Dad was just diagnosed with stage 4 cancer last week - prostate cancer which has spread to bones and lymph notes, Gleason 9.

Hi again Zoey88 , like Eddie has said PSA should be down, but depends how long ago he had his bloods taken.  Don’t panic if they aren’t low as long as they aren’t increasing.  At the meeting you should get some idea of the initial treatment strategy, but again don’t worry if they talk about ‘in a few months time’, as the HT needs to work first.  Your natural reaction is to want things to happen immediately but in reality it would be wrong to start treatment too soon.  Good luck on Monday, David

Me again! Sorry! Dad had his app with the consultant oncologist today and needs to make a decision by the end of the day whether to do chemotherapy and radiotherapy together or do chemo, radio and hormone treatment (oral) all together. This will take place over 2 weeks so will be quite intense. The consultant did initially recommend all three. However later in the app said maybe to start with radiotherapy and chemo and then leave hormone tablets as a further tool in the bag. He will continue with 3 monthly hormone injections regardless 

Dad was initially on hormone tablets and has had his first hormone injection.

The consultant to our surprise said he didn’t have the results of dad’s psa! So we’ve been trying to contact his care co ordinator for this information.  

Does anyone have any experience or thoughts you could share regarding the treatment options?

Hi Zoey88 .

It sounds as if they are going to treat your dad's cancer with hit it fast and hit it hard. Can I suggest you listen to a new video on one doctors latest thinking on this protocol.

 Advanced Prostate cancer with high PSA. 

Was your dad told what type of radiotherapy he is going to have? Is it to the pelvic area including all lymph nodes or is it to the bone mets. Is the Chemotherapy the 6 or 10 cycle protocol. How aggressive is your dad's particular type of prostate cancer -Gleason 9 only tells part of the story. If dad has a particularly aggressive form then throwing the kitchen sink at it may give him a better chance at total remission, even if he only stays on the additional hormone therapy for a short period of time. Some cancers are particularly responsive to radiotherapy, others to the Chemotherapy. Chemotherapy works at shrinking tumours quite quickly but you need the full course which can take 18+ weeks to be fully effective. Radiotherapy works over a lot longer period of time if it is EBRT - anything up to 18/24 months. Faster if it is SBRT. In the meantime the injections lower the testosterone but there is more effective control if it is combined with a 2nd generation antiandrogen. The disadvantage of staying on hormone therapy is that resistance can build up. There are several different types of hormone therapy so it is important to find out which one is being proposed and for how long as some of the hormone therapies can be used sequentially, and others can't.

I know it hasn't given you any answers but please come back if you have any questions.

Hi Zoey,

My OH was given full on treatment early on last year=. Zoladex/Abiraterone and full pelvic RT, nodes and lower ribs included. Not Chemo,. The hard hitting early on approach seems to be the thing and there seems to be some excellent combinations available. 

It sounds like dad is getting excellent treatment.

* Ive just noticed you ask the question about PSA coming down. My partners PSA held steady at 9 for a while and then he had Abiraterone that seemed to force it down within days. Read my profile of his treatment, remember everyones treatment and journey can be different and it's just added knowledge ( which you must be an expert by now )  

Let us know what he picks. 

Best wishes

L

Thanks for your help, 

im not sure on any of the answers to your questions Alwayshope other than t3bn1m1b and 6 cycle chemo. 

Just read your profile BarryW  thank you. We’ve gone with the 3 prong approach - chemo, radiotherapy and oral hormone tablets aswell as the injections every 3 months!!

thanks so much for taking the time to respond really appreciated!

All will become clear as time goes on. If you need any information about the different treatments and what to expect then we can help as many of us have trod this path with our loved ones.

Hi Zoey,

It sounds like an excellent choice,

Lx