Concerned Wife

my husband is 73 and in april of 12 found out he had prostate cancer. PSA only 5.8 We could not remove the prostate due to it being affixed to his rectum so we under went 42 treatments of radiation and started lupron in june of 2012 we were getting .01 for psa after that and things were looking up until may of 2013 when he started having issues urinating go in and they need to (create a whole because of a blockage) doctor said it was scar tissue and he had a good whole again and he would see us in 4 months for a psa. one week later on july 24th our phone rings and it is the doctor himself telling me that the cancer is still present inside the tissue that we removed and we need to come in the following day to recieve our options. we were sent to an oncologest which ordered a ct scan and bone scan our psa is still only .3 comes back and informes us he has bone mets in his femer ( its the type that makes hard knots not turns your bones into mush) he tell me that i need to have his remaining teeth pulled and we would begain zometia infusions on october 3rd. since then the psa has gone to .8 which i feel is not bad but it alarms me that its spreading when it has never been above 5.8 and that was at the very begining. my husband struggles with altizmers as well which makes it very hard to get symptoms out of him however he is telling me his hands hurting often and i see him holding them and talks more about little pains in his neck and has a cough that doesn't seem to go away much. does anyone have any insight to what is going that i may not be relizing and do i have the right to request another bone scan and chest xray i do know his gleason score is 10

Worried Wife,
I would certainly suggest a second opinion from another Oncologist. Sounds like they are moving pretty fast but not sure if your husband's other medical problems prevent him from being assertive with the Dr.s and asking the why and why not's of his situation. Others will chime in soon. Please keep us posted.
Michael

ok you guys are very knowledgeable i am just lost with all the info if there is any information that any of you need to know to help understand the situation i have all of his medical records in paper copys at home but its no much for me to try to comperhend

yes he takes a shot every six months. they said that it would slow the growth but at some point would stop working we live in a very small town travel 45 mins to see the doctors we do i am wondering if we need to start traveling elsewhere they told us he can not have anymore radiation and that the only other option was chemo i thought this was odd

I think the main things now are to prevent pain, fractures and spinal compression. The Zometa and Lupron will help with all that. They can give a single dose of radiation to any new bone mets they detect, which will provide a lot of relief. When the Lupron starts becoming less effective, there is a wonderful new drug called Xofigo that helps with the bone metastases. They will have to monitor his PSA to see when the Lupron becomes less effective. There are also other things they will monitor by a simple blood test.

Chemo, immunotherapy, and other hormone therapies are also options when the Lupron becomes less effective. You will have to weigh the added months of survival against the potential side effects of those therapies to decide if it is worth it for him, especially given his Alzheimers. All of these decisions can be very overwhelming for you. Perhaps there is a social worker at a nearby cancer center or hospice that you can talk to about all this.

- Allen

It's your husband's body & life - so yes- you have the right - indeed you have the responsibility to speak up and ask for whatever you want. The doctor does not know everything, and he is not a mind-reader, so treating him as if he is is not fair to him, or you. Are you close enough to Vanderbilt-Ingram Cancer Center in Nashville for an occasional visit? They have several urologic oncologists on staff whom you can make an appointment with.

- Allen

I've always been able to make appointments on my own. There are several prostate medical oncologists listed on the following page. If you click on the name, there will be a number you can call to make an appointment.

VICC Prostate Cancer Team

I am unfamiliar with them, unfortunately. I've only heard of Joseph A Smith who is the Chair of the surgery department, which is not what you want right now. Perhaps someone else here knows the medical oncologists.

Be sure to bring copies of all his medical records with you, or email them in advance if they prefer. I've always done most of my communications with my doctors via email. Sometimes it makes sense to set it up with your oncologist there who works with a local doctor/facility nearby who can administer shots/infusions, do bone scans and other diagnostic tests.

- Allen