Worried about father with advanced prostate cancer.

lovingdaughter_24

Hi Everyone,

I am new to this board, but am in desparate need of some hope. My father, whom I am extremely close with, was diagnosed with prostate cancer 5 years ago. He had surgery at that time for the removal of his prostate and we were told it was successful. However, months later we were told that his PSA levels were still up indicating that the cancer was still present. The doctors believed it may have spread to his pelvic bone and he received radiation treatment on his pelvis for several months. The doctor's then put him on hormone therapy to control the spread. At the time he started the hormone therapy, they told us it lasted for an everage of 5 years before the cancer found away to grow even without the presence of testosterone in the body...

Well, we reached the five year mark last month, and my dads PSA levels are rising again. The doctor gave him one final hormone shot (which will last for the next three months) and then recommended that we get some bone scans done to determine where the cancer is.

My dad has had multiple bone scans in the past, but they cant seem to detect where the cancer actually is, only that his PSA levels are rising.

The doctor said that if his next bone scan (scheduled in 3 weeks) shows that the cancer has moved to the bone, he will start chemotherapy. We were told that chemo only works if the cancer has spread to the bones.

I'm very scared. I don't know what any of this means. What will happen if the scan detects no cancer on the bones, but his PSA levels are still up? do they just discontinue treatment? I'm desparately looking to hear from people who have been through something similar.

I am supposed to get married in 10 months, and am now wondering if I should move the wedding up so that my dad is healthy enough to enjoy himself.

Thank you so much everyone.

Kongo

Loving Daughter
Welcome to the forum and I'm so sorry that you're dealing with this much stress and uncertainty about your father's health.

It would be helpful if you could provide some information about your father's original diagnosis in terms of initial PSA, Gleason Score, stage, and so forth. Also how old is your father and does he have any other health issues? The other useful and very important information is exactly what his PSA levels are now and what has been the history of his PSA since his prostate was removed and the levels started rising again.

You seem to indicate that his PSA levels are continuing to rise even though he is on hormone therapy. As your doctor suggested to you five years ago, prostate cancer sometimes becomes resistant to certain types of hormone treatment. There may be another drug that would be effective. Depending upon your father's age and quality of life, another way to reduce the testosterone level which feeds prostate cancer growth is to have his testicles removed (orichetomy). While the adrenal glands will still produce some testosterone the removal of the testes will significantly reduce the overall amount of testosterone in your father's system.

Bone scans rarely detect cancer unless it is significant. Besides the bones, prostate cancer also tends to migrate to the lungs, liver, brain, and other organs and would not be detected with a bone scan. There are other tests that can be run as well as more advanced scanning techniques.

Chemotherapy is pretty much a last resort treatment in prostate cancer. Is your father suffering from pain in his bones or any other symptoms? As you probably know, chemotherapy can have significant adverse affects on the quality of life of patients receiving it and I would seek multiple second opinions before proceeding down this path.

There are other treatments that I would investigate besides chemotherapy if the next bone scan does indicate the presence of prostate cancer. These treatments are various radiation techniques that can deliver pinpoint radiation to just the spot where the cancer has been detected. While the cancer may come back in another spot in the future, prostate cancer is fairly slow growing and this could give your father several more years of high quality life.

I would encourage you to urge your father to seek second opinions on treatment.

Unless your father is in great pain or rapidly declining health as a result of this cancer I wouldn't change wedding plans until you have had a chance to meet with more specialists.

Best of luck to you.

K

mrspjd

Advanced PCa
LD,

While you are welcome to ask all your questions about your father's advanced PCa here on this forum, I suggest you also visit another site that, IMO, may provide more up to date info about advanced and hormone/castrate resistant PCa options:
http://health.groups.yahoo.com/group/advancedprostatecancer/

Also, a few nationally known and respected PCa oncologists provide phone consultations. You may want to look into this as another option for obtaining a 2nd opinion for your dad. Good luck to both of you.

mrs pjd