Hi everyone, I am so glad I have found this community. My dad is currently admitted to the hospital right now, we have just found out that he has metastatic disease in his lungs, lymph nodes in his abdomen and chest, and all throughout his bones. His PSA is 550! We are all currently reeling from whats happening. My dad who we thought was a perfectly healthy 77 year old until just last week, when all of this 'started.' Who knows how long this thing has been growing and taking over his body. Feeling tremendous guilt that I had not noticed that anything was wrong with him, that I had not noticed his deterioration and that he was quietly suffering, the stoic man that he is. We are waiting for the doctors at the hospital to biopsy one of his sites of metastases, so we do not actually have a diagnosis yet. The hospital doctor has started him on Casodex, since his PSA level was so high and bone scan positive with disease throughout. He seems to responding well symptom wise. He says hes no longer having back or abdominal pain.
I have so many questions. What should I be doing right now to improve his survival? Is there anything time critical? Just really overwhelmed by the initial steps on how to tackle this for the best outcome for my dad. Greatly appreciate everyone's advice. Thank you so much.
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lvnbba
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I’m so sorry for what you and your family are going through. Please do not go down the guilt trip road - you could not possibly know what is going on and could easily attribute changes to ageing.
For newly diagnosed metastatic prostate cancer triple therapy is recommended - so docetaxel + androgen deprivation therapy (like lupron, eligard) + one of the new hormone drugs - either abiraterone (Zytiga) or enzalutamide (Xtandi).
That is a shocker to learn that all at once. I won't overload you with a lot of information, other than to assure you that there are a lot of great medicines (Casodex is just temporary) for advanced prostate cancer like that, and depending on how well he responds to those medicines, he may be able to live a long time with it. The latest innovation is called "triplet therapy," which consists of a drug that stops his internal production of testosterone plus a more advanced hormonal pill plus 5 months of infusions with a drug that kills off his most rapidly dividing cells.
The first job is to get him hooked up with a good urologic oncologist. Where does he live?
So sorry to hear about your father but like it has been said there are many treatments that can help. As for a genitourinary oncologist you could try John Shen at UCLA Health in LA. He specializes in treating geriatric patients; I had a consult with him. He was well spoken knew his stuff and did not talk down to me and my wife. I am sure others on this site will have some good recommendations for you.
I have Stage 4 metastatic prostate cancer. It has changed my life in many ways. I have been on lupron, then transitioined to eligard, and have recently added enzalutamite.
Two things that have given me peace of mind are having a current will, and a current advanced directive. Your father should have those in place to make his wishes clear, and to give his family clarity in any family discussions, now or in the future.
My family and yours are in different boats in the same storm. I understand how you feel.
This forum is a great source of support and information, both important to keeping guilt, confusion and fear at bay. I wish your family the very best.
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