HealingWell
Search Close Search
☰

Possible metastastic Pca

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 10/9/2013 3:57 PM (GMT 0)
Hello all
My dad's scans came back and it looks like it has spread to the bones :( although lymph nodes are not enlarged.
Its been a tough week for us.
My dad is thinking about getting a bilateral orchiectomy to slow down/arrest the growth of the PCa, as opposed to the HT. Is this the right approach?
What are the treatments typically prescribed for someone with bone metastasis and who is not having any symptoms?
Is radiation or surgery still an option in these kind of cases?
This forum has been a great place to learn about this disease.
Thanks in advance!
Posted 10/9/2013 4:04 PM (GMT 0)
sorry to hear about your father sr9....I have bone mets and my treatment is currently Zytiga/prednisone. I also get a shot of Xgeva once a month for the bones....Im also on Hormone therapy and get elligard every 6 months. Im also just starting Radium 223 and will get my second infusion next week. Another thing my insurance just approved was Provenge although I think I will hold off on that one....don't want to waste them all at once. Those are a few options I know of.....and by the way...if and when he experiences any back pain which I did...you can also get spot radiation to the spine....that helped me quite a bit and was just 10 days long....hope this helps.
Posted 10/9/2013 4:05 PM (GMT 0)
As a person with asymptomatic METS, I am on continuous HT. Until one becomes refractory (PSA rising despite HT) that is likely to be the recommended treatment. I think the drugs and the surgery effectively achieve the same result, so its a matter of personal preference

Posted 10/9/2013 4:08 PM (GMT 0)
Good point...forgot to mention Im hormone refractory so some of that stuff wont apply to your father.....if hes having no symptoms...a great option may be provenge.
Posted 10/9/2013 4:20 PM (GMT 0)

Keeping faith said...
As a person with asymptomatic METS, I am on continuous HT. Until one becomes refractory (PSA rising despite HT) that is likely to be the recommended treatment. I think the drugs and the surgery effectively achieve the same result, so its a matter of personal preference

Pretty much my situation too. On ADT and Xgeva for bone loss for 24 months if I can remain refractory that long.

So far, no surgery nor radiaiton nor chemo, just Lupron every 4 months and Xgeva monthly.

In theory the prostate and bone mets are shrinking but I have not had the prostate size measured since I went onto Lupron March 28th.

The second bone scan showed improvement over the first, and the MRI to spine showed that the glow on bone scan at T7&T8 was benign and remnants from a prior herniated disc with spinal compression. Still have so-called mild bone mets at T4 & T9 plus MRI to pelvic area showed what radiation oncologist referred to as classic prostate cancer metastatic to bone.

I have no symptoms and would pursue spot radiation if pain were to manifest itself.

LupronJim
Posted 10/9/2013 4:30 PM (GMT 0)
Thanks folks.
So if I understand correctly, orchiectomy or the ADT/HT achieve the same results.
After that, we just wait for the PSA to rise before we try something new.

On some level, it feels better to take further action rather than waiting....
I know Surgery and Radiation may not resolve the issue at this stage, but does it prolong survival or slow the spread of the disease?
Have you had similar discussions with your docs?
Thanks
Posted 10/9/2013 5:01 PM (GMT 0)
Hi there. Surgery or radiation (to prostate) does not prolong survival because the cancer is already on the outside of the prostate. Radiation is used though, to treat painful bone mets, and that has been quite a successful method for treating pain. That is official protocol. Unofficially, some doctors have tried radiating prostate+bone mets (must be less than five) with a curative intent, but there are no studies that confirm survival advantage of this approach, and not many doctors believe in it. Good luck to your Dad. My Dad is almost 3 yrs since his initial diagnosis of PC with bone mets and is doing well. There is reason for hope.
Posted 10/9/2013 6:05 PM (GMT 0)
Your dad should be thankful that he has a "loving daughter" to help him during this stressful time. Currently, hormone treatment utilizing commonly lupron and casodex to prevent growth and possibly shrink PCa tumors are used most frequently. I can only assume that your dad is very depressed now and physical castration (orchiectomy) may plunge him into deeper dispair; it is irreversible and really not necessary at this time. If he can't bear the symptoms of an orchiectomy there is no going back while hormone treatments can be modified to possibly lessen the symptoms. Please realize that this is merely my opinion.
A 2nd opinion from a medical oncologist should be made of course since he only has "possible" mets. Men have lived for many years with bone mets and some, like Lupron Jim, are fighting this disease with curative intent although I am not aware of how that is progressing. It might be worth checking out.
I wish both you and your dad the best--stay positive.
Bill
idea
Posted 10/9/2013 6:42 PM (GMT 0)
sr9sh,

Androgen Deprivation Therapy (ADT) and surgical castration (orchiectomy) both give very similar results in terms of controlling the progression of systematic prostate cancer. They also have similar side effects, some of which can be serious and all of which are annoying. Although it is not reversable, orchiectomy is less expensive than ADT and is much more convenient since it does not require periodic injections to maintain control. It can be a sensible choice for men who do not find it psychologically bothersome. On the other hand, men who don't find it bothersome are rarer than three-color tomcats.

Generally, when guys come to this forum talking about orchiectomy we talk them out of it. With either treatment your dad can expect to live for years with the disease. During those years it is quite possible that other treatments will arise that give the same control with less onerous side effects. Guys who are on ADT would be able to switch guys who had the surgery would not.
Posted 10/9/2013 7:52 PM (GMT 0)
Thanks guys
I can understand its a difficult decision but my dad seems to have made up his mind based on what he has read. It could affect him down the line, perhaps, and its irreversible, but right now he thinks its the right choice. He has a friend who went through it a few years ago without issues.
Anyways, we're going to consult an oncologist shortly to confirm the mets.

Is there anything people have been on to fight/eradicate the tumor cells?
I think I've heard of Radiation, Provenge and Xofigo (radium 223)...have I missed any others?
Chemo of course later on.
Thanks for all your answers...its extremely helpful to someone new to all this.
Posted 10/9/2013 8:21 PM (GMT 0)
With surgical vs. chemical castration I'm not sure there is a right answer. Just need to weigh it out and make a decision...as hard of a decision as it is.

I, too, had bone met(s) identified and had spot radiation to them...(I had one or two...debatable on one of them)...

He has lots of options...hormone therapy and/or surgical castration would be 1st line treatment I would think. Provenge is for castrate resistant PC as I understand it.

You might want to consult with a medical oncologist that deals solely with PC.

Jerry
✚ New Topic ✚ Reply