Worried Daughter

Hello Pateigh and welcome. We do like it when lurkers feel they want to introduce themselves. Just in case you haven't seen the link I usually point new people in the direction of a book which you can download for free which gives a good introduction to tests, what they mean and more importantly how it can be treated.

https://issuu.com/magazineproduction/docs/js_prostate_cancer_guide_for_patients_ezine

The high PSA has prompted all the scans and biopsy but there is no set order, it just depends on the department. The good news is that the bone scan is clear so now they are looking to see if it has gone walkabout or whether it is still confined to the prostate or pelvic region. This, along with the histology will determine treatment.

Urology is the normal first port of call before a referral to oncology and a surgeon if this is an option. The urologist might start your father on hormone therapy if cancer is confirmed which will put it into hibernation giving the MDT (multi discipline team) time to come up with a tailored plan of action. Don't be rushed into making any decisions. Keep a note of who and when you speak to anyone and ask for copies of all the reports. Sort out your line of communication for future reference. Don't be afraid to ask to record the meeting if you think you might not remember everything as there is a lot to assimilate. Your main question is where is the cancer and does it have any aggressive features - TNM, Gleason and histology. Timescale. Where is he going to be treated. What are his options?

Just a warning that an oncologist can have a different outlook compared to a urologist.

Once you have more information then come back if you have any questions no matter how small.

Thankyou for the information. 

I will definitely record the meeting. I just want to be as prepared as we can. 

I have also heard that the urologist will have a much more pessimistic view than the oncologist. 

I’ve said to my dad let’s ignore any prognosis, this is generally based on statistics and not on the actual person and their tolerance to treatment etc. 

I will update once he has had his appointment but thankyou again for your information and advice. 

Hi Pateigh , you have a great attitude regarding prognosis.  I was originally told 5 years, 8 years ago!  Good luck with your appointment.  I have a friend who started with a PSA in the thousands and it was contained in his prostate and treated with RT, he’s doing fine with a PSA below 1.   David

Hello Pateigh

A warm welcome from the "Dark Side"  from me too - pleased you have joined us but so sorry to read about dad. As we all have different things on our mind at meetings here's a checklist you may find of use:

Questions for my Team.

Do keep us posted as to how you get on and feel free to ask any questions however trivial.

Best wishes - Brian.

Wow, that’s an amazing story about your friends cancer being contained with such a high PSA. These stories just show that everyone is different and too ignore google and statistics. 

that’s amazing news you are also doing so well on your journey. 
thanks for the info. 

Pateigh 

Hi all, 

Just an update on my dad. 

we saw the Urologist for his results today. 

He has prostate cancer (expected) with spread to lymph nodes in his pelvis and the gland behind the prostate. Gleason score of 8. 

He is being sent for a CT scan on chest/abdomen etc early next week to check for other spread. 
His bone scan was clear, but the urologist said they are only about 60-70% accurate and he won’t be surprised if there was microscopic elements in his bones as his PSA is high at 344. 

So he said his treatment will be hormone therapy and radiotherapy on the pelvis - pending result of CT scan, but this will all be down to the oncologist who we will see after his scan. 

we are feeling positive, but I was wondering whether anybody else could advise on treatment options if there is spread elsewhere, such as the lungs for example. 

would chemotherapy be an option as part of triplet therapy then? 

I just want to be prepared for when we see the oncologist. 

My dad was very shocked by how direct the urologist was, but I’ve said to just keep positive there are lots they can do nowadays, as you wonderful people are proof of. 

Thanks in advance for all the Advice. 

Hello Pateigh 

Thank you very much for the update - the positive attitude is great. My thoughts are:

* Dad's team are amazing and are covering all possibilities.

* Don't worry too much at this moment about any possible spread to other organs - concentrate on the here and now.

* The oncologist will take in all the results before making a treatment plan - if this is Triplet Therapy this does include Chemotherapy.

I had an initial PSA of 182 and had radiotherapy to the pelvis - it's just like sitting on a sunbed! I had a few other issues along the way - you can read my journey by clicking on my name or avatar.

I hope the above helps.

Best wishes - Brian.

Hi again Pateigh , you are quite right to encourage him to keep positive.  The HT will suppress the cancer cells wherever they are, so broadly hitting with HT and RT is a good plan.  Once his PSA is down he will hopefully stabilise for years.  If the PCa spreads to other parts, deal with it once found but don’t stress about the what-ifs.  Treatments are improving all the time so what might be best now may be replaced with better alternatives when anything spreads.  David