My Dad has diagnosed with prostate cancer with bonesecondary

manikandan1

Hi All,

My father (64 years old) has diagnosed (3 months back) with prostate cancer with bone secondary. Urologist told to me that, my father has crossed the curable stage but hormonal therapy will help to extend his life and can also get relief from pain.

Before to the Orchiectomy (testes were removed) PSA was 79.8. After the surgery PSA level started to decrease. The PSA level one month after the surgery was 1.5, after second month it was 0.5 and now it is at 0.345.

Does it mean the spreading of prostate cancer further has been controlled? or Did the cancer spread over the body is getting cured?

What kind of treatment should be given to my father here after? Or Is there any treatment available for full recovery?

Please advice me.

Thanks in advance for your reply.

Manikandan
Chennai,India

Replicant · Moderator Joined: 01 Nov 2006 Posts: 741

I think what happens is that the metastases, wherever they are in your father's body, are being starved of testosterone, which they depend upon. The metastases shrink, pain is relieved, PSA drops and the mets may disappear from scans, but they are still present.

Now, for some men, this hormonal treatment (in your father's case, orchiectomy) can work for a long, long time. I know a guy who had an orchiectomy 14 or 15 years ago, and his PSA is still very low. If he lives to be 90 and dies of something else, I'd say that's as good as a cure, although technically I suppose it is not the same.

In other men, it is effective for a shorter period of time. On average, it works for a couple of years, I believe.

After this treatment fails, there is chemotherapy and clinical trials.

At present, there is not a cure for advanced prostate cancer, but there are many drugs in the pipeline.

It's good that your father has responded so well to the orchiectomy.

Best wishes.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, 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 (and thereafter) <0.1
http://pcabefore50.blogspot.com

manikandan1

Hi All,

My fathers PSA level has started to decrease continuously for four months [PSA on 14/0ct/2008 was 1.5; PSA on 14/Nov/2008 was 0.5; PSA on 12/Dec/2008 was 0.345; PSA on 14/Jan/2009 was 0.312;]

[b]But I got shocked when I saw his PSA level as 0.99ng/ml on 14/Feb/2009 and 2.45ng/ml on 13/Mar/2009. I think that it is started to spread again aggressively.[/b]

Two years back he had undergone bypass heart surgery. He is also a diabetic patient. Can I go with chemotherapy as a next level of treatment? If so when should it be started?

What kind of treatments are left for him to prolong his life.

Regards,
Manikandan

Chennai,India
_________________
PSA on 07/09/08 79.8
Orchiectomy on 11/09/08
PSA on 15/10/08 1.5;PSA on 14/11/08 0.5
PSA on 14/12/08 0.345;PSA on 14/01/09 0.312
PSA on 14/02/09 0.99;PSA on 14/03/09 2.45
PSA on 13/04/09 6.45;PSA on 14/05/09 8.991
PSA on 14/06/09 11.1;PSA on 14/7/09 15.23

Replicant · Moderator Joined: 01 Nov 2006 Posts: 741

Manikandan, can you give details about your father's hormonal treatment? Which medications he was on? This could help people like Johnw100 here give you some idea of what is going on.
I only know generalities about hormonal therapy, much less than what John and others know. For example I think that if a patient is on something like Lupron and Casodex, sometimes stopping Casodex will send the PSA back down. Or if he was on just Lupron, adding Casodex might help. Those are just examples. (John, please correct me if I got that wrong).
At any rate, the idea I'm trying to get across is that hormonal therapy (ADT), is not simple--a good oncologist will try adding this or stopping that, to see how PSA responds.
After they have exhausted their bag of tricks with hormone therapy, chemotherapy is indeed the next step, such as docetaxel plus prednisone. But chemo isn't terribly effective or long lasting with prostate cancer, so you want to stay with androgen deprivation as long as possible.

Best wishes.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, 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 (and thereafter) <0.1
http://pcabefore50.blogspot.com

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

In general, at this stage chemo therapy and clinical trials are what is left. Chemo may require full healthy kidney function however and sometimes kidney function is compromised by diabetes. Only a good medical oncologist can make these determinations and monitor the process.

Usually stage 2 or stage three trials are the safest and most promising. They include chemo, vaccines, possibly better hormone drugs, and combination's of these.

I know little about hormone therapy especially whether it can be enhanced with drugs even after an orchiectomy. I suspect it can be

It is important for your dad to be as active as possible and stay ahead of any muscle or body weight loss because that is VERY difficult to reverse once there is noticeable loss. Good diet and weight maintenance is key. Wasting, is in fact often the the ultimate cause of death from many cancers.

Good luck and best wishes in this battle.
_________________
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

Replicant · Moderator Joined: 01 Nov 2006 Posts: 741

Sorry, Mandikandan...I missed your signature file which listed the orchiectomy.

I'm not sure what is to be done at this point before moving on to chemotherapy.

Hopefully someone who knows a lot about hormone therapy will jump in here.

You might want to visit the Prostate Cancer Infolink Social Network at http://prostatecancerinfolink.ning.com/ and check out the Hormone Suppression group. Ralph Valle started that particular group. He is a chemist, a patient, and an award-winning support group leader. He and the other members should be able to give you information specific to your father's case. Prostate Cancer Infolink is a great resource.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, 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 (and thereafter) <0.1
http://pcabefore50.blogspot.com

manikandan1 · Posted: Tue Apr 07, 2009 11:31 am Post subject: Hi all

Hawk and Replicant thanks for your valuable information.

My father is currently taking "Bicalutamide 50 mg" one per day at morning along with his diabetic medicines , which I forget to mention in my earlier posts.

Regarding his weight,he lost around 7-8 kg [from 57kg to 49kg] in last August when he was diagnosed with metastases prostate cancer. But now he is gaining the weight again. His latest weight is 54.5 kg.

I got medical oncologist appointment on coming Monday.
Please advice me on questionnaires that I can put before him that would help me at this stage.

Thanks and regards,
Manikandan

Chennai, India
_________________
PSA on 07/09/08 79.8
Orchiectomy on 11/09/08
PSA on 15/10/08 1.5;PSA on 14/11/08 0.5
PSA on 14/12/08 0.345;PSA on 14/01/09 0.312
PSA on 14/02/09 0.99;PSA on 14/03/09 2.45
PSA on 13/04/09 6.45;PSA on 14/05/09 8.991
PSA on 14/06/09 11.1;PSA on 14/7/09 15.23

Replicant · Moderator Joined: 01 Nov 2006 Posts: 741

I would ask about taking him off bicalutamide might help. (Bicalutamide is marketed here under the name Casodex).

I would also ask about ketoconazole. Ketoconazole is an anti-fungal drug that is sometimes used for prostate cancer because it reduces testosterone. I believe it is used for some patients who no longer respond to their orchiectomy.

Those are just a couple of questions--maybe some other people here will have more.
_________________
Replicant

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NXMX, 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 (and thereafter) <0.1
http://pcabefore50.blogspot.com

kho2317 · New User Joined: 16 Oct 2008 Posts: 5

HI Manikandan, your dad's situation seems similar to my dad's. I had also previously posted before that my dad had suspected bone metastasis in pelvic area when he was diagnosed with Prostate Cancer back in Oct 2008. Since undergoing ADT which he took Casodex for around 3 months, his PSA dropped to 0.31 back in Jan 2009. After which, the doctor took him off Casodex and other hormone injections and the latest review with doctor yesterday revealed that PSA still remains at 0.34. However, the doctor did confirm that bone metastasis is definitely present and he does not seem to have much of a choice now except taking another hormone injection and watch & wait for next appt in 6 months time. According to the doctor, it normally takes around 2-5 years for the cancer to spread to entire body. But he also does not have much other choices as he ruled out radiation at this stage as cancer already spread. Currently there is not much of alternatives available. Not sure about India, but here in Singapore you can consider Traditional Chinese Medicine as alternatives but there's no real cure also. I recently researched another Cancer Alternative Medicine called Bio-Reasonance Therapy. You can consider that a try as it is also a non-invasive treatment which makes use of your body to fight against the degenerative cells that may attack your body.

I hope that in the near future there will be medical breakthrough soon and wish you all the best in finding a solution or cure for your dad.

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

As I stated before, my knowledge in this area is limited but I did find this rather clear response to the question of rather there are things that inhance the effects of an Orchiectomy.

http://www.phoenix5.org/Infolink/advanced/cht.html

Below is a snipit from the Phonex5 website. CHT stands for "Combined Hormone Therapy.

The Prostate Cancer InfoLink would suggest that the only forms of CHT which should be seriously considered for the treatment of advanced prostate cancer are the following:

* (a) An LHRH agonist + a nonsteroidal antiandrogen
* (b) Orchiectomy + a nonsteroidal antiandrogen.

Certainly these two forms of CHT are those which have been most widely evaluated in the best constructed clinical trials to date, and even then there are outstanding questions.

It would appear that it is possible to draw the following very general conclusions from the large, well constructed clinical trials which seem to meet most of the criteria necessary for a meaningful evaluation:

* First, CHT appears to extend overall patient survival in patients with stage D2 (or M1) disease by about 7 months, regardless of the ultimate cause of death.

* Second, there is some evidence to suggest (but not to conclude) that patients with stage D2 (or M1) disease who "only" had low levels of bone metastasis and were otherwise in a relatively good state of health respond far better than patients with later stages of the disease.
_________________
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

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

[quote="Hawk"]As I stated before, my knowledge in this area is limited but I did find this rather clear response to the question of rather there are things that inhance the effects of an Orchiectomy.

http://www.phoenix5.org/Infolink/advanced/cht.html

Below is a snipit from the Phonex5 website. CHT stands for "Combined Hormone Therapy.

The Prostate Cancer InfoLink would suggest that the only forms of CHT which should be seriously considered for the treatment of advanced prostate cancer are the following:

* (a) An LHRH agonist + a nonsteroidal antiandrogen
* (b) Orchiectomy + a nonsteroidal antiandrogen.

Certainly these two forms of CHT are those which have been most widely evaluated in the best constructed clinical trials to date, and even then there are outstanding questions.

It would appear that it is possible to draw the following very general conclusions from the large, well constructed clinical trials which seem to meet most of the criteria necessary for a meaningful evaluation:

* First, CHT appears to extend overall patient survival in patients with stage D2 (or M1) disease by about 7 months, regardless of the ultimate cause of death.

* Second, there is some evidence to suggest (but not to conclude) that patients with stage D2 (or M1) disease who "only" had low levels of bone metastasis and were otherwise in a relatively good state of health respond far better than patients with later stages of the disease.[/quote]

Here is a link that may have some application but it is a drug in trial (possibly only in the U.S. but I am not sure). I also do not know the selection criteria or if it would even be advised with an Orchiectomy.
_________________
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

manikandan1 · Posted: Thu Apr 16, 2009 6:27 am Post subject: Hi all

Thank you all for your valuable information.

I have consulted with the medical oncologist. Now my fathers PSA has raised to 6.45 ng/ml. I have asked about taking Ketoconazole.
But the doctor advised to take omnacortil-10 tablets (Morning -1 , Afternoon-1 and night-1) . I came to know that omnacortil-10 is a Steroid tablet.

I got some information about this tablet on net.

"Steroids switch off the extra bit of testosterone produced elsewhere in the body to decrease swelling and pain".

http://www.canceractive.com/page.php?n=993

Can anyone please share their knowledge on this?

Thanks & Regards,
Manikandan,

Chennai, India.
_________________
PSA on 07/09/08 79.8
Orchiectomy on 11/09/08
PSA on 15/10/08 1.5;PSA on 14/11/08 0.5
PSA on 14/12/08 0.345;PSA on 14/01/09 0.312
PSA on 14/02/09 0.99;PSA on 14/03/09 2.45
PSA on 13/04/09 6.45;PSA on 14/05/09 8.991
PSA on 14/06/09 11.1;PSA on 14/7/09 15.23

Praveenkolli · Regular Joined: 12 Nov 2008 Posts: 21

Manikandhan

We are from Andhra Pradhesh(INDIA).
My dad intially undergone surgery in chennai(Vijaya Hospital)
Later Radio theraphy at Yashodaha Hospital secunderabad and chemo at India American concer institute Hyderbad.
Can I have you contact number so that we can discuss.My contact number is +91-9701001798 or you can contact me at praveenkkolli@gmail.com.

Thanks in advance

With Regards
Praveen Kolli

manikandan1 · Posted: Mon Jun 22, 2009 1:47 am Post subject: Fathers latest health update

Dear Praveen,

First of all thanks to cancerforums.net to find a good friend to share and feel.

My contact details: Mobile +91 - 9486195969. E-Mail: manikandan.sivaramakrishnan@gmail.com

Praveen, I will send a mail in a more detail, for the mail address you have given.

Here is my fathers latest health update.

My father had radio therapy to get relief from his back pain for 10 days.

Current PSA level is 11.1 ng /ml(14/6/09) from 8.991(14/5/09).

One thing I have noticed in the PSA level is , Earlier the PSA was twice or even thrice in a month gap. To be more clear, on Jan 14 of this year his PSA was 0.312 ng/ml and on Feb it was 0.99. Almost 3 times.
See my signature for more details.

But now only 2 ng/ml (approx) was raised in a month gap (from 8.99 ng/ml to 11.1 ng/ml). But he is not taking any new drugs.

He is also taking zoledro injection once in a month to strength in his bone.

As of now he is doing good and he is able to walk with out any ones help.
I hope by grace of god he will be able to continue for a long time.

Thanks to all.
_________________
PSA on 07/09/08 79.8
Orchiectomy on 11/09/08
PSA on 15/10/08 1.5;PSA on 14/11/08 0.5
PSA on 14/12/08 0.345;PSA on 14/01/09 0.312
PSA on 14/02/09 0.99;PSA on 14/03/09 2.45
PSA on 13/04/09 6.45;PSA on 14/05/09 8.991
PSA on 14/06/09 11.1;PSA on 14/7/09 15.23

manikandan1 · Posted: Fri Jul 24, 2009 2:28 am Post subject: Alternative treatement

Hi all,

My fathers latest PSA is 15.23 ng/ml. Now a days he feels more pain, almost over all the body. Even morphine kind of tablets are not controlling his pain that much. He feels more pain on his both knees and he is unable to walk or unable sit for at least 2 mins continuously.

I planned to try alternative treatment like Chinese[TCM]. Does any one have any experience using Chinese herbal products? Please share with me.

I have searched in Google for the same and found 'Lingzhi' has showing good result on advanced prostate cancer.

Also found a nice article regarding this on the following link

http://www.holisticchineseherbs.com/news/prostatecancer.html

Please advice and share your experience on using Chinese or any other alternative natural treatments for advanced prostate cancer.

With thanks and regards,
Manikandan
Chennai, India
_________________
PSA on 07/09/08 79.8
Orchiectomy on 11/09/08
PSA on 15/10/08 1.5;PSA on 14/11/08 0.5
PSA on 14/12/08 0.345;PSA on 14/01/09 0.312
PSA on 14/02/09 0.99;PSA on 14/03/09 2.45
PSA on 13/04/09 6.45;PSA on 14/05/09 8.991
PSA on 14/06/09 11.1;PSA on 14/7/09 15.23

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