Dad with metastasis

Hi Donnak,

what country is dad in? Mitoxantrone isn't the usual second line chemo in England; assuming he has already had docetaxel, they usually try cabazitaxel next - it is a little cheaper but also in trials was found to extend life by a little bit more than mito. Has he been offered it as part of a trial? Perhaps he has already had docetaxel and cabazitaxel without success? Has he had abiraterone or enzalutimide?

We really need a bit more information from you to be able to give you any kind of reliable info but as the doctors have indicated, chemotherapy does not kill the cancer - it may reduce the symptoms enough to make him more comfortable though.

How old is he? If he is below state pension age, he may be eligible for PIP, a benefit paid to people who are terminally ill. Usually given to people who have 6 months or less, many oncologists or nurse specialists will sign the forms off if there is a reasonable chance of it being less than 12 months. Fingers crossed your dad doesn't fall into this group yet but worth knowing about as the money would help to pay for any equipment he might need to remain mobile and comfortable and / or for home care / night sitters towards the end if needed, that kind of thing. Has he been referred to the local hospice or macmillan nurses? They can help with things like applying for benefits, day centres, holistic therapies, counselling & support for family members, and starting those difficult conversations about how the person might want the end to be. They are also the experts on pain relief, usually far more knowledgeable about pain management than the GP or hospital teams.

It might feel dreadful to be thinking about the end now but it is easier to have the really difficult conversations before the person gets too ill - if it is left until later stages, it can be frightening for the person and their family. Getting the conversations out of the way soon frees the family up to create happy memories (as much as possible in the current pandemic) in the last months or years.

It is true that some men live for years after being diagnosed with metastatic prostate cancer but these men have a good response to the hormone treatment and their PSA goes low and stabilises. If your dad has already had docetaxel then it suggests that the HT has not been able to control his cancer for quite some time so he is not in the same situation as the other men you have been reading about. If he has been on hormone patches, it may be that he was involved in a drug trial or the normal HT had already failed and they tried the patches as a last resort. Your dad's cancer is active even though it is being starved - this is known as being hormone independent or castrate resistant and sadly, men do not live for a long time once they get to that stage.