Hello all, I've posted on here a couple of times about my lovely 83 year old dad, but not for a while. He was diagnosed with locally advanced Prostate Cancer Gleason 9 (4+5) nearly 7.5 years ago. He had radiotherapy and HT for 3 years, but in late 2019, about 18 months after stopping the HT, we were told that the cancer had spread to his aortocaval and retroduodenal lymph nodes and also to his bones. He recommenced HT and 6 months later started Enzalutamide. This seemed to help his PSA for nearly 18 months but after continuous rises, he was scanned late last year and found to have progression, with widespread bone disease, but no soft tissue disease. He has a right mandible lesion and progression in bilateral iliac bones. I think from reading on here, having metastasis to the jaw leads to a worse prognosis doesn't it?
They stopped the Enzalutamide and started him on Radium 223. He had a lot of pain in his jaw after the first couple of sessions and due to the cancer having metastasized there was given 5 sessions of radiotherapy, which seemed to do the trick. He was able to carry on with the Radium 223 treatment, and just had his final one today. I have been in regular contact with the radiographer dealing with dad's treatment, and she said that on average, the treatment should give an extra 4 months lifespan on average, but stressed that was in addition to his lifespan without it and that the treatment is not given to anyone with a prognosis of less than 6 months.
He has always been incredibly active, even running regularly until around a year ago but we have noticed quite a decline in him over the last few months. He can't walk as far and looks quite frail at times. It's not helped by him having to have 5 teeth out in preparation for the Radium treatment (he's now looking at having dentures fitted which I think will help his confidence). He also has other health conditions, he had surgery for Anal Cancer in early 2019, which appears to have been caught in time hopefully. He has Atrial fibrillation and mitral regurgitation and has also had several skin cancers removed over the years, and is on the waiting list for another op - poor thing! The heart consultant has been very pleased with his progress on his medications however and said he is now stable.
Now of course we know he won't go on forever, but I was just wondering if anyone knows what we can expect from here? He has a telephone appointment with the Oncologist in just over a month's time and I'm wondering if she will be able to offer him any more treatment? He has been having a bit of a soreness in his ribs over the last few weeks so whether she will arrange another scan, we're not sure. They did mention chemo before but with his heart problems, we're not sure whether that will really be an option and also given his age, not sure he will really want to embark on a treatment that could so reduce his quality of life. I've heard about Lutetium 177 and was wondering, if dad was a candidate, how we go about accessing it if the hospital are unable to offer it to him (I know it's not available everywhere on the NHS). We are in Bristol.
Thanks and sorry for the long post!