Hi all,
I'm new here. In Jan 2022 by dad (63) went into the hospital for an inflammation in his bowel and during the course of that treatment, they did other others due to an elevated PSA (in the high 10s) and he came out with a diagnosis for PC with a gleason score of 9, locally advanced, some of the nearby lymph nodes but nothing in the bone. He doesn't have private medical insurance so everything has been through the NHS, relatively speedy. They've told us it can't be eradicated, past surgery, only manageable.
He was initially put on Bicalutamide then switched to apalutamide, he's also on 3 monthly dose of goserelin, which dropped the PSA way down to 0.x, so they were doing their job of stopping the production of testosterone.
That was monitored for a while and we were then advice that the next course of action would be radiotherapy, the faster option of 6 weeks.
He went through that Jan/Feb 2023 without much adverse side effects other than the incontinence that is usually expected. His PSA started rising again shortly after the treatment - but from what we had read, this can be typical as its an inflammation marker and could take months up to a year after treatment to stabilise or even reduce.
The PSA was at 3 in April, then 5 a month later. Before the radiotherapy there was no change at all in the PSA level and there has been high stress and the expected inflammation after the radiotherapy so it makes sense that the PSA would rise.
The Doctor is suggesting that the next treatment is Chemotherapy through Docetaxel (Taxotere), 10 doses, 3 week cycles. It sounds brutal.
The whole thing has been mentioned as just the next step without much thought around the impact this will have on standard of living for my dad (we know people that have died during chemo) - the doctor seemed a bit impersonal but that's understandable, they deal with many cases. We are concerned that this is being rushed and seems like a tick box exercise, we asked to check if there were any clinical trials available and we are awaiting feedback.
Until then he's been taken off apalutamide as they say its no longer having an effect but they are keeping the goserelin.
I'd like advice on:
- If there are any other paths to try after radiotherapy or how long is a typical amount of time to wait before evaluating it's impact? 2 months seems short.
- is there possibility of getting the case reviewed by another doctor through the NHS?
He generally seems fine and fit and we know that's no longer going to be the case after chemo so this is not a decision we want to rush.
Thanks!
