Cancer back after 13 years remission

Sorry to hear about your dad.

I have a question. Is there a reason at his age to start additional therapy. I wouldn't think that his psa suddenly jumped that high, but rather a slow progression over the years. Seems like radiation would be very hard on someone that age. Couldn't it just be monitored without the radiation?

Best of luck though. Hopefully this additional therapy will knock it back down.

I never understood that either, how a cancer can come back after 10 years or so. How does that happen...is there cancer cells present since after the surgery that eventually duplicated in a repetition and progressed and became aggressive enough to survive the immune system....Something I never understood either.

At any rate, was your father being monitored after surgery? Is he seeing a oncologist with pca specialty? I think that would be the next step.

Sorry to read of your dad's relapse ----- at his age radiation will be a little tougher than usual. We often see here that PCa is referred to as a horrrible invader. Nothing could be further from the truth. What we have to remember is that it is essentially you ------- your own normal cells with your DNA, DNA which programs your cells and tissue to do certain things and perform certain functions and have a certain life span. This is why you cannot "catch" cancer except in very exceptional circumstances (those on immunotherapy or with extremely compromised immune systems). But in the normal course of evolution the DNA in all species can change. From one generation to the next a C may become an A or a T or a G and this can cause slight or major changes from one generation to the next. With cancer the DNA within a normal cell is disrupted or altered for one reason or an other within the person. Now that cell will not follow the rules. Usually your immune system will take care of this by eliminating the rogue cell(s). But if it cannot, the now changed cell can divide and multiply. But it no longer does what it is suppose to do. Normal prostate cells stay witin the prostate doing their job, dying when it is their time and being cleaned up by the lymphatic system. They are constantly being replaced by new prostate cells and they stay where thaey are supposed to. Different cells have different lifetimes------I did read once that the human body is replaced over a cycle of about seven years but this is not correct. Bone cells live for about 20 years I believe. Cancer cells have usually lost their designated use by date and are essentially immortal. They may or may not ever die. These cells can just hang around indefinately or take it into their heads to divide and multiply. But the problem now is they are altered and do not stay where they are supposed to. Although once a normal prostate cell doing its thing in the gland, now it has changed and can wander off and live happily in other parts of the body. And this is where the danger lays -------- the actual cancer isn't what kills PCa sufferers, it is what it does that does the damage. Bone is relaced by softer changed prostate cells (thus weakened), good functioning liver or kidney or brain or lung cells are replaced and the organs cannot function as was intended. Essentially your body's organised system breaks down and fails. I suppose in a way you could say your body kills itself. This is why a cure to all cancers is so illusive --------- as every person is slightly different then every case of cancer is slightly different. But I have faith in the human mind ------ we will get there eventually and eliminate cancer, probably by gene technology. Perhaps the day will come when a doctor will say " There's no great problem, it's only cancer. We can fix that easily."
Bill

Is there possibility that ADT alone would slow the progression sufficiently to allow him good quality of life the rest of his natural years? Talk to a good medical oncologist.

julios,
I thought about that as well. But if Moz's family tends to live to their mid 90's and beyond I know that HT alone might not be a great option. But I hear you.

@ChrisR
This case is not uncommon at all. I am seeing it more and more. Most studies were based on two very shaky premises: that most patients are at the median age at diagnosis (20 years ago that would have been 70+) and that ten years of data is sufficient to prove the efficacy of therapies. Well with PSA testing the median is now 64 in the US and most of these men will live beyond ten years. What's more PSA testing has brought in a new class of patient ~ guys like me under the age of 50. A twenty year study or two would certainly be nice. I have nothing for what I am experiencing. It makes me feel like the first astronauts. Point the ship and fire away!

Tony

John,
Your recommendation is very general and not personalized to the patient...

My friends father recurred at age 82 as a Gleason 10 and was discovered in his bladder. He had no PSA relapse. He was put on Nilandron and radiation was used to slow the spread in his bladder. He had had an orchiectomy when he had his prostate surgery so the likelihood of an LHRH agonist working was slim.

First it must be determined if this is aggressive and what is the life expectancy of Moz's father. I assume with Moz's experience that they are aware that G6 is not dangerous. The question is whether he is dealing with G6 or something more aggressive and dangerous. If his father is otherwise healthy and longevity is common in his family, radiation is a reasonable approach.

Tony

Julios brings up an excellent point..I must question the appropriateness of subjecting an 86 year old the the rigors of radiation therapy when HT alone will probably achieve the desired results...

Sometimes you can't help but wondering if the financial incentive presented by performing radiation therapy pushes patients in that direction when it may not be appropriate..

But who knows?? Maybe in this case it's completely appropriate...

You are right Tony, NONE of these treatments are a "Walk In The Park", ESPECIALLY for a 86 year old....

Chris,
We can't answer some of those. He had a positive DRE but no PSA tests were available. His parents cannot produce a pathology report. His relapse was a fast moving G10 but we have no idea what the original Gleason was. Back then people were not as astute as they are now. I doubt that it was aggressive else it would not have taken 29 years to fester itself into what it is today. Prostate cancer in 1981 was dealt with far differently than it is today. There was no nerve sparing procedure and orchiectomy was common with the surgery.

We just have what information that we have today. I did see his recent bladder pathology a few months ago. They were very clear that it was a relapse of prostate cancer and it was G10. He is currently under the care of my oncologist.

Tony

So there you have it. It's a personal decision and I respect it.

I certainly understand the calls for active surveillance and I can understand the decision to go forward based on good health and preference. With you there to help I am certain things can go quite well.

Good luck and if you don't mind keep us posted.

Tony

Mozart,

It would be interesting to know if it was a sudden spike. This is exactly why I think no one dx. under 60 is low risk. No matter what their Gleason score is.

Mozart250,

Glad to hear it for your dad.  That is a much better number.  I am guessing that this was probably of a years time from his last PSA test.  He will live to 100.