so confused! need your help PLEASE: Father recurring after orchiectomy in Morocco.

Hi, my dad had removal of the prostate on 2011 followed by radiation therapy and hormone therapy. The dotcor said that he has to have the zoladex every 3 months for the rest of his life. He asked for alternatif option whitch was remival of a part of the testicles to lower the testesterone. He opted for the operation on mai 2013 since then his psa was 0.0 until last april it wents up to 0.80 retested in 3 months it raised to 1.20.
The doctor asked for bone sca, he had result today it showed a spot on the lower back where the spine ends.
I thought his psa is stil low for the cancer to spread . Is that a sign that the cancer has spread to his spine?
Thank you

Changed your title. We'll see if we can't attract some more specific help. --PeterDisAbealer

Post Edited By Moderator (PeterDisAbelard.) : 7/27/2014 8:30:21 PM (GMT-6)

Hi. Thanks for your answer. My dad is now 61 years old. His psa before surgery was 12 with a gleason score of 8 (4+4) . His pathology report showed a positif margins in both sides with clear lympes nodes.The gleason score after surgery is 8 (3+5) and staged T3cN0

The spot could be any number of things. I had several spots identified as possible mets that turned out to be clusters of blood vessels. I had additional scans to identify the spots. I would have had a biopsy to confirm cancer if necessary. Your Dad should try to confirm exactly what is going on. Best of luck. BB

Hi peter.when psa started rising he did a testesterone test and the result was 0.95 .His doctor put him on casodex and asked for scans . So just the doctor who performed the scan told him that something on his spine that looks like big black spot.
He will be going to see his doctor to see what he thinks. My dad is in Morocco
Thanks for everyone here who are trying to share the knowledge they have.

Laila,

I added some details to your thread's title so we can see if anyone has some more specific advice.

Laila,

Are you in Morocco, too?

Hi laila,

All I can say is that castrate-resistance does set in eventually, sometimes sooner, sometimes later. There are a whole new set of hormonal drugs that may continue to work even after castrate resistance occurs. They include Zytiga, Xtandi, Ketoconazole and Estrogen.

Now may be a good time to begin chemo with docetaxel. There is an immunotherapy called Provenge - I don't know if it's available in Morocco.

Bone density erodes after castration, so it is necessary that he take Xgeva, Zometa, or other bisphosphonate. That may also prevent spinal compression and fractures.

It's harder to definitively diagnose bone mets after castrate resistance. Perhaps he can get a NaF18 PET/CT scan after his PSA gets a bit higher. If that indicates the spot on his spine is a met and there is only the one or very few, he can have it zapped with SBRT (3-5 treatments). If it discovers multiple mets (more than 5), he can have a single dose palliative treatment to them, or a new drug called Xofigo, if it's available there.

- Allen

Hi everyone. I went to see my dad.his back is giving him a lot of pain.his doing too many scans. Some for the stomach and MRI . His oncologist put him on cosadex and Psa dropped to 0.75
I just don't understand how can the cancer spread to his spine with a low reading of 0.85
Sometimes I think that he shouldn't do the orchiectomy and keep having the zoladex shot every 3 months. I don t know if we did the right thing by having him do the surgery. His testesterone level is 0.95
My dad is 61. I was hoping that the spot shown on bone scan is not cancer but the pain he has now everyday says something elese.
Thanks for taking time to read this

Good luck to your father.

I lived in Morocco for 4 years while growing up. My father was with the American Embassy in Rabat.

I hope he improves and does well ahead.

David