HealingWell
Search Close Search
☰

Please suggest

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/10/2018 6:28 PM (GMT 0)
My father now has PSA 27 but however scan has showed more disease burden and less PSA limited to bones. Doctor advised to three options as we have used almost all options now (Arbiterone, Docetaxal (one and half year back), Honvan). Now Doctor has given three options:

1. Docetxal rechallenge+Carboplatin
2. Cabazitaxal+carboplatin (Very costly in India)
3. PSMA 177 Lutetium therapy (Radionucleotide therapy)

My Medical oncologist has told me to decide but some times its so difficult to take decisions. Should i go for
Docetxal rechallenge+Carboplatin or PSMA 177 Lutetium therapy (Radionucleotide therapy). Please help with your suggestions.
Posted 1/11/2018 5:21 PM (GMT 0)
I don't have treatment advice to offer, and am not intimate with the advanced PC 3rd-line/4th-line treatments.

What I can offer is my personal experience working with an oncologist in a different advanced case with a different cancer, and also from a book I read titled "Being Mortal," by Atul Gawande (I highly recommend).

From the book, the author describes 3 kinds of relationships doctors have with patients:
1. paternalistic -- tells you what do do
2. informative -- gives you information, but not guidance (sounds like dad's doc)
3. interpretive -- helps patients determine priorities and achieve them

My experience is that after researching whatever you can on your own, when you (the patient, or the patient's close family member) tell the oncologist that you need more help from them making the best decision, you can steer them towards being more of the interpretive care giver...the 3rd example given above. It may become increasingly important to re-establish the physician-relationship now because over time as some advanced cancer cases switch to palliative care...then this is very important.

Good luck. Get the book.
Posted 1/11/2018 9:28 PM (GMT 0)
Listen to NKinney, Jannett. That’s a very wise reply. (Also, anything by Atul Gawande is worth reading.)
I would just add: think about what your and your dad’s treatment goals are at this point and communicate them to the MO. He/she might then be better able to guide you to a choice.
Posted 1/11/2018 10:28 PM (GMT 0)
You have been around this for awhile and I'm sure you know there are no perfectly correct answers. I personally would make a written list on paper of the pro's and con's of each treatment and see if something in the data jumps out. If nothing is obvious in the data, I found just using my gut instinct, almost void of all data, has served me well many times. Don't get lost in the data if they are similar, find a quiet place away form all things and one direction will give you a feeling of peace. That feeling will come to you for a reason! - embrace it. Then, when you wake up the next day Do Not go back into the darkness of that decision. Wish you well!
✚ New Topic ✚ Reply