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Advanced Prostate Ca with Bone and Soft Tissue Mets

Norma61
Posts: 1
Joined: Oct 2012

I am deperate for some help. My husband is 74 and was first diagnosed with PCA 8 years ago. A year ago he was diagnosed with stage 4 with bone and soft tissue mets. His bone cancer is widespread throughout and he has a large tumor on his chest and coccyx in the soft tissue. He has been getting Lupron shots for 8 months. His PSA goes up and down was at 17 two weeks ago and was 8.9 last week. During this 8 months he has become increasingly disabled. He is incontinent of stool, can no longer walk or feed himself, and is so confused he does not know where he is or who he is talking to, and has lost 78 pounds. He had a CT scan last week which said his bone lesions had doubled in size and there were numerous new sites. This Monday he had a boen scan which said that the cancer showed only minimal growth and was moderately stable (the whole time he was on the scanning table he was tearing at his clothes and trying to climb down). He has never been given a Gleason score because an attempt to biopsy the cancer was unsuccessful. At this point he is totally bedfast, calls out all night long for help, even though he appears comfortably placed in bed and is warm and dry, and can not respond to even the most basic questions coherently. An MRI of the brain was done and I was told the results were negative for brain mets. His Oncologist claims he is 'making progress' with the Lupron and wants to continue it. He also claims that all the other symptoms are not cancer related and he can not help me with them. (As of March my husband was still doing light work around the home, reading, paying bills, shopping, and has had no other diseases diagnosed.) My primary care physician keeps referring me back to the Oncologist. I currently am caring for him at home, but it is extremely difficult because he is totally immobile, has an indwelling catheter, can not feed or clean himself, and is incontinent of stool. A month ago he had his last round of radiation to the pelvis, with the hope that it would relieve some nerve pressure and allow him to regain some use of his legs. It was not successful. I do not know what to do at this point. When I ask the Oncologist to give me some indication of what is happening, he just keeps saying "the PSA is pretty good". Any comments would be greatly appreciated!

ralph.townsend1's picture
ralph.townsend1
Posts: 351
Joined: Feb 2012

I'm going to make this short and sweet. With all said, I would get your husband a new Oncologist or get him to medical school Md Anderson cancer center,ETC. Sometime I think these Doctor's follow a certain protocal and don't look out side the box.

God bless you and hubby!!!

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Norma,

I am so sorry to read of your difficulties. While your present oncologist doesn't seem to be very useful to you I'm not sure another could do much better. From your post it seems that he is simply treating PSA and not the whole person, which is what appears to be necessary at this point. Only paying attention to PSA and ignoring the incontinence, mental confusion, and other symptoms isn't doing you or your husband any good.

Your family physician should refer you to a more comprehensive treatment center appropriate from your specific situation and insurance coverage. I believe you also need to candidly discuss hospice care for your husband as well where they will focus on making his remaining time as comfortable and pain free as possible.

End stage prostate cancer is very difficult for both the patient and his family. As you know, the pain can be severe, and may well be contributing to the disorientation and other symptoms. I am not expert on these things but I would imagine that these could amplify any effect the onset of dementia might bring.

The hormone treatments are not going to cure your husband and from what you describe with the metastasis it is unlikely to extend his life at all but will certainly contribute to the deterioration of his quality of life as you are seeing now. Hospice will discontinue the use of these drugs. You may also wish to consult with another oncologist about the real benefit of continuing hormone therapy at this point.

Best of luck to you.

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