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Newly diagnosed stage 4, how long on ADT before adding ARSI?
Prostate Cancer | Last Active: 9 hours ago | Replies (12)Comment receiving replies
Thanks for the perspective North! I think the next time I meet I will just directly ask if he is delaying due to my dad's age or because that is his standard practice. I think that will at least make me understand his reasoning more clearly and I can make my assessments/judgements from there. He didn't phrase it that way when explaining, but maybe he was just trying to sugar coat my dad's age in front of him. Which is totally ok, but I took it more as not being as aggressive as I'd like to attack the situation. Obviously, he is just starting to get to know my dad and so I can sympathize from his standpoint not wanting to over prescribe a 83 year old that might not be in the best health for all he really knows. I'm obviously bias, but think my dad is doing good for a 83 year old and just has the normal slightly elevated stuff common for his age that is easily managed (blood pressure, cholesterol).
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I've heard elsewhere that one rule of thumb for aggressive treatment is to recommend it only if the patient otherwise would have an expectation of at least 10 years of good-quality life without the cancer.
Obviously, individual patients might choose differently (for example, an extra 2 years might be worth chemo for some patients), but since the majority of 83 year olds don't expect another 10 good years, there's a good chance that's where the doctor is defaulting to.
There's been a lot of push-back against over-treatment of advanced cancer in the elderly in recent years, so doctors might be a little more hestitant, but if your dad wants aggressive treatment and makes it clear to them that he wants that, then he should be able to get it somewhere.
Again, best of luck. Unfortunately, we have to be our own advocates — I must have asked for everything I wanted at least 5× (stubbornly but politely).