Metastatic PC

[saniku]

First diagnosed in 2017 with high grade PCand put on hormone therapy until Nov. 2019. At that time I had 28 radiation treatments and PSA dropped to 0.05. No therapy from Jan 2023 and ongoing. PSA started rising in early 2023 from 0.05, 0.08, 0.66, to 2.8 in June 2023. PSMA Pet scan shows the cancer has metastasized to rib, possibly lung and lymph nodes in the pelvic region. Next appointment is early August. I’m 82 and looking at quality of life v.s. length so in no rush to resume hormone therapy.

[Magnus1964]

You might consider Radium 223 for the bone mets.

[Tall_Allen]

If quality of life (QOL) is important to you, hormone therapy will improve it. Otherwise, your QOL will quickly deteriorate, and you will experience pain, crippling fractures, and deteriorating organ function. You are making the common mistake of imagining that because you feel fine now you will continue to feel fine. Unfortunately, that is not how cancer works.

[David356 in reply to Tall_Allen]

While Saniku did not fully explain why he is reluctant to resume hormone therapy it is unfair to ascribe a motive to his reluctance “ imagining that because you feel fine now you will continue to feel fine”). He said no such thing. While he can speak for himself, it is more likely than not that his reluctance relates to how he felt when on hormone therapy.

Whatever his reason you may conclude the same…there will be difficult days ahead for him if he does not resume hormone therapy…you ignore that everyone has the right to determine the glide path to their demise. And you have no idea of whether his decision is the best decision for HIM. We all make the mistake of imputing to others what we would do…not acknowledging what we would do is not right for everyone , regardless of how long and under what conditions others might live and die.

[Tall_Allen in reply to David356]

As you said "he can speak for himself" and does not need you to imagine what he really means. He posted on an open public forum, so he was obviously open to reaction to others. If you don't agree with my reaction -- it doesn't make one bit of difference to him or me.

I, like you, can only give my opinion, based on similar things I have heard from many patients over the years. My opinion is based on many patients in similar circumstances over the years, and, unlike you, I am not just expressing what I would do. You are free to offer him your less qualified opinion, no matter how ill-informed it is. That's what happens in a public forum.

[David356 in reply to Tall_Allen]

You often times , as here , dishonor the wisdom and knowledge you possess and so freely give when someone suggests a counter narrative to yours. At no point did I express an opinion as to what I would do in a similar circumstance, or what he should do now. I simply said whatever he decided was his choice. He will , I am sure , consider your opinion and that of his physicians . But please don’t go off on him ,as is your default reaction , if he decides to do something not in accordance your opinion. Again , your propensity as witnessed here, to blindly strike out if one says something you disagree with , and aver their thoughts are “ less qualified “ than yours and “ ill informed” does you a disservice. It reveals a fragile ego and pettiness unbecoming to the person who does so much for others.

[Tall_Allen in reply to David356]

If you want to fling ad hominems at me: "you often...""your default reaction""your propensity..."" fragile ego..." "pettiness..." keep them to yourself, because I'm here to help others, not to deal with people like you who only get their jollies from trolling and writing unsolicited virtue signals. I neither need nor want your help. If you are here to help others, cast your pearls of wisdom to them, not me.

[saniku in reply to David356]

My doctor said that while PSMA PET shows evidence of metastasis in my lungs, bones and local lymph nodes he does not think treatment is needed at this time. Rather he suggested coming back in two months for another PSA test. Depending on my early August PSA readings along with whether I am experiencing pain or not will determine when hormone therapy and other treatments should be started. At this time he suggests waiting two months before resuming hormone therapy and this is the basis for my decision to wait. Time will tell whether this is the right decision or not.

Thanks to all of you for your input. I just joined the forum and appreciate the feedback.

[j-o-h-n]

To saniku,

Good advice, take it..........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 07/05/2023 2:39 PM DST

[Fightinghard]

please reconsider starting the hormone treatments. The hormone side effects are not too difficult and they can buy you a few more years of reasonable QOL