4 stage cancer Gleason 4+4

Ilona_help_stepdad

Hi survivors!

Greatings from Ukraine! My dad was diagnosed 4 stage prostate cancer with metastases in lymph nodes and pelvic bones 2 months ago. Gleason 4+4.

Local doctors agreed that surgery is inappropriate in this case. So they offered hormone treatment with Goserelin 10,8 mg once in every 3 months, Abiraterone 1000mg per day, Zoledronic acid 4mg intravenously every 28 days.

PSA was 82 in the very beginning and after a month of treatment it was 32. Next week he is going on the next blood test. But it seems that his liver doesn’t like the treatment because ALT, AST, ALP became quite high during last month. So he had to take a break for two weeks from Abiraterone. And i don’t feel like the doctors know how to solve this problem.

Please, share your experiences and ways of treatment.

I have so many questions and I’d appreciate any advice. How do they cure this disease in the US?

Also I’ve ordered Biobran as additional treatment. And added cold pressed juices to his diet.

Wish you all to beat the cancer!

InfoReach_Org

Not a doctor but I had a similar diagnosis as your dad and have been following advances in this field. There are other drugs that seem equally effective as abiraterone, such as enzalutamide and apalutamide. Have you discussed these alternatives with the oncologist now that your dad does not tolerate abiraterone well. Also, you may want to look into add-on radiotherapy, typically offered a few months after ADT, if your dad has so-called low-volume metastasis. The benefits likely outweigh risks in your dad's situation. I had stage 4 (pelvic bone metastasis) and Gleason 4+5 about 10 years ago. Received combined ADT albeit a less effective one (abiraterone was expensive and not first-line at that time and others like enzalutamide were not available) and IMRT 6 months into ADT. The radiation oncologist carefully circled all lesions on MRI during treatment planning. Today there are PSMA PET/CT and proton therapy, which are better options than what I had. Best luck with your dad's treatment!

Ilona_help_stepdad

https://csn.cancer.org/discussion/comment/1710055#Comment_1710055

Hey InfoReach_Org,

thank you for your reply!

I will ask about the alternatives for Abiraterone and we have definitely planned radiation therapy in a couple of months.

Your story is really motivating! May I ask if your cancer is gone?

Did you remove animal proteins from your diet?

Clevelandguy

Hi,

My thoughts kinda parallel Inforeach, I would think there would be some kind of radiation therapy in his near future? ADT will not kill his cancer but only weaken it! If you have access to PMSA PET scan that is a great tool in identifying cancer locations.

Dave 3+4

Ilona_help_stepdad

https://csn.cancer.org/discussion/comment/1710089#Comment_1710089

Hi Dave,

Thanks for your feedback!

He has already done CT with contrast a month ago. I’ll consider your advice to do PET CT for the next time. Just googled PSMA PET here is incredibly expensive.

And yes, original plan was to do radiation in a couple months after starting ADT.

Some doctors said that radiation can be done only once in 2 years so maybe it’s better to postpone it until it’s needed to deal with the bone pain. Sounds scary as hell.

The others say that ADT might shrink the tumor/metastasis and then it will be better to do the radiation.

As I’ve mentioned, I still haven’t found the proper doctor, that knows exactly what to do. And I’m doing this research for a month only. Basically that’s why I’ve asked for help here. Cause it seems to me in the US there are way more professionals in this area.

So thank you for sharing your thoughts and experiences. It means a lot to me!

Ilona

InfoReach_Org

https://csn.cancer.org/discussion/comment/1710058#Comment_1710058

My PSA level has been <0.1 for many years. But it's hard to say if cancer is gone as I was never given a PET. I follow with my oncologist twice a year and undergo CT yearly. A lung nodule also needs follow-up. Otherwise, MRI could be a better option.

In the beginning of this journey, I read all types of educational contents, including diet considerations. I did limit animal proteins except chicken and fish. I know scientific data are scarce in that regard but diet restriction was not difficult for me so I just followed anything that is no risk. I'm now less restrictive on diet but still stick to a heart-healthy diet. Hope it helps.

Ilona_help_stepdad

https://csn.cancer.org/discussion/comment/1710112#Comment_1710112

I’m glad you’ve managed to take it under control)

We are going to follow your lead!)

Thanks for the tips!