help for my dad

otismax

Hi, I recently found out that my dad has prostate cancer. I got this information not from him but, from his wife. I am going to his doctor's appointment tomorrow and am trying to make sure I ask necessary questions. Here is all that I know

My dad is 82. He has been having UTIs and currently has a catheter. My dad told me that he was scheduled to have "some of his prostate removed" His wife told me that the appointment was to have a biopsy. She also told me that it was "very very bad" the doctor said his levels were so high that he either has cancer of prostate or colon or both. The biopsy has not been scheduled and this meeting is with the doctor. He is being seen by the VA and they certainly are not moving very fast. He is also in quite a bit of pain and has dementia.

So, from reading a bit I am thinking that his PSA levels are very high and the doctor may have indicated that the cancer may have spread but he didn't actually mention to the colon (English is his wife's second language)

What are some of the important questions to ask?  I know I want to get a copy of his lab work. I will also make sure that I know all tests that have been done and are scheduled to be done. I will ask about his pain. Then need to deal with the dementia but, thinking that will be a different doctor.

Thanks in advance for any advice you can give me.

 

VascodaGama

First things first

Otis

I am sorry for the suffering your dad’s case is causing you. Firstly you need to know his real status and which illness is the real problem that needs prime attention.

At his age it is quite common to hear about advanced cases of hyperplasia (inflammation of the prostate) that constrains urination and causes pain. The treatment for such cases when simple anti-inflammatory medication doesn’t work, is TURP (transurethral resection of the prostate). This is a procedure done by cutting the small pieces of the prostate that are obstructing the normal flow of the urine. The dissected pieces of tissue are then examined by a pathologist that will rule if cancer is existent.
In this link of BUPA you can read details about TURP that will help you to make your own list of questions when visiting the doctor;
http://www.bupa.co.uk/individuals/health-information/directory/t/turp#textBlock219494

An enlarged prostate “manufactures” high levels of PSA serum. Therefore a high PSA does not advocate only cancer. Only a biopsy can in fact diagnose a patient with the “bandit”.
Image studies can identify widespread of cancer in advanced cases with high levels of PSA. You should inquire what did the doctor see to base his affirmation, "very very bad". 

A bone scan should be done to check for metastases in bone (that would be a source for pain) and the blood test on the lipids would verify if he is fit for strong medication. Typically the recommended treatment for PCa in “older” patients (above 75 y/o) is a palliative hormonal manipulation, administered in combination with other drugs to care for incident effects. Some doctors advice chemo therapy in advanced PCa cases but that should only be done at request by the patient. The effects may be damaging and drastic.
Hormonal treatments can control well any advanced case for long periods of 5, 10 years if the patient is fit and “clean” from other health problems.

As commented you need firstly to get to grips with his real diagnosis and then proceed coordinately and timely. Do not let anxiety or family emotions to take over the case. 
Your dad will need the help from all of you. Try providing him with the comfort he enjoys at this delicate moment of his life.

I recommend you to get second opinions from specialists before any commitment. Here is a link where you can get an idea to prepare your own List of Question to the Doctors you will visit;
http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

Diet and a change in live tactics become important to counter the treatment effects. UCSF got a publication on Nutrition & Prostate Cancer, which copy I highly recommend you to get;

http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

 

Hope for the best.

Welcome to the board.

VGama 

lewvino

You have been given good

You have been given good information allready so I will only send my wishes along for knowledge and healing.

 

Lewvino

tpelle

Dementia

Otismax:  My sister died at one month short of 100, three years ago.  About three years before her passing, she was showing signs of dementia - like asking me where I lived and how do I get there.  Her doctor prescribed ARICEPT, a tablet she took once a day.  It brought her out of that fog and she showed no further signs of dementia until a day before her death.  Hope this helps.  tpelle 

moonlitnight

VascodaGama said:

First things first

Otis

I am sorry for the suffering your dad’s case is causing you. Firstly you need to know his real status and which illness is the real problem that needs prime attention.

At his age it is quite common to hear about advanced cases of hyperplasia (inflammation of the prostate) that constrains urination and causes pain. The treatment for such cases when simple anti-inflammatory medication doesn’t work, is TURP (transurethral resection of the prostate). This is a procedure done by cutting the small pieces of the prostate that are obstructing the normal flow of the urine. The dissected pieces of tissue are then examined by a pathologist that will rule if cancer is existent.
In this link of BUPA you can read details about TURP that will help you to make your own list of questions when visiting the doctor;
http://www.bupa.co.uk/individuals/health-information/directory/t/turp#textBlock219494

An enlarged prostate “manufactures” high levels of PSA serum. Therefore a high PSA does not advocate only cancer. Only a biopsy can in fact diagnose a patient with the “bandit”.
Image studies can identify widespread of cancer in advanced cases with high levels of PSA. You should inquire what did the doctor see to base his affirmation, "very very bad". 

A bone scan should be done to check for metastases in bone (that would be a source for pain) and the blood test on the lipids would verify if he is fit for strong medication. Typically the recommended treatment for PCa in “older” patients (above 75 y/o) is a palliative hormonal manipulation, administered in combination with other drugs to care for incident effects. Some doctors advice chemo therapy in advanced PCa cases but that should only be done at request by the patient. The effects may be damaging and drastic.
Hormonal treatments can control well any advanced case for long periods of 5, 10 years if the patient is fit and “clean” from other health problems.

As commented you need firstly to get to grips with his real diagnosis and then proceed coordinately and timely. Do not let anxiety or family emotions to take over the case. 
Your dad will need the help from all of you. Try providing him with the comfort he enjoys at this delicate moment of his life.

I recommend you to get second opinions from specialists before any commitment. Here is a link where you can get an idea to prepare your own List of Question to the Doctors you will visit;
http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

Diet and a change in live tactics become important to counter the treatment effects. UCSF got a publication on Nutrition & Prostate Cancer, which copy I highly recommend you to get;

http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

 

Hope for the best.

Welcome to the board.

VGama 

The dietary guidelines are

The dietary guidelines are very helpful. Thank you.

moonlitnight

Just want to say Hi

...VascodeGama has provided excellent info here. I just want to add my very best wishes for your father.

Diane m

My husband was diagnosed last

My husband was diagnosed last year with stage 4 that spread to his bones.his psa levels were close to 2000 so they removed his testicles put him on zometa to help strenthen his bones and he is on ziti gta.his psa dropped its now down to 223,which is still high but better then what it was.he takes Vicodin for the painfolio max to help him urinate andambien to help him sleep.there are al kinds of treatments out there so don't give up.I will keep you all in my prayers