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Posted 5/10/2012 1:45 AM (GMT 0)
I am a new member and I am glad to have found this forum.  Lots of good information!

Here is the story:

Dad was diagnosed with PC today.  He is a Interstitial Lung Disease (ILD) patient since the last 2 years and also had Cardio Bypass in 1995.  He is 77 years old.  His only symptom was little increase in urination frequency.  His Pulmonologist asked him to take a PSA test which read 20.  He was referred to a Urologist.  After a DRE, he was asked to go for a biopsy.  The pathology reported all six cores were malignant with 90 to 95%.  His gleason score was 5 + 3 = 8.  He met the Urologist today and he was recommended a bone scan.  His abdomen scan was negative.  Urologist wants dad to go for Bilateral Orchiectomy to control the tumor.  Dad is in India (I am in the US) and we are going for a 2nd opinion to find out if there are other treatment options we need to discuss with his urologist considering his age and health condition.  I am looking for opinions and encouragement from other survivors.  Appreciate any input.

Thanks.

Posted 5/10/2012 2:21 AM (GMT 0)
Sorry to hear about your father, and all his conditions. That's a pretty serious PC situation to be honest. With him being in India, don't what options in their medical system he would have access to. Because of his age, some would reccomend Hormone Therapy, instead of the physical castration. Lot of factors to consider here.

Wishing you both the best, and hopefully you will get some other answer to help you sort through this.

David in South Carolina
Posted 5/10/2012 3:22 AM (GMT 0)
Welcome to HW. Your dad's biopsy is serious. A Bilateral Orchiectomy will make him permanently impotent. Hormone Therapy can accomplish the same effect as the castration but it is temporary and its effect is reversed once he stops taking the medication. He may also want to radiate the prostate and prostate bed)IMRT) in conjunction with the Hormone Therapy (HT). Good luck
Posted 5/10/2012 6:08 AM (GMT 0)
Welcome
I agree with Ed and David. I'd think HT might be a better option.

One of the simplest ways to stop the tumour growing is to remove testosterone from the body. Orcidectomy (physical castration) used to be the only way to remove the testosterone by removing the source. HT does it by shutting down the testes (Sometimes HT can even be referred to as chemical castration.)
Personally I'd opt for the chemicals as they are reversible.

All the best to both of you
Alf
Posted 5/10/2012 8:11 AM (GMT 0)
If his bone scan is clear, there is also a possibility of radiation of prostate in combination with the hormone therapy. But radiation has more side-effects that a person needs to consider before a decision is made. Hormonal therapy is also very effective for many years. If I were in the US, I would try to bring my dad to some of the top prostate oncologists for a second opinion, OR have a phone consult with one of them, after you have gathered as much info as possible. All the best to your dad!!
Posted 5/10/2012 11:13 AM (GMT 0)
Thanks for all the replies here. We will check on the possibility of having Hormonal Therapy as opposed to Orchiectomy as well as look into Radiation. I was concerned with Orchiectomy since he is an ILD patient and did not know how he will cope with general anethesia. I will post the recommendation of the 2nd Urologist here. If I can get all his test results sent to the US, what usually is the process of getting a phone consultation with a local Urologist? Again, thanks for all your time and I really appreciate all the input here!
Posted 5/10/2012 3:29 PM (GMT 0)
Another quick update - Dad met with the 2nd urologist. He did not recommend Orchiectomy. HT injection every 3 months is what he recommended. We do not know the details of the specific injection he was planning but I will try to get it. Radiation was not discussed but hopefully with the next appointment we can ask if additional treatments are required along with the shots. Dad is also scheduled for Bone scan early next week! Thanks for all your support.
Posted 5/10/2012 5:43 PM (GMT 0)
Orchiectomy or pills, the effect is the same. The pills / shots are far more expensive. The side effects for physical and chemical castration are the same. After about 2 years, at your dad's age, the effects of the HT shots become permanent anyway..There's seldom any "recovery" if the medication is stopped, which is not very likely..

Radiation treatment still might be a possibility, if his doctors feel he can take it and modern equipment is available..
Posted 5/10/2012 6:26 PM (GMT 0)
Welcome to HW, thanks for joining us. You've received some good advice and info so far. I'd consider the HT and radiation, Ask about it at the earliest opportunity. Good luck to you and Dad.
Posted 5/17/2012 1:59 PM (GMT 0)
Another update. The Bone scane for my dad showed metastasis (somewhat expected considering his PSA and his high gleason score). So the Urologist has recommended Lupride Depot 11.25 mg injection every 3 months. He has also prescribed Tabi (Calutide) and one other medcine which I do not know yet. No radiation or other treatments recommended considering his age. No specific Diet changes recommended but I am doing my own research about it. Any thoughts will be appreciated!
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