First post about my dad

[Faithhope11]

My dad was diagnosed in June 2019. Psa 292. Gleason 9. Stage iv. Mets to the bone. Underwent bilateral orchiectomy and TURP in July and has been on zytiga + prednisone since August.

His psa is now 94 and hasn't gone down further. No significant side effects or pain. He's diabetic.

What would be the best treatment plan, for his situation?

Thank you ‼️

[GP24]

I would get the prostate radiated. Destroy the "mothership".

[Tall_Allen]

From what you wrote, it sounds like he is polymetastatic and castration-resistant. The TURP was a good idea- it prevents future urinary difficulties. You didn't mention if he requires or is taking a bone strengthening agent like Zometa or Xgeva.

The next step should be to stop Zytiga and try Docetaxel for 6 infusions, and Provenge. After that, he can try Xofigo. After that, he can try Xtandi. There are also many clinical trials.

[Faithhope11 in reply to Tall_Allen]

Thank you.

Not taking any bone strengthening medicines yet.

Provenge is not available in India.

[Tall_Allen in reply to Faithhope11]

He should have a DEXA scan (it's similar to a simple X-ray) to see if bone strengthening is required. Those of us who work out at the gym a lot may not need it, but the orchiectomy and Zytiga may give men who are sedentary osteoporosis.

In India, he can also get Lu-177-PSMA treatment. Because he has bone metastases predominently, Xofigo is probably the better choice, and he can get the Lu-177-PSMA treatment when metastases develop in soft tissue.

[Hidden in reply to Tall_Allen]

Great advice T_A! 👏🏼

[Faithhope11 in reply to Tall_Allen]

Thank you

[Faithhope11]

Thanks.

[Hidden]

What is your fathers age please? I’m happy that he has no side effects or pain . Keep him active . Walking is great . Does he follow the no sugar or

Starch plan ? I did the orch on 9-17 .. keep faith and hope alive . Your love is a powerful medicine ... Thanks for being his advocate . I’m not the expert on treatments. Others will answer you on that .. With you by his side I’m not worried ...He has love . Take good care of yourself while helping him out . Peace ...Scott

[Faithhope11 in reply to Hidden]

Thank you ‼️

He is 64.

[Hidden in reply to Faithhope11]

That’s young ! 🙏