My dad has stage 4 prostate cancer with liver, lung and pelvic bone mets. Tried Jevtana recently and did not help at all and cancer worsened so it was stopped after 2 cycles. Started keytruda a couple weeks ago since prostate biopsy showed MSI-H. Recently got a liver biopsy that showed prostate adenocarcinoma. He is now jaundiced with bilirubin at 10 and trending up. I’m fearing that his liver will fail before keytruda even has a chance to work (if it even will work).
Anyone know of any other options at this point? He has previously been on zytiga, casodex, and couldn’t tolerate xtandi. Still on Lupron.
TIA
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dunde8889
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An older drug, mitoxantrone, can provide symptomatic relief. Maybe that will provide the time for the Keytruda to kick in. I thought Keytruda works quickly on MSI-Hi .
Oncologist has lost all optimism about keytruda as my dad hasn’t shown any response after 2.5 weeks. He is willing to give another dose in a few days if my dad doesn’t deteriorate further. We were hoping that there would be some delayed response
I do have some questions regarding your Dad I was not able to find answers to in your posting:
-How old is he?
-Was he physically active prior to diagnosis?
-Is he physical active now in light of all the treatments, medications?
-How has he responded to the drugs, treatments he has undergone since diagnosis, physically and mentally?
-How does he assess his quality of life now?
-Is he willing to undergo treatment that will impact his quality of life further?
-What is he willing to endure to continue living?
I am not sure why you are reaching out to me about ADT-Lupron. From what I could gather about your Dad from Health Unlocked, he has been on ADT-Lupron from the time he was diagnosed in 2017. Also, your recent posts indicate his cancer is spreading. In your opinion, does he have the strength, stamina physically, mentally to endure endless treatments? My experience has been similar to your Dad’s since I was diagnosed with metastatic prostate cancer in 2018. I have endured Lupron, Zytiga, Provenge, and am currently undergoing chemo.
I know this is something that isn’t typically discussed on Health Unlocked, at least in my experience. I am not willing to endure further loss of quality of life and the endless horrors of further treatments. I am spending my time doing the things I can still enjoy and preparing for a peaceful transition from this life to whatever is beyond. From what I gather, you want you Dad to continue the fight regardless of quality of life issues, physical, mental pain. If your Dad has the will, physical strength to carry on with treatments, best of luck to him. If not, just enjoy the time you have left with him and make great memories that will make you smile when you think of him after his is gone.
My dad is 65. Before diagnosis he was very active (not necessarily exercising but take care of any house repairs or yard work). From Jan 2017 to Jan 2019 ADT has not affected his physical status as far as I could tell. This year has been the worse and has gone downhill more pronounced recently. Two weeks ago he was driving to most appointments, and able to do some work (definitely,y not as active as before but still functional). This last week is a tremendous decline.
I’m not forcing him one way or the other, and I don’t think he has made up his mind yet on what he wants done. One day he says he doesn’t want to give up and hopes keytruda works and the next he may say what’s the point of all the procedures and tests if he’s feeling this way. Currently he’s needs help with certain activities mainly due to significant edema (and pain from that) and weight gain likely from declining nutrition.
The only reason I’m asking is if time is needed to allow keytruda to work, is there some kind of treatment to bridge the gap. At this stage this seems like wishful thinking given how rapidly he declined.
I HAVE ADVANCED INOPERABLE PROSTATE CANCER BUT FORTUNATELY VERY LITTLE DISCOMFORT. THIS MAY FEEL HARSH TO YOU BUT IF IT WERE MY DAD, I WOULD BRING IN HOSPICE CARE. THEY WOULD MAKE SURE HE IS PAIN FREE FOR WHATEVER REMAINING TIME HE HAS. I LOST A SON 6 MONTHS AGO DUE TO METASTATIC CANCER. HE WAS UNDER HOSPICE CARE FOR 7 MONTHS BEFORE HE DIED, ALL WITH NO CHARGE.
TRY TO AVOID FEELING GUILT. HIS QUALITY OF LIFE DIMINISHED WHILE DISCOMFORT AND PROBING INCREASED. IT'S SAD BUT THE BEST THING FOR HIM IS TO GIVE HIM PEACE, COMFORT AND THE KNOWLEDGE HE WILL NO LONGER BE TREATED LIKE A MEDICAL TEST SUBJECT.
Your initial query was about Lupron and the impact it was having on your Father. I am 75 years old and have been on Lupron for the past 20 months. Just prior to taking Lupron my Testosterone level was 479. Within several weeks Lupron brought my Testosterone level down to almost 0 (zero). My experience going to from a normal Testosterone level to 0 (zero):
Physical
-Libido – dead.
-Ability to get, maintain an erection – gone.
-Night sweats.
-Decreased strength/mass of muscles.
-Fragile bones. Was put on Fosomax.
-Hot flashes.
-Increased fatigue.
-Irritability.
-Reduction of testicle size.
Psychological
-Loss of confidence.
-Embarrassment, depression on not having normal sexual functions, interest.
-Depressed at becoming what I felt was asexual.
-More emotional.
-Weeping, crying easily triggered.
-Sadness.
-Difficulty sleeping, staying asleep.
Being on Lupron has been one of the most difficult parts of having Metastatic Prostate Cancer (MPC). The cancer itself compromises, changes you negatively in so many ways, no Testosterone exacerbates, adds to those negative changes.
As least for me, adjusting to the impact of being on Lupron, virtually no testosterone, was almost as devastating has finding out I had cancer.
I don’t know anything about your Father regarding his Testosterone level prior to Lupron or if he was sexually active prior to cancer; however, I can say with a fair amount of confidence, Lupron has had a significant impact on his quality of life and the way he views things.
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Mets Everywhere..plse help
Mets to bones, liver, lungs and lymph nodes upon diagnosis 
Update on my father and questions regarding liver mets. 
Update on neuroendocerine prostate cancer mets to liver. 
