Anything that can be done here?

[adsnj]

4 years ago, my dad (now 72) was diagnosed with (what was at the time thought to be) localized prostate cancer. He underwent radiation and a couple years of Lupron.

This past summer, his PSA spiked to 2.0. A PET scan showed no signs of cancer outside the prostate, and a prostate biopsy showed no signs of cancer in the prostate. However, a lung nodule was noted, which had grown from 4 years prior, when it was too small to merit any attention.

He subsequently had the nodule surgically removed, and within the nodule (roughly 1.2-1.8 cm) were cancer cells, which were POSITIVE for PSA, indicating that the cancer somehow made it there from the prostate. Notably, the surrounding lymph nodes were NEGATIVE for cancer presence. It is conceivable, though not definite, that the cancer had already spread 4 years ago, but the Lupron therapy kept it at bay until now. It should be noted that there are no other signs of spread elsewhere.

So, what's next? It's my understanding that Lupron cannot be done again, since it's only effective for 2 years or so. It's also my understanding that, had the doctors known in advance that the nodule was malignant, they wouldn't have bothered to remove it.

Are there any other options, or is it time for him to get his affairs in order?

[cancerfox]

My brother has been on Lupron for almost 4 years now, and it's still working, so I don't know why your dad couldn't resume treatment with Lupron or some other Androgen Deprivation Therapy (ADT) drug unless the Lupron previously had quit working. And I'm not a doctor, but why wouldn't doctors remove the nodule four years ago if they knew it was malignant? According to the American Cancer Society, five-year survival rates after lung cancer surgery for non-small cell lung cancer (the most common type of lung cancer) are 63% for localized cancer. It seems like there should be some treatment options available for your dad now.

[adsnj in reply to cancerfox]

They didn't know it was malignant. The nodule back then was too small to merit attention.

[Tall_Allen]

You misunderstand about Lupron. It continues to be effective - it prevents the testes from making testosterone. It will always do that, even when he becomes castration-resistant. He should get back on Lupron immediately. It's time to bring out some bigger guns too. Even a limited amount of abiraterone might knock the cancer back.

Your hopelessness is very misplaced. Yes, it is likely that some rogue cells got into his lung many years ago. So that gives you some idea of how slow prostate cancer progression is.

[LearnAll]

Lupron has worked in many men for 10,15 or even 20 years. I know one man who had metastatic prostate cancer and was on Lupron only for 16 years before he died of a heart attack at age 82.

If I was your Dad's doctor..I would put him on Casodex (bicalutamide) 50 mg a day and recheck scan in 90 days and see if it is better. If not then, will go for Lupron.

Casodex has very little side effects compared to lupron.

[Magnus1964]

There are plenty of other ADT drugs if Lupron has failed. I would suggest he go back on Lupron and add casodex. You need to sit down with his doctor and get a good explanation of treatments. Doctors are not gods, demand clearity.

[Yank66]

Hubby’s been on Lupron for 7 1/2 years and will continue for life. Other treatments can be added to the Lupron-he’s had radiation, Provenge, Xtandi and now Lynparza. There is reason for hope-many advances are being made in PC. Hope is great medicine in itself.

[j-o-h-n]

Did the doctors ever consider Keytruda for treating his Lung Ca? I have been fighting my Lung melanoma with Keytruda and it is working.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 12/20/2021 10:04 PM EST