My father has metastatic prostate cancer with bone lesions in the ribs, shoulder, and legs. His PSA has remained very low for the past two years, and overall he is active. Based on survival statistics, how much chance is there for patients with bone metastasis to live beyond 5 years when PSA stays low?
Secondly, For patients with bone metastasis, how do families and doctors usually recognize when the disease is entering its final stage? What are the common signs that the end may be approaching, even if PSA is low?
My question arrises from by seeing my father health, eventhough he seems to be active , I can clearly see he has been getting week. He is 72 years now , he is under going Harmonal treatment recently our Oncologist changed the treatment from ZOLADEX & ZOMETA to ZOLEDRONIC ACID & DEGARELIX Injections. Since this change i could see mild pain in his bones. This is what worries me hence asked these two questions.
Hello MIKL
Thank your for your post - some hard questions there - so here's my answers based on personal experience.
Prognosis. We are all different. The standard prognosis for Stage 4 is to say 5 years. Statistics (which are about 4 years old) show 33% of men with Stage 4 outlive the 5 years.
PSA - It's not the best way of tracking the progression. I would say the MRI/Bone Scan/PSMA-PET Scan would be better but you won't get the NHS doing these on a regular basis. PSA can be a fair indicator but there are exceptions - aggressive cancer cells lose the ability to produce PSA, Hormone Therapy keeps PSA low, your father could be a "low secretor", and there are more.
The End - Again we are all different. Your father is 72 so old age is a factor, any other co-morbidities are also a factor. Bone pain is a significant indicator, but as I said we are all different.
Personally I know why you are asking the questions - however I am sure his team are doing all they can to support him. All I can say is keep an eye on him, report any changes in his health to his team, be there for him when he needs you (even if he thinks he's fine) and take time to make as many memories as you can.
We are all terminal as human beings - and we have stage 4 members on the Community way past their "5 year" date.
I apologise for being blunt - I am being honest from what I have seen. Happy to answer any questions. I have plenty of resources should things deteriorate in the future, but hope they won't be needed for a long while.
Best wishes - Brian.
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