraj8]

Thank you. I have been thinking that the tumor can be hormone-refractory because the psa is not very high and he has bone met (I have been reading about on the Internet) but its reasonable what you say, we have no wait and see.

[Sisira]

Your dad is already a Winner because of two things. He has survived beyond 80 and he has such a caring daughter by his side! His PCa is medium risk, still not CRPC and I think priority should be given to his quality of life, peace and happiness in mind. In all probability hormonal therapies will buy him sufficient time. I wish him well!

Sisira

[nereabg in reply to Sisira]

Thank you, you are right, he has survived beyond 80 and the priority is his quality of life. No pain yet, which is my great fear. He doesn´t know too much about it for his own good.

[j-o-h-n]

To: nereabg

81? A 1936 baby hmmmm, he's just a youngster. He'll be around for many many years to come unless a jealous husband shoots him. Tell him to laugh laugh and then laugh.

Good Luck and Good Health.

j-o-h-n Friday 01/05/2018 1:14 PM EST

Brrrrrr.... Cold

[nereabg in reply to j-o-h-n]

Yeah he is a 1936 youngster. That´s what the doctors remind us just in case. We know it but it´s always hard no matter the age specially when his general health is good. Hope he dies from some other cause...it is the only advantage of being (very) elderly.

[Break60]

What does “ concerned about the evolution “ mean? If he’s otherwise healthy and only has a couple mets SBRT might work for him. It’s over quickly has no side effects and better than ADT which has side effects . 81 is not old for men who have taken care of themselves.

[nereabg in reply to Break60]

Hi, I am concerned about the evolution because maybe the combination psa not very high+bone met is an indication of poor prognosis of the disease. The oncologist told us it was something "remarkable". Probably a high psa responds more effectively to androgen deprivation... but we don´t know yet. The doctor told us that chemotherapy was not and option considering his age.

But we have to wait and see. I will tell you about.