Taking Lupron & Flutamide, but Flutamide Failed moving on to Casodex

My Dad is 80 years young. 1.5 years ago he was diagnosed with advanced prostate cancer. It had already metastasized to his lower back area on the bone. His PSA was 550 upon his diagnosis. He was immediately put on the Lupron shot every 4 month and Flutamide administered by pill daily. The PSA went down to 1.6 and that lasted for about 1 year.
At the last appointment in November 2010 his PSA had risen to 37. They immediately stopped the Flutamide and put him on one pill of casodex daily in conjunction with the Lupron shot every 4 months. The last bone scan in December showed that the cancer is all over his pelvic region and on some vertebrae. He has a migrating kind of PC cancer and it builds bone on bone (blastic). It makes his hip rotation very tight, but he is taking daily PT to stop himself from seizing up. He was a very active and SOCIAL man, but he isn't doing much of that anymore. Of all the doctors we have seen.....no one talks about what's to come. His prognosis is pretty good....2-3 years....from November 2010. I'm his support and I have no idea what is next for us. I have read and read, but it is all such medical hoopla that I'm not sure how to best prepare.
My Dad was a leader of Firemen and women his entire life and it has all slipped away...I know he is 80 years young, but his is a fighter and that coupled with a little denial can go along way.
Does anyone out there have any advice for what is to come? Sincerely, Marty's Daughter


  • VascodaGama
    VascodaGama Member Posts: 3,664 Member
    You may expect a drop of the PSA again
    Marty’s Daugther

    Your father did extraordinary well in arresting the PSA down to 1.6 from a high 550, on a double blockade HT. It is typical of doctors in exchanging drugs once some fail. In his first protocol, Finasteride was controlling benign growth cells and Lupron took care of the cancer. Casodex will aid in the control of the cancer and you may expect a drop of the PSA again.
    A drug called Zometa is known to fight the cancer in bones. It is a bisphosphonate of the “heavy-duty” type with its own side effects but it has been successful in arresting metastasis to the bone in many advanced cases.
    You may discuss the matter with the doctor but I recommend you to read about the drug’s side effects firstly (google its name).

    If the cancer becomes refractory to hormone control (HRPC), then your father will move into the so called “second line” HT mixed with another class of drugs such as immunological drugs and chemo. However expect that to happen, if any, many many months/years from now.

    Diet and mild physical exercise is good to counter the side effects from therapy. I would suggest you to read a book that addresses cases similar to your father’s written by Dr. Charles “Snuffy” Myers, a well-known PCa oncologist (if not the best) who is a cancer patient himself. (google his name to read articles about his advices for advanced cases)
    “Beating Prostate Cancer: Hormonal Therapy & Diet”.

    I like to read that you are so involved in his support. Surely he will continue his leading spirit to extinguish for good his cancer.
    I wish the best to you both.

    Welcome to the board.