How bad is it?

Hi Betty7,

Welcome to the online community. My name is Anne, and I’m one of the Nurses on the Support Line. I’m sorry to read that your father has been diagnosed with prostate cancer and am glad you have reached out to us for more support. I understand how confusing and overwhelming it can feel when a loved one is diagnosed with cancer. There is often a lot of medical jargon and terminology used which can add to the confusion.

It's important that you and your father understand his diagnosis and have an opportunity to ask about his prognosis, if desired. It can be difficult to advise on someone’s prognosis as it depends on how well they respond to treatment and how quickly the cancer cells are growing. However, your father’s consultant or Clinical Nurse Specialist (CNS) should be able to have a chat with you about this in more detail.

It may help for me to explain a bit more about the diagnosis he has been given. There are 4 main stages of prostate cancer which go from T1 to T4. T means tumour and 4 means the cancer has spread into other nearby organs. N refers to ‘nodes’ and N1 means there are cancer cells in the lymph nodes near the prostate. M stands for ‘metastasis’ and M1a means there are cancer cells in lymph nodes outside the pelvis. You may also hear this referred to as advanced prostate cancer. You may find it helpful to read through our information on advanced cancer.

The Gleason score refers to how quickly the cancer is likely to grow or how aggressive the cancer is. Prostate Cancer UK has information which explains the Gleason score in more detail. A Gleason score of 9 means the cancer is classed as high-grade (more likely to grow quickly).

I’m glad to hear that your dad is managing to walk fine at the moment. However, I understand the physiotherapist has suggested arranging a stair lift as soon as possible. With advanced cancer, it’s difficult to predict how quickly things may change and how much someone’s mobility may be affected. However, in most cases, it is good to be as prepared as possible early on so that people can continue to be as independent as they can be by having equipment in place should they need it.

You mentioned your dad is on Degarelix and is considering starting Apalutamide. Hopefully he won’t experience too many side effects of these drugs. If he is struggling with any side effects or unsure about new symptoms, do encourage him to speak to his GP or his healthcare team at the Hospital. There are usually ways to manage most side effects.

It must be a difficult time for both you and your dad. Please don’t hesitate to give us a call if you’d like to talk things over with one of my colleagues. Our family and friends forum may also be worth considering for some peer support for yourself.

Take care for now,

Anne - Cancer Information Nurse Specialist

Cancer Information Nurse Specialist 

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

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