Dad is now 73. Lives in Sydney, Australia. Ethnicity is Caucasian.
PC history below:
2020 May: PSMA test and rising PSA at 4 give rise to biopsy. Reveals Gleason 4+3 stage 2b.
2020 June: Ends up getting robotic RPC. In post surgery biopsy PC did just breach Prostate capsule. But margins negative. Restage to 3a. Still 4+3 Gleason but high grade percentage (4+5) is 55%. No cancer in seminsical vessels.
No further treatment recommended.
2020 to 2022: PSA drops off to undetectable and life continues.
2022 May to August: PSA rises and doubles in a 3 month period to 0.14.
2022 August: PSMA test confirms cancer is very lightly in 5x Lymph nodes in the pelvic area
Oncologist treatment is the following:
Start ADT Lupron immediately
Late September start xtandi (takes a while to get into Australia)
Suggest course of meds 1.5years
This month (October) PSA now dropped to 0.1 but the oncologist wants it below 0.1.
Next PSA test in 3 months using PSA as the only detection mechanism unless it goes back up.
In December Radiotherapist to do targeted radiation on affected nodes for 30 sessions.
Oncologist thinks 80% chance of survival for next 5 years
Radiotherapist thinks 95% chance survival for next 5 years
He currently does heaps of walking, is eating healthier and doing strength workouts 2x a week but is a bit overweight.
He is having vitamin d and calcium tablets.
Is this the best course of treatment?
Ive read about the triplet therapy incl. Chemo? Ive read about cycling meds to reduce CRPC dominance? Any thoughts in relation to his cancer profile? Should he be doing this?
Is the radiation therapy correct or should it be targeted over the entire pelvic area or other suggestions?
Is tri monthly PSA detection the standard for monitoring, considering his PC profile?
What do you think the overall survivability is for his PCprofile?
Any other suggestions on treatment are welcome thanks.
He recently decided he is going to see another oncologist just to be sure of his decision
Many thanks. Ive been reading up as much literature as I can and this forum has been invaluable.
My Dad is my best mate.
The pelvic nodes could be radiated too at St. Vincents. You could get a second opinion there:
very helpful. I will let him know. Thankyou
how do you know this guy btw?
I have watched presentations by one of his colleages in nuclear medicine. So I looked up who is in charge of radiation oncology at that hospital.