My Dad was just diagnosed with metastatic prostate cancer

Sunflower - We are here for you and your Dad. What state you in( or is your father in ? ) . this can matter on treatments. No Health insurance issues?( Why I ask is im learning in the USA your private plans can be difficult at times- In Canada we dont even pay for medicine, IV's, or MRI's ect so we have to educate ourselves about your system). But a Canadian can learn ! HA!!! Very Smart that your there for him, he needs you - very good son ! As testing progresses we will get a better idea of options. Age 80 , PSA 73 . PSMA-PET scan lit up like a Christmas tree . SO far this is not great news , BUT you have come to the right place and Cancer Care has advanced so much now ... Let us know what the Dr's say . You must have a summary from Urology( URO) , Radiation Oncologist (RO) and , Oncologist (O)and any other Dr's in the mix . How you feeling ? can you stay with your dad for a long time ? No problem about your mom , dad can visit . Usually PC treatments are not too invasive or disrupting . God Bless Sir ! James on Vancouver Island .

Given the clinical data you present they may discuss systemic therapy.

Since he is on ADT to lower his T and begin reducing tumor burden, there may be discussion about potentially adding an ARI.

Unlikely from you describe as his health would chemotherapy or radiation come into treatment discussion. That's not to say no, radiation could be used in selected locations to reduce tumor burden and the pain from those. Chemotherapy can be hard and are and fitness to go through it are important factors in that decision.

There are other agents which may come in to discussion which have been mentioned here though sometimes they are FDA approved for metastatic castrate resistant advanced prostate cancer which the clinical data you describe doesn't indicate he is.

The issues of overall health may come into play in the treatment decision as well as your father's preferences. Some mentioned palliative care. As discussed, it doesn't mean no care, may simply avoid the heroic measures.

It may seem like an oxymoron but he may be off to a "good" start, his visit to the ER, the labs and imaging, oncology starting ADT and follow on discussion with a multi-disciplinary team and YOU!

Kevin

Hopefully the first appointment will discuss treatment options and the probability of success.
All that aside, the most important and possibly curative element is the Love your father feels from you. That will be the first treatment in addition to any physician recommendations. All the best to you and your Dad…

Thank you! My Dad has a bone scan today to see what has been affected. His walking has gotten very unsteady, I ask him if anything hurts he said no.. I have to fly out this afternoon back to my husband and it breaks my heart he is alone, I just pray for GODs loving arms to hold him so he doesn’t fall😭

Hi
I'm a little late to replying here.
My husband has metastatic PC too. PSA was close to 300, CT scan then showed cancer outside the prostate which put it at advanced, then biopsy showed mostly gleason scores of 8 and 9 (a few 7s) Then PSMA Pet scan showed it everywhere! hips, pelvis, bones, lymph nodes both near the prostate and near the neck, innumerable lesions in lungs and I think that was it. Oddly enough my husband is not in pain, his problem was peeing a lot and some ED but last year was hard for us as we took care of his parents and they passed away, so the ED we thought was stress and a little pill worked sometimes 😉 I'll also say my husband is 55, eats right (eats perfectly NOW!) exercises daily- always has. He got diagnosed in February or at least that's when it all started.
Oncologist put him on ADT right away- it took QUITE some convincing!! anyways, monthly Firmagon shots (could have switched to lupron after the first firmagon shot but my husband is sticking with this for now) then eventually daily ADT pills (zytiga with prednisone), it had to be delayed because my husband had tried to take a bunch of supplements and in the end wrecked his liver (long story) but once his liver was normal again he started the pills. Now he's in the middle of Chemo (round 4 of 6 is tomorrow) and overall he's doing ok!
He's weaker and more tired, but nobody would know by looking at him, he also just looks like he has a buzz cut as he didn't lose all his hair, it's come out in chunks!
I know that it's important to eat right and exercise while on ADT and force yourself to do it, it seems to help my husband a lot!!
He IS under palliative care and now getting disability, but he's not old and frail and dying- well statistically and medically he IS, but we try to live each day to the fullest! Keep our faith in the Lord and press on!
I'm taking it harder because I don't want to be a widow so soon, after losing my in-laws in the fall and my mom two weeks after my husband's diagnosis, I do get down and depressed, but try to stay strong. We have 4 children (2 are adults, but 1 is a recent graduate and still lives at home while working, so 3 kids at home)
My husband is 100% fighting it now, which is quite the change from when it first hit us, he thought he was going to die soon, as statistically 35% make it 5 years, that's still in the back of our minds.
I'm certainly not looking forward to the "old and frail" hospital days, as I still have memories of my in-laws in and out of the hospital and hospice and nurses etc.
I guess I'm just commenting to say, hang in there, you're not alone!!

Thank you so much for writing your story! I had to fly home today and my heart broke! My Dad is 87 and my mom has Alzheimer’s and lives in a nursing home. They have been married 70 yrs! Dad does pee a lot but the only pain he has is his thighs.. He also has lesions all over and in his lungs. All of a sudden his walking is so unstable that’s what scares me more falling. I took him to the VA to apply for anything! I also have great faith that GOD is always with him, we had many talks good and bad about cancer. He also is on palliative care, no chemo because of age and he is just on bicalutamide and relugolix. Not sure about injections or pill? His next appt. Is with another oncologist in a week. I told him to just try to enjoy everyday and we are working on getting him a small motorhome to take a trip! I will be praying for you and your husband and GODs grace and peace

I feel your pain, my father in-law had dementia for years near the end too and my mother in law had a bad heart (pacemaker), it was really hard in the end, she got worse and worse and was in and out of the hospital. I'd go to the hospital, meanwhile my husband had to be with his dad, because grandpa could wander off or had no idea what's going on. (and he's a retired doctor! - so sometimes he could have full detailed conversations about her medical situation, then the other minute he's asking my husband what his job is 20 times or whatever)
When grandma passed away, we had to tell grandpa about 3 different ways, he was just sad, not crying, but just sad, didn't really talk anymore either.
He even got to hold his wife's hand or touch her hand and he perked up a minute and looked at her and then lowered his head and sat there so sadly. He passed away 9 days later!
They were both in their 90s and toward the end when he was talking, he told her that it's ok to die, that he would die soon after her! and he was right!
My mom passed away overseas (I'm from Denmark) she was in a nursing home and her health was bad but got worse at the beginning of the year and after my husband's diagnosis, she passed away 2 weeks later, I didn't get to fly over to see her, but she was in the hospital (again) and I got a nurse to hold the phone to her ear and I knew she was unresponsive but I told her I loved her and it's ok to die and then hung up and 5 min later the hospital called that she had passed away!
Death is a strange thing!
We got all 3 cremated and now have 3 trees in our yard where we put the ashed in the dirt next to the roots. 2 trees on one side of the house for my in-laws and one tree on the other side for my mom! I told my husband he better fight this because I'm not starting a collection!!

@sunflower64, I'm glad that your father is in the care of palliative experts. Palliative care is sometimes referred to as comfort care. They will keep him comfortable.

How is he doing? How did the last oncology appointment go? How are YOU doing?

My husband also had a bone scan, I really think it was just to get a "starting point" because the ADTs had cause osteoporosis later on..... in our case, the survival rate is low anyways, so I really don't think my husband has to worry to much about osteoporosis, THOUGH the cancer had spread to his bones, I didn't see the scan, just the write-up and it's all over his body, it was a fight to get him to start ADT, but the pharmacist pretty much yelled at him saying to start treatment right away or he might have a break or worse a spinal or pelvic break that could land him in a wheelchair etc. It's all very scary!
My husband is "young" and fit, he goes to the gym daily, so it's different than your dad, but if he has brittle bones now and not steady, there's a high chance of a break?!
My in-laws got Prolia shots for maybe 10yrs or more, I have no idea if your dad would qualify for that or not, I know they couldn't have surgery or teeth extracted while on Prolia, or at least not for several months maybe?
I bet you don't want to encourage a wheelchair, my mom was using a wheelchair the last few years of her life and she got worse and worse, so....

I was On Fosamax for about six years when I started ADT. It’s just a pill you take once a week and it strengthens your bones. In some cases, it can make them too strong (brittle) but that’s not a common problem for men.

It’s a lot easier on the body than Xgeva (Prolia) or Zometa.

Something to ask the doctor about.