Hi all,
My dad was diagnosed with stage 4 metastatic prostate cancer about 5 weeks ago. His current MO has him on a zoladex injection and next ADT has yet to be added.
I want to ensure my Dad has the best health team. He is currently being treated at BC Cancer in the Fraser Valley.
As his current MO is a general MO I was hoping to find recommendations on a PC specific MO located in Vancouver or anywhere in the lower mainland.
thank you
Martin Gleave at Vancouver Prostate Centre is one of the best in the world.
Hi TA, we had my dads family doctor refer us to him. We were set up with a phone appointment with one of his fellows that basically said since Dr Gleave does not do chemo it wouldn’t make sense to have him as the MO and therefore suggested we stay with our current MO. The fellow did state what they can do is send a suggestion regarding triplet therapy to his current MO if that’s the route we want to take
That's odd that he doesn't do chemo. Try Celestia Higano.
My understanding that Dr Gleave is a urologist/surgeon and yes a top prostate cancer researcher but not specifically a MO. Dr Chi is the top MO (and head of BC Cancer). I've had two in-person meetings with him and he has been great.
Hello,
I too live in the Fraser Valley and I too have metastatic PCa. When I was diagnosed my PSA was just below 1700 and the cancer had spread to most of my bones from my neck to my knees. On scans I lit up like a Christmas tree. That was nearly ten years ago. Like you I wanted to get referred to the Prostate Centre at VGH. I saw Dr. Gleave and I still see him and hear from him from time to time. My primary oncologist however is at Abbotsford Regional Hospital and Cancer Care (ARHCC). My doctor is good, very good and I have never regretted going there for treatment. I am currently on the SPLASH clinical trial being run by the BC Cancer Agency in Vancouver. Good luck!
Wow. May I ask what treatment you're on and what is you're PSA now.My husband just finished Chemo 3 months ago after Xtandi stopped working after 15 months. He had his prostate removed in 2017. Was fine until 2020 when PSA went up to 48. Scans showed cancer metastasis to the bones in 3 or 4 spots. Xtandi brought it done to 24. Then it started going up, so Chemo for 10 sessions. A break for 3 months then they have him on Radium 223. His first of 6 injections was 3 weeks ago.
We are hopeful he has another 5 years.
Hello Docker,
Since diagnosis (May, 2013) I have been on Zoladex (goserelin) except for one year when I was on Firmagon (degarelix). Five years ago my oncologist added Xtandi (enzalutamide) to the mix. When that stopped working last fall I volunteered for and was accepted into the SPLASH trial. The clinical trial team switched me from Xtandi to Zytiga (abiraterone) plus Prednisone. I had some radiation after diagnosis (neck and lower back) but I have never had chemotherapy. I still have my prostate. My oncologist's position is the "horses are out of the barn", so there is no reason to remove the barn. 😊 My current PSA score is .81 not high enough yet to crossover to the Lutetium arm.
Thank you for your prompt response.
Hi RyderLake2. You certainly have an interesting and impressive track record! I'm very interested in your oncologist's position on "the horses are out of the barn", so there's no reason to remove the barn. I intuitively share that opinion, though I think a lot of docs don't. As one who is probably oligometastatic, I spoke to a radiation oncologist a while back re zapping the sites external to the prostate itself. His feeling was, if undergoing radiation, we should get "the mother ship" as well. So, 2 different approaches, neither which I've undergone so far.
Hello,
Any surgical or radiation procedure has positives and negatives. Removing the prostate after the cancer has metastasized to other areas of the body (normally the bones) is called "debulking". I too initially thought we should remove the "mother ship" but in the considered opinion of my medical oncologist the negatives of doing a prostatectomy after my cancer had metastasized outweighed the positives. I went along with his advice. I also thought of having brachytherapy (radiation) done but went with androgen deprivation (ADT) instead. Good luck!
Hi. I was diagnosed about 3 years ago .
I went on bicalutmide for a month or so .
Then my urologist put me on 3month injections of Zoladex which in the lat 6 months was switched to Goserelin a generic version of the afore mentioned .
Tired but not chronically so at times. But take the odd B12 injection to help out.
PSA measures <0.05 always .
Which I have tested every 3 months prior to my injection.
At the start my PSA was around from memory 11.0 - but that figure came down very rapidly.
I am 82 years of age.
Good luck and keep fighting.
Hi, hope you and your dad are doing well.
I'm here for my brother. He lives in Vancouver as well. He has diagnosed with stage 4 prostate cancer last August(2022). Since then his family doctor refuse to refer him for another Oncologist and told him that the waiting time is very long. We really want a second opinion but recently he told to my brother that your current MO has to refer you and I can not do anything. I live in Toronto and here for any medical reason our family doctor has to refer us.(even for second opinion).
My question is: is his family doctor right? I mean in Vancouver Family doctors can not refer patients for another doctor or second opinion?
Now he goes to BC Cancer Agency for his MO meetings and goes to a Urologist that is not located in BC Cancer for hormone therapy.
Thanks in advance.
P.S. My brother is 54 years old and I'm his very very worry sister.
Hi Rasher,
Thank you. My dads first chemo appointment is today and hoping for the best. We received a second opinion from Dr Gleaves office from Vancouver Prostate Center. We asked my dads family doctor to refer him for a second opinion and to send the reports he had on file to him. Dr Gleaves office reviewed the reports and suggested a treatment plan (triplet therapy). BC cancer wait times are said to be long. However we’ve been able to get appointments relatively soon by calling and following up. Initially chemo wait time was 6-8 weeks but first appointment was booked much sooner. All the best to your brother
Thanks so much for replying. I wish all the best for your dad. My brother had triplet therapy as well. He finished chemo in March but since then his PSA is rising every month and nobody give him a call to discus about the results. When he called his MO last week he didn't answer and then he had a call from BC Agency that told to my brother '" you have to call your Urologist ". His Urologist told him you have talk with MO and when he asked for second opinion from his family doctor he told him it's not my job, you have to ask your current MO.
We are so confused that why his family doctor acting like this?! He wants to change his MO, but his family doctor doesn't help him for referral. Is Dr. Gleave appointments time takes long time? I mean how long should we wait after referral?
Thanks so much for your time and information.
Hi Rasher, I'm sorry your brother is going through this. I believe with BC Cancer he should have an in person meeting with his MO every 3 months where they discuss the PSA results. For my dad, his urologist hasn't been involved thus far. He was the one who did the biopsy and gave the diagnosis but after that its all been handled from his MO at BC Cancer. My dads family doctor sent in a referral to Dr Gleaves office. I then followed up via phone call to confirm they received the referral and let them know how time was off the essence as we wanted an opinion before choosing a treatment option. The in person wait time was long but we were able to have a call within a week to discuss my dads labs and scans, which were reviewed by Dr Gleave and a colleague prior to the call. I am not sure why the family doctor isn't helping with referrals. BC Cancer promotes asking for a second opinion as they state it is the patients right to do so. So maybe asking his MO to set up the second opinion may be the best way to go as BC Cancer guidelines state that they do have to provide one. Hoping for the best for your brother
Thanks so much. I will tell him about these information. Your help means a lot for us.
Wish the best for you and your dad.
yes, his PSA going down from 43 to 3.6 and then started chemotherapy , going up to 4.5 and then started Nubeqa its going down to 1.2.
Then after finishing chemotherapy started to going up . The last one was 6.5
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