Second opinion for husband's stage 4A prostate cancer? And update

Posted by cheriekhan @cheriekhan, May 14 2:07pm

My partner was diagnosed with stage 4 A prostate cancer with spread to pelvic lymph nodes. Oncologist has recommended surgery followed by radiation and hormone therapy for a good prognosis. He is 65 healthy and no symptoms. PSA was 11. Has a history of prostrate cancer. Was wondering if we should get another opinion regarding getting surgery first. The dr wants to treat it aggressively. Any advice on what to expect, next steps appreciated.

More Information: Hi father died of prostrate cancer as did his uncle. His Gleason score was 9. And all 12 pieces of the biopsies had cancer: Prostatic adenocarcinoma, Grade Group 5 (Gleason score 4+5=9), involving 100%, 100%, 90%, 90%, 90%, and 80% (15 mm, 14 mm, 14 mm, 14 mm, 14 mm, 5 mm) of 6/6 cores. PSMA pet scan results: Intense PSMA uptake in the prostrate gland from apex to base.No psma avid osseous metastases. Non puma avid low attenuation bilateral adrenal nodule are indeterminant. Recommend dedicated contrast imaging for further evaluation. They did genetic testing waiting for results. This is being done at Cornell Weil in Manhattan with experts in the field.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

@ganway

My husband has stage 4 prostate cancer that has gone to his limth nodes and spinal column and even the neck and shoulder bones. They do not recommend surgery for this once healthy 88 year old. The only treatment is the Fermagon shots every month and Xtandi pills 80 mg a day. He has seen a medical onchologist . They are only doing the hormone therapy to block the testoterone. I am wondering if he shouldnt go to Vanderbilt or omewhere else for advice. Can anyone suggest anything else? They have given him maybe 3 years.

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Hi @ganway, I'm sorry to hear that your husband has stage 4 prostate cancer. Once cancer has spread, the surgical options are not commonly used. Here's more information from Mayo Clinic about treatment options for stage 4 prostate cancer. https://www.mayoclinic.org/diseases-conditions/stage-4-prostate-cancer/diagnosis-treatment/drc-20377972

You might be interested in these 2 discussions where members are talking about treatment for stage 4 cancer with Firmagon:
- Stage 4 prostate Cancer: Firmagon + Abiraterone?
https://connect.mayoclinic.org/discussion/stage-4-prostate-cancer-metastasis-to-bones/

- Has anyone else moved from Firmagon to Orgovyx?
https://connect.mayoclinic.org/discussion/has-anyone-else-moved-from-firmagon-to-orgovyx/

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