Help on what to expect with this 6 month follow up?

[FormulaRob]

Hi All,

My father will be going in for his 6 month follow up on August 2nd. 6 months since he has completed radiation. So my extreme anxiety and worrying has officially returned in full force. In the past gaining knowledge here on this forum has restored some of my sanity so hope it is okay that pry for some extra information here

My father has completed radiation in February of 2023. He is gleason Score 9 with maybe 88% of his prostate being cancerous. original PSA 226. Doctors have classified him being between stage 3 and 4 (they literally said that they can't decide which). No distant spread shown on multiple scans. Only close by lymph nodes affected and a "suspicious" spot of Pelvic bone which they could not tell if cancer or not. He has been on ADT for the last year as well.

My questions are:

1. What can we expect on this follow up. Will they just set up new scans to see where he stands?

2. What would be considered a success / failure. Should the prostate be completely cancer / tumor free if the radiation was successful ?

3. Is there anything to be positive about here? with his baseline stats can I have any optimism that he is truly going to be around for many years to come. I am wondering statistically with his current situation.. is it likely that he will be here 10+ years ? or am I being unrealistic. I know it differs person to person but I feel like someone could at least tell me how likely that is

[WillowHawk]

Hi Rob. Nice to see you here-- I've been busy elsewhere, but everything is fine with me. I trust there are many positive routes for your Dad but, as usual, we'll see what the Amazing Advisors here have to say. Hugs-- keep taking care of your own self, exercise, eat right... gotta set those good habits now! Kate

[FormulaRob in reply to WillowHawk]

Thanks Kate I hope the summer has been treating you well ! thanks for the friendly advice much appreciated always helps to have those reminders during stressful times

[Tall_Allen]

He should expect to be told to continue ADT for 3 years and to complete 2 years of abiraterone.

[FormulaRob in reply to Tall_Allen]

He has had his follow up today. This is the summary

-They did say to remain on ADT for 3 more years

-Abiraterone not given

-He has numbness that is on the front of pelvic area and wraps around to bum cheek and down leg. The oncologist says because he did two sets of scans before treatment (radiation) and there were no mets there. Along with his PSA now being under 0.1. He believes it is some sort of nerve. They are setting him up with a new CT scan and Bone scan to be sure about this

-At the end of the 3 years od ADT if PSA goes up then he will have to go through Chemo. If PSA does not increase then radiation was a success

Nothing really else was said other than so far so good.

[Tall_Allen in reply to FormulaRob]

Why are they not giving him 2 years of abiraterone too?

ncbi.nlm.nih.gov/pmc/articl...

[Bret5]

When I started triple therapy 6 weeks ago, my oncologist at City of Hope said “everyone’s cancer is different but right now the median life expectancy for someone in your situation is 5 years.” Btw I’m 64 years old and was in very good health. Perhaps you can get a prognosis like that or hopefully better. That said, I decided to focus on what I do every day and how I interact with every person I come into contact with. I suggest not wasting time or worry thinking or talking about theoretical how many years left. A car accident or heart attack could end it tomorrow. Suggest staying positive and take a day at a time. If you have any religious feelings, I recommend a book I just finished “Between God and Cancer”.

[FormulaRob in reply to Bret5]

Hi Bret,

yeah originally he was given the same prognosis of 5 years. They said that to him strictly based on the PSA level (226) and no other info. I feel like that made an assumption that he would be lit up with cancer once they got to the scans but surprisingly no distant spread was found so hopeful that those scans didn't miss anything and that the prognosis improved. Appreciate your reply and advice.. taking it one day at a time is the only thing that is getting us by but I have some mental relapses where I let the whole situation consume me.

I used to be religious (catholic) but abandoned it quite a while ago. Although this situation makes me fear what's next and makes me a little more open to it again. thanks for the recommendation

[Cactus297]

If I am reading what you’re saying correctly there are no distant Mets. If it doesn’t spread and is only regionalized I don’t see why he can’t be alive in 10 years if he takes the meds Tall_Allen recommended. There are other treatments beyond those too. But if no meds work or stop working and or the cancer spreads the situation could worsen. We are all in the same boat living from test to test. It’s really difficult for sure. 🤗for the best outcome for you and all of us.

[FormulaRob in reply to Cactus297]

Thanks Cactus, that is true !! This is just the new reality ( I HATE IT LOL) .. I wish for the best outcome for all of as well. have a great day

[Cactus297]

I just read your Dad’s bio. Yes it’s difficult accepting the new reality. It’s taken me a year but I’m finally adjusting. The doctors do their part and the patient does theirs and that’s the best we can do. I think your Dad will be better off with a team of oncology specialists than a urologist. Get the best you can. He’s fortunate to have such a caring son.

[FormulaRob]

Definitely difficult, I can relate on the year to adjust.. I am definitely mentally stronger than a year ago in terms of keeping my mind under control instead of racing off but FAR from a walk in the park! I just read your bio as well and see that it is your son going through this that is extremely tough i'd imagine we've had simiar struggles with coping from the moment of first finding out. I hope you are staying strong and I wish your son the best

[Cactus297]

There are times when it still consumes me too, but I am getting better about accepting and mindfulness. The reality is if we let it mentally consume us in a way it’s won. Just can’t let that happen! 👎👎👎 Yes I think our struggles have been very similar and we’re both working at staying strong.