My husband was diagnosed with high grade prostate cancer in 4/06 Gleason 4+3=7 in 12/12 cores with 90 to 100% involvement of the tissue cores. His original clinical staging was T2c versus T3. PSA at that time was 6.4.
-First treatment was brachytherapy and IMRT. Undetectable PSA never reached.
-Recurrance in 2009, no spread to bones. Began ADT and continued that on and off (PSA low of 0.01) until 2018.
- Fall 2018, PSA rose to 40 and PCa found in 3 lymph nodes. Continued ADT.
- In 4/2021, bone scan showed approx 12 mets throughout thoracic skeleton (CRMPCa) out of the blue.
- In July 2021 we switched oncologists because he was only being treated with lupron and casodex and we felt the treatment wasn't aggressive enough. He was switched from casaodex to enzalutamide.
-Feb. 2022, he had spine surgery to address a met that had escaped the vertebrae. Recovered like a champ,
-Feb/Mar 2022 had 3 sessions of radiation,
- Mar 2022 began docetaxel which was stopped after 3 sessions because PSA and alkaline phospatase were rising.
-April 2022 switched to cabizitaxel and stopped after 3 sessions (7/13) for the same reason.
He is 7 weeks out from his last chemo session and has been experiencing significant lumbar pain (onc says mets, spine doc says possibly degenerative disc disease - but the pain is constant now so likely mets) leading to vomitting, then to deydration, then to kidney failure, to hospitalization (small lacunar infarcts found on the MRI and now a liver lesion they think is PCa) and 4 days of torture by the neuro team looking for stroke, afib, and a number of other things. Since discharge on 8/25 he has continued to decline rapidly.
For a man who was still rowing and exercising 3-4 times a week 4-5 weeks ago, he is increasingly weak, sleeping much more, has lost his appetite and is vomiting daily (We have been together 32 years and I think he has vomitted 2 times as long as I have known him!). He can walk about 0.1 mi now and then is in pain and needs to rest.
PSMA scan this week showed very little PSMA activity so our follow up with the oncologist was rough. He said if we do nothing, the average time left is 9-12 months and followed it up with the fact that my husband is not a statistic. We know that and have always been extremely optimistic, but things aren't looking good right now. He is proposing carboplatin and possibly immunotherapy if that doesn't work but also counsuled my husband to consider how much he wants to put his body through since none of us have seen him this weak. He turns 75 on Thursday, but presented much more like a 60 year old even 2 months ago. They are also running a DNA blood testing (he was negative for the standard mutations in 2019) to see if there are any more detailed mutations to indicate treatment options. We have a 13 year old and I work full-time, so this sudden shift from someone who has "managed" this disease so well his hard on everyone.
Sorry for the long background, but I know this group is so helpful when armed with details.
I have a few questions for the group:
1. We haven't received a good explanation for the regular vomitting. He is taking antiemetics, but they aren't keeping it at bay 100%. Is this a natural part of the decline/catabolic state or is there something we aren't seeing? No one seems too worried about it and they just want to treat it with the anti-nausea meds.
2. I worry that the carboplatin will take too much of a toll on him, but the PSA keeps rising (latest was 219 and alk phos 708). But if the cancer is what is taking the toll, it may help and slow the decline?
3. What other treatment options (allopathic or otherwise) should we be asking about?
4. Have you rebounded from this kind of physical low state that is not chemo/radiation/ADT induced and what was most helpful and supportive?
We aren't ready to give up, but I admit we are crossing some i's and dotting some t's again. We are shooting for at least 5 more years for our son which would really defy some odds, but even our son is a perfect post-PCa miracle, so we have defied odds before.
Interpretation - Stable or Growing PCA?
Hello, dear people!
Anne for Ron
End of holiday??
