advice please

Hello Live Long,

Sorry to hear about your dad. The doctor's plans for him seem sensible to me but I am not the expert on bone metastases that some of the guys here are. They'll be along in a few minutes but I thought I'd just pop into say hello.

The hormone therapy should help with his symptoms (if he has any) and help will slow down the cancer from getting into his bones. Any sort of surgery is worrisome for a man in his tenth decade but it sounds like he is fairly fit for his age based on what you said so he should do OK.

Hello Live Long ..........

I too am a new member, and I do have some similar problems as your Dad. While I do still have two kidneys, I was in the hospital twice last year and once the year before with kidney problems - and my Oncologist firmly states it is because of the spreading of my Prostate Cancer, which essentially came back to life in the past three years.

My last trip to the hospital was in June of 2012 ... and it was for about 8-days ... and it was because my creatin level (unknown to me at the time) crept up to in the range of 13 to 14. In February of that year, I had nefrostomy tubes placed at both kidneys while in the hospital for close to two weeks for suspected kidney failure. By May, both nefrostomy tubes were removed, per my Urologists OK ... and I was back in the hospital within a month.

The result of the last trip was - a nefrostomy tube went back in for the right kidney ... and an internal stent went in for the left kidney. I did have some problems with white blood count for much of the past year, and did have procrit shots every two weeks or so with a blood test every single week for at least 7-months. Lately, my kidneys are behaving better, and my last procrit shot was about 6-weeks ago with Mondays reading at a 12.2! My next blood draw is (can't believe it) 5-weeks from now!!!!

I stated all that kidney background only because I don't think it is real common with Prostate Cancer, and your Dad has a kidney history. While my Onco has stated that I do have some bone metastas shown from my last three catscans, I am fortunate enough for this not to be my major concern or pain just yet - and have no knowledge or opinion about the bone screws and plates. 

I do, however, have some history with Lupron ... perhaps the hormone that your Dad may be going on. I have been on Lupron for over 18-months after a few months of being on Casodex. Many people (from reading some of these threads) have varying side effects with Lupron, but it does seem that there are a few very common side effects! Getting tired often or quickly seems to be almost universal - and emotional swings seem to be pretty common. There are many other side effects that seem to be present much less often - and the doctors office should have literature outlining the possible side effects.

And please note ... side effects can be present by so many other factors - like other medications, other ailments and individual body chemistry.

My history:

Current age - 70

Age at time of Dx - 61

External radiation treatments (25) in 2003/2004

Brachytherapy (96 seeds) in 2003/2004

Six years of good PSA readings

The above hospital and kidney history

The above Casodex and Lupron history

Zytiga - over 5-months in 2012 - but PSA slowly rising

Taxotere - over 7-months in 2012/2013 - with steadily dropping PSA

Off any form of chemo - over 2-months recently - PSA doubled

June 20, 2013 - start of Xtandi .... TBD!!!!!

Hope this is of some help to you - best wishes to your Dad.

Hello and welcome, sorry to hear about your dad's situation.

I couldn't imagine doing that type of surgery to a man of 92. It would be a long and difficult recovery, even for a younger man. Plus if it was being done as the direct result of the prostate cancer, it doesn't seem like a good fix to me (not a doctor).

The Hormone Therapy part, would makes sense to try to slow things down and buy your father some more time, however with his other health issues, seems a bit of a gamble to me.

No easy answers here. Have you gotten any second opinions yet, perhaps from a well qualified oncologist?

david

I too question the wisdom of any major surgery on a 92 year old..I would be getting second and third opinions on having any surgery...If he has had a biopsy, then he has a Gleason score..Very important when it comes to treatment decisions. Many men get a huge response with hormone treatment, easing the pressure on his bones and kidney. It's not impossible for his 204 PSA to be lowered to below 10 or even below 5...Drugs can then be used to strengthen his bones.. You need to consult with a Medical Oncologist, preferably one who specializes in prostate cancer..Most doctors don't expect a 92 year old to have much fight left. Once you can convince them otherwise, there is a whole cornucopia full of advanced treatments out there... In one recent case, someone in similar condition to your father, though younger, was treated with two new drugs, Xtandi + Provenge concurrently. This resulted in a COMPLETE remission, PSA undetectable that has lasted for over 11 months..It just depends on how hard your Dad wants to fight...But again, to me, the bone surgery recommendation is a red flag..

In younger men, hormone therapy can have some profound side-effects. How ADT will affect someone your Dad's age you need to find out so everybody understands what is going on, including your Dad....

Does he have bone pain? HT doesn't work for everyone, but it works for most, for some time, and it delivers a great deal of bone pain relief within two weeks for most people. And it'll clear a lot of those bone lesions. I'm sure his age would mean slower healing, but many guys get tremendous amounts of healing, so possibly that alone could be the 80 for the 20 and spare him surgery?

Roger that PeterD, thank you for your kindness.

The information is excellent DavidG, so sorry for what you and your family is going thru, very sad. You all are not alone, feel that…...