medved

Sorry to hear the unhappy news.

A few things you might want to do:

First, find out what the gleason score is. 6-8 is not an answer. There's a big difference between 6 and 8. It should come in the form of two numbers - a total and then how the total is derived (primary and secondary). For example, 7 (3+4).

Second, whatever the gleason score is, arrange for a second reading by an expert in prostate pathology. You could try the Bostwick Lab in VA or Dr. Epstein at Johns Hopkins. There are a few others too, but those come to mind. The reason for this is that Gleason readings are important but they are also often wrong, so it makes sense to get a second reading from an expert. This is not very expensive and your doctor can arrange it. If you doctor tells you he won't do this, you need a new doctor.

Third, you mention a urologist, but if the cancer appears to be metastatic and your father in law is on "hormone" treatment, then he should be seeing a medical oncologist (perhaps a urologist too, but not only a urologist). Try to get a medical oncologist who has substantial expertise in prostate cancer. If he is able to travel for treatment, I can suggest (as can some others on this board) some experts. If he cannot travel for treatment or consultation, then at least get the most experienced you can find in your area. (It is hard for an oncologist who treats 50 different kinds of cancer to keep fully up to speed on the latest developments in all of them).

For the type of cancer you describe, a hormone treatment is not surprising. That sounds like what one might expect. These treatments are, unfortunately, not a "cure" but on the other hand they often help people live for a long time (and sometimes live full lives and eventually die of something else). Sometimes these treatments are combined with other sorts of treatments, but then that depends on the specific situation. Also, there are various hormone treatments and various approaches and combinations, etc. That's why you need a good, specialist doctor.

I suggest he ask his doctor about a bone mineral density test. That is particularly important for someone on a hormone treatment (which you may also see referred to, by the way, as anti-androgens or LHRH agonists). And while you are at it, ask whether there is something the doctor recommends to protect bones. This might be something like Fossomax, or perhaps a stronger medication called Zometa. Protecting bones is important. Might also ask doctor about Vitamin D and Calcium supplements.