72 y/o Dad has Stage 4, Mets. Looking for your BEST ADVICE on treatment.

[DaughterOnAMission]

I love my dad more than anything. I'm on a mission to keep him alive.... pls help.

*Stage 4, possible mets in lumbar. Has spread to bladder. PSA 17.75 April 2018 up from 5.75 in 2012. Gleason 8. Near Los Angeles. Kaiser.*

Kaiser says Lupron, and Casodex, radiotherapy for pain. I hear Lupron has heart risk so not happy with that. I believe he should do Zytiga and Zolodex.

What hormone treatment works best for stage 4 D2? Radio yes? Other advice? Zolodex? Zytiga? What combo is best?

Since he's on the edge of Mets and no mets I believe it should be treated as Mets.

[Tall_Allen]

So he is metastatic and still hormone responsive. There are several good options for him, described here:

pcnrv.blogspot.com/2017/06/...

Either Zytiga or docetaxel should be available through Kaiser.

[Hidden]

Get a different oncologist. As Tall_Allen stated, "Either Zytiga or docetaxel ". The sooner the better.

[snoraste]

Second the opinions here - go to the best specialized prostate cancer center you budget and logistics allow.

[mcom]

My dad is stage 4 with confirmed bone mets in his pelvis. They started him on Lupron last month with Casodex for only for 31 days. It dropped his psa to undetectable levels. He no longer takes the Casodex (they just wanted him to do it for the first month to keep his testosterone levels in check while the hormone got into his system). He will have his second injection of Lupron in July and they are also starting him on Zytiga with prednisone trying to eliminate the cancer completely. His family has a history of heart problems and they did check him early on for calcium deposits (which he does have) but they did not mention anything about adverse affects.He is not in any pain so they are telling us that radiation and chemo are off limits.

On the holistic side of things he is going on a more alkaline diet and taking immune booting supplements.

[DaughterOnAMission in reply to mcom]

Sounds like what we will do. They actually aren't sure if he has Mets or not. He's on the verge but LNs are enlarged. So likely lymph involvement and spine. Having another doctor look at the scans and possibly doing MRI. I want them to treat it strongly as if he does for sure have Mets because the cells could be anywhere in the body...

[mcom in reply to DaughterOnAMission]

Our doctor is going pretty strong at it especially because of the Mets. He said he wants to throw the kitchen sink at it as long as my dad can handle it. He is in good health otherwise so I’m hoping for the best! Good luck!

[DaughterOnAMission in reply to mcom]

We are with Kaiser, is he too?

[Dan59]

Welcome to the club. As I read your post, it says “Mets to the Lumbar”, Lumbar is the lower spine and would mean Bone mets. IMO Tall Allen and Bill have the best suggestions.. Doing early chemo or zytiga has been shown to improve survival in stage 4 in randomized clinical trials and approved as standard of care in this case in the recent 4 or 5 years. It is hitting it hard early and praying for a durable remission. I wish you the best. I have heard there is a really Good MO named Tanya Dorff in your area. I wish you the best.

Dan