I recently found this forum and this is my first post. My dad was diagnosed with prostate cancer 10 years ago in 2012, with pelvic metastasis in 2018. He’s been on all types of medications, and he shares very little about it with me unfortunately - it’s likely because I’ll be worried. But from what I know, he’s been on prednisone, Zytiga, dexamethasone, hormone injections, radiation, etc. His PSA was at bay for many years until the past year where it very slowly started to creep back up. It was at 0.03 but now it’s at 0.77 after about a year or so (with blood test monitoring every 3 months).
His oncologist has recommended he start chemotherapy and I’m worried out of my mind if it doesn’t work or if he doesn’t respond. As his 25-year-old daughter, every day all I think about is “How much time do I have left with him? I’m not ready.” He’s now 61, which I’m guessing is young-to-average age of those with prostate cancer. I want to know if there’s anything I should know about chemo, whether there are other treatments we could possibly seek out (it should be noted that he didn’t qualify for genetic treatments), etc. We’re also located in Canada, BC specifically so if anyone knows of any trials or treatments that might be available, please do send me your suggestions
Edit: anyone have any knowledge about survival or extending life with chemo for patients like my dad?
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Since the cancer is castration resistant he can request Provenge a cancer vaccine which has been shown a survival advantage. Before starting a new treatment they should document radiographic progression of the cancer.
They could do a PSMA PET/CT which is approved by Medicare and offered in many places.
If there is progression of the cancer since he already was treated with zytiga the next steps could be chemo with docetaxel if he did not have previous chemo or cabazitaxel if he had docetaxel before.
If the PSMA PET/CT shows PSMA expressing metastases he could be treated with Lu 177 PSMA which has been shown to prolong life and it could be more effective than chemo.
There are clinical trials for Lu 177 PSMA treatment
Thank you for all this! I’ll try to look into and consult about some of the procedures and treatments you mentioned here in Canada. Dad hasn’t ever been on chemo before, but I will also try to inquire if there are oral chemos he could try out too. We are all just hoping he is able to live a long and healthy life, to the best of his ability.
If he never had chemo before, then Provenge and docetaxel could be next treatments when radiographic progression of the cancer is documented, even when is determined by bone scan and CT scan.
I wish you the best of luck.
At age 61, if he has no other major health issues, he should tolerate chemo well. I did at 65.
Yes it was. My PSA was 850, 4 bone mets and numerous lymph node involvement. I jumped on the chemo train right away. Also used a drug, Neulasta in conjunction with chemo. Chemo worked extremely well for me. That was 7.5 years ago.
Docetaxel - Pretty much standard front line chemo. I did six sessions.
Note: I'm not a doctor.
I'm not real knowledgeable, but I think it's called Docetaxel. I think if you read on the forum you'll find most people tolerate it quite well.
I've also heard that you can sometimes go back after chemo and do a different one of these androgen blocking drugs. This is based on my limited knowledge, not a doctor either.
Would you please be kind enough to tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
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I hope he does well whatever route he chooses..... You're a wonderful daughter (Pinay is my guess)....Stay and keep posting here. You're come to the right place for information and help..
Would you please be kind enough to tell us your bio. Age? Location? When diagnosed? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)?
All info is voluntary, but it helps us help you and helps us too. When you respond, copy and paste it in your home page for your use and for other members’ reference.
Lu-177 is more effective if he was to qualify for it on a PSMA scan if he is chemo naive. That is something to consider . You have some time and a scan may be a great next step. As a side note I was one of guys that went to India and while by pure luck it is where I landed it turned out to be the best financially (which thank goodness was not an issue for me but it was during the onset of Covid) Then I got Dr. Ishita Sen and her protocol is now considered cutting edge as she favors fewer infusions at a higher dose for chemo naive patients . I was losing traction fast before I went 18 months ago and now doing quite well. My friend who went with me is back at United flying ( met him in this site) There are quite a few trials here so just something to look at.. Blue Skies
Wow! We sought initial treatment for him for his prostatectomy (I think that’s what it’s called) in Bangladesh (my dad’s home country). They were amazing, and they also initiated his first few rounds of radiation too. Again, I’m not up to date on the details because dad hates talking about this stuff unfortunately. But maybe we will try to consider treatment elsewhere if that’s feasible.
I don’t have much to offer advice was but wanted you to know I’m in the same boat with my dad I’m 32 and my dad is very private about everything so I feel like I never know how he’s really doing. Wishing you the best and know you’re not alone
I was on chemo for 30 weeks. It brought my PSA down from 30 to 5 my lowest point. I found the side effects tolerable. I lost my hair but no big deal. If he decides to go that route this site can help you with ideas to help with side effects. I’m not very open with my daughters either.
Hi- I am sorry to hear that your father may need a different treatment in the coming days/weeks ahead, but it does sound like he has hope that whatever his next treatment is, he might have a good response. I will keep my fingers crossed. I would appreciate you keeping us advised as to the next steps he takes and how he responds. I, for one, am in a VERY similar position as your father, having been diagnosed in 2012 at age 54 and my PSA has started to rise ever so slightly over with my last 2 PSA tests, so I might need to move ahead with a different treatment shortly. I too have basically been on Lupron, Zytiga and Prednisone for most of my 9+ years along with one round of radiation in 2014.I wish you and your father the best.
Wow! That is uncannily similar to my father’s trajectory. I will definitely try to keep updated on my dad’s progress. It seems like Provenge isn’t something that’s available in Canada but has been very effective for many many people with prostate cancer. I’ll still inquire about this with my dad’s oncologist and see what he says. It’s been really stressful. I really do wish you all the best and I hope you stay strong! 💪🏽 All my thoughts and positive wishes are with you, and everyone struggling with this.
I'm no expert but I don't think that a PSA of .77 is particularly worrisome though the steepness of his increase is. I'm in a similar situation as your dad and mine is 4.19. I have discussed this with my two oncologists and neither is inclined to slap me on chemo just based on some numbers. Nor to change my treatment in any way. We're trying to get my insurance company to approve a PET scan and, based on results from one of those, we will discuss a change in treatment (possibly including chemo). It seems that your dad might want to get a PET scan or at least a bone scan and an injection CT scan.
Hi, I am from Sydney Australia. Diagnosed at age 64 (2020) PSA 17, Gleason 9. Treatment here included Zoladex (injection every 3 months) and Cosudex (daily tablet). They also immediately started chemo. Docetaxel, 6 rounds, one every three weeks. PSA dropped from 17 to 0.09. It’s now 0.08
It’s only been 18 months since I started treatment. So far it appears to be working. Side affects are different for each person. In my case I appear to have handled the treatment with minor side effects. This included loss of hair, numbness in my feet and hands, and dis-colourisation of my toe nails.
As I understand it, each person will have different responses to different types of treatment. At 64 my doctor believed I was in good physical fitness to handle the chemo.
He's very fortunate to have .77...some men have close to 100! At .77 he shouldn't have to go on any treatment
First, everyone is different in terms of disease scope and any existing co-morbidity factors. I would listen to the MO and quit worrying taking solace that chemotherapy with hormone therapy is killing the little bastards. Once metastatic, I think the best course is systemic if one is in relatively good health. You might think about it along these lines...., would it not be better to undergo chemotherapy when the body is strong and the tumor burden minimal? A good discussion point with your pro.
Stress is not good for anyone with cancer. Early diagnosis is critical. Positive thoughts and attitude is important. Negativity in thoughts and comments by others is bad.
Me? I have been most fortunate and many consider the except rather than the rule. I was DX’d with prostate cancer at 56. Metastatic at 57. I immediately underwent a six month chemotherapy plus hormone therapy. To day I am 75. As this was a clinical trial, my experience was different than most. Essentially alternating weekly infusion of Taxotere (docetaxel) and Adriamycin (doxorubicin). This is a standard of care for metastatic breast cancer; it is not standard of care for metastatic prostate cancer.
Thank you so much - you’re absolutely right. I do need to quit worrying and just believe that these treatments will knock these suckers out. Keeping my fingers crossed for the best and I’m so glad that you are here and healthy! 💪🏽
I am in British Columbia too, just outside of Victoria. I am getting excellent care at the BC Cancer Agency in Victoria. I had docetaxel chemo there 3.5 years ago, shortly after I was diagnosed at 55. It isn't fun but it was easier than I imagined. It really knocked my cancer back and it has remained suppressed since then.
I wish your father the best of luck with his treatment.
Hello! We are also located in BC, although in the lower mainland. Thanks so much for sharing your experience - I’ll inquire about which type of chemotherapy the doc is suggesting dad goes on. He’s currently under the care of an oncologist at BC Cancer, Surrey. So glad that your cancer has remained suppressed and I hope it stays that way for a long time coming!
Gourd Dancers treatment 18 years ago was not the norm but became the norm as we know it today for metastatic dx. Chemo now sooner than later. Some sail thru chemo feeling like they have the flu for a week after each infusion. Others feel more run down and for a longer period than a week.
For me I made sure to walk even if it was very minimal everyday. I just kind of adjusted to it a became Mr. slow shuffle feet walker.
3 days after each infusion is the strongest run down feeling.
Typically a white blood cell boost infusion is given with the chemo infusions as chemo diminishes white blood cells.
Steroid prednisone is typically given daily during the entire regime and dexamethasone the day before, day of , and day after each infusion.
If a dexa bone density scan indicates low bone density or if bone metastasis is widespread a bone strengthening agent is also give as well (Zometa, Xgeva).
A lot of good comments here on treatments, trials etc.
If you are unable to take advantage of any of them the chemo being offered is still a good step towards knocking out a lot of cancer cell lines present in his body.
Not all men but some men after chemo the effect on the cells (sensitized, elimination of non-hormone sensitive cells) allows Zytiga to work again or if not Xtandi to work again.
Due to the extent of my cancer at diagnosis and the fact that I am riding along life comfortably now keeping it relatively asleep. I feel like a long timer even though I was diagnosed a little over 2 years ago (26 months). 2 years was one of the low end estimates of my expiration date.
Due to the aggressive treatment with chemo, the Zytiga, and so many more treatments available I am optimistic I will be here for many years.
My PSA at dx was 1621, with skeletal metastasis thru out from skull to shins.
Lymph node involvement from pelvis to collar bone.
Now PSA 1.2 and last standard scans showed no new activity in bones.
I knew nothing of treatment for prostate cancer. I knew chemo was a strong treatment and I was glad it was offered to me right away. Really felt like I was going after the beast and extending my life.
Wow that is absolutely incredible.. I’m really so happy for you and all of the replies on this thread have been so so reassuring. I absolutely know that each person is different, but the positivity goes a long way and I just want to be able to do as much as possible to be an uplifting backbone for my dad. I’m so glad you have gone through the treatments required and have suppressed that aggressive progression! Hoping and praying that it stays this way for you, and wishing the same for my dad!
Hi. I'm also in BC, being treated in Victoria. I've got 30+ mets to bones, currently have done 6 of 10 chemo treatments (Docetaxel). Treatment is every 3 weeks. First week is rough, major fatigue but typically weeks 2 and 3 you recover well.
Any type of therapy can fail, or it can succeed. 0.77 is not very high (is that a typo?). If it were me I'd wait another couple of months at least. Get another PSA test and go from there.
You have to go with the best advice the doctors (not necessarily people on this list, including me) give you.
My PSA has been unmeasureable since about April 2020. I heard from a colleague that his went up to about 2,800 before he started chemotherapy (that is not a typo!). I think you dad has some time yet.
If he doesn't respond to chemo, I don't know. Ask the doctors, hope for the best.
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