Dad just diagnosed

Dear Tifany,

I am sorry for your Father's diagnosis.

Please find a previous thread that you can review for information. This will be a good start.

http://csn.cancer.org/node/289172

This is treatable, however things must be done in a coordinated fashion with excellence.

Please feel free to ask specific questions.

We are here for you.

Best,

H & O

Dear Tiffany,

Welcome to the board.

I am sorry for you, your dad and the family. We all surfer when a member is caught with cancer. Anxiety is friend of the enemy. Try to be positive when talking about the matter in front of him.

I would like to know details about your dad’s diagnosis. How have they found cancer in the liver?

Was there any biopsy of samples taken in the liver or was the cancer diagnosed via an image study?

The best exam to identify and locate the cancer in the whole body is through PET scans using specific contrast agents proper to identify prostatic cancer. Gleason 10 is the highest prune for spreading but maybe still confined to areas possible for being eradicated.

Can you tell us more of his histology with the disease, when did he start having symptoms? How high has been the PSA?

Can you share information regarding his liver function tests such as; ALT, AST, ALP, Albumin, and GGT. All this data surely is at hand and may have been obtained from the blood sample used for the PSA test.

We have read the stories of patients with similar status as those of your father. Chemo did work in some guys in particular with liver problems. I do not know how far the treatment did extended their lives over long periods (above 10 years) but some guys had improved situations and enjoyed life. Your dad is very young and he should try the combination treatment proposed by his physician.

Nutrition is important chemo therapies. You could help him providing information in regards to diet. Please make a copy from this link;
http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

The family should provide him with the best comfort, probably an outing or travelling with allow time to settle down things.

Best wishes for tomorrow’s appointment.

VGama

VascodaGama said:

Be positive

Dear Tiffany,

Welcome to the board.

I am sorry for you, your dad and the family. We all surfer when a member is caught with cancer. Anxiety is friend of the enemy. Try to be positive when talking about the matter in front of him.

I would like to know details about your dad’s diagnosis. How have they found cancer in the liver?

Was there any biopsy of samples taken in the liver or was the cancer diagnosed via an image study?

The best exam to identify and locate the cancer in the whole body is through PET scans using specific contrast agents proper to identify prostatic cancer. Gleason 10 is the highest prune for spreading but maybe still confined to areas possible for being eradicated.

Can you tell us more of his histology with the disease, when did he start having symptoms? How high has been the PSA?

Can you share information regarding his liver function tests such as; ALT, AST, ALP, Albumin, and GGT. All this data surely is at hand and may have been obtained from the blood sample used for the PSA test.

We have read the stories of patients with similar status as those of your father. Chemo did work in some guys in particular with liver problems. I do not know how far the treatment did extended their lives over long periods (above 10 years) but some guys had improved situations and enjoyed life. Your dad is very young and he should try the combination treatment proposed by his physician.

Nutrition is important chemo therapies. You could help him providing information in regards to diet. Please make a copy from this link;
http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

The family should provide him with the best comfort, probably an outing or travelling with allow time to settle down things.

Best wishes for tomorrow’s appointment.

VGama

There is a difference of survival among men with advanced disease. I know several who are living several years. There are many  new high tech drugs, diagnostic tests and procedures that are now available to fight this bandit.

Dear Tiffany, I truly believe that your Father will survive with proper medical treatment. 

Best

BE HOPEFUL & OPTIMISTIC

tiffany2015 said:

Thank you all for your

Thank you all for your advice, words of encouragement and just knowing that you all are here and have went through is a comfort knowing that I can speak to this group. 

I know some asked about how he was diagnosed and treatment etc.  He was having pain about 2 months ago peeing and due to his insurance it wasnt until June 1st that they sent him for a prostate biopsy.  The day after his biopsy he was really sick and just hurting all over so his urologist sent him to hospital because he thought infection.  It was during his stay that they did a cat scan and saw all the areas.  After discussing with radiologist, gastroentrologist, medical doctor and oncologist he was confirmed to have stage 4 prostate cancer that metastisized to his liver (confirmed by biopsy) and to his lymph nodes (also confirmed by biospy).  Friday after receiving the news they then wanted a chest cat scan and a bone scan.  Today we got the results and was informed that the cancer has spread to his lungs, chest lymph nodes and now his spine (specifically the area around the L5).  His PSA score has never went above 90.  There were no other indicators.  They are starting Chemotherapy next Tuesday and will also be doing hormone therapy.  He will be doing chemo every three weeks and they will be using Docetaxel (Taxotere). 

I try so hard to be strong for him and not let my emotions get the best of me but it is sometimes too hard.  My son (his grandson) who is 7 has so many questions.  All he knows is that his papaw is really sick and when asks if God is going to let him die I have no idea what to say.  My dad is a fighter and is so strong and I keep telling myself he can beat this but the facts suggest otherwise.  My brother and I are just so lost and confused because one minute we have to worry about just prostate cancer to now worrying about if he will make it through this.  I really appreciate everyones support, encouraging words and willingness to help me through this on this board.  God bless each one of you! 

My heart goes out to you, your family and, of course, your father.

The rapid spread of this cancer from his prostate, to his lymph notes, to his liver, to his lungs and now to his spine indicates a VERY, VERY aggressive cancer.  You need to keep your emotional strength up to support your father and your family, but I think you know how this will probably end.  The only question is how and when. 

If you are not familiar w/the chemotherapy drug, Docetaxel, here is a link to a pretty good summary of how it is used and its side effects on a patient: http://www.macmillan.org.uk/Cancerinformation/Cancertreatment/Treatmenttypes/Chemotherapy/Individualdrugs/Docetaxel.aspx.  The list of side effects is extensive and far from pleasant.

I am pragmatic and I am not a religious person.  So, forgive me if I'm blunt but you need to take steps now to prepare yourself and your family for what will likely happen, including getting your father's financial and other affairs in order.  Doing those things hopefully will provide you w/a distraction from watching your father deteriorate. You should also take time AWAY from tending to your father and his affairs every now and then.  Otherwise, you will end up an emotional wreck. 

If you are religious, arrange a counseling session w/your priest or minister if you think it would be worthwhile.  Also try to get some of your other family members to do some of the "heavy" lifting.  Sounds like you are taking on the primary responsibilty for your father's care and, if there are other family members who can help, you should ask them to do so, so that you do not have to take on the burden alone.

Just keep in mind that such things are a part of life and try to recall all of the fond memories that you and your father have shared together to keep your morale up.

Good luck and best wishes!

VascodaGama said:

Focus in extending his quality of living

Tiffany

I am sorry to know about the extensive spread of the cancer. Swing said it all. I think it aggressive and difficult to treat. His physicians will provide what is best available and will try to manage the pain along the treatment but the wide spread and the side effects from the medications may turn the situation unbearable in particular when your dad is suffering already with pain and discomfort.

It is difficult to accept but this is time to consider the worse. The whole family should know about the matter and be involved. I know you are trying your best too. You need to realize that cure may be impossible so that you may focus your efforts by providing him with what he likes best and extending his quality of living. Anemia is a bad scenario in advanced PCa patients. Read about ways to fight it.

From the age of your father, I presume that you and your brother are young and know little about this cancer but you should consider any hereditary situation running in the family. Be cautious.

You and your family are in my thoughts.

VG

Family members of prostate cancer patients are more likely to develop prostate cancer than the rest of the population; so please notify other family members, uncles and even cousins. Generally it is best to have a PSA test at around 35 for a benchmark, and then regular testing ; PSA, Digital Rectal Exam, etc. starting at age 40. Early detection of the disease is better treated.

Eat Heart Healthy; heart healthy is prostate healthy. 

About 7 year ago there was a study at Albert Einstein, done among Askenszi Jews that showed a correlation between prostate cancer and breast cancer, so you and your sisters, aunts get your mamograms, and also eat heart healthy.

tiffany2015 said:

Thank you for responding

Thank you for responding @swingshiftworker, @vascodaGam and hopeful and optimistic

Yes the cancer he has is very aggressive.  His doctor told us that when someone his age gets prostate cancer it tends to be very aggressive and it is definitely proving that us.  I am slowly triyng to accept the outcome of what I know will be and it is very difficult.  I ask myself daily how do I prepare and the only thing I can come to is that as long as my dad is peaceful and Ok with what happens then I need to be too, as much as I can.  Thank you Swingshiftworker for providing the link on the side effects of the chemo they have him on.  They went over a few of them but not all.  While speaking with my dad last night he thought that his cancer was curable, and the doctor actually informed him that it was not.  They will try to control it but thats all the can do.  I hated and it killed me to be one to tell him that his cancer is in fact not curable.  I know that with all the information we are receiving things get misconstrued or forgotten and I am sure I will have to remind him of things as we go down this road. 

The good thing is is that we have executed a living will, working on Power of Attorney and he has informed me of his wishes should the time come for that.  We are slowly gettings in order in case the worse case scenario happens. My  brother tries to help but he is very much in denial and my fathers girlfriend only helps when it is convenient for her.  I dont mind doing what I need to I am just trying to keep it from taking a toll on me and still raise my son without interruption in his life. 

Someone mentioned that I must be young due to my dads age and in my eyes I am.  I am 31 and my brother is 34 and as I informed my brother he needs to go ahead and go to a urologist to have his baseline and ensure that everything is ok.  They are going to be doing genetic counseling with us and we were informed that prostate cancer and breast cancer has a direct correlation.  My dads mother died of breast cancer when she was 45 so I guess that makes it even that more important for my brother and myself to keep an eye on things. 

Tiffany,

There does seem to be some general link in prostate cancer discovered in younger men and aggressiveness. My brother-in-law was diagnosed a few years ago in his 40s, and despite treatment at MD Anderson, it took him.  The great American singer Dan Fogelberg died of it a few years ago, at the age of 56. And yet many older guys live with the disease for twenty years or more, virtually symptom-free.

Swingshift mentioned the chemo drug taxotere; here is another link to it, if you are interested in reading.  I know that the responses to you have been blunt, but it is of course possible that your father has some quality time remaining.  I did hospice and then was Executor for both of my partents and their estates in recent years; you having a Will, power-of-attorney, and medical directives will make things much easier than they otherwise usually are.

A cousin recently tested "BRCA 1" positive, and following the actress Angilina Jolee, had both breasts removed as a preventative. BRCA 1 officially gives a 65% liklihood of aggressive breast cancer, but other studies quoted in the articles following Jolee's surgery put the number as high as 87%. Taxotere is also the most common drug given to triple negative (Hormonally resistant) breast cancer patients.

http://chemocare.com/chemotherapy/drug-info/Taxotere.aspx

I did a six-month-long chemo combination therapy of five chemo drugs years ago.  If your dad is offered an IV port, I strongly recommend that he get one.  Installation is a thrity minute, easy surgery.  Chemo can scald the small veins if spilled, and constantly getting needles is unpleasant for most patients. I am wishing the both of you better news than might be reasonably expected,

.

Harmsgal49

I sense anxiety in your post but from the few info you got in hand regarding the diagnosis nothing is indicative of an aggressive form of cancer. In fact one positive sample out of 14 is not voluminous and it could relate to a sort of indolent cancer that would not bother the well living of your father, for the rest of his life.

PSA 13 is high but it could relate to added conditions from a case of hyperplasia (BPH). The Gleason pattern and score is missing and you should call his doctor’s office to get the exact number. You can also request for a copy of the pathologist report where they described what they found in the biopsy, including any indication of existing BPH.

The MRI may provide more clues on the extent of the cancer. With such image study the urologist will provide your dad’s clinical stage. However, the need for a treatment should be carefully judged because of the age of your father and his loss of quality of life that a therapy may cause.

You do not like waiting (“…I have a terrible time dealing with…”) but you should not rush into a decision without proper details of the real status of your father. Do things timely and coordinately and with knowledge.

Being a son of a PCa patient makes us at higher risk of being positive to cancer. I would suggest you to be cautious and get checked.

Best wishes.

VGama

VascodaGama said:

Harmsgal49: Wait for the facts

Harmsgal49

I sense anxiety in your post but from the few info you got in hand regarding the diagnosis nothing is indicative of an aggressive form of cancer. In fact one positive sample out of 14 is not voluminous and it could relate to a sort of indolent cancer that would not bother the well living of your father, for the rest of his life.

PSA 13 is high but it could relate to added conditions from a case of hyperplasia (BPH). The Gleason pattern and score is missing and you should call his doctor’s office to get the exact number. You can also request for a copy of the pathologist report where they described what they found in the biopsy, including any indication of existing BPH.

The MRI may provide more clues on the extent of the cancer. With such image study the urologist will provide your dad’s clinical stage. However, the need for a treatment should be carefully judged because of the age of your father and his loss of quality of life that a therapy may cause.

You do not like waiting (“…I have a terrible time dealing with…”) but you should not rush into a decision without proper details of the real status of your father. Do things timely and coordinately and with knowledge.

Being a son of a PCa patient makes us at higher risk of being positive to cancer. I would suggest you to be cautious and get checked.

Best wishes.

VGama

No one can really give sure advice.  One can only give opinion and personal experience.  Mine is that in this case (NOT harmsgal), I would not accept any treatment until i personally investigated all the side effects, what per cent of patients are helped, what per cent of patiens are killed by the treatment, and every aspect of treatment.  Treatment with these highly toxic, unproven, and expensive drugs is chancey at best in your father's situation.  Sure, some are going to be helped, but many others are going to suffer horrible side effects and possibly have curtailed life.  And if the severe pain starts extended life is not going to be an asset.  Whether help or not, these drugs WILL decrease quality of life, but are sold on the basis of (maybe false) hope of a cure or life extension.  Sure, there maybe some who are very much helped, but the many more who suffer and die are not here to refute the success stories.

   My experience having very advanced stage 4 bone matatstases is to do nothing with the doctors but a lot with diet, meditation, exercise, and spiritual inner work.  I am not looking at or for the future.  My goal is to make every second, every minute, every day full of gratitude for all I have been given and to spend as much quality time as possible not only with my loved ones, but also with all my brothers and sisters in the Family of Man.  I live totally in the moment  and totally in the love space.  My suggestion is to not be much concerned with doing things which may be negative and only add false hope and suffering,  but, rather than doing, concentrate on being - being in the moment, being in the love space, being in harmony with nature and loved ones and being grateful for all that is happening, even if you do not like it.  love, Rakendra

tiffany2015 said:

Thank you all for your

Thank you all for your advice, words of encouragement and just knowing that you all are here and have went through is a comfort knowing that I can speak to this group. 

I know some asked about how he was diagnosed and treatment etc.  He was having pain about 2 months ago peeing and due to his insurance it wasnt until June 1st that they sent him for a prostate biopsy.  The day after his biopsy he was really sick and just hurting all over so his urologist sent him to hospital because he thought infection.  It was during his stay that they did a cat scan and saw all the areas.  After discussing with radiologist, gastroentrologist, medical doctor and oncologist he was confirmed to have stage 4 prostate cancer that metastisized to his liver (confirmed by biopsy) and to his lymph nodes (also confirmed by biospy).  Friday after receiving the news they then wanted a chest cat scan and a bone scan.  Today we got the results and was informed that the cancer has spread to his lungs, chest lymph nodes and now his spine (specifically the area around the L5).  His PSA score has never went above 90.  There were no other indicators.  They are starting Chemotherapy next Tuesday and will also be doing hormone therapy.  He will be doing chemo every three weeks and they will be using Docetaxel (Taxotere). 

I try so hard to be strong for him and not let my emotions get the best of me but it is sometimes too hard.  My son (his grandson) who is 7 has so many questions.  All he knows is that his papaw is really sick and when asks if God is going to let him die I have no idea what to say.  My dad is a fighter and is so strong and I keep telling myself he can beat this but the facts suggest otherwise.  My brother and I are just so lost and confused because one minute we have to worry about just prostate cancer to now worrying about if he will make it through this.  I really appreciate everyones support, encouraging words and willingness to help me through this on this board.  God bless each one of you! 

Hi Tiffany sorry for your dad's diagnosis.  I anm curious do you know if the biopsy is adenocell or small cell.  It can make a huge difference.  I would contatc Johns Hopkins they have a lot of amazing trials and are getting decent results with traditional therapy and vaccines.  some patients diagnosed stage 4 are in 3rd year of the study.  Good luck.