Re: Another worried daughter needs help...Dad has Stage 4 PC.
Hi! I am sorry you are going through this stressful time.
As for your first q, yes, it seems to be standard mode of treatment in India. Jim and others here have had success in adding another class of drugs, the 5-AR inhibitors(Fincar is the finaseteride generic, Proscar is the duasteride generic) to the regimen. But, I have not yet been able to find a doc in india who thinks it will help. You should check whether his urologist recommends it. It is great that they are giving him Zometa infusions right away. It is supposed to help a lot to stabilize and also lower the spread of bone mets.
From what I have read(in my layman's opinion) it is how low the PSA goes after intervention(PSA nadir) that decides how soon the cancer will be back or how aggressive the disease is. A PSA nadir of <0.05 is what is considered true remission here(Check PCRI website for more info on PSA nadir). His Calutide dosage can be increased to upto 150mg daily to help bring down the PSA some more. Ofcourse, PSA levels might not be truly indicative of his disease prognosis..as kcon suggested before, some people have very high PSA but are still doing fine.
Apart from the medications, daily exercise to maintain strength is very important. He should be having calcium/vit D supplements along with his Zometa infusions. Pomegranate juice is also thought to be beneficial. Following a mediterranean diet is also thought to be better for prognosis.
MY FIL is also in the same situation. Delayed diagnosis, back pain dismissed as complications from a slipped disk. Esp considering his family history, he or his docs should have thought of it a yr or two earlier. I truly understand the need for maintaining a detailed family history now..unfortunately, it was a costly lesson.
To answer Kcon's q from another indian perspective. Preventive diagnosis is not very well practiced in india..esp for tumor marker diagnosis etc. Most people have preventive diagnostics for heart/diabetes related ailments. So, PSA tests are not done unless some doc makes the connection between urinary difficulty or bone pain and PC. Its truly a shame.
Good luck to your dad and your family.
From what I have read here and all the books and website regularly reccommended by the people here, it is definetely possible to find a treatment plan that works for your dad. So don't lose hope!