What does it mean?

[TerribleAtInternet]

I'm slightly embarrassed to be asking strangers on the internet, but I'm a little frustrated by the lack of information given by the doctors. My dad (63) just got diagnosed - Gleason score 8 - and after a new scan they've concluded there's two mets - one in the pelvic lymph node and one in the seminal vesicle. They did a bone scan earlier, and it was clear, thankfully. Most likely they will put him on radiation and hormonal treatment but they, I quote, haven't decided yet. They haven't said anything at all about a prognosis, or how treatment might affect him. They didn't even mention the Gleason score when he was diagnosed, I had to ask about it.

I want to be of support to my dad and family, so I've tried to read up a lot on prostate cancer during the months we've been waiting for the results. Obviously I understand that all cases are different, but I'm having trouble understanding if this kind of metastasis still is treatable, as in it can possibly be cured? Or does all types of metastasis mean they treat it in terms of just slowing it down? Or is it a wait and see how the treatment goes-kind of thing? Thanks for your patience.

[Tall_Allen]

Yes, it might be curable. They have to irradiate the entire pelvic area - pelvic lymph node metastases are stage N1. The cancer in the seminal vesicle isn't considered to be a metastasis - it is stage T3b. (The Gleason score doesn't actually matter when there are metastases.)

The kind of radiation that has the greatest odds of curing him is called brachy boost therapy. This involves external beam radiation to the entire pelvic lymph node area plus a brachytherapy boost to the prostate plus 3 years of ADT plus 2 years of Zytiga. They will also include a boost dose to the seminal vesicle and the visible cancer in the lymph node.

prostatecancer.news/2018/03...

[TerribleAtInternet in reply to Tall_Allen]

Thank you for taking the time to reply. This is very helpful, I appreciate it.

[Scout4answers]

This is a great site to get info, it definitely empowered me to ask the right questions of doctors and help shape the direction of therapies. Knowledge is power.

I had a similar DX, check out my profile for a look at what may be ahead for your dad. Exercise is the thing that he can control, that will most effect his outcome.

[Mgtd]

As you can see from the responses above you will get the most updated information available and all of us have been down that road so we understand the physical and emotional impact on the patient and their love ones. Keep us posted and encourage your dad.

Tall Allen is an amazing source of information and knowledge.