Need advice

[Samdres]

Hello, my dad has PC stage IV met to bladder and liver

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, controlled with palliative pills

10-17-19 got discharge from hospital due to he has the second chemo in other hospital close to his home.

10-18-19 He could not get chemo due to he was too weak and kept vomiting, he got admitted to ER

Stayed in the hospital till feel better for second dose.

10-31-19 Got second chemo and got discharge the next day.

11-06-19 Appointment with the Dr and he could not get the third chemo due to he was too weak.

Attached is the liver test like AST, ALT that i keep tracking and the PSA test:

8-1-19 50.3 ( when he got diagnosed )

9-23-19 474

10-22-19 833.5

Dont know why is increasing the PSA so fast when he got already 2 lupron injection and 2 chemo dose.

The next appointment is 11-13-19, and my dad feels weak and not eating only drinking. Don't know what to do and would like to aks the doctor about Immunotherapy or what should be the next step because dont see improvements in the liver.

Please, if you have any advice or suggestions about next step I will be greatly appreciate it.

[Tall_Allen]

SIR microspheres cannot be used when liver mets are extensive.

[tango65 in reply to Tall_Allen]

What is extensive? Please, provide a reference.

[Tall_Allen in reply to tango65]

Extensive= “tumors are growing and stretching out the liver” Radioembolization can only be used focally - it destroys tissue.

[Tall_Allen]

PSA will increase immediately after chemo because cancer cells are dying. Hopefully, it will decrease eventually.

My friend, also with extensive liver mets, is responding well to cabazitaxel + carboplatin. His LDH got very high at first, but has come down now. My friend gets an antihistamine before each infusion, and comes back a couple of days afterwards for 1-2 liters of iv fluids.

If his liver can be biopsied without incurring excessive bleeding, an IHC analysis is probably a good idea; a genomic test requires more tissue, and may sometimes be useful if possible.

[Samdres in reply to Tall_Allen]

Exactly the same, my dad is getting cabazitaxel + carboplatin and yes, he is going for IV fluids and after that he feels better. He already got a biopsy in the liver, what do you want to know ? thanks for your reply

[Tall_Allen in reply to Samdres]

What did IHC show? Normal acinar adenocarcinoma?Did he get a genomic analysis?

[Samdres in reply to Tall_Allen]

It says prostatic adenocarcinoma is positive for MKX3.1 and negative for GATA3. I think we didnt get the genomic analysis.

Today after Dr appointment was not encouraging, Dr said : the PC is advancing and she may refer to my dad to a trial clinic to try new drugs . 😔

[Tall_Allen in reply to Samdres]

That identifies it as acinar adenocarcinoma of prostatic origin. Was there anything about chromogranin A, synaptophysin, CD 56, INSM1 (these would be rare), or PSMA? Let me know which clinical trials she is considering.

[Samdres in reply to Tall_Allen]

It doesnt say anything about that, if you can give me your email I can send you the report, probably I can't find it .

[Tall_Allen in reply to Samdres]

They may not have checked for those. If they have retained the tissue, they can stain for those. I'll PM you.

[Hidden]

Dear samdres, I am sorry that your father suffers so . 😫APC is a gut wrenching brutal disease when it’s rolling on us .its bad .. I’m glad the catheter is out and no blood . Not eating is detrimental ...Get him his favorite ice cream ,he needs calories ..Try anything to raise his spirits ... Others with expert advice will answer you what to do . I just applaud you as his advocate .. love him a lot . Comfort and consol him .. Thats what counts . Stay strong yourself in order to be by his side .. God Bless🙏

[Shooter1 in reply to Hidden]

Been off a month for vacation at Portland Burn Center. Don't recommend needing them. Pain and extreme weakness from burn, grafts and a month in bed. Just when I was finally getting strength back a year and a half after chemo.

Doug (now in north Idaho)

PS Nice snow today.

[Hidden in reply to Shooter1]

Hey guy ! Wtf? What happened brother ?

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

This may be the answer to your question. From Shooter1's previous post :

"Must wear gauntlet gloves to put wood in stove otherwise I burn the back of my hands without any feeling, just get blisters. Any Ideas?? Sometimes new normal kind of sucks.

Geezamacripe!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/13/2019 10:24 PM EST

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

Thanks I missed that post . Terrible pain . No one needed that .. we’ve met shooter in person . He’s a wonderful gent . Hate to hear it .

[j-o-h-n in reply to Shooter1]

Holy Chit...... When it rains it pours... Get Well.. we need a straight Shooter....

(Gauntlet gloves hmmmm)

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 11/13/2019 10:27 PM EST

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

Thanks j-o-h-n 😫

[Shooter1 in reply to j-o-h-n]

Got out my trusty antique kerosene weedburner, fired it up and during use it split the hose between pressure tank and burner. My right side was sprayed and arm fired up. Fire=fuel, oxygen and heat, No way to get rid of fuel or oxygen with petrol fire, so walked to nearest hose bib and ran arm under it to cool pealing burned cloth and skin off as I got fire out. Thought I had it until I looked over shoulder and saw flames there. Back under water again. Got it all that time. Wives really, hate it when you go into house yelling for help. Dr's tell me months to recover. Stripped thigh and side/flank for graft material. Only one long surgery acct. my sensitivity to general anesthetic . 10% 3rd degree +10%+ skin removal for grafts,my body suffers. Makes prostate surgeries look easy. Doug .

[j-o-h-n in reply to Shooter1]

Now you've giving me second thoughts about being cremated....... thinking about the wood chipper... as a fall back position.....

For me I'd tell them to take graft material from my tits.... but don't touch my nipples cause they're so sensitive...

Get better and heal quickly....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/15/2019 6:32 PM EST

[Shooter1 in reply to j-o-h-n]

Really don't need nipples on my arm.

[j-o-h-n in reply to Shooter1]

Just think, they would be a conversation piece....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 11/18/2019 5:31 PM EST

[Hidden in reply to Hidden]

Maybe include protein drink if not up for solid food?

[Samdres in reply to Hidden]

Thanks for your words and time to reply. After he receiving chemo the bladder problems stopped and the bleeding but today Dr said the PC is advancing.

[Hidden in reply to Samdres]

It’s Good that it helped the bladder. Damned pc . 👎