Dad's advanced prostate cancer, stage IV, - Start here! - Prostate Cancer UK Online Community

User

Posted 18 Jul 2016 at 09:07

Hello everyone,

Wanted to share with you the experience with dad's prostate cancer, he is 73 years old and suffering from early Parkinson and occasional spine pain which has been going on for about 10 years now. It started in April 2016, when a high PSA level appeared in the medical exam (12). The doctor advised a biopsy to see what was going on. At the beginning of May 2016 the biopsy was performed, with the result coming in at the end of May. Out of 12 cores, just one came back positive, Gleason score 3+4=7.

At this stage the doctor advised surgery, and an MRI prior to that. The MRI came out with no obvious signs of cancer apart from the small area where the biopsy was taken, doctor advised that there could be cancer on the back of the prostate which is not visible on the MRI.

Surgery was scheduled on 17.06.2016. After the surgery, the doctor came out of the OR with a straight face and said that the cancer was spread to the seminal vesicles, but he managed to get everything out and sent to biopsy.

Following surgery, dad spent one month in hospital recovering, he suffered lymphorrhagia and had to stay with two drainage bags. After 3 weeks, 3 albumin IV's stopped the lymphorrhagia. Apart from that, recovery went pretty well, eating, drinking and a bit of incontinence.

He was discharged from hospital on 15.07.2016, on that day aI got the biopsy report following the prostatatectomy. Gleason score 4+5=9, sharp rise from Gleason score 7 prior to surgery. Cancer stage T3bN1Mx, invasion of some lymph nodes adjacent to the prostate gland which have been removed. This makes it a Stage IV prostate cancer. This afternoon he has an appointment with the oncologist for treatment options. We will see how that goes, the surgeon didn't advance any life expectancy, he just said that it's as bad as it gets, it's a Gleason 9, short of 10 which he has never seen on a biopsy, with metastasis on regional lymph nodes.

Post biopsy and pre op, the PSA shot at 20. PSA will be reevaluated at the beginning of August, as well as a bone scan will be performed to check for bone metastasis, his spine/hip pain might also hide some prostate cancer that has spread there. Post-op lung scan revealed nothing.

It has been a pretty hard 2 months and very weird I think, from just one positive core, PSA 12, to Gleason score 9 and Stage IV metastatic cancer. Indeed, the mistake my dad made was to skip 2015 for PSA testing as he had no symptoms apart from urinating 2 per night as he has been for a few years, point which he has given Avodart. Indeed, even if he skipped a year, the cancer was pretty fast to spread.,

I hope the future prescribed treatment will keep the cancer from developing very fast, but the stage IV statistics and age do not give good prognosis.. Will keep updates.

User

Posted 18 Jul 2016 at 13:13

Hi Andrey

I am so sorry to hear of your Dad's suffering - it must be a very difficult time for you.

My dad was diagnosed last week and his Gleason score is 5+4. He has to have an MRI prior to surgery and its all very new to us - the first time something has happened like this in the family and its taking some getting used to, although Dad is bearing up the best of the lot of us.

This is a fabulous site - it's been so helpful for me, giving me help and information and loads of support about how I can help Dad.

Wishing you and Dad all the very best - we're here whenever you need us

Janey :) x

User

Posted 18 Jul 2016 at 15:15

Hi Andrey

If your dads consultant has never seen a Gleason 9 or 10 I suspect he is very inexperienced in dealing with Pca. He also says it's as bad as it gets which sounds strange at this stage. Have you had the full histology? Did he say if there were clear margins?

The shock of a cancer dx is bad enough and it's still early days. Spread to seminal vesicles and nearby lymph nodes is not uncommon. If that is as far as its gone it may still be "cureable". Depending on the next PSA test results and bone scan results it may be worth discussing adjuvant or salvage RT with the oncologist

Whatever the outcome I wish you all the best

Bri

User

Posted 18 Jul 2016 at 17:46

Hello Andrey and welcome to the site.

4+5+~9 is not brilliant. It isn't the worst case scenario either so please hang onto that thought.

There will be other members along with their stories which may help you. We are all different in the way we react to treatments, even if the cancer is the same grade, but we have members on here with PSA in the hundreds and Gleason as high as it will go. Even if they are in the no cure camp, they are still being treated and living their lives fully.

It does seem odd that a doctor should say it's as bad as it gets. Perhaps he is preparing you for the worst but really I think you should hold onto the thought that even though the scores aren't brilliant there is a lot being done now in terms of treatment.

Anyway, I'm sure some of the other members will be along to offer their support too so hang in there for a while.

If you have any questions please feel free to ask.Somebody is bound to be able to advise you

*****

We can't control the winds - but we can adjust our sails

User

Posted 18 Jul 2016 at 20:27

The sharp rise in PSA between biopsy and op may be a red herring, particularly if he stopped taking the Avodart in preparation for the operation - Avodart halves PSA (approximately) so if he was taking it when he had his first PSA test it was nearer 24 than 12. The concern would be the surgeon not knowing that but as bri has already said, if he hasn't seen a G9 or G10 before he doesn't sound very experienced.

I think there may also be some confusion about staging - you can't really have T3 and stage 4 - the T number is the stage so he is either locally advanced T3 or advanced T4. The T4 will be determined by whether his spine / hip pain is due to mets I guess.

I hope that the appointment with the onco this afternoon gave you some clarity about next steps.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 18 Jul 2016 at 22:31

I note from your profile you are in Romania, was your Dad's treatment carried out in the UK or in Romania.

Thanks Chris

User

Posted 19 Jul 2016 at 08:26

hi,i am surprised that he had rp with spread to seminal vessicles,i have t3b no mo which has involved my seminal vessicles,i could not have rp,i went down the ht/rt route,i am now on my first ht holiday,but good luck.

User

Posted 19 Jul 2016 at 09:11

I agree with some of the comments here, my own hubby had Gleason 10 and T4 in initial biopsy and further confirmed later when he had a TURP (removal of some prostate tissue which had been blocking the urethra). He had PSA of 25 on diagnosis, that was getting in for six years ago. Try not to be too downhearted, you may be surprised at how well he does when he is on treatment.

Love

Devonmaid

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Dad's advanced prostate cancer, stage IV, - PSA,Advanced prostate cancer

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