Treatment

Your brother is going to have to sort this out with the oncologist. When multiple metastases are involved there is one protocol called Triplet Therapy whereby the second generation antiandrogen and chemotherapy are started concurrently and this is demonstrating improved outcomes BUT they should commence within 12 weeks of starting hormone therapy.

https://www.clinical-genitourinary-cancer.com/article/S1558-7673(24)00002-8/fulltext

Different oncologists have different protocols but what your brother has to consider is that hormone therapy will put the cancer into hibernation whereas chemotherapy will kill it. Do you know why he has chosen to have chemotherapy after HT?

Radiotherapy is sometimes given to deal with the 'mothership' so it might be an option at a later date depending on how the cancer reacts to the initial radical treatment.

Thank you for your reply I really appreciate it . The oncologist said that it didn’t matter how he had it and I think he chose the tablets first as he was panicking about chemo etc that was his only reasoning . He does feel like his oncologist was not very informative and made him feel like there wasn’t that much hope that’s how she made him feel . He’s getting quite anxious about her saying no radiotherapy it’s in multiple lymph nodes so it won’t do any good he’s feeling very uninformed and felt very like he didn’t matter in the meeting with her  he came away feeling very low . His partner was with him and said the same never really offered much hope . I have told him that on here there is many people with diagnosis of different levels even like his and there’s lots of treatments and lots of hope 

thanknyou 
BG

It is important to have confidence in the oncologist and if you are worried then your brother can ask for a second opinion. This can be done either through the NHS or privately at a centre of excellence which would be quicker.

Thank you Alwayshope  I will pass on what you have said and I really appreciate you replying 

BG

Hello Bg65 

Don't forget The Christie NHS Trust is only an hour away.

Here's our guide to Getting A Second Opinion.

Good luck - Anything else, just ask.

Best wishes - Brian.

Thank you Brian I did discuss Christie’s today with him and I think he will get second oppinion but he’s worried because he has to go this Monday to start the Apultamide so he’s thinking if he’s already started the treatment would they still give second oppinion is it late once treatment plan started 

thank you

BG

Hello Bg65 

I can't see why not - I think it's important to start treatment but to be sure he's on the right treatment path and to make him feel confident he's on the right path a second opinion is vital.

Best wishes - Brian.

Hi Brian

thank you again for all your help he feels so much better and I do think he’s going for the second oppinion on his treatment . I feel that if second oppinion is same as first then at least it will give him some confidence in his oncologist . He does worry that he’s offending his oncologist and he’s worried about that by asking for second oppinion 

thank you

BG

Good Morning Bg65 

I think offending the oncologist is a small problem compared to ensuring that you are on the correct treatment plan for a life changing illness.

We had it last year two Community members, same diagnosis totally different attitude and treatment plan from their respective consultants.

Best wishes - Brian.