Looking for advice for my newly diagnosed dad

[Springsunshi]

Hello, I was wondering if you can offer some thoughts on my dad’s situation.

He was diagnosed with prostate cancer in February after a week in hospital with urine retention. A Ct scan he had in hospital showed 2 small mets in pelvic area. He’s had a biopsy which showed Gleason 4 +5 and his PSA in hospital was 54.7.

So far he’s had hormone tablets for 28 days and a 3 monthly hormone shot.

The oncologist first appointment gave him the option of apalutamide or doxetal with daralutamide . Gave him some leaflets and told him to have a think about it.

He has since had a bone scan and has a follow up appt with his oncologist on Tuesday which I think will discuss bone scan results and the decision for treatment will be made.

My dad is a fit 76 year old with no other health issues until now. However since being in hospital in January and a turp operation in March he’s looking thinner and more tired. But I’m sure he’s worrying alot too which is taking it’s toll.

I have been reading a lot and trying to educate myself on the best option but I’m so confused. My dad doesn’t ask many questions during his appointments so I just want to make sure he follows the best treatment route. The oncologist gave my dad the impression that the decision on treatment was for him to make which is quite a tough choice!

I would be so grateful for any thoughts on my lovely dad’s situation?

Thank you

[Justfor_]

PSMA PET/CT asap

[Springsunshi in reply to Justfor_]

Thank you, I will ask his oncologist next week. Forgot to mention we are UK based so not sure if this is available on NHS.

[Justfor_ in reply to Springsunshi]

Hmm... It is available on NHS but it will not be easy to persuade them approving this imaging for an untreated man. They normally hold it off for later. If your means permit it, you can go private. IMO, the money spent will be more than justifiable.

PS: The cost in EU countries is 1500-2000 Euros. Depending on where you are, Republic of Ireland or Belgium-The Netherlands-Germany can be a day return trip.

[Springsunshi in reply to Justfor_]

Ok thank you so much for this information.

[Researcher50]

Do genetic testing, if you can, as down the line it might make a difference in treatment.

[Springsunshi in reply to Researcher50]

Thank you - yes I am going to ask the oncologist about genetic testing as my dads sister had breast cancer.

[Tall_Allen]

I don't think it's a tough choice. The standard of care is "Triplet Therapy" - Lupron+Docetaxel+Darolutamide. You can read about it here:

prostatecancer.news/2021/05...

Because he has very few metastases on a bone scan, he should also get radiation to the prostate. This is known as "debulking" and can be done anytime after he completes docetaxel:

prostatecancer.news/2018/09...

These therapies will hopefully delay progression for a long time.

[Springsunshi in reply to Tall_Allen]

Thank you so much for your reply and these links it’s really appreciated.