Treatment Plans For Advance Prostrate cancer

I'm in the same place you are, maybe a step or two ahead. Has he had a PSMA-Pet scan? That's probably the next step. Then look into the PSMAddition phase III trial comparing standard of care to Lu-177 (which has shown good results so far), NCT04720157 . It won't let me post the link but google the name or number and it should come up.

Welcome @shineon, I noticed that you wished to post a URL to a research trial with your post. You will be able to add URLs to your posts in a few days. There is a brief period where new members can't post links. We do this to deter spammers and keep the community safe. Clearly the link you wanted to post is not spam. Please allow me to post it for you.

- An International Prospective Open-label, Randomized, Phase III Study Comparing 177Lu-PSMA-617 in Combination With SoC, Versus SoC Alone, in Adult Male Patients With mHSPC (PSMAddition) https://clinicaltrials.gov/ct2/show/NCT04720157

Have you taken part in a clinical trial before?

@kamiljan01, deciding on a treatment plan is something that members talk about often in the forum. You might find this discussion useful:
- How to choose treatment for prostate cancer?: https://connect.mayoclinic.org/discussion/how-to-choose-treatment/

What treatment options have your brother's cancer team suggested for him?

The decision your brother and his medical team will be based on many factors, some clinical, some personal preferences.

You indicate some of the clinical data, age, stage, there are other pieces missing which can help the forum provide feedback based on our journey and personal "research."

Did he have a biopsy, if so, what did the pathology report say?
You say it has spread outside the prostate, that tells us he had imaging, what it doesn't tell us is what type of imaging, what were the results, was the cancer found in the lymph nodes, bones, organs, if so, where?
What is his general state of health, any cardiovascular issues, diabetic...
Any family history of prostate cancer?

One place to start is the NCCN Guidelines, they are the standard of care. I've attached those.
The Prostate Cancer Foundation has an excellent guide too - https://www.pcf.org/guide/prostate-cancer-patient-guide/

His treatment decision should be based on the clinical data, his preferences for treatment, balancing quantity versus quality of life and be informed by doing his "homework." The choices will be many...

Kevin

I went traditional based on cancer teams recommendations: (1) Radiation, (2) Chemo, (3) Hormone, (4) Trials.

Mindful I knew nothing about stage IV prostate cancer before I got it. "That couldn't happen to me," I thought. Tens years of watchful waiting PSA's suddenly it/PSA goes from slightly elevated to 100+ within 2 months. Emergency room diagnosis because my urologist was on vacation. Thats okay people deserves vacations. Within two days I was introduced to my cancer team by wonderful PA. Started treatment within a few days. Bedridden for 6 months. My wellness, which I live by now, began to return. I'm in year three now. Tell you brother life gets better with one hitch. Your old life doesn't return. It never will. Your new life is what you make of it. Hard to believe but I am a better version of myself cancer or not.

I concur about using these resources, with one caveat. The PCF (Prostate Cancer Foundation) guide seems (to me) to have a bias against Proton Beam Therapy. They label it “experimental”.
It’s my impression that PBT may be a very effective focused treatment for prostate cancer metastases; minimizing ancillary damage from traditional radiation.
Some resources regarding metastasized prostate cancer the Prostate Cancer Research Institute:
Advanced Prostate Cancer Support Group Leader:
https://youtu.be/c2FpNpm6LRQ
16 Years Surviving Metastatic Prostate Cancer:
https://youtu.be/OvtufEjj7ig
Overview Advanced Prostate Cancer Treatments
https://youtu.be/8Fq1EOprcjc

One of the things to remember with Prostate Cancer is that diagnostic tools and treatments are evolving rapidly. Since my own diagnosis 11/2019 and PBT treatment 01/2020 the new PSMA pet scans have been approved and new treatment regimes. Perhaps I am optimistic, but I would say that where we are now is not where we will be in two years time.

There are many resources when trying to determine what to do.

That's good news, lots of information...the flip side, overload, conflicting...

The Kwon videos are useful too though I have seen people disagree, too include his peers.

Kevin

Psa reading of my dad is 3000. He is 73 years old and was having body ache and constipation from last 6 month.
Pet scan shows that it has spread a lot. What are the best treatment options and all the recovery stories are wlecome.

I just want to wish your dad the best of luck with his treatments of choice, my husbands chemo was Lupron

It may help members of the forum to provide more clinical information, exactly where did the PET CT scan say the PCa was, lymph nodes, bones, organs... was there a biopsy, has he had any labs...what is his health condition

A starting point would be to read the NCCN guidelines - https://www.nccn.org/guidelines/guidelines-detail?category=patients&id=50. Those will give you a baseline for treatment discussions with his medical team. That team should include a urologist, radiologist and oncologist, preferably with expertise and concentration in PCa.

I say his health because one of the treatment consideration may include chemotherapy. Other health issues such as cardiovascular disease play in treatment decisions. Another matter to discuss with your father is quality and quantity of life. Any treatment options have side affects so it can be a tradeoff, longer life but with some side affects he will just live with.

Finally, do some homework on doublet and triplet therapy, then discuss with him and his medical team. Here is one link, you can find others - https://ascopost.com/video-roundtable/updates-in-prostate-cancer-1/doublet-or-triplet-androgen-deprivation-therapy-options-for-metastatic-prostate-cancer/

The clinical data you did share with the forum indicates an aggressive PCa which may require aggressive treatment.

Kevin