help for a friend from a survivor of anal cancer

I am surprised with your descriptions
Hi Teacher,
I am surprised with your descriptions about your friends’ diagnosis, particularly his PSA of 2.3 after surgery which may be low (in comparison with his PSA pre RP ?). However, a patient on stage IV is not recommended at the beginning to undergo surgery. Stage IV cases are considered systemic with certified metastasis to other parts of the body. These patients are cared with a combination of chemo and radiation therapy, or chemo and hormonal therapy.
His doctor should know of the narrow (if not impossible) success of RP treatment in his case.
Low PSA levels are usually achieved with hormonal treatment in stage IV patients but hormonal treatment is a palliative way for caring of prostate cancer. It is not a predicted cure but an extension of life span that can keep the cancer "at bay" for a long period of time (there are many cases of ten or more years).

I would suggest your friend sees an oncologist specialized in prostate cancer. They are the proper doctors for stage IV patients.

I hope your friend has a successful recovery from the RP.
VGama

Kongo said:

Difficult Situation
Teacher,

Your friend is in a difficult situation as you know. As Vasco points out, surgery for true Stage IV PCa is rarely done as removing the prostate will not affect the cancer that has spread to other parts of the body. At this stage, radiation is generally only used as a pallative treatment for pain caused when the cancer has metastasized in the bones.

If prostate cancer has spread beyond the prostate, surgery will not be able to lower the PSA to zero as the growing cancer at distant parts of the body is continuing to generate PSA, which is likely what the readings indicate six weeks after surgery in your friend.

I think at this point he needs to discuss chemotherapy and hormone treatment as possible opitons of treatment.

Stage IV PCs in a man so young is very rare. The long term ;prognosis is not good.

K

Stage 4 PCa
Survivor,
Welcome to PCa forum and congratulations on being a cancer survivor! As a survivor, you know that all cancer is very serious, but stage 4 is more so. However, IMHO, it is not a death sentence. In the face to face PCa networking group that my husband and I attend, we have personally met several men with stage 4 disease who, with treatments, are proof that one can live 10+ years with advanced disease, especially with some of the newer tx drugs/courses available. Of course, as you already may well know or learn from others, issues related to quality and quantity of life are always a delicate subject and a very personal and individual decision process.

I would reinforce the suggestion that your friend be seen by an oncologist specializing in PCa ASAP. A PCa oncologist is different from a surgeon, urologist, or a radiation oncologist because he/she can help guide him in formulating a comprehensive tx plan that may include a combination of several tx modalities such as chemo, hormones, and/or radiation. I would also strongly recommend that you, alone or if possible, with your friend, locate and attend a face to face PCa networking/support group in your community. The men and women that make up these groups are a great resource for info/doctors/txs, etc. and very knowledgeable about all stages of PCa. However, some groups are better than others so, if at all possible, attend several. The best way to locate a PCa group in your community/city is to Google “us too prostate cancer” or “the wellness community” or call the 800 phone # for the ACS (American Cancer Society—the sponsor of this CSNetwork forum), for the location of their nearest PCa group (their online PCa group location finder is not always up to date).

Your friend is lucky to have a caring person such as yourself seeking info in an effort to be helpful to him. All the best to both of you.
mrs pjd