Advanced Prostate Cancer to bone and liver

[swelnetz]

My Dad was diagnosed with Prostate Cancer back in 2011. Here is his history (sorry if this is too much information).

PROBLEM LIST

Prostate cancer, status post prostatectomy, Gleason 4 + 5 = 9, March 2011. Pathology: ypT3b pN1 cM0, stage IV with positive obturator node.

Adjuvant Lupron for 2 years.

Rising PSA without radiographic evidence of progression July 2015, status post salvage radiotherapy to the prostatic bed and regional lymph nodes fall of 2015, also given androgen deprivation therapy for 6 months.

Rising PSA, reinitiation on androgen deprivation therapy without radiographic evidence of disease, January 2018.

Initiation of bicalutamide February 2020, for rising PSA, switched to Zytiga and prednisone February 2021, due to rising PSA.

Patient switched to enzalutamide early 2023, secondary to rising PSA.

Initiation of Taxotere and prednisone June 2023, for metastatic disease.

Zometa for bone metastases.

Treatment holiday March 2024 - May 2024, without evidence of progression. Taxotere had been reduced to 60 mg/m2 dosing.

AS OF JUNE 2024 : My dad now has significant progression and significant involvement of the liver. He had a biopsy done 2 weeks ago and the results are as follows: Metastatic non-small cell carcinoma, immunopheno typically most consistent with metastatic prostatic adenocarcinoma. We are waiting on additional pathology results. My dad has resumed his chemo treatments and says he feels good, with the exception of leg weakness.

I really want to know if anyone has dealt with the progressions of the disease not to just the bone, but also to the liver. What treatments were you all on? I would appreciate any information.

Thank you !

[Tall_Allen]

Why did he have to cut back on the docetaxel dose? I also nothice he got less hormone therapy than usual. Is his health status poor?

[swelnetz in reply to Tall_Allen]

They cut back on the docetaxel dose because of the weakness in his legs and the PSA was remaining low. (See numbers below). They remained low until the chemo holiday. I am not sure about the hormone therapy - I don't think I was aware of that. His healthy status is fairly well, besides the weakness. Appetite is good, he does ride 4-5 miles several times a week on a stationary bike. Often has trouble sleeping at night. He will meet with his doctor on Tuesday (July 2nd ) and have labs and a chemo treatment.

Date Value

Jun 4, 2024. 37ng/mLHigh

Apr 30, 2024 6.9ng/mLHigh

Mar 5, 2024 0.9ng/mL

Feb 14, 2024 1ng/mL

Jan 24, 2024 1ng/mL

[Tall_Allen in reply to swelnetz]

One can't depend on PSA alone to know if the dose is right. They determined optimum dose to delay progression longest. Maybe discuss a full dose next time, or Jevtana, to see if he gets a more lasting benefit. You can always pull it back after the first infusion if his legs get weaker.

[swelnetz in reply to Tall_Allen]

Tall_Allen ~ are you able to read a Tempus xT pathology report. It’s way over my head. I spent hours trying to google on what different readings meant. The thing is, my parents live in Wisconsin, both my sister and I live in other states and my dad has his oncologist appt on Tuesday. We’d like to kinda know what the doctor may be telling him about this report prior to his appt. Wondering if one of us should be conferenced in so we can listen and take notes. If you think you can interpret it, I’d love to forward it to you for some insight.

[MoonRocket]

Despite being a rare event, lately there have been several men who have developed liver metastasis of both normal PCA and small cell PCA. If you search the advanced PCA board for liver metastasis you'll likely get severely hits. Chemotherapy seems to be the primary treatment outside of a clinical trial.

[GP24]

Liver mets can be treated with SIRT: en.wikipedia.org/wiki/Selec...

[j-o-h-n]

Seems like all us guys in our 80's have leg issues........(and just now I'm getting sleeping issues).. I guess meds first chill us then kill us..........

Good Luck, Good Health and Good Humor.

j-o-h-n

[Mgtd in reply to j-o-h-n]

Thanks for the warning about leg/sleep issues. I was always taught to listen to my elders.

Something to look forward to as I approach 80. I have noticed that I no longer have “Betty Gable” legs anymore but that has not stopped me from wearing shorts in the summer.

[j-o-h-n in reply to Mgtd]

Who's Betty GRable?

Good Luck, Good Health and Good Humor.

j-o-h-n

[Mgtd in reply to j-o-h-n]

Picture is worth a 1000 words!

Betty Whatever

[j-o-h-n in reply to Mgtd]

You're right..... that Lass seems familiar....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Parscore]

I recently completed a new treatment approach with Swedish, called Histotripsy for my liver Mets. An absolutely fascinating approach. I was # 29 to receive this treatment. I will know how successful it was in mid-July. A very long waiting list I understand at this time. But you should google Histotripsy and watch the video. Good luck.

[Shorehousejam in reply to Parscore]

Don’t mean to hi jacked thread. Did you consider Y-90 Sir Spheres at all? I have pca liver metastasis and started Keytruda, having radiation to prostate bed tumor that I belive seeded the liver and Y-90 Sir Spheres

[swelnetz in reply to Shorehousejam]

We are still waiting on the BRCA gene test to come back to see how the oncologist is going to treat my dad who has bone and now liver mestatasis. I'll update once we know we are going to proceed.