Second line hormone therapy and steroids

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User

Posted 11 Apr 2015 at 11:16

Hi,

I am Kim, my dad has had prostate cancer for the past 7 years and has been treated with hormone injections every three months. The three monthly hormone injection has been working very well for the last 7 years and he has had no problems, at that time his tumour had come out of the prostate but was not in any nodes. The consultant he had in cornwall said it was so slow growing that he could live with this and they could watch and wait and treat it with hormones. In November his PSA began to rise and he changed consultant as he moved up to where I live and the new consultant took scans and we have found out that he now has stage 4 prostate cancer and it has spread into the lymph nodes in the abdomen and is incurable. His bone scan was clear and it seems that it has just spread into the lymph nodes at the moment. His consultant has started him on steriods called detamethasone and does not recommend chemotherapy at this point. I just wondered of anyone else had any experience of using steriods as a way of treating their prostate cancer and how effective this is as a treatment? We are hoping that it will help reduce his PSA which is 26. This has all come as a bit of a shock to us all and I would really appreciate any advice on how things progress regarding treatment options now that the hormone injection is losing its effect.

Thanks.

Kim

User

Posted 11 Apr 2015 at 18:21

Hi Kim,
This is probably not what you want to read but I think someone misunderstood dad's diagnosis all those years ago. Dad would not have been put on permanent hormones if it wasn't already incurable (stage 4). If it had been curable, he would most likely have had an operation or radiotherapy, and if he had had radiotherapy he might have been given hormones for a few months or up to 2 years but not forever. Maybe no one explained it to him properly at the time or maybe in the shock of being diagnosed he forgot some of what the doctors told him at the hospital.

Either way, he has done brilliantly to last on hormones for 7 years without needing to change to another treatment - some men find the HT stops working after only a couple of years. Chemo is generally only given to men in the final stages of the disease as prostate cancer is not a type of cancer that chemo can cure - despite the public perception, different kinds of cancer need different treatments.

Dad has done so well on the HT, there is every reason to be confident that dexamethosone will also produce good results for him. Even though that won't work forever, there are then many other treatments that he will be able to try including very new treatments that are being trialled with chemo to see how they respond. I think that the fact the cancer has still not spread beyond the lymph nodes is great news and shows that the doctor in Cornwall wasn't completely talking nonsense even if it feels that way to you at the moment.

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

User

Posted 12 Apr 2015 at 08:45

Thanks for your reply and information. When he was diagnosed the gleason score was 3 and the consultant said it was so slow growing you could treat it through watch and wait. For two of the years, they just watched it and then started the injections with the guidance that when the PSA rose they would treat it then. The new consultant here in cheltenham said he was misinformed and that he should have been treated with radiotherapy from the start while the cancer was contained in the pelvis.

It is positive about his long response to the hormones and the consultant was pleased that it is not in the bones. Just have to take it one step at time. Thanks for taking the time to reply, I appreciate that.

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