My father, 77yo, psa 400, gleason 9. Treatment?

X1010,

Sorry for this news, and your need to join us. Yes, his initial treatment is well within the standard of care. This is started to halt the cancer while the next steps are determined. Most likely, he will be set up to start radiation treatment in a month or two. The initial Lupron also has the beneficial effect of weakening the cancer cells so that when the radiation is started, it is more effective.

His diagnosis, while very serious, is absolutely manageable for a long time. He will be around for quite a while, in all likelyhood.

Where are you located? Where is he being treated?

X1010, There are many guys in here who have had similar diagnosis and are still kicking 10 or more years since diagnosis. The really good news in your initial comment is that there are no apparent metastasis. If he's organ contained, then a course of radiation plus the Lupron will control it for a long time.

Also, sorry to hear this news, but as others have said, there are successful treatments such as the ADT treatment he's been given. Your move to a second onco opinion is terrific. I've used two different onco docs the past 5 years and consult with both while considering next steps.

One suggestion I have is to make sure the "metastases tests" include a proper scan, ideally a PSMA. I had special blood tests done at diagnosis to determine if there was any PCa outside the prostate. Results were negative. When I went in to start radiation on the prostate, the doctor said he wanted to make sure there was nothing outside the prostate. A PSMA scan showed bone and lymph node mets. Other scans and those "special blood tests" showed nothing outside the prostate, but they were wrong. That changed my treatment plan drastically.

Not sure what PSMA scan availability there is in Germany, but I know they do LU-177 PSMA treatments there, so they almost have to have availability for PSMA scans. Don't be alarmed by this...Just consider this as a precautionary step as he begins treatments. We're here for you and your father.

I think the final decision is up to your dad.
Getting 6 or 7 years gets him to my age (83).
I know it's not a popular idea, but I'd get the darned thing removed.
I already have an implant so ED wouldn't be a problem.
I may have to make a decision in a year or so, and my PSA is now 7, up from 4.6.
I had a cousin who survived D-Day in a glider and died from PC.

X1010 said...
Hi everybody,

my father was diagnosed with prostate cancer a few weeks ago and the results are quite frightening. He is 77 years old, in quite a good condition (no comorbidities) but the cancer is quite large, but still locally restricted and all the tests did not reveal metastasis.

The doctor immediately put him on hormone reduction therapy but that is it. The psa already went down to 15 in a few days under the chemical castration but they will try to reduce it further.

Is that the right way to deal with the cancer? How many years do we have left together? I am quite sad today.

Unless the tests performed were a PET scan, I doubt he does not have metastasis with a 900 PSA.

X1010,
I don't think it's productive to get wrapped up in all the "what if" stuff. Like others have said, your Dad has a great chance to be around for quite a while. 🙂

X1010 ~~~

We're here to encourage you and your father. Would he be interested in joining us here online? He can simply read and view - or he can also post.

We welcome you both here.

I was diagnosed in 2013 with a PSA that climbed up over 100, by the time I was officially diagnosed. A long list of scans and imaging followed.

My treatments began the day I was diagnosed - in the form of ADT injections.

Within one month, my PSA tumbled down by about 100 points. Within a couple of months, my PSA tumbled down into decimal levels, below 1.OO.
It was beyond all expectations I had, for those initial treatments.

Subsequent treatments have followed - such as chemotherapy, radiation, and the daily medication known as ZYTIGA (Abiraterone Acetate). These are revealed in the treatment history shown beneath my signature.

I remain active, exercise each day, and live life to the fullest.

My dad stands along us here as a prostate cancer patient, too. He has fared well since treatments over a decade ago. He is in the same age range as your father.

My key lessons learned, since my initial diagnosis? Here we go:

Treatments have improved greatly in recent years. The arsenal of treatment choices has expanded in the past couple of decades. Radiation has become more precise, chemotherapy is less caustic to the system, and newer breakthrough medications have been approved.

I share my HOPE with you AND your father today!

I'm thankful to hear your father's treatments have already made an IMPACT!

I will watch for your future posts and updates. Keep us posted, and let us know how your father is faring!

My best to you & your father ~~~
CYCLONE - # Iowa State University

DjinTonic said...
According to this 2020 study, the risk of having metastatic disease (as determined by bone scan) with a diagnosis of G9 and a PSA of 300-500 is about 82%. (See Figure 1)

Djin

Yes, thanks, he had the bone scan too but they did not find anything. So maybe he is one of the 18%. But we know that the diagnosis is not 100% safe

X1010,
I have not read many of the replies to your post. Sorry if I repeat other advice.

All I really want to say is relax. Take a breath. There is much hope. I have lived with this disease for near 16 years. My PSA was over 3200. The cancer had spread to bones and other organs. The cancer is currently undetectable. The treatment option the doctors are going with is textbook. Lower testosterone, hopefully the tumor shrinks and if the cancer is truly organ confined consider other treatments. I echo the sentiment of others however I have known people who had a very low PSA and a large amount of cancer and I have known people with high PSA that the cancer remained ogan confine. This is the discovery and learning phase. Life is going to change but it is very likely that at your dad‘s age he will outlive the cancer. The disease is serious but there is hope