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Dad’s Prostate Cancer Journey: Next Steps — Part II

Read Part I of “Dad’s Prostate Cancer Journey: Next Steps” here.

But back to the appointment. Sitting in the exam room with my parents, sister, and the doctor, I waited anxiously for him to tell us his and the radiologist’s thoughts about the PET scan and future treatment for my dad. I was hoping that he could have radiation again to zap those hot spots and get rid of them (and the cancer) for good. Or surgery to cut out the dangerous cells. Or even chemotherapy, to poison them away. The doctor said “no” to all of these options.

Dad’s treatment option: hormone therapy

Instead, the doctor said the recommended next treatment, due to the number and location of the abnormal and probable malignant spots, is hormone therapy. Meaning, Dad would get injections of hormones to help lower his testosterone, which is what feeds prostate cancer. The hormone therapy usually helps shrink the tumors and lowers the PSA level, however, it’s not a cure. The latter part of this news is what I didn’t want to hear, of course.

I want a cure for my dad, and I want it desperately.

Finding the right question to ask

Racking my brain to think of all of the questions that had been swirling around in my head before the appointment, I tried the best I could to think of some “magic” question that would give me that answer I wanted.

Why can’t you use radiation to kill those two spots? What about proton radiation (I had read about this being done at the Mayo Clinic)? Can’t you kill it all with chemo? Can’t you remove the lymph node? Can’t you…do something else?

The doctor listened to my questions and answered them calmly, however, I swear I detected some exasperation in his voice and demeanor as he shot them all down. Too risky to operate. Too risky to use radiation again. The side effects of chemo would probably damage his quality of life and wouldn’t be worth it.

Why hormone therapy was the best option

The doctor also suspects that since the cancer initially spread outside of the prostate wall, minuscule malignant cells were probably already floating around other places in my father’s body. And, he argued, that the cancer could be controlled by the hormone therapy as long as Dad was on it and responded well to it.

Hmmph…okay, I guess. Although I wasn’t feeling at all okay about any of this. Dad, on the other hand, in his usual and almost bizarrely nonchalant way, agreed with the doctor and didn’t push for anything else. He’s scheduled to have his first hormone injection sometime soon after Christmas and New Year’s.

A question for the community…

While I respect the decisions my father makes about his own health, I don’t want to stop fighting for him if there’s anything I can do to help. What that is right now, I’m not exactly sure. I wonder if he should get a second opinion — at the Mayo Clinic, possibly. Or if I should try to reach out to other patient advocates who are dealing or have dealt with a similar prostate cancer situation. If it could save his life, I just want every possible, plausible option explored. I may sound like a cynic, but I know too well myself that science and medicine aren’t always perfect — and doctors aren’t always right.

What should I do? What should Dad do? I wish someone had a magic answer for us.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ProstateCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

  • Clark
    9 months ago

    A lot of the cancer procedures rely on playing the odds. I had a radical prostatectomy 6 years ago, then the cancer came back after 5 years so I did 33 days of radiation and 6 months of hormone therapy. But realistically the radiation is really a maximum likelihood thing since they really don’t know where the cancer cells might be. I did not at all enjoy the side effects of Lupron. Fuzzy brain and it really is chemical castration. However, as I wait for my next PSA test, I am definitely considering the alternatives and know that I would do the Lupron again if that was all there was.

  • ninaw moderator
    9 months ago

    Thanks for commenting, @Clark. I’ve heard a bit about genetic testing of tumors for more targeted treatments, and I hope that and other areas of research can make treatments seem less haphazard. It’s common to see community members feeling sick of Lupron after finishing it and seeing a low PSA, but then coming back around to it if PSA tests worsen. I hope you hear good news, and feel free to check back and let us know. – Nina, ProstateCancer.net Team

  • dele0527
    9 months ago

    Doug is right on point with his comments, and the 5000+ is factual, we had a member in our group who had a 15000 psa, and he lived well and fought valiantly for 15 years after being diagnose. Be there for your dad, but remember “each day is a good day to have a good day”, and always get a second opinion, get educated about your medical situation, and ask questions, and if the doctor isnt a good fit move on.

  • ninaw moderator
    9 months ago

    What @dele0527 said reminded me of Todd’s story here: https://prostatecancer.net/living/becoming-cancer-warrior/. While as sevensix said, no treatment choice is smooth sailing, there’s a way to keep moving forward. – Nina, ProstateCancer.net Team

  • sevensix
    9 months ago

    For your father it matters not what treatment protocol is selected, all have undesirable consequences. By androgen deprivation that infers Lupron and Casodex injection and oral meds? Lupron is long lasting with annoying physical side effects coupled with emotional “challenges” where your support is absolutely vital during his treatment. ADT is tough on the soul. My treatment of choice were six-month Lupron, Casodex oral, and 39 IMRT radiation sessions over 8 weeks. Statistically, that is a 63% chance being symptomatic free at six years. Not a cure, just a good poker hand worth playing. Be strong. Your father needs you.

  • Doug Sparling moderator
    9 months ago

    Hi @angela,

    I’m so sorry you dad’s prostate cancer has returned. Though I am not a doctor (therefore don’t consider this medical advice), I am living with stage 4 prostate cancer and spend a good deal of time as an advocate, lately as a patient research advocate at the NCI-designated cancer center where I get my treatment.

    While a second opinion never hurts, what your doctor has told you sound like the treatment I would expect given your father’s age and the fact that it’s spread.

    Once prostate cancer has metastasized, then treatment becomes systemic, which is generally hormone treatment and chemotherapy.

    Unfortunately stage 4 prostate cancer is not curable, but the good news is that it can be kept under control in many cases. Hormone therapy is one of those treatments.

    I’m on my second chemo in a year, I’ve been on hormone therapy for 15 months (a Lupron shot every 3 months) and abiraterone (Zytiga) since November and my PSA has gone down from 5,000+ to 2.8. I feel really well physically and mentally and I enjoy life with a passion.

    It’s awesome that you are helping your dad anyway you can. I can tell you it means a lot. Best of luck. If I had the magic answer I’d share it with the world.

    Doug, ProstateCancer.net Team

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