Prognosis for Stage 4 Metastatic Prostate Cancer

Posted by phil89 @phil89, Jan 16 1:08pm

Good afternoon, and thank you to any one in advance who is reading this and is able to offer any insight/similarities with their journey.

My dad (68 yrs) started experiencing crippling pain in his back this past May, that led to him being almost completely immobile. He was ultimately diagnosed with Stage 4 metastatic/advanced prostate cancer, with metastases to his pelvic and abdominal lymph nodes, as well as to his bones. His Gleason score was 9 at the time of his biopsy, and his PSA level was 800 ng/ml.

For treatment, he has received a total of three shots of Luteinizing hormone–releasing hormone (LHRH) which he will receive indefinitely, is presently taking Darolutamide (Nubeqa), and underwent 6 cycles of chemotherapy (Docetaxel) which he completed in December. They did a round of scans halfway through his chemo and told us that although the cancer seemed to be responding to the treatment (thank goodness!), it was incurable and will eventually find its way around the Darolutamide, hormone therapy and chemo. After chemo my dad's paralyzing pain was reduced to what he described as mild discomfort, which was a huge relief. His PSA settled at 5 ng/ml in the end.

About a week ago, my dad sat me down and said that he did not want to worry me, but admitted that pain seems to be coming back in a way that is progressive and more continuous. He is really worried he is going backwards, but this has not yet been confirmed and for now we are just trying to manage the pain. He has another round of scans (CT, bone scan and blood work) scheduled for next week, and now I am feeling concerned with what they may find.

I am not really sure what to ask, or how to ask, but I am just wondering if there is anyone who can give me some insight on whether they have had a similar experience with pain returning after chemotherapy, and how they managed it.

Finally, my dad's oncologist has been hesitant to offer my dad an honest prognosis, and just keeps saying "it depends". My dad is 68, and does have a history of congestive heart failure (2017), but is healthy otherwise (no diabetes, not overweight, gave up smoking 20 years ago). I know it may potentially be difficult news, but would anyone looking at the information I provided be able to let me know honestly what they think his chances are at living another 5 years or more?

Thank you again, Phil

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melcanada | @melcanada | Mar 26 9:30am

How old are you now? I am near 80
Why not docetaxel for chemo
They tell me that's next if Xofigio fails
Advise please

melcanada | @melcanada | Mar 26 9:26am

In reply to @leeaniel "What's mets?? I'm retired in the Philippines with stage 4 Prostate cancer." + (show)

Metastasis in my spine L 1 L2 lumbar and T 6 7 8

leeaniel | @leeaniel | Mar 26 8:47am

In reply to @melcanada "I am 4 years with mets to bone Xtandi failed Now 3rd shot of Radium 223..." + (show)

What's mets??
I'm retired in the Philippines with stage 4 Prostate cancer.

leeaniel | @leeaniel | Mar 26 8:43am

In reply to @greglynch7 "I’ve had stage 4 PCA for>20 yrs. with bony Mets for 10 years. No visceral Mets...." + (show)

Thanks Greg, you made my day! 😀

melcanada | @melcanada | Mar 26 6:07am

In reply to @lag "My husband has been at Stage 4 since 2011, so for 13 years now. We have..." + (show)

Thanks See my latest reply far down below and comment pls

melcanada | @melcanada | Mar 26 6:05am

In reply to @greglynch7 "I’ve had stage 4 PCA for>20 yrs. with bony Mets for 10 years. No visceral Mets...." + (show)

I am 4 years with mets to bone Xtandi failed Now 3rd shot of Radium 223 Xgeva and Zolodex as well 2017 had radiation take prostate out 2020 radiated L2 1 inch out

How old are you now? I am near 80
Why not docetaxel for chemo
They tell me that's next if Xofigio fails
Advise please

greglynch7 | @greglynch7 | Mar 25 9:09am

I’ve had stage 4 PCA for>20 yrs. with bony Mets for 10 years. No visceral Mets. From several hormones threrapies, chemo. , radiation to radium 223 and now Pluvicto. Also had PROVENGE 6 years ago and xgeva also.
So I’ve had every treatment modality ( they may still recommend more chemo other than docetaxel).
I plan to be around for awhile but no one can prognosticate as everybody is different. My PSA is still >100 but has come down from 400 on Pluvicto.
You have multiple options at this point but be confident that many men are alive after 20 years of stage 4 disease. Hopefully you can get relief of your pain with further treatment or pain medications.
You’re not alone with this disease.

melcanada | @melcanada | Mar 25 7:07am

In reply to @lag "My husband has been at Stage 4 since 2011, so for 13 years now. We have..." + (show)

https://crukcancerintelligence.shinyapps.io/CancerStatsDataHub/

melcanada | @melcanada | Mar 24 12:00pm

In reply to @digger "Your story sounds just like mine I’ I had zovigo last winter,i get my 2 nd..." + (show)

If only in bones look at Radium 223 or Xofigio Its working for me after Xtandi failed

On Xgeva and Zolodex too

lag | @lag | Mar 22 5:54pm

My husband has been at Stage 4 since 2011, so for 13 years now. We have met many other men who have been at Stage 4 long enough that they consider their metastatic prostate cancer a chronic disease which cannot be cured but can be controlled. If you are under the treatment and monitoring of experienced providers at a highly rated cancer center, this is possible for you too, Phil. (Hooray for your daughter--you are lucky she is involved.)