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Advanced Prostate Cancer
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mcrpc , stage iv with aggressive treatments

My father was diagnosed as having stage IV metastatic prostate cancer with tumor in prostate, bone mets in pelvic region, affected lymph node in May 2016. He started on docetaxel 6 rounds chemo and 6 monthly Eligard injection. After chemo was over, started on bicalutamide daily. PSA was down to .04 from 17.Later received IGRT radiation in prostate ,pelvic and lymph nodes for 38 cycles. PSA went down further to .01. PSMA PET scan showed complete response. Feb 2018 ,PSA was still .01 with Eligard and bicalutamide but follow up PSMA PET scan showed recurrence in prostate. He underwent radical prostatectomy and biopsy results showed all negative margins ,there was 20% cancer tumor in prostate left lobe and left seminal vesicles. right now he is following same Eligard 6 monthly and instead of bicalutamide he was prescribed 3 tablets enzalutamide daily. Fingers crossed .. will keep updating.Wish everyone all the courage and blessings to fight it out.

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That is a very aggressive treatment plan, and it looks like he's gotten very good response to it so far. I suspect that when radiation is used for whole pelvic treatment of metastatic PC, it is necessary to use brachy boost therapy on the prostate. Do you know how big a dose he got to the prostate? How is his continence?

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True, it has been pretty aggressive . His continence was perfect after radiation,may be due to IGRT technique, he received 60 grays initially which was later boosted to 75 grays in prostate. His chemo ended in Sep2016 and he was on radiation Nov 2016-Jan 2017. However, after radical prostatectomy in Mar 2018 , bladder control is not in good shape but seems to be improving after 4 weeks from surgery. He uses diaper through out the day and uses penile clamp during his morning evening walks. Surgeon is expecting him to regain control within 6 weeks to 6 months. My father is 63 years old and otherwise very fit with only frequent urination as his symptom during diagnosis. Gleason score was 5+4 = 9 so doctor suggested salvage aggressive treatments. I feel being very regular with his exercise helped him too. he used to walk 3kms in morning then same in evening plus some meditation\yoga exercises. This has reduced after surgery but hopeful to see him back to his daily schedule soon.

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I'm glad he's regaining continence. 60 Gy to the pelvic LNs is good, but the boost could have been higher. Anyway - that's done - and hopefully that will slow it down. I practice Mindfulness myself - it keeps my mind focussed on the present, so that I don't get stuck in dark places for very long.

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Thank you. Yes , though it reoccurred after chemo and radiation along with ADT going on. I am hopeful the surgery that removed prostate, seminal vesicles and some lymph nodes would help him. We are advised for blood tests every month right now as he is also on Enzalutamide and a follow up PSMA PET scan in June 2018. hoping for best and wish you all the best too.

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Catetkr, that’s a full plate for anyone. A lot of crossed fingers and toes . APC doesn’t let us sit back , when it’s aggressive it’s treated aggressively. Keep him happy in anyway possible. Thank you for being his advocate. Very kind and thoughtful, you must love him tremendously. I wish you a peaceful spirit in trying times.You can heal him with your love..

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Spiritual and emotional support and healing is so import on this voyage.Time for us to band together and love each other.. we see the brevity of our very existence. Make the most out of every day he is with you. Peace good daughter.

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Thank you very much for your kind words. Wish you all the best too. we plan trips with him in between. Just wish to give best possible quality of life along with treatments. We are hopeful and he is fighting it out with a strong will too.

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He is blessed to have you... APC can be overwhelming .. to comprehend and deal,with. Not easy for the family either.. keeping sane and in good spirits are huge parts of our healing process. Good luck to your father..

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thank you very much

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Congratulations on his response. Our thoughts and prayers are with you and your dad! Please keep us posted!

James

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Thanks , we are fighting it out with all ways possible. we are hopeful. Wish you all the best too. will keep updating

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If your father may want to do more in the area of urinary incontinence and the strengthening of pelvic floor muscles as he recovers from his procedure(s), there are on-line sites/resources available that might be helpful. Here is just one of many.

continence.org.au/pages/con...

Charles

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Thanks very much, I will discuss these with him. Currently he is just doing Kegel exercises. will keep updating. Wish you all the best too.

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Good luck. I get a Elagard and Lupron shots monthly and take Xtandi Dailey. My PSA is .005 over the last 9 months. Hang in there

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Thank you. Wish you all the luck too. Good to know you have good response to Xtandi. How many tablets daily do you take? He has been given 3 daily for now after surgery. Its been around 2 weeks since these tablets started.. PSA was .01 before it. We have to repeat the PSA test in another 15 days along with sr. creatinine,LFT and CBC.

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4 tablets a day, they won’t take my prostate out ,not worried as long as PSA stays down. Full bone scans in June that will be almost 2 years since the bomb was dropped

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Much luck

Where was the PSMA test done with a PSA of .01?

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We are in India right now. Test was done here in Bengaluru. Oncologist had advised it even though PSA was .01 as he had some pain in pelvic region and last scan was done around 1 year back

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wish you all the luck too..

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thanks

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Sorry for your dad. Sounds like they are trying to kill the monster 😀😀😀😀 they won’t take my prostate,say it’s to late to do anything with it. Keep us informed how Dad does 😀😀😀

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yes we just hope the monster goes away :) wish you all the luck with your treatment. will keep updating.

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