Update on dad: no chemo yet!

[PHnerd]

I recently wrote on this forum for the first time with my dad’s history. For the many others who don’t know my dad’s progression:

“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).”

Forgot to mention he’s also had his prostate removed since 2012. His latest blood reports showed his PSA is at 0.97. We were certain the doc would put him on chemo after his last visit (less than a week ago). But the oncologist said he doesn’t see any reason to switch treatments yet! Dad’s PSA has slowly been increasing for 2 years, from 0.03 to 0.97 (no that’s not a typo haha). We’re in the clear for the next 3 months at least. Another set of bone scans have been requested. Will update after his next appointment - for now we’re happy!

[Tall_Allen]

"...but now it’s at 0.77 ""His latest blood reports showed his PSA is at 0.97." One of them must be a typo.

If he has had 3 PSAs all above 0.1, you can use this to calculate his PSA doubling time:

mskcc.org/nomograms/prostat...

[PHnerd in reply to Tall_Allen]

Not entirely sure what good that would do since he’s cleared by his onc anyway.

[Tall_Allen in reply to PHnerd]

If his PSADT is rapid, it may be time to change therapies.

[PHnerd in reply to Tall_Allen]

I guess I’ve largely just left that up to my dad’s oncologist. I already don’t really know many details, like the specific dates for these PSA results. And anytime I ask for more details dad doesn’t wanna talk about it. Why is it that dads don’t want to share how they’re doing with us? I’ve been telling him it’s not a sign of strength to be hiding how he’s feeling or doing with us. But I can’t force him to be more open.

[tango65]

Treatments are usually change based in progression of the tumors determined by radiologic and nuclear medicine scans and not by changes in the PSA.

To determine PSADT could be useful. One can used it to decide how frequent to measure the PSA, it also has a prognostic value.

The PSA is low, perhaps it could be the time to have a baseline PSMA PET/CT (more sensitive than bone and CT scans to find metastasis) and follow the cancer with this technique.

If he has radiologic progression then treatment should be changed.

[PHnerd in reply to tango65]

His oncologist has been monitoring him for years now and he said based on PSA and dad’s latest bone scans from June, he isn’t thinking about changing the treatments right now. That being said, dad is feeling a bit more pain in the same area where his cancer metastasized 3 years ago - and this has been worrying me sick. I’m not sure what type of bone scans they are, it’s a set of them. As I mentioned, he shares very little with me and although I go with him to his appointments I feel like I still never know the details. I think the doc said he wants to wait a bit because the medications he’s on right now are still effective for him.

[j-o-h-n]

Listen to "da boys"...... they know their stuff..... You're correct 61 years old is young and having Pca since he was 51...... I'm guessing You're Pinay...... Well tell your DAD daughters are entitled to worry about their Fathers..... Give him my regards.....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/06/2022 3:10 PM EST

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

I’m just really frustrated. I feel like South Asian fathers have this sense of machoism where they don’t want to share their thoughts or feelings with their family as much because they see it as a sign of weakness. But year by year I see my dad’s mental state, confidence, happiness, etc. diminish. And it not only hurts him but also the rest of us. I’ve tried my best to help my dad as much as I can with what little I know - I just feel helpless.