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Old 12-19-2011, 09:23 AM   #1
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Suggested treatment "locations" for advanced prostate cancer

I'm in need of some quick advice regarding potential treatment locations for my father's situation.

The details: (apologies for some of the fuzziness of the details, l live across the country and get all the info in small pieces)

Age: 60, lives in southwest ohio
Initially detected with a PSA test - 4.6 (rose from 4.1 over a very short period - maybe a month or two)
Biopsy: 4 of 8 cores positive - one 6, two 7s (3+4), one of the 7's was 50%, and one 8 (15%)
CT / Bone Scan - everything looked good except for some spots in his arm/shoulder area
X-Ray - confirmed that something was indeed there,
MRI - confirmed bone cancer in his arm/shoulder area
We have yet to catch a break with this

He just got the MRI results this morning. The urologist that my father has been working with (since the biopsy phase), told him that he was going to call Ohio State (The James) today and speak with (I'm guessing) a medical oncologist, to get a better sense of the options, as well as probably hand over my dad's case to him.

We want to consider the best treatment options available - so I'm wondering if those in the forum can provide where they think we should consider . . . we will be doing our own research of course, but this advice could save us some time and point us in the right direction.

If you can provide any guidance with regards to how to best get in touch with any of the places you recommend, that would be even more helpful.

Thank you in advance (and I apologize if there is another link that has discussed a similar topic, feel free to point me there if need be!)

 
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Old 12-20-2011, 10:36 AM   #2
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Re: Suggested treatment "locations" for advanced prostate cancer

You are in the right direction. Your dad with metastases, Gs8, and voluminous cancer will get better advice from an oncologist specialized in systemic care. Dr. Charles Myers is one of the best oncologists in the world for such cases.
You may get the contacts you need searching the net by typing his name. In his own site you can listen to the several videos (ask Dr. Myers) on prostate cancer topics.
He has also an excellent book dealing with systemic prostate cancer (Beating Prostate Cancer; Hormonal Treatment and Diet).

All treatments have risks and side effects. I would recommend your dad to read details on the influence of each treatment and to get second opinions on his case.

Hope you find what you looking for.

Baptista

Last edited by Baptista; 12-20-2011 at 11:07 AM.

 
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Old 12-20-2011, 04:40 PM   #3
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Re: Suggested treatment "locations" for advanced prostate cancer

Hi hotpink3 and welcome to the Board!

I'm sorry your young dad (I'm 68 ) has had this blunt introduction to prostate cancer, but, though his case is challenging as Baptista noted, there is a solid basis for optimism.

You asked about sites that would be best for your dad. Baptista made excellent points, and I'm sure you and your dad would gain confidence from reading the book Baptista mentioned. Moreover, your dad is not that far from Dr. Myers, whose practice is within a short car ride from the Charlottesville, Virginia airport.

There are some other experts who dedicate their practices to prostate cancer or have a large proportion of prostate cancer cases, but most of them are on the West Coast. One is the Mark Scholz/Richard Lam practice on the coast near LAX; I'm mentioning that practice as Dr. Scholz is the medical co-author of the recent book (2010) "Invasion of the Prostate Snatchers." Though the book is especially useful for men considering whether to have a biopsy or with low-risk cases, it also has important information for men on androgen deprivation therapy (also known as "hormonal therapy," or "hormonal blockade"). There is a doctor in West Virginia who specializes in prostate cancer, but I don't know much about him.

Ohio has some excellent doctors and facilities, but my hunch is that those doctors would stick closer to the established "standard of care" approaches. That may sound good and wise at first impression, but the problem is that that "standard" can be years or even a decade or more behind what physicians have learned in practices that see a large volume of prostate cancer cases, especially for men with advanced and challenging cases. I'm convinced that I have personally benefitted from approaches used by experts dedicated to prostate cancer. The Cleveland Clinic has a fine reputation. Ohio State has a dynamic cancer research program that likely includes activity in prostate cancer and associated doctors who do both research and clinical practice.

It's good that your dad will be consulting a medical oncologist. I'm convinced that even excellent urologists are in unfamiliar territory when dealing with advanced and challenging cases. I'm guessing that the doctors I follow would want your dad on triple androgen deprivation therapy ((1) LHRH-agonist or antagonist drug like Lupron, Zoladex, etc; (2) an antiandrogen, most likely generic bicalutamide at 150 mg/day, perhaps with a drug like ursodiol to help prevent any rare liver problems; and (3) Avodart (or perhaps one or two finasteride pills) daily) plus a strong bone density drug to protect bone density and act to some extent against the bone mets. Zometa is one powerful drug that has been so used, though it has an infrequent but potentially serious side effect, osteonecrosis of the jaw, plus some other potential side effects (as do all drugs). Transdermal estrogen is another possibility. A short round of chemo, usually well-tolerated for at least the first round, might also be employed. There are also some new drugs that might be helpful at this point.

Diet and other lifestyle tactics appear to be important. They are well described in the book that Baptista mentioned.

The book "A Primer on Prostate Cancer - The Empowered Patient's Guide," second edition, is getting a bit old now, but still has great information. It recommends blood tests for CEA, CGA, NSE and PAP for men with presentations like your dad's, as well as monitoring testosterone and dihydrotestosterone (DHT) in addition to PSA.

Keep your spirits up! Your dad really does have a decent shot at many quality years of life! Tremendous progress is being made in prostate cancer treatment, including treatment for advanced cases. It's not a matter of adding just a few months of life beyond the current standard; many patients do far better.

Take care,

Jim

 
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Old 12-20-2011, 04:57 PM   #4
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Re: Suggested treatment "locations" for advanced prostate cancer

thanks for both of your very thoughtful and encouraging replies.

I will definitely be tracking down the books that have been suggested.

I will also be investigating the cleveland clinic and Dr. Myers. The West Virginia dr has also been mentioned to me (i believe on a different message board), and will look into him further as well.

again, thank you so much for the information you have provided. It's a lot of information to digest, but I feel like I'm finally starting to grasp much of it!

 
Old 12-27-2011, 06:45 AM   #5
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Re: Suggested treatment "locations" for advanced prostate cancer

hi hotpink3

since you live in arizona and IF your Dad can travel to you , have you thought of going to the fabulous MAYO CLINIC which has a Phoenix location? having grown up in MN and having actually been to the Jacksonville, FL, facility --- i know of no better place that will do an entire-body-multi-doctor approach. good luck with your search.....

 
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