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Advanced Prostate Cancer
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Father in Law - PSA 467

Hi there,

I’m trying to do some research for my father in law who is 75. He recently moved to the US and his insurance provider had him do a PSA test which came back at 467. He had his prostate removed 12 years ago.

I would rate his health and his activity as excellent. Always moving very active. Very engaged with life and family

The scans show that he has some cancer in his Pelvis and his chest. Stage IV

Doctor has told him to proceed with horemone therapy and chemo immediately. He doesn’t really want to do the treatment as he feels great and is concerned about how this might impact his quality of life

I guess the million dollar question is what are the risks by him not doing any treatment. What can we do to help determine if treatment is worth it? The cancer obviously didn’t show up overnight.

I appreciate any feedback.

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Yes it could have showed up quickly---or it could have taken a long time---we do not know as we are dealing with over 20 Pathologies, and any number of Gene Mutations. He is obviously Metastatic, and Castrate resistant. I am one year younger---and at war with my Pca. I have not yet had to be concerned with Chemo combined with Hormone Therapy---probably Zytiga would be the choice today to go with Chemo---I am not a Doctor. Been on this site for a long time---so I have read hundreds of stories and journeys.

If it is in the chest--is it upper ribs or lungs? But regardless, the PSA is saying there is a load of Cancer----and when the colonies get going, they go to other places in the body to make more colonies. Chemo with whichever Hormone drug chosen can add 5-10 years of decent life. When this beast gets into bone it eats it up and then fractures can occur, if in the spine we get the possibility of spinal fractures--that can affect the spinal cord.

So I am personally urging you all to seek treatment. the current quality of life could end one morning waking up with severe pain. Trust your Doctors, and get 2nd opinions----please.

Nalakrats

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Thank you for the response. What is an ideal type of doctor to see who would likely be up to date with the latest treatments and being able to determine how aggressive the cancer likely is.

Is a general oncologist sufficient or are there doctors who are more specialized specifically for prostate.

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Best is to have an Oncologist whose specialty is Prostate Cancer--and best if it can be at a Center of Cancer Excellence, such as John Hopkins, MD Anderson, Memorial Sloan Kettering, Mayo, Dana Farber, UCLA Med. School, Levine Cancer Institute--et al. Tell us where you live in a new post---Title---Looking for a Center of Excellence for Prostate Cancer---near me---I live Where????. Someone will get back to you.

Nalakrats

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Please take heed to nalakrats. Brillient!

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Agree with Nalakrats on seeking treatment. With treatment, you can potentially live a long time with very reasonable side effects, whereas without treatment things could get worse really fast. Allowing stage 4 prostate cancer to grow unchecked is really a bad idea, in my opinion.

Nalakrats, you said he was castrate resistant, please tell us why you think that. I didn't see anything that would indicate castrate resistance.

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Maybe I should have said the likelihood was there--when Pca moves to the areas as in this case, with such a high PSA---I would be suspicious---thanks for correcting me.

Nalakrats

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Hello. So sorry for your dad. Yes he may feel good now, but for how long? When I was diagnosed with Stage 4D1 cancer two years ago I felt great. However I knew that I was (and still am) playing with time. I decided on agressive treatment.

In your dad’s case he may feel good but the cancer is there and it is not going away on it’s own. While it may of taken a while to get where it is now, a PSA of 467 is high. In addition the fact that has spread is of particular concern. It is a big gamble not to address it thinking that he will die of something else first. Unfortunately no one knows the answer to that. The one thing that is assured, the longer he waits for treatment the harder it will be to maintain.

Please assure him that not all treatments have horrible side effects that you read about or see on TV. Take me for example. Currently (after surgery and radiation) I am on a combination of two hormonal therapies, Lupron and Zytiga (with prednisone). Yes they have side effects but they are not that major. I am still quite active. I still rode over 1000 miles on my bike last year and will soon be going on yet another scuba trip in the Caribbean. The point is the side effects are manageable. They in no was get in the way of me enjoying life. While I have not had chemo there are a lot of men here that reported that the side effects were not that bad.

Most important, there is one good side effect of hormonal or chemo treatment, time. Time for him to be with the ones he loves.

The goal of this note is to reassure him that if he decides on treatment the side effects will in all probability not be as bad as he is imagining. He could always start treatments and then stop if they are to hard on him. Of course the decision for treatment is his.

Your whole family will be in my prayers.

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Hi Dave, one of the problems with PCa is the lack of symptoms sometimes. If it is as widespead as they say i think your father in law should hit it hard with everything they tell him. I could bet is been awhile. Most likely with no treatment it will be long painful ordeal.

Thats my 2 cents

Thomas

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If he’s as strong as you’ve said he is he should do fine.. I haven’t done chemo . But many say they did it without too much suffering. Personally , I’d make sure he does what’s nessesary. He will be chemically altered. If he’s a calm man .Then That might not be too terrible either.. We all handle things differently.. After 12 yrs, that’s a blow. I’m not a doctor but I think that Doing nothing is not an option.. with treatments he’ll live .. We all must make the best of today. We are all living on borrowed time. Give him love. I’m sure that you do ,or you wouldn’t be seeking answers here. You’ve come to a great site. I know that you’ll get many answers from our overexperienced crew. Daughters seem to be the ones always there for their fathers. With your love he will be around for some time. Look to Dr_Whos videos that he gave us in the last 2days. Great explanation of APC treatments. Keep asking questions. There is nothing easy about APC for patients or thier loved ones. But love is there. There is hope . Thank you for sharing . I wish your father and your family the best possible outcome with treatments. Is that an Egrit?....? They’re marvelous fishermen ...Take care of yourself during this emotional time for all . It’s a time for much positivity. You’ve got this..

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I’m sorry ! Father in law. You are being a fine daughter to him. Good luck!

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Your dad is not castrate resistant.....go on Lupron/Zytiga to get PSA <.1 and then get off..when the PSA goes back 1 go back on....you can repeat this on/off cycle for years...also study showed on/off doubles time to resistance

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Lupron/Casedex sounds like they can be a brutal combination for some people I.e adverse side affects.

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Dave,

I agree with everyone else that treatment is absolutely necessary. With a PSA of 467, your father-in-law's feelings of good health are probably not going to last very long. The cancer will get worse and, the worse it gets, the harder it will be to treat.

You asked about finding a good doctor. That's a great question! It's important to get the best doctor you can find.

Here is a link to the U.S. National Cancer Institute web page on NCI Designated Cancer Centers. They're hospitals and clinics that the NCI believes off the most advanced treatments in the U.S. They all research centers where the doctors tend to be scientists as well as doctors, and where they keep up with the latest research.

cancer.gov/research/nci-rol...

If you click on the "Find an NCI Designated Cancer Center" link within the page it will let you search by state or region.

Best of luck.

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Don't know will this help Im on firmagon and cannabis oil so far great results last scan I have a prostrate my psa 4 I have stage 4 with mets best of luck john

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