I’m a care giver for my dad. He is 80. He has always been healthy and workout. No previous diseases or illness before this. He started with not being able to urinate back in November, which landed him in the ER. They put in a Foley catheter and prescribed (Flomax)(tamsulosin) daily pill to help relax the prostate, then sent him to an urologist.
The urologist did a PSA blood test which came back 363. Even though dad goes yearly to his primary physician and his yearly blood work always came back good, this was the first time we ever heard of a PSA test and his primary Dr never included it in any of his checkups. The urologist sent him for scans which came back with prostate cancer & one gland plus metastasized to bones (no organs affects). If the primary Dr would of ran PSA testing, the cancer would of been detected earlier and the spread to the bones could of been prevented.
The urologist wanted to perform a TURP surgery first before sending him to oncologist, but I got him to oncologist first. The oncologist put him on a hormone therapy Casodex(bicalutamide) daily pill and every three month hormone therapy injection. The hope is to stop the spread or shrink the cancer. Also he gets a monthly IV infusion of Zometa to help with bone damage caused by cancer spread to bone. This was at the beginning of December.
Mid December he had the TURP surgery. It was a success. Foley catheter no longer needed and full control of urination with no issues. The TURP surgery still is a success, but wondered about anyone’s else’s experiences with TURP surgery? Did anyone have one that was a success, but then months later their urinating issues returned? What was the solution then? Just wondering incase something new might arise
At the end of December his PSA was down to 75, with no side effects from any of the meds. At the end of January PSA down to 15, still no side effects from meds. It seems the ADT treatment he is on is working. Just wondering, anyone have issues with PSA decrease but when they got scans again showed cancer spread to organs or other parts even though PSA was going down? This is not happening to dad, but just wondering.
Now its end of February, he had his monthly infusion and blood work this past Friday. Waiting for new PSA levels that should post tomorrow, but the rest of his blood work came back good.
But this morning had first side effect, nausea. Never vomited, but feels nauseous when eating. Is this normal on hormone therapy? The thing is both the infusion & daily pill state it can cause nausea as side effect, so how do we know which one is causing that issue? Or if it’s something else going on? Worried. He is already naturally small, and now today he barely ate because of this new side effect. Any advice? Anyone ever had nausea with these meds? So weird this side effect didn’t start till 3 months after he has been on it? Any advice? Could it be something else causing it?
FYI: The urologist stated hormone treatment that dad’s oncologist is using is temporary because the body will eventually resist it. So he set us for a cancer clinical trial appointment for next week as a plan B treatment plan when the hormone therapy no longer works. Any advice on that statement or experiences? Anyone going through a recent clinical trail that is working for them, or can you share experiences that didn’t work for you and you don’t recommend?
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FightNow
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PSA level 15 is still too high and cancer cells are still active because they are still producing enough PSA (15)
in order for himto be cancer free his PSA needs to be below 1 and his Alkaline phosphatage needs to be below 60.
Good news is that his cancer is responding to ADT and we might see PSA level 1 in next few months. After it happens, his scans will indicate that cancer is fully under controlAnd that also will eliminate his urination problems.
Which clinical trial are they discussing?
I don't see why he should consider a clinical trial at this point since his PSA is still coming down, still on the first line of treatment. IMO, there is no need to be thinking about what he is going to do "when the hormone therapy no longer works" since that could be years away and there are quite a few proven treatments available for when that happens.
They do need to help get the side effects under control. Nausea is not a common side effect of ADT as far as I know. There are quite a few ADT drugs available so he could switch and see what happens. You said he is getting a monthly infusion. Were you talking about ADT shot or something else? Just wondering if something else could be causing the nausea.
When it comes to stage 4 prostate cancer: I would be discussing treatments with an Oncologist, not a Urologist since advanced PCa is an Oncologist's area of expertise.
There is no way to know how long your Dad's TURP will last. It could last the rest of his life. If he has radiation to the prostate he may need another.
For now I would stick with the casodex and Lupron.
IMHO - nausea as a side effect of Lupron isn't surprising.
Most men on Lupron will tell you the side-effects get worse with the length of time you're on the crap. The first 3 months of my treatment were a walk in the park - I was sort of "what's all the hubbub about Lupron?" - after 6 months I had a good inkling of what the hubbub is about, and after 12 months I certainly have experienced almost everything anyone has reported for Lupron side-effects.
I have a 2 page single-spaced list of side-effects for Lupron, so far I haven't had excessive vaginal bleeding or unusually heavy periods. The rest? At least 60% have a checkmark next to them.
It sounds as if your dad is healthy with the exception of the PCa. One thing to really think about since he is 80 years old is quality of life vs quantity of life. While reaching for any possible treatment is just natural - it's worth considering what impact the treatments will have on his ability to enjoy life. If the treatments add 6 months of misery to his life - to me - that's a net loss.
You mentioned in your posting "If the primary Dr would of ran PSA testing, the cancer would of been detected earlier and the spread to the bones could of been prevented." I think the world "would" should be replaced with "might" - there is no certainty with anything related to PCa. The doctor was simply following currently acceptable guidelines for PCa testing. It's been demonstrated that men over a certain age are generally not helped by detecting PCa in them - that might simply grow very slowly and they pass away from other causes. I forget what the cutoff age suggested was - but I'm certain 80 was well past it. If you go look at nomographs of age/treatment/survival - there are surprising facts. The vast majority of men past around 75 who are diagnosed with PCa will die from something else - given treatment or not given treatment. The difference (from memory) is about 10%. And that's where the quality of life should be considered. If treatment is going to destroy the man's ability to enjoy life - why bother?
I do wish your father well - and hope he finds the ADT to work well without side-effects, but before considering additional treatments that he and you consider the impact those treatments might have on his enjoyment of his life.
It's a good thing that you're posting here. In all the many years and medications that I take I have yet to experience nausea . However all of us fighting the tiny bastards do not always respond the same to meds or mental issues. Keep FightingNow and in the future. Give my regards to your Dad...
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