Confused

[Beach18]

66 yo, had RALP 3 years ago, Gleason 3X4, cancer in 1 node, PSA after 0.1 and now 10.5 with multiple bone mets on recent scan and minimal pain. Have diffuse coronary artery blockages and refused 5 vessel bypass last year - and am doing well on cardiac meds at this time.

All regimens for me at this stage have a fair amount of cardio toxicity. Have seen both Med Oncology and Uro and concerned about treatment. On good diet, no dairy, take supplements and started metformin - any suggestions?

[Tall_Allen]

So you can't use any kind of hormone therapy? What about docetaxel? Xofigo? Provenge? I would be weighing my estimated life expectancy for cardiovascular disease vs for prostate cancer in deciding which treatments to pursue.

[Beach18 in reply to Tall_Allen]

Thanks TA - That’s exactly it - which is worse?!

Don’t want to accelerate heart issues with ADT - can’t get Xofigo which looks promising without ADT first; thinking of avodart and casodex as a primary therapy but who will do that for me

#2 cause of death with PC is heart disease and there’s not a lot of info concerning risk stratification for the two together

[Tall_Allen in reply to Beach18]

Can you get your cardiologist and your oncologist to talk. Maybe there's some middle ground they can propose to you.

[rococo in reply to Beach18]

I know dr myers was doing it for some older patients, but he retired. Dr susan slovin was at sloan Kettering in nyc also doing casodex monotherapy. Rocco