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Prognosis for Stage 4 Metastatic Prostate Cancer
Good afternoon, and thank you to any one in advance who is reading this and is able to offer any insight/similarities with their journey.
My dad (68 yrs) started experiencing crippling pain in his back this past May, that led to him being almost completely immobile. He was ultimately diagnosed with Stage 4 metastatic/advanced prostate cancer, with metastases to his pelvic and abdominal lymph nodes, as well as to his bones. His Gleason score was 9 at the time of his biopsy, and his PSA level was 800 ng/ml.
For treatment, he has received a total of three shots of Luteinizing hormone–releasing hormone (LHRH) which he will receive indefinitely, is presently taking Darolutamide (Nubeqa), and underwent 6 cycles of chemotherapy (Docetaxel) which he completed in December. They did a round of scans halfway through his chemo and told us that although the cancer seemed to be responding to the treatment (thank goodness!), it was incurable and will eventually find its way around the Darolutamide, hormone therapy and chemo. After chemo my dad's paralyzing pain was reduced to what he described as mild discomfort, which was a huge relief. His PSA settled at 5 ng/ml in the end.
About a week ago, my dad sat me down and said that he did not want to worry me, but admitted that pain seems to be coming back in a way that is progressive and more continuous. He is really worried he is going backwards, but this has not yet been confirmed and for now we are just trying to manage the pain. He has another round of scans (CT, bone scan and blood work) scheduled for next week, and now I am feeling concerned with what they may find.
I am not really sure what to ask, or how to ask, but I am just wondering if there is anyone who can give me some insight on whether they have had a similar experience with pain returning after chemotherapy, and how they managed it.
Finally, my dad's oncologist has been hesitant to offer my dad an honest prognosis, and just keeps saying "it depends". My dad is 68, and does have a history of congestive heart failure (2017), but is healthy otherwise (no diabetes, not overweight, gave up smoking 20 years ago). I know it may potentially be difficult news, but would anyone looking at the information I provided be able to let me know honestly what they think his chances are at living another 5 years or more?
Thank you again, Phil
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Do you know what's the difference between Lu 177 PSMA and Radium 233. And which is more effective.
My husband was 58 when first diagnosed, has been Stage 4 since 2011, and is now 77.
He had docetaxel several years ago, which was quite effective, after a bunch of metastases appeared on his spine. When the cancer recurred last year on his spine and other bony spots, he had occasional radiation, mostly SBRT, to the metastases as they appeared. Now the new metastases are appearing much more frequently and in greater numbers, so systemic treatment with Pluvicto was prescribed by Dr. Kwon. He will have his third Pluvicto infusion on April 10. When we asked his medical oncologist what treatments were available after the Pluvicto, he named cabazitaxel, Xtandi, and docetaxel. We haven't asked Dr. Kwon that question yet, but will do that when we see him next. I hope that is what you wanted to know.
Xtandi stpped working after a year Heence on Radium 223 3rd injection tomorrow
Radium is only for bone mets Lu177 is all up Both similar
radium no hair loss easier to take
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1 ReactionHi @dailyeffort, Bill, did you have genetic testing done? Which was right for you?
Hi Colleen,
I had germline testing (which tests for hereditary gene mutations) done through the Promise Study. It is free for prostate cancer patients. Patients can apply through their website and complete the sample collection at home. The results can identify if some of the powerful new immunology therapies might be effective.
I have localized Gleason 9 prostate cancer with current PSA < .03 following 2 years of ADT + abiraterone and prednisone as well as proton therapy. Rather than do somatic testing (genetic testing of prostate cancer tissue or circulating DNA) on the original biopsy samples, my oncologist wants to wait and test if/when there is a biological recurrance evidenced by a rise in PSA. The reason to wait is because the tumor genetics can change from the original biopsy through modification or mutation.
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2 ReactionsIt sounds like your Dad is getting appropriate treatment by his medical oncologist. I can understand why the doctors are reluctant to give a prognosis. The field and treatments are changing so rapidly that there isn't definite data to predict survival 5-10 years down the road. I believe if he continues to get state-of-the-art treatment he will live at least another 5 years, maybe a lot longer. This is what my medical oncologists told me.
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3 ReactionsWe’re looking at COVID mutations just like prostate cancer mutations- AGREE 100%.
I am new here and thanks in advance to anyone reading and commenting. I am 77 years old and just got the news that I have osteoblastic metastatic disease. I guess I am somewhat lucky that it is not in any major organs, (heart, kidneys, liver or others). It also has not reached the bone morrow yet. I am just now being evaluated for treatment. They are looking at a three step approach, Lupron, Darolutamide, and Docetaxel. Has anyone else had this kind of treatment? I live in the Black Hills of South Dakota, so my options are not as great as if I was in a more populated location. Meantime stress and anxiety are trying to eat me alive. Thanks for reading and thanks for this forum.
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5 ReactionsURGENT I am on Zolodex every 12 weeks to reduce testosterone the fertilizer of pc
When cancer went to bones they radiated 1 inch out of L2 lumbar in 2020 Then put me on Xtandi or Enzalutamide which lasted a year keeping my PSA down to 1.7 It rose to 9.8 so takenOFF of Xtandi which fails after a year
They were going to start Chemo docetaxel when I went to PMH Princess Margaret Hospital and said NO
As its only in bones you qualify for Radium 223 or Xofigio which targets only cancer cells in bones and kills them and only the cancer cells No hair loss just a tad tired and occasional pooping One 3 minute injection in vein every 4 weeks for 6 months then another bone scan My local Mississauga hospital does it every Wed for me so no travel to Toronto Its all covered by healthcare I am 79 Had prostate radiated out in 2017 It came back 4 yrs later
They also include a 12 week needle injection of Xgeva that puts calcium from the blood back into the bones I take 600 mg of calcium with D and K pills from pharmacy as well as 2 apple cider vinegar gummies daily
GOOGLE all these names
Stop chemo get immediately on Xofigio. Lu 177 is still clinical trials but its for cancer that has spread outside the bones Radium 223 is for bone only which you have
Find Xofigio support from a oncologist Save yourself I am on 4th injection Feel great.
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