Update - Advanced Metastatic Prostate Cancer
Recently my neighbor, 59 years old, received this diagnosis. He lives alone. No support system. He does not understand what is happening to him and asked me to step in and help with doctor's visits, managing meds, and generally helping him understand what he is facing.
He recently was discharged after at 18 day stay at the hospital. Biggest concern was kidney failure and creatine levels were at 19.9. The prostate was found to be significantly enlarged with a tumor on the left side. PSA is 606. Biopsy confirms stage four.
Metatisis sites determined by a Cat Scan of the abdomen are seminal vesicules, bladder, kidney, pubic bone, left femur, possibly left lung. Pet Scan to happen this week and I believe the scan may reveal more sites.
I took him to his first oncology appointment on Friday. The doctors have not told him the full story and only break more bad news to him a little at a time. When he was in the hospital they mentioned it was in his pubic bone and femur. At the appointment two days ago they told him it was also in his bladder and seminal vesicules.
He completely shuts down and really isn't able to hear them. I ask the questions.
The oncologist has a 'treatment plan'. Hormonal therapy to remove all testosterone from his system in hopes it will slow down the cancer growth. They also want to start him on chemotherapy. One infusion every three weeks for the next 5 months. I think the chemo med started with a t, but I did not write it down. He also said the cancer was extrememly aggressive with a very high gleason score. He did not mention the number and I didn't ask for some unknown reason.
Oncologist said he was 'optimistic' that my neighbor would at least survive through this initial treatment plan. He did not appear 'optimistic' to me at all.
I work full time and run my own business so I have been staying up very late at night researching prostate cancer. Sadly, I am familiar with other cancers as I have walked this path with more than one person in my family.
As I'm researching I'm wondering if it's possible that palliative care is my neighbors best option and that bringing hospice in at the earliest possible point may greatly enhance his quality of life. The oncologist did tell us that if he makes it through the chemo they will continue with the hormone shots and that people sometimes live for a couple more years. They do consider this palliative care.
The oncologist said he is not a candidate for radiation (there's a proton beam center right here in town) because of how far the cancer has spread. The doc also said that the chemo is going to make him quite ill and he will lose all his hair. I think he should have the right to know all of this so he can carefully choose the option that makes most sense for him.
I also think he should seek a second opinion. He is relying on me completely. After the oncology appointment he asked me if I understood everything the doc said. I told him I did. He said good, because he heard a couple of bad things and he can't handle knowing anything else right now. But he's glad I know...
Would appreciate your opinions and differing perspectives so I can be as much help to this man as possible. Keep in mind that his treatment options are limited because he is on Medicaid and currently has zero income.
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