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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spryguy | @spryguy | Oct 2, 2022
In reply to @dsingstock "Thanks my Doc was talking Lupon before the last scan. Will let you know what happens..." + (show)
@dsingstock

Thanks my Doc was talking Lupon before the last scan. Will let you know what happens on Wednesday.

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Thanks, Let me know.

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proftom2 | @proftom2 | Oct 3, 2022

First, you're at the right place. Mayo Connect is full of a bunch of supportive cancer friends walking the same path. Lots of learning from your Docs and Researchers ahead and your new friends here.

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lleecc | @lleecc | Oct 20, 2022

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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3 replies
dsingstock | @dsingstock | Oct 20, 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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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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2 replies
dsingstock | @dsingstock | Oct 20, 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

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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1 reply
norske46 | @norske46 | Oct 20, 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.

Jump to this post

@dsingstock: Life certainly gets complicated. Caring for your other half is a full-time job. You certainly don't need the complications of Stage 4 metastatic prostate cancer. However. We play ghe cards we are dealt. We just keep pushing forward trust your medical team and try to stay positive. .

As an update on my case, I reacted badly to going back on enzalutimide. My legs and body are extremely weak with no stamina. My appetite has dropped to nil. Eating is hard work. My PSA has gone up to 1011. Now I am waiting for another round of scans next week: endoscopy, colonoscopy, MRI, bone scan, CT scan. Options for treatment look like either another round of chemo or a round of Lu177 (Pluvicto).

Good luck with your tests and treatment plan, I pray you get it under control.

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1 reply
dsingstock | @dsingstock | Oct 20, 2022
In reply to @norske46 "@dsingstock: Life certainly gets complicated. Caring for your other half is a full-time job. You certainly..." + (show)
@norske46

@dsingstock: Life certainly gets complicated. Caring for your other half is a full-time job. You certainly don't need the complications of Stage 4 metastatic prostate cancer. However. We play ghe cards we are dealt. We just keep pushing forward trust your medical team and try to stay positive. .

As an update on my case, I reacted badly to going back on enzalutimide. My legs and body are extremely weak with no stamina. My appetite has dropped to nil. Eating is hard work. My PSA has gone up to 1011. Now I am waiting for another round of scans next week: endoscopy, colonoscopy, MRI, bone scan, CT scan. Options for treatment look like either another round of chemo or a round of Lu177 (Pluvicto).

Good luck with your tests and treatment plan, I pray you get it under control.

Jump to this post

Thanks for getting back to me. Many prayers your way my friend, as you have a tough row to hoe. Hopefully the light at the end of the tunnel is near. Take care.

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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.

Jump to this post

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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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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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

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