What about my dad's prostate treatment?

[goodgoal]

Hello,

My father is 53 years old and 3 years ago his PSA was 5.3. As a result of the biopsy, ASAP was found in only two foci. Other foci were clear. After 3 years (2022), each PSA was 24 as a result of increased infection. As a result of the biopsy, cancer was detected in 8 foci and the score was 5+5. As a result of PSMA Pet, it was determined that there was no metastasis in the skeletal bones, as follows, and it was found in the rectum and other regions. Thereupon, the professor of urology decided to apply chemohormonal treatment, which will take 6 cure. He said that after the treatment, there is a chance to remove the lymph nodes with surgery. The first chemotherapy is now over and the PSA value has dropped to 4.8. What do you think of this treatment plan? I'm curious about similar stories and comments.

PSMA PET Conclusion: A lesion with intensely increased PSMA uptake (prostate malignant neoplasm) that extends from the base of the prostate to the apical level on the left, extending posterolaterally to the prerectal distance and creating the appearance of invasion. - There are LAPs consistent with the metastasis of the primary disease showing intensely increased PSMA uptake in the presacral areas of the pelvis, bilateral external - iliac and obturatory lymphatic stations, bilateral common iliac areas and interaorcaval distances in the upper sections. - PSMA PET/CT study consistent with LAP findings suggesting metastasis of the primary disease showing intensely increased PSMA uptake located in the left upper paratracheal area in the mediastinum.

[Tall_Allen]

It is ridiculous to even think that surgery can find every single lymph node with cancer. In fact, the cancer in the mediastinum is not in a good place for radiation either. It is a good idea to alternate chemo and advanced hormonal therapies (Zytiga or Xtandi). I assume he has been on Lupron all along. Soon, he will qualify for Lu177PSMA when it is approved.

[j-o-h-n]

Greetings goodgoal,

I'm sorry but:

Would you please be kind enough to tell us his 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 him and helps us too. When you respond, copy and paste it in his/your home page for his/your use and for other members’ reference.

THANK YOU AND KEEP POSTING!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/19/2022 6:59 PM DST

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

My father is 53 years old and this disease was randomly diagnosed in Turkey. My father feels very fresh and looks younger than his age. The 2019 PSA:5,6 biopsy results are ASAP in only two regions at these dates. Other foci were clear. End of 2021 PSA: 8 foci are positive in 24 biopsy, the other 4 foci are clear. Gleason score 10 points for 8 focus. He is currently undergoing chemotherapy and hormone therapy.

[j-o-h-n]

Thank you madam for your quick reply. It may worth your time to copy the details of your post into your home page for bio history. This way it will always be at hand for you or others to view. You're a wonderful daughter for looking out for your dear Father. Send him my regards and keep posting here... p.s. at 53 years old your Dad and plenty of years ahead of him...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/20/2022 3:50 PM DST

[NecessarilySo]

After rereading several times, (and being not a doctor), I get the general gist of what your father is going through. What I see missing is mention of any kind of treatment such as surgical removal of or radiation to the prostate. (I could be overlooking the obvious?) Chemo and hormone therapy is probably appropriate, but with Gleason 5+5, which is as high as they get, I would think removal or radiation would be the obvious first step. I personally feel that biopsies are a cause of metastasis, and would rely more on PSA and scans for evaluation after initial biopsy. I also prefer rad therapy over surgery to avoid metastasis.

[goodgoal in reply to NecessarilySo]

Thank you for your answer. Yes, I'm thinking the same thing. Metastases to other sites occur due to biopsies.

[goodgoal]

Thank you very much for your detailed and informative article.