Advanced Prostate Cancer
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Advanced Prostate Cancer Treatment

Hi, I am new to this community. My father(89 y/o) has advanced prostate cancer, that was diagnosed in Nov,1996 PSA was 49. It was stage 4 with mets to one lymph node found.Treated with Lupron, Casodex and Radiation. 2 years(2015) ago his PSA started rising and the cancer spread to his left shoulder. He was treated with Radiation and started on Trelstar and Xgeva(for his bones). May,2017 he started having pain in his shoulder and was treated with Radiation again and is on a Fentanyl patch of 25mcg. His PSA was 2. Now it's 5 and the Dr. would like to start him on Taxoter IV infusion once a week every 3 weeks along with Prednisone daily.His pain presently is under control. We go back to the Dr 2/21 and the Dr plans to explain this to him and get started. Does this sound like a good treatment plan?

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Gosh---your father went 19 years and it came back--unbelievable damn disease. Yes IMO the next steps outlined is usual for younger men--hope and pray that his age is not an issue. The plan should be positive at any age, if fit and hardy. Still hard to believe--all those years--and it coming awake.

Nalakrats

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I am very sad to say that he is not in great condition, he fell and broke his hip in Nov. He is recovering currently. Nearly independent except he's not able to drive, but he's trying hard. He's very thin and frail and gets GI blockages from scar tissue. He had multiple GI bleeds starting in 1996 when the CA was found from diverticulitis. That is how his CA was found. An enlarged lymph node in the pelvis region was found with the first bleed. I am thankful it was found. He has a positive attitude and his doctors call him their miracle patient.

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God is in charge! Doctors are following standard protocol.

Nalakrats

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At his age, you really do need to consider how difficult chemo is and what quality of life it may or may not give him. Especially considering that you say he's not in great condition, I would think twice about doing that. In fact, so many of the treatments are very difficult and some decide definitely not worth taking away whatever quality time one has left. Just do the research and know the facts before jumping into it.

Charlean

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To us, that are just starting our journies ,19 yrs is a godsend . Gives me hope of more time then theDx. My mom is 90&1/2. Still driving and independent. I’m amazed with your father. .Sorry for the recent events .Your father has a wonderful caring daughter like you.Thats at least one reason for those 19yrs .. And hopefully many more.. They told me I’d never see 80. I’m 57.Your story makes me think differently. Sounds like you are on top of the treatments. We all know APC comes with suffering. I pray That’s limited for your dad. To have a child by your side when you are 90. That is the true payoff for having children, a lifetime of love. Love him.. Thank you..

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Thank you. I pray your treatment goes well. He lives alone and was driving till he broke his in November :( I am. trying to get him to move in with me soon. My mother passed away at 88 last April and he took very good care of her. She had stage 4 BR cancer diagnosed in 2003 that never progressed past her axillary lymph nodes, she had a masectomy, chemo and radiation. She developed urinary sepsis while in a rehab facility that led to her death last year. They were married 62 1/2 years. Both of them beat their prognosis and I am very thankful.

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My moms still lives alone but slipping ..Took endomethicine for arthritis for 30 yrs until a yr ago the dr said “ Stop it, it has destroyed your kidnies.” Now has stage 4 critical kidney disease. But she says Fiddley D. ! I’m 90 and still smiling. We are lucky to have our parents with us for so long. Much luck and stay strong yourself..

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LULU there is hope. I am starting my 20th year in fighting the beast.

Rich

PS: I know two on this forum who are on there 25th year.

Rich

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Thank you ! That sure helps us uninformed beginners...you are a inspiration to us all ...

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I am 58 and have stage 4 , biochemically recurrent after prostatectomy, Taxotere with lupron and after .01, went to .51 with doubling time of less than 2mos within 1.5 years of surgery. I think your dad is amazing and has certainly done very well considering stats for his condition. I suggest you start looking at Johns Hopkins, Mayo, Sloan Kettering and clinical trails on NIH, searching for similarities in conditions of patients with your dad's history. It may or may not be helpful but it will certainly give you a sense of the incredible breadth of types of prostate cancer conditions and treatments out there. You might also pick up Patrick Walsh's book "Surviving Prostate Cancer". It is very thorough in covering conditions, treatment options, side effects and decision making. It has helped me greatly.

When all is said and done, you and your dad need to know the options and select an oncologist you have faith in but ALWAYS ask about all the treatment options, side effects, etc. from an informed position. Your dad is very fortunate to have you.

Our prayers and good wishes are with you.

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At is age I am surprised his doctor did not suggest Zytiga or xtandi before going to chemo. I not a doctor but chemo seems a bit harsh for an 89 year old.

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I'm not a doctor and don't know what is best for your father, so all I can do is offer suggestions for things to discuss with a specialist.

One is, as Magnus suggested, trying Zytiga rather than docetaxel chemotherapy.

Another suggestion is to discuss dosages. Given that your Dad is old, thin, and frail, the side effects of treatment could be too hard on him, however he may be able to reduce the side effects and still benefit by a reduced dose of the drugs. That may work for docetaxel by giving much reduced dosages, possibly at more frequent intervals, and for Zytiga by just giving fewer pills per day. If it turns out that the side effects are too onerous, you'll be glad that he didn't get the full dose with even more onerous effects.

I don't know if this is a good idea but an oncologist might know.

Best of luck.

Alan

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I assume that the bone pain is from large bone mets. This would be not good. The low PSA is not helping you. Are they confident of what the problem is with the bones? You need bones.

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