Hi all,
Hope you are all keeping well.
Per my post four weeks ago, my lovely Dad has been diagnosed with Stage 4 PCa (T4, N1, M1b), initial PSA of over 500, with spinal cord compression (3 lesions on the spine). He has had 5 fractions of RT on the spine and an initial injection of Firmagon (Degarelix). He's now had his second HT injection, now Goserelin (Zoladex). He's also been given a short supply of Bicalutamide apparently to prevent a testosterone flare-up (though I'm not sure if this was only prescribed because his second HT injection was slightly delayed).
We had his first outpatient oncology appointment today (and for reasons not to bore you with!) it felt quite rushed so we didn't have an awful lot of time to ask questions. We queried about treatment going forward and the consultant mentioned having chemotherapy first, then tablets later - then could consolidate treatment with further radiotherapy directly on the prostate. I was confused by what he meant by 'tablets'? Would anyone be able to shed any light on this please? Is this like anti-androgen tablets and abiraterone?
I also briefly mentioned triplet therapy which the consultant said would also be a possibility. The consultant mentioned wanting to hold something back in the back pocket whenever the time comes that he isn't responding as well to the other treatments - I'm wondering what treatments these are? I'm also aware that we don't want to rule out any treatment too early. It sounded like the consultant is happy for us to go away and have a think/do some research and we will discuss further at the next appointment.
I'm wondering if there is a 'usual' treatment pathway for PCa, or if anyone has any experiences - particularly with triplet therapy?
Many thanks in advance.
Helloskye_saturn
So sorry you haven't had any replies to your post - I am on holiday but just thought I would check in (too much sun is not too good for you!!),
So as far as I know:
* The 28 days of Bicalutamide is standard when you first start HT treatment - as you say to stop any tumor flare. It's normal to have them in conjunction with the first HT injection.
* As your dad is T4 chemo would be the normal practice to fight the cancer and I assume he means in connection with steroids - But I don't know - you need to check with the consultant.
* We have at least 4 Community members on Triplet Therapy - it's quite new and I am hoping with me replying to this post and it goes to the top of the forum one of them will reply to your question.
Sorry I can't answer in full but my personal journey is on the HT/RT route - I am sure others will respond.
Best wishes and keep us posted.
Brian.
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