1. < Prostate Cancer

Metastatic Prostate Cancer: Where do I go from here?

Posted by dsingstock @dsingstock, Sep 26, 2022

PSMA PET scan revealed radiotraser uptake in the right 7th and 9th ribs consistent with osseous metastasis. . Where do I go from here. I am 82.

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melcanada | @melcanada | Nov 20, 2022
In reply to @dsingstock "Finally met with Urologist and Oncologist. Plan is to do 30 days of Casodex, get CT..." + (show)
@dsingstock

Finally met with Urologist and Oncologist. Plan is to do 30 days of Casodex, get CT scan with contrast of my chest area to enlarge metastasized area of tye ribs and get a 6 month Lupron injection. Started Casodex but CT and Lupron injection to follow a shortly. Psa taken on 9 Nov 20.8. The one in September 12.0. Heard that I should be drinking 64 ounces of water daily with Casodex. Is this true? Also to be reevaluated every 3 months and psa taken. Any other suggestions or recommendations. Thanks and God bless for what you all are going through. Dave

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They nuked 1 inch out of my L2 lumbar I am castrate sensitive, so Zolodex is working to stop testosterone the fertilizer of PC My PSA 1.2 but after a year now up to 4.22 Getting bone scan and CT scan to see

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dsingstock | @dsingstock | Nov 19, 2022

Finally met with Urologist and Oncologist. Plan is to do 30 days of Casodex, get CT scan with contrast of my chest area to enlarge metastasized area of tye ribs and get a 6 month Lupron injection. Started Casodex but CT and Lupron injection to follow a shortly. Psa taken on 9 Nov 20.8. The one in September 12.0. Heard that I should be drinking 64 ounces of water daily with Casodex. Is this true? Also to be reevaluated every 3 months and psa taken. Any other suggestions or recommendations. Thanks and God bless for what you all are going through. Dave

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1 reply
melcanada | @melcanada | Oct 30, 2022
In reply to @plugger "Mate my feeling goes out to you. I have suffered from prostate cancer for going on..." + (show)
@plugger

Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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2017 PC with 40 days radiation Jan 2018 + Bicalutamide and 1 year Zolodex so PSA then <.01
March 2021 PSA 26 and MRI found L2 lumbar with 1 inch of cancer then intensely radiated and back on Zolodex and now every 3 months Recently PSA rose to 4.22 then 3 weeks later 5.32 I feel great but concerned I have been Stage 4 castrate sensitive metastasized Pray its not turning resistive 78 last month

Phone call with Oncologist Monday St Rita please intercede again for me

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biih | @biih | Oct 30, 2022
In reply to @plugger "Mate my feeling goes out to you. I have suffered from prostate cancer for going on..." + (show)
@plugger

Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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I am surprised ( and amazed) at the comments shared by the guys above…
My journey began in 2004-5 with PSA 6.9 and gleason 6…(Not sure the ratio). I had 8 weeks of radiation thinking the best for the future.
However, in 2021 (17 years later) MRI and biopsy showed a BCR. Even though my PSA was only 1.6, it was slowly increasing…consults with my local doctor to Memorial Sloan Kettering (NYC) recommended Salvage HD Brachytherapy…Having had radiation initially i decided against it. I am not sure about cryotherapy…From Oct. 21 to March 22, i was on firmagon (ADT) which was difficult…
I don’t know how some of you are maintaining a positive attitude…
I am waiting for a another PSA in December . It is currently - .444 after having ADT.
I hope whatever the next step i will remain positive…Thanks for sharing all of your experiences…Peace to you all…

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plugger | @plugger | Oct 30, 2022
In reply to @dsingstock "Thank you for sharing this wealth of information. Sounds like you have been to hell and..." + (show)
@dsingstock

Thank you for sharing this wealth of information. Sounds like you have been to hell and back and still maintain a positive attitude. That is wonderful and I compliment you for that. My last psa was 12.2 and rising about 1.5 per month. I am told it is non curable stage 4 and metastasized in lower right ribs. Also like with you it can be controlled with the right medication. This will happen in November when I have appointments with both Urologist and Medical Oncologist. You hit the nail on the head about staying positive. Prayers help too. I need to stay strong as I am the care giver for my other half with vascular dementia. Thank you so very much for your come back . That I really appreciate, especially the meds. Take care and God bless.

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Mate my feeling goes out to you. I have suffered from prostate cancer for going on 6 years and it has metastasized in the left ribs and sacrum. I had the prostate removed in 2017. I am also fighting balder cancer and an aggressive form of Leukaemia but remain positive and lead an active life. I am fortunate that I have a very understanding and loving wife, we have been together for over 60 years. I have been on ADT (Zoladex) for a few years and my PSA quickly went down to 0.008 and has been there ever since. I have a PSA every 3 months to coincide with bladder cancer treatment. I know that when we are confronted with difficult hurdles we remain positive and handle what is dealt to us as best we can and I am sure that God looks after us whenever hard times come around as we know they will but he will always be by our side.

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2 replies
Moderator
Colleen Young, Connect Director | @colleenyoung | Oct 29, 2022
In reply to @lleecc "I can’t help you but I think I’m in the same situation as you. I’m 77..." + (show)
@lleecc

I can’t help you but I think I’m in the same situation as you. I’m 77 and a recent bone scan revealed widespread osseous metastatic disease. Briefly,
I have very little libido and my size is pretty minimal after being on testosterone deprivation therapy for about two years. Extremely frustrating not to be as intimate as I would like with the lady I dearly love. Though she is very understanding and accommodating I know it is very difficult for her, too.

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@lleecc, to offer a woman's perspective, cuddles, touching and just being together to share experiences count as intimacy too.

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melcanada | @melcanada | Oct 21, 2022
In reply to @norske46 "@dsingstock : I am sorry to hear of your diagnosis. My first advice is to stay..." + (show)
@norske46

@dsingstock : I am sorry to hear of your diagnosis. My first advice is to stay positive and be patient (I know how hard that is). Here is my story as an example. In February 2019 I was diagnosed with metastatic prostate cancer. PSA was 541. I had cancer in my spine, some on the sternum and ribs. I started on hormone therapy using bicalutimide and added Eligard a month later (I get a shot every six months). I had 44 radiation treatments that summer. PSA dropped but started to rise again so we went to Enzalutimide. We added radium223 treatments before going to docetaxel. My PSA dropped again but now has started to rise again so I just started back on Enzalutimide to see if we can bring the PSA down again.

The take away from this is there are many treatment options available to you. Talk to your care team (primary care provider, urologist and oncologist) to develop a treatment plan. Be patient and continue to do those things that give you enjoyment. I find prayer to be helpful. As scary as the initial diagnosis is, there is time for successful treatment to bring the cancer under control. I have been at it for 3.5 + years. Stay positive.

Good luck on this difficult journey.

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4 years after 40 radiation treatment C appeared in my L2 lumbar as PSA went from <.01 to 26 Intense radiation on L2 took out 1 inch C Back on Zolodex as I am Stage 4 metastatic but castrate sensitive so PSA now 1.2 but yesterday test was 4.22 Should I be concerned? Just turned 78 Feel great
Enzalutamide waved off until if and when needed
Testosterone feeds pc Forget sex If needed you have 10 fingers and a tongue to please partner

Google St Rita saint of the impossible Her intercession has aided me amazingly I am castate sensitive because of her prayers to JESUS Oncologists had written me off and wanted chemo enzalutamide 2 years ago

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melcanada | @melcanada | Oct 21, 2022
In reply to @lleecc "I can’t help you but I think I’m in the same situation as you. I’m 77..." + (show)
@lleecc

I can’t help you but I think I’m in the same situation as you. I’m 77 and a recent bone scan revealed widespread osseous metastatic disease. Briefly,
I have very little libido and my size is pretty minimal after being on testosterone deprivation therapy for about two years. Extremely frustrating not to be as intimate as I would like with the lady I dearly love. Though she is very understanding and accommodating I know it is very difficult for her, too.

Jump to this post

4 years after 40 radiation treatment C appeared in my L2 lumbar as PSA went from <.01 to 26 Intense radiation on L2 took out 1 inch C Back on Zolodex as I am Stage 4 metastatic but castrate sensitive so PSA now 1.2 but yesterday test was 4.22 Should I be concerned? Just turned 78 Feel great
Enzalutamide waved off until if and when needed
Testosterone feeds pc Forget sex If needed you have 10 fingers and a tongue to please partner

REPLY
kujhawk1978 | @kujhawk1978 | Oct 21, 2022

News nobody wants to receive.

Don't see your clinical history so may be more challenging t answer. Things for the forum to know may include prior treatment, any data such as doubling and velocity times...

The first question my be your overall health and life expectancy as that could influence any treatment decision.

You could decide on radiation to the identified sites and then actively monitor with your medical team to see what happens.

Given there is likely micro metastatic PCa, may want to consider adding a defined period of ADT, could be 6-18 months, stop and then actively monitor.

There are other treatment options such as LU-177

https://www.urotoday.com/conference-highlights/eau-annual-congress-2022/eau-2022-prostate-cancer/138224-eau-2022-state-of-the-art-lecture-future-perspectives-in-the-management-of-mhspc-where-are-we-heading-to.html

https://www.urotoday.com/conference-highlights/2022-annual-meeting/aua-2022-prostate-cancer/137265-aua-2022-the-impact-of-older-age-on-the-oncological-outcomes-for-high-risk-mhspc-treated-with-upfront-intensive-therapy.html
Kevin

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lleecc | @lleecc | Oct 21, 2022
In reply to @dsingstock "Thank you for your reply. My prostate cancer has recurred and metastasized in my lower right..." + (show)
@dsingstock

Thank you for your reply. My prostate cancer has recurred and metastasized in my lower right rib cage. It is non curable stage 4. It is controllable but need to develop a treatment plan. We do that in November with Urologist and Medical Oncologist. Regarding sex haven't had any for over 12 years. Other half said no erections no sex. Like living with a sister. She now has vascular dementia and I am her 24/7 care giver. Thanks again for your comment. I keeping a positive attitude, healthy in other areas and trying to beat this situation.

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Thank you for your response and take solace in knowing that your spouse is fortunate in having someone like you take care of her.

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