New Diagnosis

[Ali1980]

Hello all! My Dad was recently diagnosed with advanced prostate cancer. I’m not up with all the lingo yet but I do know it’s stage 4, M1 I believe with a Gleason score of 9. Unfortunately they didn’t know how extensive the cancer was until he was in surgery for his prostatectomy and the surgeon had to abort because he saw the tumor had grown out of the prostate. He did take some tissue from the peritoneal cavity and it came back with cancer in it as well. They said it was peritoneal carcinomatosis? Anyhow, we met with the oncologist yesterday and he is recommending chemo and hormone therapy simultaneously. Does this seem to be the gold standard of treatment? They are doing genetic and MSI testing to see if he could possibly qualify for any clinical trials. My Mom and I just want to make sure we do the best thing obviously. We are not close to any big cancer centers but I don’t know if the options would be different if we made the trip to one or not. I’m so greatful to have found this community and any info is greatly appreciated!

[Tall_Allen]

The combination of chemo and hormone therapy is probably the best approach when there are visceral (organ) mets. What did the immunohistological analysis of the peritoneal tissue show? (e.g., some kind of rare prostate cancer? did it show somatostatin receptors?). There are only a few kinds of therapies (PARP inhibitors in clinical trials, or carboplatin chemo) that can be linked to certain genomic characteristics. There are a few more under investigation. Keytruda is FDA-approved for MSI-Hi/dMMR. When you have both the immunohistological analysis and the genomic analysis in hand, you may want to arrange a phone consult with one of the top experts in rare kinds of PC, like Oliver Sartor at Tulane. It is a good idea to talk to experts who have more experience in treating patients with his type of PC.

[Ali1980 in reply to Tall_Allen]

Thank you so much for the information..I am anxiously awaiting more test results. I am wondering if he has a rare type of cancer as I’ve tried to research peritoneal carcinomatosis r/t PCa and there doesn’t seem to be much literature.

[Tall_Allen in reply to Ali1980]

This is the first time I've seen it mentioned in connection with prostate cancer. Try to get hold of the immunohistology report that was already done on the biopsied tissue. Let me know what it says - I may be able to help you understand it at least.

[tallguy2]

Sounds like your father is getting excellent care. Some oncologists wait until chemo is over to start ADT. I personally preferred to do it simultaneously.

Good luck!

[Ali1980 in reply to tallguy2]

Thank you so much for your response! I really like our oncologist but it’s hard to know if we need to seek out a second opinion. Either way, I know he needs to start treatment ASAP.

[HopingForTheBest1 in reply to Ali1980]

If it is available, seek out a second opinion. At a minimum it may very well confirm the current course if treatment.

[Ali1980 in reply to HopingForTheBest1]

Thank you!

[Bebby1]

Here in Australia that is the exact first line treatment for advanced Your dad has a wonderful support in you both

I wish him all the best

[Ali1980 in reply to Bebby1]

Thank you and same to you!

[tom67inMA]

It sounds like your dad has a very good treatment plan! There are several studies which show benefits to hitting the cancer as hard as possible as early as possible.

I'm currently on Lupron and undergoing chemotherapy (Docetaxel). When chemo is completed Zytiga will be added to my treatment without waiting for signs that the Lupron is starting to fail.

Chemo side effects are a bit of a drag but are much easier to tolerate when the body is still mostly healthy. Also, exercise greatly helps with side effects and keeping a positive attitude. I still go for runs, shovel snow, and split firewood between chemo treatments, just a bit slower than I used to.

[Ali1980]

Thank you for your response. I’m hoping his chemo side effects are manageable. I will definitely encourage exercise. Prayers to you!

[larry_dammit]

Sorry to hear about the monster, yes the treatment they are recommending is the same I did when I was diagnosed with Stage 4 in August of 16, you didn’t say his age but I was 66 and weathered the chemo O.K. don’t be afraid to ask questions here on this site or your oncologist,we care and the doctor can help a lot. Lots of liquids,eat anything he can , nausea pills are a must. Naps and love. Just a short list. 🙏🙏🙏🙏🙏🙏

[Ali1980 in reply to larry_dammit]

Thanks for the info! He’s only 67. I’m really glad I found this community😊

[j-o-h-n]

Thank you for telling us his age, would you be kind enough to let us know your location and where he is being treated and his doctor(s) name(s). This info helps us help you.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 02/08/2019 6:35 PM EST