Madeline
Hi, I am sorry to hear that your Dad's Mets seem to be increasing. It is hard for anyone here to give you any specific advice on this one , I am not a medical practitioner so all I can do is let you know my thoughts.
Looking at your profile your Dad's daignosis was with T3bNM1 that indicated that it was an advanced cancer with evidence of spread by the way of Mestatases in the sternum but not in soft tissue or Lymph Nodes. The Gleason score of 7 could be read in one of two ways as 4 +3 or 3+4 if it was the first that is a little worse than the second but significantly better than a score of 8, 9 or 10 which is the worst and most aggressive type.
The RT will almost certainly have helped to shrink the prostate and keep the Cancer under a degree of control which should have lessened your Dad's symptoms and discomfort.
The latest scan has shown that the Mets are increasing which is not uncommon with this grade of PCa, the size and number of "hot spots" and the distribution of them is something your Dad's medical team will look at closely before advising on any additional treatment, they will also look at the trend in his PSA results from the blood tests they do regularly, your Dad started out with a PSA of 19 what has it been recording as since diagnosis? Is your Dad relativley fit and well other than the PCa as that may also influence any decision on the treatments that may be offered if they feel any additional treatment is necessary or advisable.
Latest evidence is showing that chemo given sooner rather than later can be beneficial for Men with advanced metastatic PCa if they are otherwise fit and healthy. However Chemo for advanced PCa is not always the same immediate urgency as it is for other types of cancer where Chemo is THE only option.
Has your Dad just seen the Consultant and had the latest scan results explained to him or has he got an appointment coming up soon? You have not said if they have mentioned any additional treatments or the options there might be.
It may be best if your Dad is concerned about taking his holiday that he calls his Consultant's secretary and explains the situation and asks them to advise if he should proceed as planned.
Best wishes
xx
Mo