Conflicting Messages?
Hi everyone,
My father was diagnosed with stage IV prostate cancer (metastatis to bone) two months ago. He's just finished his second round of chemo.
He did a lot of the initial doctor visits "in secret" - i.e. we didn't even consider that he might have cancer - so I missed the majority of his initial consultations. He told me that his oncologist said he would need 6 rounds of chemo and then he'd be fine. He had a biopsy with a urologist - gleason scores between 7 and 9. Dad said the urologist said that was "curable."
The messages I'm getting from my dad conflict wildly with all the googling (armchair physician, right?) I've done. I need to know if we're looking at a very limited time left; this ambiguity is very difficult.
If I called his oncologist, would he speak to me? Can I ask for a pathology report from the urologist? Was my dad likely told that he doesn't have long and he's doing a protective thing?
Any insight would be appreciated...
Comments
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Hipaa laws?
Hi Angel,
It all depends on the Hipaa laws and if you are your fathers legal guardian. The doctors are very funny about what info they tell to who, but I think it's worth a call to your Dad's doctors. All they can say is no, and if they do then you need to talk with your Dad or Mom for more info. They might not do it over the phone but if you went in person they might talk with you. Give it a shot.
Dave 3+4
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angeline,
Whether you get to speak to the doctor ir not, be informed that metastatic prostate cancer (PCa) is never curable. Chemo is usually (not always) begun only if the oncologist views the situation as end-stage. The usual drug is Taxotere, somtimes alone, or with other chemo agents along with it. Prednisone (as steroid pill) is usually given at the same time.
Metastatic, Stage IV disease is frequently controllable with Hormonal Therapy ("HT"), sometimes for a long time (several years is not uncommon). It is possible the doctor wants to beat the disease back and then begin HT, but that is pure speculation.
It would be good if you could get permission to follow his progress directly; I would work on that through your father. But the statement "I will get some chemo and then be well" does not sound like a statement any oncologist could responsibly make. Your dad might have heard wrong, or he might be trying to protect you just as you suspect, no telling.
Chemo is harsh and very dibilitating, especially in the elderly, so anticipate him getting profoundly weak and possibly losing his mobility.
It is unlikely a doctor or his office would give you any information on him, unless he is cognitatively disabled. Getting a power of attorney and living will are important things to do if he will allow it.
max
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Chemo may not be the best course
Your armchair research appears pretty valid. And chemo is not particularly effective in these prostate cases. Hormone treatment is....but.....it's commonly name is chemical castration for a reason. Other than that, the side effects are pretty bearable. Once the cancer becomes castration-resistant (eventually happens), there are still more options for treatment. My own armchair research resulted in our visiting world-renowned experts, and finding that some recommended standards-of-care are not really the best options for survival and quality of life. Please be assertive in advocating for your father. He may very well have decades ahead of him (you didn't give his age).
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