1. < Prostate Cancer

matatisized prostate cancer

Posted by bmjob @bmjob, 3 days ago

My husband (85 years old and loves his quality of life) was diagnosed with metastasized prostate cancer in March 2025: stage 4 and Gleason of 7.
no symptoms of prostate cancer. Had a PSA 6 years ago, which was 3.2. They stopped giving them when you get older.
Recent pSA 32.
After high PSA, they did testing, and the PSMA scan found that the lymph nodes are
Stage 4 in the Pelvis and stomach, not in bones or organs as of now.

So far, no treatment. he is having a hard time thinking about treatment as he has afib, diabetes, and high blood pressure, and just does not feel good
Any comments please.

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brianjarvis | @brianjarvis | 3 days ago

At 85y and quality of life being a priority, only he knows what that level of QoL looks like to him.

> Regarding his Gleason 7, is that a 3+4 or a 4+3?

> Did his MRI or biopsy report indicate phrases like cribriform pattern, extracapsular extension, seminal vesicle invasion, perineural invasion or intraductal carcinoma mentioned? (If not, that’s good. Some of those terms are indicators of more advanced disease.)

> In his PSMA PET scan report, what were the SUVmax scores assigned to the lesions in his lymph nodes and in his prostate? Those SUVmax scores indicate the severity of the cancers.

> Has he had his biomarker (genomic) and genetic (germline) tests yet?

> Has he enrolled in any prostate cancer support groups yet?

If I were in his circumstance - especially with other risk factors (age) and comorbidities (e.g., afib, diabetes, and high blood pressure) - I would discuss conservative approaches with my doctor that buys me time and treats the disease, with the best QoL

Usually, at his age and health status, they would recommend Watchful Waiting (https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/watchful-waiting-for-prostate-cancer), but since it’s already metastatisuzed, they won’t recommend thst.

Your husband’s experience is a good lesson-learned for others:

> Whenever they stop “giving them when you get older” - all men have to do is ask to have the PSA test included with all the other bloodwork. That’s all it takes.

> Prostate cancer is usually asymptomatic, which is why early and annual screening for early detection is important.

Wishing him the best and keep asking questions.

REPLY
beaquilter | @beaquilter | 1 day ago

Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in good health and only symptom was peeing frequently which we thought was just an enlarged prostate and part of getting older.
PSA in Feb was 300 or around there, that triggered a pelvic CT scan which showed cancer in lymph nodes and outside prostate so stage 4! Then a biopsy and most of the Gleason scores were 8-9! so fast growing aggressive cancer cells!
Then finally a PSMA scan and it showed it all over his body, his lungs, spine, pelvic bone, lymph nodes near lungs and I forget where else, sounds like he lit up like a Christmas tree! (I did suspect the lungs because he's had this very mild ahem cough for YEARS!)
We don't GO to the doctor, he probably went last in 2019! Ever since Covid, we've REALLY NOT wanted to go to the doctors....
Anyways, here we are.
Treatment has been ADT shots and ADT pills, my husband was VERY against being chemically castrated! He works out at the gym daily and really thought it's his manhood, that he'd rather die than being castrated. But after long arguments and talking to different people, he finally agreed to do the ADT hormone shot, Firmagon (which I'm finding out is an OLD shot, but unlike Lupron it doesn't raise testosterone first and then plummets, the Firmagon just lowers it, and with such severe cancer it was the best option) He was supposed to just get the Firmagon once and THEN switch to lupron, because the side effects (anger etc) are not as severe once the testosterone is already lowered, but my husband hasn't switched yet, so we go monthly to get these injections.
Early on, he researched EVERYTHING online and tried supplements and lots of things, resulting in his liver ALT numbers going way up, to the point where he was in liver failure (blood work wise) but felt totally fine and had no symptoms, but he quit everything!
Then after his liver got almost normal he started daily ADT pills (Zytiga) and Prednisone (steroids)
He IS a lot weaker and more tired but he keeps going to the gym almost daily and does stuff around the house and we walk the dog every morning etc.
almost 2 weeks ago he started chemo (Docetaxel) and it's supposed to be 6 rounds 3 weeks apart! (He refused chemo for a while too but finally relented)
I don't know about radiation, they talked about it briefly at our first visit, but I think they'll see later, because it seems radiation is pointless if he's riddled with cancer! but hopefully this triple therapy gets things under control and scans will get better!
It's been tough, but we're hanging in there, he's very conscious of quality vs quantity of life but has also realized that it's not just about him, it's also about me (his wife) and our 4 kids (9-22yrs, 3 still live at home)
Hang in there!

REPLY
2 replies
brianjarvis | @brianjarvis | 1 day ago
In reply to @beaquilter "Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in..." + (show)
@beaquilter

Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in good health and only symptom was peeing frequently which we thought was just an enlarged prostate and part of getting older.
PSA in Feb was 300 or around there, that triggered a pelvic CT scan which showed cancer in lymph nodes and outside prostate so stage 4! Then a biopsy and most of the Gleason scores were 8-9! so fast growing aggressive cancer cells!
Then finally a PSMA scan and it showed it all over his body, his lungs, spine, pelvic bone, lymph nodes near lungs and I forget where else, sounds like he lit up like a Christmas tree! (I did suspect the lungs because he's had this very mild ahem cough for YEARS!)
We don't GO to the doctor, he probably went last in 2019! Ever since Covid, we've REALLY NOT wanted to go to the doctors....
Anyways, here we are.
Treatment has been ADT shots and ADT pills, my husband was VERY against being chemically castrated! He works out at the gym daily and really thought it's his manhood, that he'd rather die than being castrated. But after long arguments and talking to different people, he finally agreed to do the ADT hormone shot, Firmagon (which I'm finding out is an OLD shot, but unlike Lupron it doesn't raise testosterone first and then plummets, the Firmagon just lowers it, and with such severe cancer it was the best option) He was supposed to just get the Firmagon once and THEN switch to lupron, because the side effects (anger etc) are not as severe once the testosterone is already lowered, but my husband hasn't switched yet, so we go monthly to get these injections.
Early on, he researched EVERYTHING online and tried supplements and lots of things, resulting in his liver ALT numbers going way up, to the point where he was in liver failure (blood work wise) but felt totally fine and had no symptoms, but he quit everything!
Then after his liver got almost normal he started daily ADT pills (Zytiga) and Prednisone (steroids)
He IS a lot weaker and more tired but he keeps going to the gym almost daily and does stuff around the house and we walk the dog every morning etc.
almost 2 weeks ago he started chemo (Docetaxel) and it's supposed to be 6 rounds 3 weeks apart! (He refused chemo for a while too but finally relented)
I don't know about radiation, they talked about it briefly at our first visit, but I think they'll see later, because it seems radiation is pointless if he's riddled with cancer! but hopefully this triple therapy gets things under control and scans will get better!
It's been tough, but we're hanging in there, he's very conscious of quality vs quantity of life but has also realized that it's not just about him, it's also about me (his wife) and our 4 kids (9-22yrs, 3 still live at home)
Hang in there!

Jump to this post

Whenever I start thinking too hard about the journey that I’ve been through, I think about this guy who had these (attached) numbers.

He attends a prostate cancer support group Zoom meeting every Wednesday evening. He’s a wealth of knowledge, and will answer any questions you have.

Your husband and you should join in that Wednesday evening Zoom meeting.
REPLY
melcanada | @melcanada | 9 hours ago
In reply to @beaquilter "Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in..." + (show)
@beaquilter

Hey, my husband is stage 4 as well and newly diagnosed. Devastating! He's 55 and in good health and only symptom was peeing frequently which we thought was just an enlarged prostate and part of getting older.
PSA in Feb was 300 or around there, that triggered a pelvic CT scan which showed cancer in lymph nodes and outside prostate so stage 4! Then a biopsy and most of the Gleason scores were 8-9! so fast growing aggressive cancer cells!
Then finally a PSMA scan and it showed it all over his body, his lungs, spine, pelvic bone, lymph nodes near lungs and I forget where else, sounds like he lit up like a Christmas tree! (I did suspect the lungs because he's had this very mild ahem cough for YEARS!)
We don't GO to the doctor, he probably went last in 2019! Ever since Covid, we've REALLY NOT wanted to go to the doctors....
Anyways, here we are.
Treatment has been ADT shots and ADT pills, my husband was VERY against being chemically castrated! He works out at the gym daily and really thought it's his manhood, that he'd rather die than being castrated. But after long arguments and talking to different people, he finally agreed to do the ADT hormone shot, Firmagon (which I'm finding out is an OLD shot, but unlike Lupron it doesn't raise testosterone first and then plummets, the Firmagon just lowers it, and with such severe cancer it was the best option) He was supposed to just get the Firmagon once and THEN switch to lupron, because the side effects (anger etc) are not as severe once the testosterone is already lowered, but my husband hasn't switched yet, so we go monthly to get these injections.
Early on, he researched EVERYTHING online and tried supplements and lots of things, resulting in his liver ALT numbers going way up, to the point where he was in liver failure (blood work wise) but felt totally fine and had no symptoms, but he quit everything!
Then after his liver got almost normal he started daily ADT pills (Zytiga) and Prednisone (steroids)
He IS a lot weaker and more tired but he keeps going to the gym almost daily and does stuff around the house and we walk the dog every morning etc.
almost 2 weeks ago he started chemo (Docetaxel) and it's supposed to be 6 rounds 3 weeks apart! (He refused chemo for a while too but finally relented)
I don't know about radiation, they talked about it briefly at our first visit, but I think they'll see later, because it seems radiation is pointless if he's riddled with cancer! but hopefully this triple therapy gets things under control and scans will get better!
It's been tough, but we're hanging in there, he's very conscious of quality vs quantity of life but has also realized that it's not just about him, it's also about me (his wife) and our 4 kids (9-22yrs, 3 still live at home)
Hang in there!

Jump to this post

JUST DID MORE PALATIVE RADIATION ON SCAPULA BONE AND t 10 TO 4 iT HELPS A LOT

oN ABITRATERONE AND PREDNESONE I QUALIFT FOR lu 177 IF AND WHEN

80 YEARS AND 9 YEARS SINCE RADIATION OF PROSTATE

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