Question about Chemo and anyone know good oncologist in the Troy, Michigan area

[Olivia007]

I have written many times and I just need to ask more questions so I will be armed with what to think about and questions I should ask.

Dad is 81 years old has HBP, High Cholesterol, diabetic, is on medication for all his ailments plus the symptoms of some of those diseases like neuropathy and Tamisulon for urine issues due to prostate

Gleason 8 Diagnose 12/2014 biospsy

Bone Mets (supposedly) not 100% sure one scan shows current not so much can't include cant exclude initially 2014 scan said bone Mets in humerus and femur today not really seen???? Old scans claim there is only in 2 areas?

On Lupron injections andXgeva

Provenge 2017

Zytiga and prednisone for about 13 months

current PSA 1.98 as of July 2019

testosterone total <2

Pet CT Axumin prostrate scan 4/2019

the PSA level started to rise .95 in April, 1.17 in May and 1.98 in July 2019

Discontinued Zytiga and prednisone 7/2019

But still and will forever be on Lupron and xgeva

now Urologist is telling us to see an oncologist (which we probably should have seen one to begin with)

My question is, dad had the last test the Pet CT Axumin scan so they can see why his PSA level is rising but it showed nothing bad and nothing new? According to urologist "inconclusive"

So what will the Oncologist look for and what more scans will be done? If we do decide chemo we know there is no cure but I keep reading it will stop the pain. My dad has the normal aches and pains of an 81-year-old what pains is everyone talking about? so I'm baffled if chemo will not cure him ( I understand it will prolong his life but how?) and there so far isn't new showing mets what are we doing or what should I ask the oncologist in October? Any input will help. Forgive me if I sound dumb.

Thank you all in advance

Olivia

[Hidden]

Hi Olivia,

Don't feel like you sound dumb, you're asking good questions. The key thing for me is: Is there progression? Sounds like he is not having much pain which is good.

You said referring to his scans: "nothing bad and nothing new". To me, that means no progression and no change in treatment. His PSA may be rising, but it's also very low. If it were me, I'd be staying on Zytiga regardless of PSA if there was no change in symptoms and/or progression showing up in scans. PSA increase alone is not enough to justify a change in treatments.

Another issue is Taxane chemotherapy causes neuropathy and if he already has it, that could be a problem.

[Olivia007 in reply to Hidden]

Thank you kindly I still wonder why the urologist wanted him off of zytiga but we will see what the oncologist says

[Hidden in reply to Olivia007]

As a general rule, once the cancer spreads you need a Medical Oncologist. It's preferable to have one that specializes in Prostate Cancer or at least have a specialist available as part of your team.

I do have a doctor who is a specialist in Prostate Cancer. I am also on Zytiga and I have discussed what would be next if my PSA starts going up. What he said was we would first try Dexamethasone for the steroid (see SWITCH trial). That will often buy you some more time on Zytiga. Then if the PSA continues to rise, we do imaging to see if there is progression. If no progression or new pain symptoms, etc. stay on Zytiga. If there is progression, then do a biopsy to see what we are dealing with and make a treatment plan based on that.

I'd really recommend outlining the steps going forward with his Oncologist as I have. That way you know what the plan is moving forward. I find it gives me a lot of peace of mind. Hoping for the best for him.

[Hidden]

Go see Dr. Caram at University of Michigan Cancer center. She trained (Oncology Fellow) under Dr. Hussein who is considered one of the best prostate cancer oncologists in the world. She is considered the best in Michigan, I know she is my oncologist and I have gone through a few. Extremely intelligent, caring and most important, she stays on top of all the latest treatment options.

[Olivia007 in reply to Hidden]

Thank you

[WINGER19]

I'm from the southern metro Detroit area, I've been to U of M, but didn't have a name and ended up not being very impressed with the doc I eventually got, found Karmanos and Dr Heath. So far I'm impressed, she seems knowledgeable, but even better she is very warm and friendly, I never feel like I am just a number.

[WINGER19]

Sorry for some reason the paragraph on chemo didn't make my post. All I can tell you is that chemo seems to be a very person specific experience. I am going on my 5th treatment of Docetaxel and haven't had any issues, I'm 65 may be different at a different age. I would try it a see how he does. ZGood luck and God's blessing.

[j-o-h-n]

October? can't you get a sooner appointment?

BTW do remember Olivia is one of my favorite female names?

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 12:25 PM DST

[Olivia007 in reply to j-o-h-n]

We r waiting till October because my siblings are not speaking to me and I need the support so I’m waiting for my husband to come home he works in Baseball and that’s when the season is over. I think he will be alright he still will be getting his PSA checked and his injections and the urologist said that was fine October wasn’t to concerned

[j-o-h-n in reply to Olivia007]

Siblings.... It happens in all families.... don't fret.... If you Dad can ride it out till October then I guess he can wait...Well you can always find support here... Stay well and give your Dad a hug and a kiss every day... and try to laugh.

youtube.com/watch?v=C6eycfP...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 7:14 PM DST

[Olivia007 in reply to j-o-h-n]

U r so cute and sweet 😘

[j-o-h-n in reply to Olivia007]

I know................................................................. 👀

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 7:52 PM DST

[monte1111]

Hi, favorite name Olivia. Sounds like you are doing the researching and etc. and have been left holding the ball. If you really have to wait until October, just unfriend the siblings for a while and just relax. As you say, urologist has done his job, time for the oncologist. If dad is ok with it, morph into Scarlett O'hara and see an oncologist now. Siblings and husband don't have cancer. Friend your siblings and call your husband with what oncologist suggests. And I assume dad has a vote. Nothing anybody can do or undo happens on first visit. I am sure waiting until October is fine. That's a lot of worry time. Good luck to you Olivia and dad. We wish you well.

[j-o-h-n in reply to monte1111]

So you won't feel left out........

youtube.com/watch?v=MZ0odI8...(Not working as expected?)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 7:55 PM DST

[monte1111 in reply to j-o-h-n]

I could have waited till October to watch that. Amazing that you can come up with such obscure videos at the drop of a top hat. I'm guessing you have a disk jockey and a colony of penguins on your payroll. A tip of the top hat to you sir. Cute and sweet? I'm not going there. Olivia, have a nice weekend.

[j-o-h-n in reply to monte1111]

And a tip of my MAGA cap to you too sir.....

BTW I make my entire staff wear tuxedos....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 08/03/2019 8:30 PM DST