Hi all - I am new here. My dad was diagnosed with stage 4 prostate cancer with mets in his bones and lymph nodes in February 2024. He was diagnosed with adenocarcinoma with Gleason 8.
He was started on hormone therapy and had bilateral orchiectomy as well. He is in great health apart - mentally and physically. He is asymptomatic and is very active. The medical oncologist believes that he should not start on chemo right away. We have spoken to other MOs for a second opinion and to my shock all of them are agreeing to this treatment plan. He has responded well to the treatment thus far and PSA dropped from 24 at the time of diagnosis to 4.5 in 27 days.
I live in Canada and my dad is in India. I am 31 weeks pregnant and super worried for my dad. I am doing everything I can but distance makes it so much more worse. He has a good support back at home and is very positive that he is not going anywhere soon. Now he wants to visit me during my delivery which is going to be in early June. My question is whether he should travel considering his diagnosis. I am meanwhile trying to get some second opinions for getting him started on chemotherapy as I have seen so many people benefitting from triplet therapy. Its just hard as his medical onco has convinced him that it is not needed at the moment.
I want some assurance and some direction here! Thank you.
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Justgettingitright
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I too live in Canada. Your Dad is recently diagnosed, responding well to hormone therapy, and wants to visit you in Canada and meet his new grandchild. I can't see any reason why he shouldn't.
I am just too scared of causing health issues due to traveling. It’s unfortunate that I am so far and he being the dad he is, wanting to visit. Too scared.
thanks for responding. They believe that the benefit is to people who have Mets in the organs as well. They want to keep chemo as next line of treatment. I am not able to convince the MO somehow. I hate to be this far and not be able to advocate the right away.
My husband is in a similar situation. He’s Stage 4, mets to three bones (scapula and two ribs.) Also to lymph nodes and seminal vesicles. Gleason 9. Diagnosed in November 2023. On Zytiga, prednisone and gets an Eligard injection every 3 months. He finished 28 IMRT radiation treatments 3+ weeks ago. His PSA is undetectable right now. He’s done very well with every treatment so far. His MO is Indian (although sounds like he was born in the U.S.). He also prefers not to use a triplet therapy approach from the get-go. Believe me, I’ve questioned him enough to annoy him, I think. He said that since my husband has low volume mets at this point and none to his organs, he feels that chemo isn’t indicated. He talks a lot of quality of life. Sure, I definitely don’t want my husband to go through the side effects that often comes with chemo, but if it will add longevity, then why not? On the other hand, how MUCH longevity? Would it mean having to endure some very unpleasant issues only to have a year more? Or maybe months? As it is, he’s responding well to his treatments and his PSA is low enough that it’s undetectable, maybe his MO knows what he’s talking about. He said that if he stops responding to his present hormone drugs, then there are more options available, including docetaxel chemo.
Soooo, that’s where we’re at. As you, I had thought Triplet therapy was the new SOC (standard of care) for men with mets and with a higher Gleason score and stage. Apparently not. Best wishes to your dad. I would definitely travel if I were him! As long as he’s feeling well!
Your Dad sounds a lot like my husband. He also was diagnosed with stage 4 prostate cancer with mets in his bones and lymph nodes. That was in March, 2020. He is still asymptomatic except for side affects of ADT. He had chemotherapy (Docetaxel) along with immunotherapy, which was part of a clinical trial. Other than that he has only been on ADT, first monthly shots of Firmagon, now taking the pill form (Orgovyx). The standard of care in the US for someone like my husband when he was diagnosed was chemotherapy and ADT. Just recently that has changed to triplet therapy, where another type of ADT is taken (pill form).
There have been so many additional treatments since my husband was diagnosed that if/when his PSA starts rising he has many new treatments to choose from. Your dad is right that he isn’t going anywhere any time soon. My husband just passed the 4 year anniversary of his diagnosis and is still doing fairly well. As for travel, we started traveling again in 2022 and have been lucky enough to enjoy some great trips. Although he tires more easily than in the past, it doesn’t stop him. We are enjoying life as much as we can while he still feels good. I know how frightened you must be right now because I remember well how I felt when my husband was diagnosed. Just be there for your Dad, as you already are, and try to take it one day at a time. This site can help you realize there are many in the same boat that have lived many years after a Stage IV diagnosis. If you can find an online support group, that helps too. I wish your dad many years to get to know his grandchild.
my Dad has Gleason 10, mets to spine and when I asked his oncologist about triplet therapy, he looked at me like I had three eyes and shrugged it off. It was very odd. I don’t think the triplet therapy is very common standard of care treatment where he is being treated. That said, he has started hormone therapy, with radiation therapy to follow soon so we will see how it goes. Currently, he is feeling great, hoping this continues. All the best to you and your Dad and have trust that he is in good hands.
Your Dad is good to travel to see you and his new grandchild.. he can wear a mask in the flight if you think he is immunocompromised. I would encourage him and let him live a normal life as possible..
i travel all the time, ride my motorcycle, go sailing, swimming and horseback riding.. i had my DX April 2013.. doing Triplet therapy.. my doctor says chemo can wait.. have fun and enjoy the company of your dad!
He has the same diagnosis as I had over 10 years ago, his treatment is on track, I’ve done some additional things that you can read in my profile, wishing y’all the best.
His situation seems to be similar to mine. My diagnosis showed local spread to lymph nodes with a PSA of 248 and Gleason scores of 9-10 on all cores. I also chose to go with a bilateral orchiectomy (quite unusual in the US) rather than regular hormone infusions. I have had no other treatment. Last month marked three years since the surgery and I feel great. I still work full time and travel several times per year, including rigorous mountain biking trips to the mountains of New Mexico. Your father should have no problems with travel.
My oncologist advised me early on that chemo would increase my overall survival "but not by that much". I cannot speak to that but after three years my PSA is slowly rising and is now around 5 which is still not a major concern.
Maybe “not by much” overall survival is what my husband’s MO is keying into and is thinking more about quality of life at this point. In that case, it makes sense. As much as I want my husband around for as long as possible, I sure don’t want him to suffer from form debilitating side effects just to have “not by much” more time with us. Hard to know WHAT approach to take. You sound like things have been gong well for you without added chemo.
Congratulations on your new arrival. And, I am SO happy that your dad is mentally and physically strong. My dad lived with Prostate cancer for 17 years on MANY treaments with a vital and optimistic outlook. He and my mom traveled the world, even the up until September of 2022. His cancer spread to bones, etc..,but he NEVER stopped having something to look forward to.
He did conventional treatments, and radiation several times on his spine. AND, used medical marijuana gummies for pain, sleep, and to increase his appetite. He opted to not to Chemo, as that was his last "option" before he left us...but he was at peace at 88.
I think you might just add years to your fathers life by meeting his new grandchild.
Keep sharing things to keep him mentally "going".
I'm rubbing my prayer rock for you, and him right now.
Your Dad's situation is very similar to mine. From what I know and understand, chemo (using docetxel most likely) is the third leg of triplet therapy. It needs to be started within a few months of starting ADT therapy. I started ADT in February 2024 and have spoke to my MO and recently to NIH and intend to start chemo as late as June of this year. Was going to start in late April but my daughter is graduating college and I didn't want to have to worry about side effects, etc. After her graduation, the calendar is pretty clear.
My only concern with your father traveling would be during chemo since his white blood cell count will be suppressed, by design. You can mask, etc. and each individual can determine how much risk they can accept. I personally intend to minimize travel, etc. Not live in a bubble, but just take extra precautions. Without chemo in the equation, I would say do whatever he wants to do every day!
Best of luck to you and your father and congratulations!
I started triplet therapy Docetaxel, Nubeqa, Lupron age 60 in July 2022. . I had had six chemo infusions over the span of 18 weeks at which time I stayed a way from crowds and travel. My goal was to walk my daughter down the aisle on March 23. 2024 which I did. I have two grand children, my hope is to live long enough so they will remember me. My PSA has been undetectable for over a year thanks to triplet therapy. Side effects from treatment were minimal and quality of life has slowed down a bit. I was in great shape before, exercise helps me to adjust to my new normal. I had to make some personal sacrifices during my chemo treatment, ie. Funerals, weddings, birthdays, , family reunions and travel. When my PSA hit undectable we celebrated with family and friends. Best wishes.
Well we know you're 33 and pregnant......... now tell us how old is your Dad. He certainly can fly to Canada to be with you and the new baby. BTW you forgot to mention the baby's gender. If it's a boy I think you should name him a great Hindi name of "JOHN" and if it's a female you can name her another great Hindi name of "JOHNNIE".
My dad is 67! He says he is sweet 16 with 51 years of experience. Also, it’s a boy and thank you for the suggestion. Your reply made me smile the first time today. Thank you
Well your Dad's sense of humor is definitely sweet as will your baby boy's be. Okay, I'll settle for his middle name of JOHN and a first name of "RUDRA" (I noticed that the letter "R' is very prevalent in Hindi names).....May Rudra be a very healthy loving son who will respect and take care of you and your Dad (Mom too) in your senior years.
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