Need help from Bangkok, thailand..my dad got prostate cancer, psa 200+

Hello,

I just found this board that is really useful as in thailand we don't have a forum like this.

My dad (65 yrs old) has a prostate cancer with PSA 220 and Gleason score 9 (4+5)

(adenocarcinoma, presence of perineural invasion)

He seems normal, only sometime hard to urine with no blood. (he has had this problem for 2 yrs)

The doctor appoint him to has a prostatomy and also cut the testicle off.

I asked if there is any other way, he said no. this way will reduce the hormone and effective.

I asked if the brachytherapy can be done? the answer is "No"

I asked can he use the hormone therapy first, doctor said "no, coz of high psa"

I asked about bone scan, he said my dad will have a bone scan before the operation.

I asked about the side effect after surgery. he said only hot temper like golden age women.

Not much information from Doctor coz we go to the public hospital, there r a lot of patient.

all my info come from the internet. I decided to take him to this hospital, coz it's the most famous, good reputation hospital in bangkok.

I trie to have my dad the bone scan test be4 the appointment. and luckily a nurse help us to have the test.

the result is "No definite evidence of bone metastasis"

We will have an appointment before an operation on 2nd May. anything I need to ask the doctor?

- is this the common way to cure (orchidectomy)? high psa & G 9

- is there any other treatment?

- Should we consult the other doctor for second opinion?

- How can we know if the cancer spread to lymph node or not?

My dad said he won't have a testicle remove. now he use the other way..like vegetarian, has thai-chinese herb, reflexology and massage.

after a couple day of reflexology he has a normal urine.

From I've read, many cases with higher PSA and same G score have Hormone therapy, and it works well.

I think we still can use the Hormone Therapy. but why doctor said no ? :(

 

Post Edited (JJ_BKK) : 5/1/2012 8:45:22 PM (GMT-6)

sorry about your dad. Others with advanced PCa will be able to share their experiences with you.

best sentence I've ever read on this board. "I asked about the side effect after surgery. he said only hot temper like golden age women."

Hi...my husband has been treated for PC and is doing very well. He is a GS 10.

Your father is a very lucky man to have you helping him with this disease.

My Best Wishes to you and your dad. Good luck.

Kathy

thankkkkks you all .. yr opinion means a lot to me & my family.

best sentence I've ever read on this board. "I asked about the side effect after surgery. he said only hot temper like golden age women."
LOL I don't know how to explain coz I rarely use English. plz try to understand my english though

So most patient in the USA doesn't have a surgery, while it's common in thailand.
Our family won't have problem with high cost, but I choose the doctor from his reputation.
I will ask him for HT first. coz dad won't do the surgery anyway.

more question, is it neccessary to have a prostate surgery and then use the HT.
or better way is no surgery, use HT and RT.

and after the patient have the Hormone Treatment, their urine back to normal??

any further info, plzzzz advice

JJ_BKK: Sorry to hear about your father. I agree with what others here have said about RT + hormones vs. surgery. I'd definitely get a second opinion.

I spend several weeks a year in Thailand. There are definitely some first-rate hospitals and doctors in Bangkok. I've been to Bumrungrad twice, once for gallstones, once for food poisoning. I'd feel confident having surgery/treatment there for pretty much anything if the need arose. I know a few people who have had major surgery there with no problems.

BTW, I also stock up on all of my meds while I'm there. I have pretty good insurance here in America and it's still much cheaper buying there and bringing back a year's supply. If Lupron is available there, I'd imagine the prices would be lower as well.

โชคดีนะครับ

Hi JJ

I'm also a Gleason 9 but my PSA was 2200 with widespred bone mets when I started HT. The HT is kicking the crap out my cancer. PSA 2200 2/15/12, 1500 3/28/12. Going in for week 12 blood work on the 3rd and I hope to see another big drop in my PSA level.

I make it a point not to give advice about treatment, but I wanted you to know that HT on it's own can be very effective.

I wish you, your dad, and all that care, good luck!

I lived in Southeast Asia for several years. A very close friend has been the CEO of Bumrungrad for about 10 years. I understand it to be very high quality and in line with US health care at about 1/3 the cost.

JJ, is this where your father is being treated?

JNF : JJ, is this where your father is being treated?
- No..but I think I'll go to Bumrungrad for 2nd opinion. and I don't know which doctor is the top prostate cancer oncologist there. can u suggest, pleaseee ?

Thanksssss for the US oncologist name too, but i'm afraid that I'd have a problem with language communication on phone, but I may take a chance in future, who knows.

the Doctor, we r consulting with, is Urologist. so should I better see the oncologist or ....??

With PSA 220, G4+5 How many time will he have for the RT?? I heard that RT is very painful.
If he has a prostatomy first, will it be easier to get rid of the cancer?? then less RT ?

and At this point, is the brachytherapy in the choice of treatment?

Another question, with HT, when the PSA drop low, Does it mean the cancer get smaller??

I really appreciated all opinions u give me here. Thank you thank you thank you... =^^=

PS. I heard about some medicine called "Abiraterone" , but don't hear anyone use this drug.

Post Edited (JJ_BKK) : 5/1/2012 11:40:26 PM (GMT-6)

let my try to answer some of you questions in last post:

1.) You should definitely see an oncologist at this point, if you can find one that has extensive experience treating prostate cancer. There may only be a handful of these in Thailand and you may have to ask around to find one. Prostate cancer is a very complex disease with a lot of variations so you want to find an oncologist who deals with prostate cancer every day, not once a month.

2.) When PSA drops low it usually means there is much less cancer in the body. Often symptoms liked blocked urine can go away once the right hormonal therap (HT) is given, because this shrinks thte cancer that is causing the blockage.

3.) Abiraterone is a very new medicine and it is usually held until late in treatment when HT has failed. But in some cases it is used at the same time as HT to hit the cancer from two directions at once. There are trials going on in the US to test Abiraterone at different stages of treatment and in combination with various other drugs and radiation treatments. There may be trials in Thailand too. I don't know. You'll have to ask locally.

4.) I went to a database of scientific articles on prostate cancer and searched on Thailand and this gives the names of various doctors that are publishing articles on prostate cancer in Thailand. Check this link:

http://www.ncbi.nlm.nih.gov/pubmed?term=prostate%20cancer%20thailand

You probably wont understand the headlines or the articles, but that is no problem; it is not the point. I am suggesting this resource only as a way of finding out which doctors, which universities, and which hospitals are doing the advanced research on prostate cancer in Thailand.This would be a good start to see who might be an excellent doctor for your dad. You can call some of these and ask for referrals.

Good luck!

Post Edited (proscapt) : 5/2/2012 12:57:01 AM (GMT-6)

One of your questions hasn't been addressed. You said you heard that RT was painful. It has been our experience here on the Forum that when it is done by a trained doc, with accurate and correct alignment, that it is painless during the treatments. After effects or side effects may be uncomfortable for a while, such as requency of urination, painful or stinging urinate, loose bowel and such. Done right, I don't think Radiation could be called painful by any description. In the States, most radiation ranges from 66 to 76 grays (units of radiation), spread over around 36 to 39 daily does, weekends off, and takes maybe 15 minutes per day, start to finish. There are a couple of different types, that you can look up- EBRT (external beam radiation treatment) being the most common. It's the same machine used for other cancers, so is common in most Radiology Departments that do radiation treatments. Hopew this helps.