Questioning Doc Decision

[Samdres]

Hello,

My dad is 55 yo, we live in marylnad USA. He was diagnosed with PC metastasis to bladder and liver after we went to emergency bc he started peeing blood.

He got his first Lupron shot like 3 weeks ago. On October 3rd we came to emergency room ( Adventist Shady Grove Hospital ) because bladder obstruction and a intense liver pain, doctor placed a catheter and he stayed in emergency until now.

Tree days ago he started peeing blood and peaces of clot coming out and seems dry blood. for now he has the catheter on and the color is better ( kinda of ping ) but they have it connected waiting for better results.

Oncologist Dr DongMei Wang from Montgomery Oncology Care and Hematology regionalcancercare.org/bios... . She is part of the hospital and actual Oncologist and she wants to do Chemotherapy right away because the bleeding in the bladder.

I feel its a fast conclusion and I'm waiting for second opinion appointment in Georgetown Hospital in Washington DC where the oncologists are specialize in prostate cancer. The hospital can not discharge him because his conditions. I read about chemotherapy is not good for prostate cancer and would like to confirm this statement,

Urologist offer a surgery to stop the bleeding for now, and we can go to other hospital for second opinion.

Any advice Will be appreciate it .

UPDATED :

10-10-19 My dad got a bed and a opportunity to be seen by Dr Nancy Dawson at Georgetown , she recommend chemotherapy right away due to the aggressiveness of the PC. They control the pain in liver due to tumors are growing and stretching out the liver. No more catheter for the bladder but still peeing every 20 minutes and no blood.

10-12-19 got first dose of Chemo

10-14-19 having nausea and fatigue

[AlanMeyer]

Hello Samdres,

I'm sorry to hear of your Dad's condition.

Chemotherapy with docetaxel was approved for prostate cancer quite a few years ago. Before that it was thought to be ineffective but studies on men who had failed all other treatments found it extended life by an average of 2-1/2 months.

More recent studies have been done on men who had NOT yet failed all other treatments (your Dad's case) and it was found that, in cases of aggressive disease, the combination of Lupron with docetaxel is much more effective than Lupron followed by docetaxel after the Lupron fails.

I think the oncologist from Montgomery Oncology Care and Hematology is probably right. However, having said that, I'll also say that I think your decision to get a second opinion from a research oriented hospital with prostate cancer specialists is an excellent one. Their opinion will be far more informed than mine.

I expect that your father is going to go through a lot of suffering for a while. Chemotherapy can be pretty toxic for some patients, causing nausea, vomiting, peripheral neuropathy, and infections (due to temporary damage to the immune system.) So while you've got some time, it might be worthwhile looking into how to mitigate side effects with anti-nausea drugs, Neulasta, ice baths in various places, and dosage/frequency adjustments (smaller doses more frequently if the standard doses are too toxic). Get expert advice if you can from both Dr. Wang and from the Georgetown doctor about these issues.

I'm hopeful that things will eventually calm down and your Dad will be able to go home and resume a normal life. How long that lasts will depend on how well he responds to treatment. There are men in this group who have lived reasonably normal lives for a decade or more with a disease that used to be much less treatable than it is today.

I wish you and your family the best of luck with this.

Alan

[AlanMeyer]

Since I wrote my previous reply I had a chance to look more closely at the brief resume of Dr. Wang at Regional Cancer Care Associates. It looks pretty impressive. Her training in China appears to have been at a top flight research and education center and here in the U.S. she had residencies and fellowships at very impressive places. Second opinions are always warranted in life threatening diseases like cancer but the first opinion looks like it also came from a very competent oncologist.

Best of luck.

Alan

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

Your Halo definitely does not need polishing....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 10/09/2019 6:00 PM DST

[Hidden]

So sorry that your dad and family is having to go through this. I don't have any advise on chemo. If he's eligible for social security, he could apply for disability and with his visceral spread to liver, they should award it to him automatically.

[larry_dammit]

Diagnosed August of 16. , stage 4 with Mets in the spine, ribs and lymph nodes, 2 weeks of casadex , 6 rounds of taxotere chemo, with lupron and Xgeva shots monthly. It’s working for me. PSA is 0.05 I was put on Xtandi when I finished chemo. Feeling better most days. Fight the monster 🙏🙏🙏

[Hirsch]

Have you consulted a urologist who can look inside your bladder and offer a surgical intervention for you at this time.