Newly diagnosed with advanced prostate CA & starting treatment

rsgdmd

63 yr old, retired dentist; no family history of cancer. In early April, went for routine physical. Only complaint was having to pee too often at night & occasional urgency. Doc didn't like way prostate felt & did PSA. 18 mo prior, it was 2.8; this time was 28.2!

Sent to urologist who ordered biopsy, bone scan & CT. Biopsy 9/12 samples had cancer; 8 were Gleason score 4 + 5, one was 4 + 4. Bone scan showed metastatic activity in left shoulder blade, 4 spots on different ribs and a spot in the hip. I expected to have cancer, but not stage IV. That hit like a ton of bricks.

Saw Dr. at Penn (I live in Philadelphia) who started me right away on Casodex. Getting Dexa scan and chest CT (with contrast) tomorrow & Lupron injection (3 mo) next week. One week later, start on abiraterone & start chemo (docetaxel) at end of June.

They are following regimen from phase III clinical trial PEACE-1, which showed improvement using 3 meds (vs 2) for advanced cases. Anyone on this regimen? Experiences with docetaxel? Any advice would be appreciated.

Thanks

Clevelandguy

Hi,

Sounds like your doctors are attacking your cancer aggressively which is good. The testosterone lowering drugs should help slow down or arrest the cancer growth rate. From what I know your drug treatment regimen is typical for advanced cancer. I was kind of wondering why they did not treat your shoulder blade, hip, and ribs with spot radiation? Another question is what are they doing for your Prostate, drugs, radiation? Could they radiate your Prostate and the other spots over a series of treatments? I am not a doctor but those are some of the questions I would be asking if it was me. I am sure others here will chime in on reviewing what has happened. Good luck……….

Dave 3+4

rsgdmd

https://csn.cancer.org/discussion/comment/1697066#Comment_1697066

They are being aggressive, which is good. In fact, they accelerated the treatment - original plan was Lupron for 1 mo., add abiraterone for 1 mo. & then start chemo. I asked about the bone mets and they said that since I'm asymptomatic, it could actually make it worse at this point. I think any radiation would be after go thru chemo.

I am going for a 2nd opinion in about 10 days, so will see what they say, but don't expect to hear much different.

Thanks.

centralPA

Philly is a good place to be for what you have. Penn and Fox Chase are both world class. I can imagine what a shock it was to hear the news.

No experience to share, just letting you know you’ve been heard, and I’m thinking about you!

Edit: two thoughts, first get the book by Mark Scholz, The Key to Prostate Cancer, an easy and highly informative read. Second, keep an eye on trials related to your cancer treatment. Prostate cancer is an active research field. Google in LU-177 for example.

Fights on, rsgdmd

VascodaGama

Your doctor's recommended protocol is proper for your systemic case. That is the way when wide spread of metastases are found. This is a palliative therapy, with no intent at cure but to arrest the spreading.

The truth is that you can't treat all positive spots with radiation as this cannot be done twice at the same area. Typically doctors reserve radical approaches (surgery or spot radiation) for future treatment of pain (spine and joints) or metastases at critical places (lungs, liver, etc) when these exist.

The side effects from chemo and hormonal can be nasty. In your shoes I would educate on the matter to be informed and would inquire about counter measures to overcome the effects.

Take a family member with you for your next consultation.

Best wishes and luck in this journey.

VGama

curren

I am 64 and am also battling a very agressive stage 4 Gleason score 9 metastatic disease. I started seeing Dr Kwon at the Mayo Clinic two years ago. I had 3 lesaion that where large on my sacrum bone. We started with Lupron {three month dose} and he put me on chemotherapy(6 cycles of Taxotere) then a radiotherapy (26 treatments over 5 weeks). This seemed to go well but after about 4 months PSA started rising quickly . The cancer was active again in the same location I told my doctors i wanted to be Very agressive in treating it. So we hit the same spots with the Pronon Beam radiation and this killed it in those large spots. So i have had radiation twice on the same spots . Now i go back to Mayo every 3 months for a scan and we do find the cancer appearing just outside of the perimeter of the last radiation boundry and hitting it with the Proton Beam. I haven't gotten the (all clear) scan yet but believe it will be scomming! I hope that this helps you with wour fight!