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Dad just diagnosed - what to expect

User
Posted 28 Mar 2023 at 14:34

Hi all,

My 76 year old dad has recently been diagnosed with PC.  I am just looking for some help understanding what his scores me, what the treatment is like and what are his chances of making a recovery.  

He has no symptoms and only found out due to a routine blood test.  We were told his initial exam and MRI did not show anything to worry about, but a biopsy confirmed cancer.

PSA - 6.3

Samples taken - 9

Samples that contain cancer - 3

Gleeson score - 3+4=7

T2

N0

Mx

His caner is localised.

No CT or done scan done. Why?

He has an appointment in a 3 weeks with an Oncologist to discuss and asses fitness for hormones and RT.

Many thanks.

User
Posted 28 Mar 2023 at 23:20

Your dad's life expectancy without cancer, would be about another ten years. So any treatment they give should not be so aggressive or prolonged as to spoil those years, and even if the treatment failed as long as it heald the cancer back for ten years it would be a good outcome. The scores you quote are not too bad.

Active Surveillance is an option, but with three out of nine cores positive and some Gleason 4 cancer, in five years time things may start to look a lot worse. I can't believe prostatectomy would be a good idea. The risks of incontinence and erectile dysfunction are moderately high, and though it would almost certainly remove any chance of death by prostate cancer I think the downside is excessive. I would have thought RT with perhaps six months of HT would be enough to kill the cancer or at least knock it back 10 years.

Of course his medics have seen all the test results and be able to make a better judgement than someone on the internet.

The average 76 year old would be able to tolerate RT and HT quite easily.

They may do a bone scan, but with it being T2  and a lowish PSA I think it is unlikely to have spread.

Dave

User
Posted 29 Mar 2023 at 01:26

Age is an increasingly important factor when treatment is being considered for Prostate Cancer (PCa). PC is an Acronym for Pancreatic Cancer. If Dad is fit and there are no contraindications, surgery might be an option based on the details provided. However, side effects of surgery can be more severe than HT+RT which is a major reason why this form of treatment is given to elderly men. Although HT does have some side effects, it is likely that Dad would be on these only for a short time, rather than long term as more advanced patients often are. The RT is most likely to be EBRT which is painless, rather like having an X ray but continuously from different angles. Twenty fractions (sessions), is becoming used more often but some hospitals still use the 37 fraction regime but of a lower radiation dose per fraction. There are other combinations used occasionally and indeed other forms of RT.

Some men prefer to be just monitored at least for a time but as Dad has been diagnosed at an early stage he has to consider whether he would risk cancer progression and treatment when he is older. Another possibility might be one of the Focal Therapies if he is suitable. Most hospitals don't mention this, largely because they can't offer it. However, it does mean going to London or a few other towns for the procedure having first checked on suitability. Side effects are generally milder than Surgery or RT and the procedure can be repeated or followed by Surgery or Radiation in need. I was originally treated with radiation in 2008 but because this failed had HIFU (High Intensity Focal Ultrasound) in 2015 and again in 2021. My PSA is now 0.03 and I was told last week that my recent MRI showed no cancer. HIFU and other forms of Focal Treatment can also be given as a primary treatment for PCa so maybe worth Dad investigating his suitability.

All forms of treatment have their failures and successes and men can have varying responses to treatment even if the figures of their diagnosis may be the same.

This is a link to the 'Tool Kit' with a lot of basic information about PCa and most of the major ways it is treated. https://shop.prostatecanceruk.org//our-publications/all-publications/tool-kit?limit=100

 

 

Edited by member 29 Mar 2023 at 01:29  | Reason: to highlight link

Barry
User
Posted 01 Apr 2023 at 21:29

My dad was 77 years old when diagnosed with prostate cancer. Same grade and Gleason score as your dad. My dad had 6 months of HT and RT. He had minimal side effects following the treatment. The most bothersome were/are the hot flushes. 3 years on, his PSA has stayed at 0.02, hope this continues! He celebrated his 80th birthday late last year and has recently just come back from a long holiday! This community is amazing - we would have been lost without it. Wishing your dad all the best with whichever treatment path he chooses. He will be fine.

 
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