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Daughter
New User
Joined: 12 Jul 2008
Posts: 2
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 Posted: Sun Jul 13, 2008 10:19 am Post subject: PSA 464, Gleason Score 5+4 |
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To say I am devistated by my father's diagnosis of metastatic prostate cancer, at stage 4, with a PSA of 464 and a Gleason Score of 5 +4 with partial bladder outlet obstruction is an understatement. The biopsy says diffuse adenocarcinoma of prostate. His bone scan showed bony metastases in his thoracic and lumbar spine, multiple ribs, sacrum, rt. iliac bone, rt. femoral neck, distal left humerus and sternum. The CAT scan showed a mass of 5.5 x 8.1 cm and multiple enlarged lymph nodes. I am shocked.
He has been a strong, energetic, seemingly healthy, totally independent 85 year old man who drives his neighbors to church, mows their lawns and is always there to help others in need. Who new he was harboring this, up until now, silent cancer?
Only 3 months ago, his first symptoms appeared... lack of appetite and taste, loss of energy, followed by frequent urination in the night. He also complained of a nagging back pain.
Although he sees his family doctor every 3 months for blood work (monitoring a thyroid condition) and has an annual physical, only a digital exam of his prostate was done. Had I only known, I would have made sure the PSA was included.
We have not been given an actual prognosis but I know this is very grave. My major concern is his comfort. The urologist has started him on Bicalutamide and he has just received his first androgen blockade injection. Dad says he feels better already...his appetite is coming back and his back pain is gone. His nightly urination has gone from 4 times to 2 times.
A TURP has been scheduled 8 days from now to help relieve the partial obstruction of his bladder opening. We have been apprised of the risks involved and the discomfort.
Here is what is weighing heavily on my mind. What medical procedures do we go forward with, considering the advanced stage of his cancer, and still insure him the most comfort and quality of life? I am his closest relative (my mother died 4 years ago) and the responsibility for his care is ultimately my own. Should he have the TURP?
My father is very strong minded and, I say this with love, he has always done what he pleases and marched to his own drummer. He is a very tough old guy. To my dismay, he has said no to a second opinion.
So, I am turning to this forum. Any input would be most welcome and I thank you in advance.
His Daughter |
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brainman
Chief Admin
Joined: 13 Oct 2005
Posts: 4434
Location: Tennessee
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| Posted: Sun Jul 13, 2008 3:11 pm Post subject: Re: PSA 464, Gleason Score 5+4 |
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Daughter, how devastating! I am very sorry about your father's advanced Prostate Cancer.
Yes, have him do on with the TURP. While is will not necessarily extend his life, it will make him more comfortable with whatever time he still has left.
At this point, it sounds like his only option for treatment is chemotherapy. I do not know how difficult on the body chemotherapy for Prostate Cancer is. I am sure others will know more about that. I just know that at 83 any treatment will not be easy.
You and your father are in my thoughts and prayers.
_________________
Jim
Site Administrator and long-term cancer survivor
1992 Astrocytoma grade 2, left motor strip
2005 Recurrence this time said to be an Oligodendroglioma grade 3, same location.
http://cancerforums.net/viewtopic.php?t=2405My Story Part 1: http://cancerforums.net/viewtopic.php?t=2528
My Story Part 2: http://cancerforums.net/viewtopic.php?p=7350
My Story Part 3: http://cancerforums.net/viewtopic.php?t=8029
Blog http://jimhawkinsport.blogspot.com/ |
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Replicant
Moderator
Joined: 01 Nov 2006
Posts: 273
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| Posted: Sun Jul 13, 2008 4:41 pm Post subject: ADT |
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Androgen blockade, (androgen deprivation therapy, or ADT) is the first line of defense in a case like your father's. It sounds like he is responding to it--good!
I don't see why the TURP would not be a good idea--I'd go with the doctor's advice on that.
ADT usually works for 2 or 3 years, but eventually the patient becomes hormone refractory. BUT--sometimes men respond to ADT for a decade or more!
After ADT, there is chemo. This is not the kind of chemo where you're violently ill or anything like that, although it does have some side effects. The standard right now is taxotere + prednisone. The downside is that unlike some cancers, prostate cancer doesn't respond very well to chemo. The reason is that it proliferates relatively slowly, and chemo attacks fast proliferating cells. BUT--the taxotere/prednisone tx was something of a breakthrough, because before that chemo for prostate cancer was purely experimental.
And while your father is undergoing the above, enjoying life, you can be assured that other treatments are in the pipeline and undergoing testing. Exciting new treatments that use nanotechnology, for example, to find and attack cancer cells wherever they may be hiding.
Unfortunately, at this time, there is no cure for advanced prostate cancer. Treatments are palliative (meaning the intent is to delay the disease and relieve symptoms--to "palliate" literally means "to cloak"). But that doesn't mean that next month we won't open our newspapers to read that a cure has been found.
There are many men on the Usenet group (also it's a Google Group) called alt.support.cancer.prostate who have had advanced prostate cancer for years and years, successfully battling it back with ADT and getting on with life.
The tactic for your father in this battle now is to manipulate his hormones to delay and confound the enemy. Eventually that battle may switch to one using chemotherapy.
My advice is to make sure he is in the care of a medical oncologist who specializes in prostate cancer. They're out there, and can make a big difference.
_________________
Replicant
Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T3a, N0M0, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 <0.1, 12/07 <0.1, 4/08 <0.1, 11/08 <0.1
http://pcabefore50.blogspot.com |
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johnw100
Senior User
Joined: 15 Apr 2006
Posts: 155
Location: australia
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| Posted: Mon Jul 14, 2008 5:36 pm Post subject: Re: PSA 464, Gleason Score 5+4 |
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A friend of mine just called in to see me on his way to the airport to start a 4 week overseas holiday.
In August 2005 he was diagnosed with Gleason 8 Prostate Cancer and bone involvement. He has since been on hormone therapy: his PSA has reduced to .9, there is no bone pain and few side issues. He maintaines an active lifestyle, which is a very important element.
He recently gave me a copy of the book about Hormone Therapy and Deet by Dr Charles Myers, which is the publication I now suggest to anyone interested in hormone treatment, as it containes a wealth of information, case studies from Dr Myers, tools for remission. Dr Myers contends that most men diagnosed as "hormone resistant" actually are not, and that hormone treatment can remain more effective than often thought.
My friend Ian, along with many other men who have used various forms of Prostate Cancer treatment, has posted his story on the "yananow" website which has lots of good information. The guys there are happy to answer any specific questions.
Hormone treatment is indirect: it can take a couple of months to be fully effective, and it can shrink the prostate:
in light of the fact that urinary symptoms have started to improve already, my inclination would be to advise the doctor of this progress, discuss if an immediate TURP is necessary, or whether it's more prudent to monitor improvement for now.
Best wishes |
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nexusnijmegen
New User
Joined: 25 Jul 2008
Posts: 6
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| Posted: Sat Aug 09, 2008 11:15 am Post subject: Re: PSA 464, Gleason Score 5+4 |
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Hi there, I'm really sorry about your dad's advanced PC. My dad's PC was also diagnosed via a TURP, but he eventually did a RP so as not to endure another TURP in future - for some parts, the TURP was uncomfortable and but bearable, he was still talking directly after the operation. I was told in high Gleason (8 and onwards) due to aggressive growth more TURP is required and hence an RP was thus suggested.
My dad is due for ADT soon, but I decided to quote this from the Google list from the people who did benefited from ADT:
[quote]I'm not going to soft-soap it, Alex; a G9 with a 78 PSA is about as bad as
it gets before it starts getting really bad. That said, I've been on this
newsgroup a number of years and have since seen 850 or more cancer victims
come through it. Of these, 25 had a PSA that was higher, including one that
was 4900! I'll tell you what I know of several who had high PSAs and stayed
around to talk about it.
I don't know how high GeoffH's PSA was at diagnosis, but it was high and he
was 62. He had surgery and is on androgen deprivation therapy (ADT). Last
month he reported he reported his PSA was at 0.50.
dave481 had a 39.8 PSA and 10 Gleason (the worst) at 54 in FEB 2006. He had
surgery and when they found out how bad his cancer was, they put him on ADT.
In March, his PSA was 1.2.
Ben had a 43 PSA at 65 in FEB 2004. He had radiation and ADT and when I
last heard from him last year, his PSA was 0.7.
Dick (no relation that I know of) had a 45.5 PSA and Gleason 8 at 67
in 1997. He had surgery. Eventually he went on ADT. I last heard from him
in March, his PSA was down to 0.1.
Billnjackie had a 46.5 PSA and G9 in 2002 at 55. We last heard from him
last year, but I forget what his PSA was. I know it had be down to 0.45
before that.
Bob had a 55 PSA in 2000, including bladder cancer. He was still
alive a couple of years ago.
Bob C, you may have just read, is still kicking with a 0.040. He was dx'd
in 2000 with a 55 PSA at 55.
DP was 49 when he found he had a 59.2 PSA and G9 in 1999. Last I heard in
2006, he was at 0.10.
Dora's husband was 82 with a 66.5 PSA and G10! Henry lived two
more years before succumbing.
kherav's father, at 59, had a 100 PSA and three years later was finding
cancer in his bones.
Hugh was 55 when he found he had a 140 PSA in 2006. He knocked it
down to 0.90, but sadly died of a heart attack.
Martin is the only man in this group that did not get treatment. He
was 63 when dx'd with a 145 PSA and a G9. He tried alternative therapies
and died about a year later.
In May, Chris told us of his cancer since 2005, including his 176
PSA which is now down to 0.05
John was dx'd at 48 in 2003 with a 635 PSA. He fought hard an long
and left us in OCT of last year.
John was 52 with a 704 PSA in 2001 and died at the end of last
year.
Jim and Curtis both lasted two years with PSAs over 700.
Robert was 61 and a former Marine when he was told in 1999 that he had
a PSA of 1000! He went on to found the Prostate Cancer Networking Group of
Greater Cincinnati [link deleted by admin] and created the
authoritative website at the time called [link deleted by admin]. He died in 2003,
but if he were alive today, I think he'd tell your father his last four
years were worth living.
Maynard was 68 in 1998 when he found he had a 1614 PSA and G9. He
died in 2004.
And finally, William 243 was 50 in OCT 2000. He already had bone metastases
and his PSA was 4,900!!! "When did he die?", you ask? "Not yet" he would
answer. We communicated last in APR 2008! [/quote]
I hope it brings you comfort, diagnosis of PC should not be a sentence! At least thats what I am going to continue believing! |
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Hawk
Experienced user
Joined: 22 Nov 2006
Posts: 90
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| Posted: Thu Aug 21, 2008 11:27 am Post subject: Great Post |
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[quote="nexusnijmegen"]
I hope it brings you comfort, diagnosis of PC should not be a sentence! At least thats what I am going to continue believing![/quote]
What a great post !!! Thanks nexusnijmegen
To the Daughter: The world needs people like your Dad to remind the rest of us how to live  Tell him to smack this thing on its butt. Unless something else takes him (none of us have a promise of tomorrow), he likely has GOOD years left.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT |
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brainman
Chief Admin
Joined: 13 Oct 2005
Posts: 4434
Location: Tennessee
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