Uncle just diagnosed - Stage 4

Apologies he has been on Bicalutamide and due to start injections next week 

Sorry to hear this Julie. He will get passed from urology to oncology, if he hasn't already.

The traditional treatment for Stage 4 is hormone therapy to manage the disease and slow down the spread, with chemo used too for patients well enough to have it.

For patients with only a very small number of mets away from the prostate, it has been shown that treating the prostate with radiotherapy also slows down progression of the disease and this is becoming more common now. It seems that blowing away the primary tumor in the prostate seems to starve new mets of some chemicals they like, but this doesn't work with widespread mets. If they are prepared to do radiotherapy on the prostate, they may be willing to include a tiny number of pelvic mets too in the radiotherapy target. This is unlikely to be curative because by the time mets show up, there are likely to be micro-mets (too small to see on scans) elsewhere too, but it is nevertheless likely to set the cancer back some way, and may extend life.

So these are some things you could ask about. There are other considerations such as his age and other health conditions, and if the risks of radiotherapy are worth any potential gains in each case.

Hi Julie

Depending on his health, there’s an assortment of treatments he will undergo, like chemotherapy which is a bit harsh, then there’s enzalutamide or arberaterone to name a few, starting hormone therapy will reduce his PSA a lot and attack the cancer, from there depends on his health is how they proceed. Admitting when I had this done, I was on the same as your uncle then chemotherapy then radiotherapy, hit it hard and fast, but I was fairly strong even at 63, now 70 ok iam feeling the effects, but still here and hope to be for another Christmas or two ( my favourite time ) so keep positive, the team know what their doing, if you have questions then ask them, that’s what their there for.

Stay safe

Joe

Hi Julie

Radiotherapy does get more difficult once in the bones.

Chemo and HT probably the best option.

Also consider clinical trials by searching cancerresearchuk.org and looking under clinical trials.

There are some new treatments specifically aiming at advanced cancers , could be worth a look.

Good luck 

Steve 

Thanks all for your replies.  We know that this isn't curable but treatable...it's just when you hear the word cancer you automatically fear the worst (as in how imminent is this going to be)....human nature I guess.  My uncle is a very young, strong and fit 72 year old and is so so positive!  We just seem to feel the need for constant reassurance at the moment x