I have an older post about my father's situation, if you're interested.
In May 2022, my father was diagnosed with stage 4 prostate cancer with extensive metastases and a high Gleason score. He started hormone therapy and the doctor recommended chemotherapy "as soon as his body could handle it."
Currently, he has been on hormone therapy since the diagnosis and is halfway through Docetaxel chemotherapy - I'm actually waiting outside the hospital for him to be done with his 4th infusion.
Earlier today, we met up with the doctor who said that he was showing a mixed response to the treatment. We had scans right before the chemotherapy started, so it might be because of that but the gist of it was it typically shrinks or not responds consistently. In his case, the lung metastases and some lymph nodes have shrunk while the liver and other (chest?) lymph nodes have gotten a little worse. According to the doctor, his PSA dropped drastically, came back up a little around November and then has plateaud since.
Generally, he's been fairly active and is in good health. I wouldn't believe he was a stage 4 cancer patient if I didn't know.
Does anyone know more about this kind of situation? Thanks!
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Worriedson9
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Thanks for the response. You're almost always the first one to respond and I greatly appreciate it. If I didn't know any better, I'd be inclined to think you were an AI with an oncology speciality.
He's undergoing triplet therapy now after they've added chemotherapy: Zoladex, Zytiga with Prednisone, and Docetaxel. We got him referred to another hospital for a second opinion and to find out if there were any clinical trials he was eligible for. He got a liver biopsy to rule out a more serious cancer, as well as a genetic test. They ruled the gene in question, which also made him ineligible for the trial.
Hi WS. I see you are from Canada, not sure what province. I'm in Ontario and my situation is very similar to your Dad's, even including timing. It looks like your Dad is on triplet therapy and this is fantastic: Abiraterone/Zytiga+Prednisone ARAT, Zoladex (or Firmagon/Degarelix) ADT, and 6? cycles of Docetaxel chemo. All at the same time.
My understanding is this is what your Dad is doing. This is fantastic because it is the leading therapy in the entire world as far as I understand.
On the subject of triplet therapy, and if you haven't already seen it, here is a video by Dr. Di Maria Jiang of Toronto's Princess Margaret Hospital discussing the latest prostate cancer therapies.
Specifically she comments that the adoption of triplet therapy by other hospitals has been slow, despite its clear advantages.
The video URL also has the link to the Toronto Prostate Cancer Support Group, if you are not already connected. There is also a private subgroup called "Warriors", for people with metastasized prostate cancer. It took me awhile to realize that the groups are really very different.
For those who may be new to the term "triplet therapy", the idea is that you don't do one therapy after the other, where "other" means "failure". You do them all at once up front and the research shows that the advantages in life expectancy are very strong.
You have reported that some of the masses have shrunk. That seems like really good news. I finished my chemo not so long ago and felt a lot better, and my scan was heartening, but I am also experiencing very, very strong fatigue. My plan is to exercise, if I could only get around to it more often. (For the record I'm also on a low carb diet, but that's not necessarily something everybody wants to do or that it is even a good idea.)
Success and strength for your Dad as he completes his Docetaxel!
Coincidentally today, this Tuesday January 3rd, this evening there is the monthly online prostate cancer Toronto Support Group meeting. You have to register here:
Did they do a biopsy of the liver mets? It may be important to determine why the cancer is not responding. Genomic, histological and IHC studies may have an answer and guide future therapies.Triple therapy requieres that ADT, chemo and zytiga are done at the same time.
Hello! Worriedson9 ! Are you the 9th son? Be strong for him . He needs you now . Worry begets more worry but it just shows that you care . I’m sorry about your father . Mine had this too! But I’m a sublime fool… I didn’t pay attention or go to a doc until it was almost too late for me. I was 53,now im 61. You son must check yourself starting at 40 . I did not! You’re 50% more likely to get this too because of dad . He is suffering . We all do . To different degrees . Keep him up mentally and really love and help him anyway that you can . Get him up and out for a walk or whatever when he doesn’t feel like it . Someone to get him going is helpful . My dad got pc at 69 and passed of a heart issue at 71 .I was 2000 miles away at the time and only saw him for a day one month before he passed . A real bummer . He was withered up and gaunt looking . It hurt me to see him suffer .. So , if you can spend time with him ,do so . My dad was 23 yrs ago . I love him more now than ever . I wish that I had a son to help me now . Baby him if you can . Spoil him to try to comfort him . Anything he wants is alright .. There are no promises made with this disease. Time is precious for us all once we are diagnosed . But Some have survived for decades with even worse starts . This no cake walk for us and our families . Lots of prayers . Hang in there with him . You are the good son. That is Awesome ! 👏👏👍
Sadly stage 4 is considered incurable, I also an G9, BRCA2 stage 4 but not quite advanced as your dad. My original PCP died unexpectedly of Pancreatic Cancer, the practice assigned me to a PA that was trained when they were discouraging PSA testing and biopsies.... long story but it took a full two years to get referred to a specialist.... it's hindsight but knowing what I know today the PA should have referred me Stat after my first psa as it was over 6. By the way, since your dad has PCa, you are in high risk category and should begin screening as early as age 40. A good primer on this disease and early treatment options, pros and cons/(morbidity side effects) is survivor Bob Markini's well researched book "You Can Survive Prostate Cancer...2nd Edition" Availible on Amazon. Important to educate yourself so you might avoid, or minimize the journey your dad and I find ourselves on.I heartily recomend you research survivor stories, most did standard of care(SOC) recommendations as well as various alternatives on top of SOC. Two that I know of were given mere 2 or 3 months to live with advanced stage 4 cancers. The first one stumbled across research via his Alma Mater bulletin board, the other aggressively researched ways to starve cancer. Both are cancer free five years plus now. Hey, you have nothing more to loose and everything to gain in searching cancer survivor stories. The two I particularly favor are Joe Tippens and Jane Mclelland. Joe's discovery is quite easy to add on top of standard of care. Jane Mclelland's approach is more complicated and adds to standard of care drugs that attack cancer metabolism.
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