Dad with prostate cancer

[dunde8889]

Hi, never knew this forum existed and I have been reading a lot in the last week. There is so much information here and appreciate reading everyone's experience.

Unfortunately, my dad was diagnosed with stage 4 prostate cancer in January 2017 with a PSA around 110 and a CT showing enlarged right prostate and an enlarged lymph node on the right. Biopsy showed Gleason 4+4 on all samples. At that time with the enlarged lymph node they did not recommend surgery or radiation. Bone scan was negative. So he started on casodex for 30 days and lupron. PSA dropped to the 4s before starting to uptrend to 6 in late 2017.

At that time zytiga/prednisone was added. PSA dropped 2, but then uptrended throughout 2018 to 16. He started to develop right hip/pelvic pain in January 2019. At this same time he developed blood and clots in the urine. He eventually got a MRI in March 2019 that showed suspected cancer involvement of the acetabulum and right pelvic bone. Bone scan at that time was positive in that area. CT showed very enlarged prostate and enlarged kidneys with abnormal function. PSA went up to 39. He tried xtandi but could not tolerate the effects and therefore stopped after 1 week in March. Currently not on any other treatment (besides lupron every 3 months).

He then had a TURP and stents placed last week. Radiation oncologist believes the prostate cancer is extending to the right pelvic area as one big tumor and has bone involvement. He suggests radiation to help with the hip pain and also shrink the prostate and plans to start next week. Oncologist is considering starting chemo after radiation. An PET scan (axumin) was ordered but not scheduled so far.

Over the last 1-2 months he has been very fatigued, lost appetite, low grade fevers and is losing weight. I am concerned that the cancer is spreading which is causing his symptoms. No infections were found to explain the fevers.

I would appreciate any input from the community. Is radiation then chemo the best option now? Thanks in advance

[Hidden]

It could work? I’m sorry he’s in the heat of this battle . I hope that he can get into a clear zone and get a break from this dreaded but persistent pest ..I’m not the expert . Others that are in know shall answer . I welcome your advocation for him. You are his blessing. Keep asking questions .🙏

[Tall_Allen]

I think that's a very good plan. Maybe consider Provenge when he gets his spot radiation. Also, discuss Xofigo with his oncologist. There are many good clinical trials too. The VISION trial (Lu-177-PSMA is very promising).