Oncology Referral - What Happens Now?

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My 84-year-old Dad had an advanced prostate cancer with spinal and pelvic metastases diagnosis in 2024. Gleason score 9. He has been receiving hormone injections every three months and was doing well initially. In October 2025 his PSA began to rise slightly, so a daily tablet of Bicalutamide was added. We have now been informed that his most recent PSA has risen again and is currently 18, and he is being referred to Oncology. He is generally well in himself and has no symptoms from the prostate cancer that are troubling him. His main difficulties come from other health issues rather than the cancer itself. While he does not want to be “messed about with,” as he puts it, we would like to understand whether there are still hormone based treatment options that could help and whether any are worth trying in his situation.

  • Hello MiniMee,

    I can see that no-one has replied to your question so this reply will pop it back to the top of the pile again.

    My thoughts are that the oncology appointment will be to consider what options may be available for your dad taking into account his other health conditions.  There may well be other HT & other treatments available & I'm sure others with more knowledge will be along shortly with their thoughts (bear in mind that none of  us are medically trained). 

    Best Wishes

    Brian

  • Hi  , Brian ( ) has given a great reply.  I would just add that often as we advance in age, quality of life becomes higher up the list of priorities and questions about treatments vs time.  Remember that there are downsides to all the treatments and living longer isn’t always the top priority.  I am sure his team will offer alternatives, just don’t feel obliged to give instant answers and make sure he (you) fully understand what the treatment, effect and outcomes are likely to be.  Once you have their alternatives, please come back and we can probably help.

    Best wishes, David

    Please remember that I am not medically trained and the above are my personal views.

  • Hello  

    Apologies - yes I did see your post yesterday but never got around to replying, Thanks  for returning it to the top of the group.

    I would think Dad's oncology team will be looking at his other co-morbidities and his quality of life before deciding on any change to his treatment. Yes there are 2nd generation HT treatments available - but is it worth prescribing them if the side effects cause Dad issues.

    As you say there are spinal and pelvic involvement I would also be asking the question - should dad be having a PSMA - PET scan to see if there is any change in his diagnosis.

    I am not medically trained and can't go against medical advice - but would be considering the question quality of life over essential treatment.

    I hope my ramblings above help.

    Best wishes - Brian.

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