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Is there hope

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User
Posted 09 Feb 2019 at 09:03

My husband was diagnosed in 2017 with advanced prostate cancer. He was only 48yrs old. His gleason 9. PSA 90. So the road began with brachy then radiation. Spread to lymph nodes. More radiation. Hormone therapy too. Scan in November showed no spread. Only to have PSA in Jan showing 70 again. PET scan this week. To find out yesterday its in abdominal area. Cyst in kidney and liver. Not sure if metastasised. But concerning is the spread to lungs..it has been an emotionally exhausting day. He is only 50 now. What is the reality of our situation and is there hope? Doc stopping hormone therapy as not helping and wants to start chemo tablets.. Please if anyone knows what lies ahead.. 

User
Posted 09 Feb 2019 at 09:03

My husband was diagnosed in 2017 with advanced prostate cancer. He was only 48yrs old. His gleason 9. PSA 90. So the road began with brachy then radiation. Spread to lymph nodes. More radiation. Hormone therapy too. Scan in November showed no spread. Only to have PSA in Jan showing 70 again. PET scan this week. To find out yesterday its in abdominal area. Cyst in kidney and liver. Not sure if metastasised. But concerning is the spread to lungs..it has been an emotionally exhausting day. He is only 50 now. What is the reality of our situation and is there hope? Doc stopping hormone therapy as not helping and wants to start chemo tablets.. Please if anyone knows what lies ahead.. 

User
Posted 09 Feb 2019 at 11:26
This is difficult to answer because in the UK he would not have been offered brachytherapy - it is reserved only for men with low or intermediate risk prostate cancer (usually G7 or less, PSA of 10 or below) whereas your man already had a very high risk diagnosis.

Different countries do have slightly different approaches to advanced cancer treatment; depending on which hormones he was on until now, in the UK they would probably have tried:

- adding a second kind of hormone to the first

- stopping the second hormone to see if there is a withdrawal response

- changing to Abiraterone or enzalutimide

- starting docetaxel chemo

- changing the hormone treatment to an oestrogen one like Stilboestrol

- in some countries (including SA I think) surgical castration is more common than in the UK

- a second line chemo like cabazitaxel

- Radium 223 if there are bone mets

Is he black? Were you ever told what kind of prostate cancer it is (adenocarcinoma is the most common but there are many other types, some of which don’t respond to normal treatments)? Most important - exactly which hormone treatment has he already had?

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

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User
Posted 09 Feb 2019 at 09:54
Hi Lomi,

So very sorry your husband has been diagnosed with PCa and it is at an advanced stage and this at such a young age too.. One can never be sure how a man in his situation will respond to treatment. There are further down the line systemic treatments like the chemo he has started and perhaps radium 223 and maybe immunotherapy if it can be afforded and he is prepared to have it abroad as it may not be available in South Africa.

I do hope, as both of you must, that one of the treatments will give him significantly more time. You don't say how he is coping with his situation but obviously it impacts heavily on you and you must look to your own health also,

Barry
User
Posted 09 Feb 2019 at 11:26
This is difficult to answer because in the UK he would not have been offered brachytherapy - it is reserved only for men with low or intermediate risk prostate cancer (usually G7 or less, PSA of 10 or below) whereas your man already had a very high risk diagnosis.

Different countries do have slightly different approaches to advanced cancer treatment; depending on which hormones he was on until now, in the UK they would probably have tried:

- adding a second kind of hormone to the first

- stopping the second hormone to see if there is a withdrawal response

- changing to Abiraterone or enzalutimide

- starting docetaxel chemo

- changing the hormone treatment to an oestrogen one like Stilboestrol

- in some countries (including SA I think) surgical castration is more common than in the UK

- a second line chemo like cabazitaxel

- Radium 223 if there are bone mets

Is he black? Were you ever told what kind of prostate cancer it is (adenocarcinoma is the most common but there are many other types, some of which don’t respond to normal treatments)? Most important - exactly which hormone treatment has he already had?

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

User
Posted 09 Feb 2019 at 16:29
Loml, chemo is not delivered via tablets but by intravenous infusion. Clearly, further treatment needs to be systemic as the PCa has spread. There are many options as Lyn has said. If it helps at all, I was diagnosed in 2007 with similar numbers and am still going strong after a variety of systemic treatments, so don't despair. It may seem dark now but there will be light at the end of the tunnel.

AC

User
Posted 09 Feb 2019 at 17:07

But chemo can be given orally in liquid or tablet form AC if not the usual method in the UK viz https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/oral-chemotherapy.html

 

Edited by member 09 Feb 2019 at 17:08  | Reason: Edited to highlight links for easy reference

Barry
User
Posted 09 Feb 2019 at 17:54
There are oral chemotherapies used in other countries, as Barry says. Abiraterone and Enzalutimide can also technically be referred to as chemo.

Reading the post, I assumed the tablets referred to were probably steroids in preparation for the start of infused chemo?

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

User
Posted 10 Feb 2019 at 12:07

Hi Barry.. We both not ok.. Have not even told family and kids the latest as right now we ourselves cannot absorb it all. We are kind of restricted with medical benefits here.. We doing the oral chemo once authorised.. And do not know where to from there.. But we still have to hope and be positive. Thanks for the feedback. Hope all well ahead for you too.

User
Posted 11 Feb 2019 at 08:04

Hi Lyn. Sorry late reply.. Quite an emotional weekend.. I think in honesty that the brachy was a waste as a month later it had spread out prostate and he went for radiation. We seeing oncologist today for plan ahead. He was on hormone injection and daily hormone tablets. Doc said to stop as not working. Mentioned a drug which we will hear today more of.. From there I do not know.. Thanks for the info. Will definately see if doc mentions any.. Just do not know what to expect ahead. Thanks Lynn

User
Posted 11 Feb 2019 at 08:09

Hi AC.. Am very hopeful if you mention 2007 and are still ok.. It is my hope and prayer. Can only remain positive and not give up

 
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