Help please for understanding thing

Hi Nillie & welcome

You've raised a lot of issues here but I will try and answer your main two.

Firstly looks like your dad has done alright since first diagnosed all those years ago considering he didn't have any treatment initially.

About the Gleeson score, I think it is possible that the Gleeson score can go up over time and the cancer gets more aggressive. But not necessarily and the only way to tell is to have another biopsy.

A psa result of  125 is quite high but doesn't automatically mean that it's spread to the bones. It is possible that some scans might not show the cancer, I believe the best scan is a PSMA pet scan for detecting PC that had spread to the bones. Perhaps it's time for another biopsy and bone scan or MRI initially to see what's going on

All the best

Steve

My dad is 84 and has had prostrate cancer for a number of years, he has regular check ups and his PSA is about 48.

I can't answer your questions but he was told about 50% of men aged 70 or over will actually have some cancer in their prostrate, and its is very usually very slow growing, almost dormant in many cases, in thee elderly men.

This is not an official medical response but trying to help you proportionalise things. It seems to me he has made decisions about it and is making sensible decisions as he goes along.

Prostrate cancer is known as the silent killer and anyone with suspected symptoms should get medical advice of course, but again, in elderly men, it is often a much slower growing cancer.

Thanks a lot Steve, i tried to ask him which scan he had for his bone scan but no luck at all as he does not remember the name, however i am going to see him about 2.5 weeks later so will try to check if i can see any hospital letter etc. Also because he has had his last bone scan about 2 months ago i doubt if they would do another one soon :(( but i will have a look for PSMA pet scan thanks a lot

Nillie 

Hi Nick. Thanks for the answer. When he refused having operation or other offers he has been made, i was little bit angry with him, however now i am thinking he has made the best decision for himself to be honest as it seems slower growing cancer as you say.

Probably forget about the bone scan then, as u say they won't do another so soon and anyway looking on the bright side, it was clear.

An MRI or CT scan at some stage to possibly see what is happening with lymph nodes.

Hopefully the HT might have sorted that one though.

Steve

Yes hopefully HT will work for a long time. By the way there is some point which i did not understand as well. Why only urologist check him? End of the day it is cancer so why oncologist does not involve as there are metastasis. Is it how things work in the UK? I mean even it is prostate cancer does it mean it should be only urologist's responsibility and decision what treatment he should be having?

Thanks

Nillie

Nillie

I think that urologist refers to everything in that area ie :waterworks corner etc an oncologist is someone who specializes in cancer. Possibly get him to see an oncologist at some stage.

If your dad has been seeing the same person for years it would be good to get a different view on the matter anyway

Steve

Nillie,

In the Uk you can ask for a second opinion at any time and it will be given to you so if you are concerned about any aspect of his treatment, ask for a referral.  

One thing to bear in mind is that a non-prostate cancer man aged 84 will have a PSA level of around 8 anyway so 14 is not so far away in real terms.  And a PSA of 125 could indicate metastatic cancer in many men but it is not always the case.  There are patients with PSA levels as low as 4 who have metastatic cancer.  So it is not an exact science by any means.

At the hospital where he is having treatment, look up the Macmillan nurse who will be based there.  He/she will give you all the help and advice you might need.  If you Google Macmillan xxxxxx (name of the hospital) you will find the details.

One other thing is a well known side effect of hormone treatment is a short term memory loss.  So it may be that combined with his age and general health.

Regards.