What should I be asking

I think I would just go along to the appointment and wait to hear what the onco thinks. You could check that dad is at or below castrate level, this indicates whether he is hormone refractory (the cancer has learnt how to survive without testosterone) or whether the HT he is on is not knocking the testosterone back successfully. Next steps usually vary depending on the above.

You could also ask whether there is anything that can be offered for the bone pain - a short zap of RT might be an option but depends on whether he has had RT before, where the bone mets are, etc.

Do you know exactly where the bone mets are sited? If he has spinal mets you might want to talk through with the doctor the symptoms of spinal cord compression .... it is rare but best to know what you are looking for and what to do if dad shows any signs. If they have never discussed with you where the mets are, maybe now is the time to ask for details, especially with new scan results.

I hope it goes well on Wednesday

Hi Jo
We chatted through a treatment plan with our Onco, which went like this (we had already had Casodex and it failed). They are monitoring the PSA, and did scans to see what was happening! bone and MRI, at some point in the next few weeks we will either be started on chemo or be offered Abiraterone. It depended on PSA numbers and speed of climb versus progression according to the scans.

As it happened the cancer is progressing and the PSA is climbing but we got a three month stay and will now be having that conversation on Monday. We fully expected three months ago that treatment would change and it didn't. Maybe we will get the same result this time. We do trust their judgement, the view is that timing is very important and delaying the next treatment (but not too long) will extend John's life.

The important thing for us was that a plan was in place and we felt that ten once was on the case. Good luck with your visit, please let us know what they decide to do.

Lots of love
Allison xx