My dad 88, is mCRPC status since September 2018. He was on Firmagon for 15 months before that. Was started on Xtandi in October 2018. Latest PSMA pet scans show progression of PCa. PSA is 1740, shot up from 155 in September. Not a candidate for aggressive chemotherapy. Zytiga not considered due to poor response to Xtandi. Started on oral Fosfestrol and Inj. Xgeva, firmagon to continue. No pain, but weight loss and poor appetite.
We have limited treatment options now.
1. Getting blood test to check for Brca1 Brca 2 gene mutation. Not the Biopsy route as Pca is in bones and lymph nodes and difficult to obtain sample.
2. Lu 177, though I have no idea of the side effects and if at his age it will be tolerated.
What else can be considered ? Looking for quality of life and palliative options. (New Delhi, India)