Update on my father. Triplet therapy?

[gio2x]

After my last post, my father underwent spinal cord decompression surgery - they did laminectomy and partial corpectomy of the fractured vertebrae and did pedicular screw fixation to stabilize the spine. It's been 2 weeks since surgery and he is prescribed bed rest for 4-6 weeks. After 1-2 more weeks he will start physical therapy and by the help of it I hope he will regain mobility, partially at least.

The results of biopsy came - Gleason 7 (4+3) which was not very bad news after hearing PSA number at the diagnosis. The MO gave us the treatment plan of - Casodex, Zoladex, Chemo (Docetaxel) and radiation therapy after that. With the help of this site, I know that early Chemo (6 rounds) is important. I've been reading about the benefits of giving Abiraterone (Zytiga) early versus later as part of triplet therapy and also told his doctor about that but I am not sure what the future steps will be. What do you think - should we be more persistent about early Abiraterone? We live in an Eastern European country and I suppose triplet therapy is not considered standard of care here yet.

Every piece of advice would be much appreciated. Many thanks for the informative and encouraging words on the last post.

[Tall_Allen]

Yes, abiraterone+Zoladex+docetaxel, all at the same time. Radiation to his prostate is useless if there were 4 or more bone metastases. Email this to his oncologist:

thelancet.com/journals/lanc...

[gio2x in reply to Tall_Allen]

Thank you. I will definitely tell her this. Does gleason score change anything in terms of prognosis?

[Tall_Allen in reply to gio2x]

Once there are metastases, Gleason score is irrelevant.

[lakeheadguy]

I had 2 doses of hormone therapy and 37 treatments of radiation in 2016. In January of 2022 I was diagnosed with radiation proctitis-a horrible condition (uncurable-dead small and large intestines). Radiation proctitis can manifest up to 10 years after treatment. Inquire about the side effects. My PSA is now 0.03 so cancer appears to be gone but radiation proctitis can be managed. Search this site for radiation proctitis - informative.

[Hidden in reply to lakeheadguy]

Hey lakeheadguy! That’s a horror story . I did imrt 7 yrs back . I’m praying for non of those complications . Hope you find relief . 😎✌️

[ThirdHarmonic]

My only opinion is that every person's body responds differently. I've had the prostatectomy, external radiation, Lupron, nubeqa, zytega, and now on a clinical trial with sabizabulin. Those work for some people. The first month with sabizabulin is not looking good for me. But maybe it will kick in during the 2nd month.

[Hidden]

Oh boy! Those “ ectomies” sound painful . He’s giving it the o one two three ouch . May it push that pc away for many years! compassion and love is what’s needed . Get him through this .. 🙏❤️

[noahware]

Yes, triplet! But I don't understand the addition of radiation... in what form, exactly?

[gio2x in reply to noahware]

Thanks for the answer. MO recommended consultation with the radiation oncologist and that's what I was trying to say. He doesn't have pain in bones as of now, so I don't know if he will get radiation to metastases in near future or not. I guess radiation oncologist will tell us that.

[Shelboop]

I’m so glad to see your dad did well with surgery, I’ve been thinking about you guys.