Father just diagnosed with advanced prostate cancer

Kksmiles

A little over a week ago my dad was given a stage 4 prostate cancer diagnosis that spread to lymphnodes. He's 63 - PSA 81 - was started on Casodex and will be given Lupron shot in a week. He went for his bone scan today and we're anxiously waiting results. I need to know what's worked, treatment wise, for anyone in a similar situation. Urologist wants to "save" radiation and chemo for when my dad is at a point he no longer responds to hormone blockers. Is that normal?? From what I've read, removing the prostate is no longer an option at this point. Why can't it be removed along with the infected lymphnodes?? He has an appt with the Oncologist in a few days.. I know we'll get more info then, but my head is spinning right now with all of this new info. Any help is so, so appreciated!!

eonore

Father

Hi Kk,

I am sorry about your father’s diagnosis.  I am sure more knowledgeable forum members will chime in, but let me be the first.  Can you tell me how the urologist determined that your father is stage four and that lymph nodes were involved?  What were the results of the biopsy?  Is the treating urologist a specialist in prostate cancer?  Are you treating at a top cancer center?  

If your father truly has metastatic disease, than hormone therapy is standard operating procedure.  There are situations however, where radiation may still be indicated even with a small amount of metastatic involvement.  The casodex and Lupron will put everything on hold, and give you time to explore all options.  Don’t hesitate to seek second opinions.  Seek out the best facility and the most experienced, knowledgeable doctors you can.  I assume that the oncologist you are speaking to is a medical oncologist.  You may want to meet with a top radiation oncologist too.

Eric

Max Former Hodgkins Stage 3

eonore said:

Father

Hi Kk,

I am sorry about your father’s diagnosis.  I am sure more knowledgeable forum members will chime in, but let me be the first.  Can you tell me how the urologist determined that your father is stage four and that lymph nodes were involved?  What were the results of the biopsy?  Is the treating urologist a specialist in prostate cancer?  Are you treating at a top cancer center?  

If your father truly has metastatic disease, than hormone therapy is standard operating procedure.  There are situations however, where radiation may still be indicated even with a small amount of metastatic involvement.  The casodex and Lupron will put everything on hold, and give you time to explore all options.  Don’t hesitate to seek second opinions.  Seek out the best facility and the most experienced, knowledgeable doctors you can.  I assume that the oncologist you are speaking to is a medical oncologist.  You may want to meet with a top radiation oncologist too.

Eric

Agree

KK,

First, I agree with Eric that your dad absolutely need premium care. His is not a case for the local "ACME Urology" practice.  Also, be aware that although urologists can perscribe hormonal therapy ("HT")and other drugs, most are NOT board certified as medical oncologists.

IMRT (radiation therapy or "RT") is often used in an attempt to cure PCa that is outside the gland, on the assumption that it may not have travelled very far beyond. Sentinel lymph nodes, means those around the grand, are usually treated.  This is common practice, but really constitutes hoping for the best, because microscopic PCa cells are not detectable via imaging.

It is correct that surgical removal would not be recommended by most doctors in his situation. It would worsen his quality of life beyond any likely clinical benefit, and is not curative of metastatic PCa.

Seek second opinions while he is on his current meds.  And be aware that many, many men here have lived long lives, even decades, on HT and other therapies, after receiving diagnoses as serious as your fathers,

max