Looking for answers

[tallen]

Hello everyone, my dad went to the ER this week with kidney failure and we learned he has stage IV prostate cancer that has spread to lymph nodes and bladder at least. His Gleason score is a 9 and his PSA is above 700. I can tell from the way the doctors are communicating that this is very bad, over the last few days they have come up with a treatment plan of Lupron injections and radiation. What I have not been given is a clear prognosis, perhaps my dad has and he is trying to protect me. Has anyone been in a similar situation or know where I can learn more? I have found some info but nothing with such high PSA. Thanks so much in advance

[AlanMeyer]

Tallen,

Currently, there is no known cure for metastatic prostate cancer - which your Dad has. His case is advanced (high PSA and invasion of the kidney and other organs) and aggressive (Gleason 9). If he is lucky, he may have a good response to androgen deprivation therapy (the Lupron) and radiation and, in the best case, live for quite a few years with a good quality of life. If he is very old and weak, or unlucky and unresponsive to the ADT, a typical life span used to be quoted as 18 months or less. Doctors are often reluctant to make a prognosis, but in this case, they may not be able to give you any useful prognosis until after they see how he responds to the treatment. The lower his PSA goes and the better his kidney function recovers, the more hopeful will be the prognosis.

If he's strong enough to fight the disease, a more aggressive treatment would be to combine the Lupron with either Zytiga, Xtandi, or docetaxel. The first two are more powerful ADT drugs. Docetaxel is a chemotherapy drug.

As Nalakrats suggested, your Dad should find a good medical oncologist who specializes in prostate cancer and urological diseases and discuss the options with him.

In the U.S., I think good medical oncologists can be found at the teaching and research hospitals recommended by the National Cancer Institute. See: cancer.gov/research/nci-rol...

Again following Nalakrats, I suggest that you post information about where your Dad lives, there may be people in this group who can recommend good oncologists nearby.

Best of luck.

Alan

[patandemma]

why did he get kidney failure? Was it because he had such a large prostate it was causing obstruction ? This happened to me,very high BUN & Creatinine levels,hypertension and acute urinary retention >1000 ml. Three months later with continuous decompression with a catheter,all levels normal,no hypertension (never treated with meds) and later had a TURP. Never had kidney problems again.

If your dad is lucky it is a simple mechanical problem

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How is dad..???