Prostate cancer stage 4 with bone metastasis now spreaded to liver

Posted by amee @amee, Jul 8 10:52am

My dad diagnosed with stage 4 prostate cancer spreaded to bones on may 2023. Gleason score 3+4. So far he had orchidoctomy, docetexel chemo 6 cycle and was on enzalutamide since 15 month but recently we got a bad news that it has spreded to liver and cancer has changed its type to neuroendrocrine. Has anyone from this group has come across anything like this before and if so what are treatment option look like and also life expectancy

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Profile picture for inconsolable @inconsolable

Anyone of the doctors mentioned liver resection? I remember a patient from my father's "abiraterone group" who underwent liver resection after CT showed 2 mets , but one was too big for SyberKnife (or too close to the colon, i can't remember now) and from what I've heard he is doing just fine! Also SyberKnife is also an option. Ask the doctors. And don't give up!

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In my father's case there are few mets in the liver and all are tiny. Not sure if early diagnose would have that option. Rightnow he has started carboplatib + etopside. We are hoping for the best.

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Profile picture for amee @amee

In my dad's case it happened after taking enzalutamide for 15 months. If we would have picked different medication like abirateroen would have prevent it?
Also not sure if it is due to the treatment path we had Orchidactomy to start with and then chemo and enzalutamide.
Or combination of orchidactomy and enzalutamide.
Or instead of enzalutamide we would have gone for Lu 177 would have prevent it?

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First, I am sorry to hear this progression for your Dad - this cancer is a beast. I am curious to know how you discovered the transition to neuroendocrine? Via a new biopsy or blood test? I know there are a couple tests like CgA and ?Napsen, but not sure about other ways to confirm.

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Profile picture for dpfbanks @dpfbanks

First, I am sorry to hear this progression for your Dad - this cancer is a beast. I am curious to know how you discovered the transition to neuroendocrine? Via a new biopsy or blood test? I know there are a couple tests like CgA and ?Napsen, but not sure about other ways to confirm.

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Via new biopsy

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Profile picture for amee @amee

In my father's case there are few mets in the liver and all are tiny. Not sure if early diagnose would have that option. Rightnow he has started carboplatib + etopside. We are hoping for the best.

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Great, tiny is always good to hear when it comes to cancer. I would definitely ask about radiation, maybe after chemo or if chemo doesn't work, CyberKnife is really effective in killing mets but they have to be up to a certain size, i think for liver it's 5cm (around 2 inches). Best wishes to your dad❤️

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I have not heard of the change to neuroendocrine. I have prostate cancer that metastasized to my liver and bones. Biopsy revealed it is all adenocarcinoma which means it originated in the prostate. I wish your father the best and pray that he lives long and pain free.

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Profile picture for inconsolable @inconsolable

Great, tiny is always good to hear when it comes to cancer. I would definitely ask about radiation, maybe after chemo or if chemo doesn't work, CyberKnife is really effective in killing mets but they have to be up to a certain size, i think for liver it's 5cm (around 2 inches). Best wishes to your dad❤️

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His biggest is 3cm

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Profile picture for jspbap @jspbap

I have not heard of the change to neuroendocrine. I have prostate cancer that metastasized to my liver and bones. Biopsy revealed it is all adenocarcinoma which means it originated in the prostate. I wish your father the best and pray that he lives long and pain free.

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I was under same impression. But this is therapy related. May know what was the treatment you have done so far after diagnosed with prostate cancer

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For the past 3 years I have been on Lupron injections every 3 months and Nubeqa 600mg twice a day. There are some side effects though none of them serious enough to discontinue the medication. Since I have adenocarcinoma, the idea is to keep my testosterone and PSA to virtually zero. My doctor elected not to introduce chemo or other drugs unless there are signs that the present treatment is no longer working. I have had no further scans as their results would not change the course of treatment. Also, I’m 76, a young 76 but still old. Quality of life at this time is more important than quantity. Again I would like to give my prayers to your Dad for a long, painless life.

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Profile picture for amee @amee

His biggest is 3cm

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Perfect, so you have a backup then and if that fails you have another backup-resection. If i understood the radiologist on the CyberKnife correctly, you only need 1/6 of the liver to be working properly to lead a normal life.

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