Husband diagnosed with metastatic prostate cancer

[Barnacle124]

He is 79. The diagnosis process lasted six months or so...and ge wasn't diagnosed until he had a psma pet scan on January 6.

[TylexGP]

Hi Barnacle,

I know the diagnosis can be overwhelming. If yo can add a bio with specifics. Gleason score, pathology, where his Mets are;,it will us help answer questions you might have. This a great group and are here to help and support.

[Barnacle124 in reply to TylexGP]

I put some more information into the profile. Hope I did it right.

[Tall_Allen]

That is highly unusual. He is lucky they found it. If the Lupron shrinks it, I hope he discusses triplet therapy (ADT+chemo+2nd line hormonal). I hope the genomic study (do you know which one?) reveals something useful.

[Barnacle124 in reply to Tall_Allen]

It is weird...which is why the doctors have been so slow to act. There are probably two explanations: 1) he has higher grade cancer that wasn't found in the biopsy because the prostate is huge, and/or 2) there is another cancer involved as well.

[Tall_Allen in reply to Barnacle124]

Perhaps a biopsy of a metastasis with histology and immunohistochemistry in addition to the genomic study would be useful.

[Barnacle124 in reply to Tall_Allen]

The radiology oncologist recommended a second biopsy of the largest lymph node( which isn't particularly large). The medical oncologist wants to proceed with the ADT, which seems to involve bicalutamide ( 50 mg orally) plus am injection. His reasoning: 1) if the cancer is something other than prostate, it will not respond to the ADT treatment and can be biopsied later( six weeks). 2) We know that there IS prostate cancer, so better start treatment. 3) A biopsy of a lymph node always has some risk..and my husband is 79 and has a pacemaker. "The first duty of a doctor is to do no harm", he said. Glad he's read the oath!

[Tall_Allen in reply to Barnacle124]

He's right that met shrinkage with ADT is diagnostic for PCa, and if it showed up on the PSMA PET scan, it probably is normal PCa. I was thinking more of the sternum met, which should be pretty easy to biopsy with just some local lidocaine.