A few (bizzare) questions for anyone treated

Ag123

Backstory: My dad's PSA has been increasing steadily since 2018. (from 2.5ish in 2019 to 4.5 now). He's scheduled for MRI. The urologist said given the steady increase he think it's likely to be it's cancer.

He's turning 69 and is pretty fragile even for his age- already been through intense chemo/radiation for head and neck cancer, and now has debilitating long long side effects - for instance he gets frequent aspiration pneumonia as he can't swallowing well still.

So I have a question for anyone diagnosed. I know it's a rough and anxiety-provoking path. And each case is different. Now, if he has cancer, I will certainly discuss everything with his uro/oncologist (I'm booking for second opinion NO MATTER what the urologist says in case biopsy is sus).

But it would be really helpful need more subjective input from the very people who have been through it. So please bear with me :)

- How long did your treatment last?

- Is it possible to completely avoid chemotherapy? If so, what treatments are chosen typically?

- If you had radiation, how long did it last? And was it tolerable? How long did it take for you to come back to your normal life/activities after radiation? (asking because for head and neck radiation is like having your head fried. it's devastating and only gets worse).

- Are there oral options (pills)? If so, how are the side effects for them? (asking this since he frequently travels overseas).

- Lastly, I'm trying to plan a little vacation for him to relax and have fun, but this will coincidently be right after his MRI. Is 6 weeks too long to wait for biopsy/and treatment?

Thanks so much in advance!

Rob.Ski

If MRI shows something, biopsy would probably be next. If it is cancer, might be low grade where he could do active surveillance, which is monitoring. If it is more aggressive radiation or surgery could be options. Got to see what biopsy shows to see if treatment is necessary. Right now you need more info.

Clevelandguy

Hi,

Only a biopsy will determine if he has cancer & the qty and aggressiveness of the cancer. BPH(enlarged Prostate) could also be a cause of his PSA increase. Having sex or riding a bike before a PSA test will also make it increase. I would imagine a nuclear scan(MRI or PMSA PET) would also be done to determine the location/spread outside of the Prostate. You can live a long time with a Gleason score of 3+3 with no treatment. After all the info has been gathered, it’s your choice of radiation/surgery or no action. If it was me I would do the PMSA PET(not a regular MRI) scan first, then the biopsy if needed, then the vacation. A PET scan is much more sensitive to finding small tumors and spread than a regular MRI in my humble non medical opinion. Also chemo is usually not a standard course of treatment unless the cancer has spread throughout the body to other organs or tissue. From what I know chemo is usually a last resort type of treatment.

Dave 3+4

Old Salt

I second the two posts above.

More in general, your Dad has had a very tough history considering he had head and neck cancer. I am reluctant to say this, but prostate cancer can usually be dealt with more easily IF it is detected early. It appears that the latter may be the case and as Rob and Dave already pointed out, your Dad may not even have prostate cancer.

I highly recommend taking that vacation! Prostate cancer is typically slow moving.

Please keep us informed about the planned evaluations.