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Old 04-03-2008, 12:04 PM   #6
dusty49
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Join Date: Mar 2008
Location: WA Australia
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Re: Whats the next step

Hello Able 5,
To answer your question, No dad never had PSA levels tested until after he got prostate cancer. He has always been a fit and healthy man and had not seen a doctor since 1957. He always said he never trusted them. He rang me one day and asked me to go to the chemist and get him something for what he thought was a urine infection, but instead of going to the chemist i made an appointment for him at the local GP's. I picked him up, took him to the docs, then the shock st it, he was put straight into hospital and was diagnosed with prostate cancer with mets and well advanced.
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Old 04-20-2008, 09:12 PM   #7
IADT3since2000
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Join Date: Nov 2007
Location: Annandale, VA, USA
Posts: 908
Re: Whats the next step

Quote:
Originally Posted by dusty49 View Post
My dad was diagnosed with prostate cancer in September 2006. ... by Feb they told him he has bone mastasis and underwent radiation therapy, and after several months of having zometa infusions and 3 monthly lucin injection, things were still getting worse his PSA levels were still high, over 900 if i recall.
It was then decided in January this year to start chemo therapy as his cancer had become agressive, he was told he will have 6 treatments of chemo therapy and depending how it goes they will go to eight. Today would have been his 5th treatment, only his PSA had risen again to 1200 and looking at my dads feet and legs which are so swollen they look like they were going to burst, they decided against any further treatment. ... My dad is 76 years old and has never had a sick day in his life, now i am watching him fade away as the weight just seems to fall of him. He was 80kg before he got prostate and is now 52kg. I would like to know where it will go from here.

Dusty,

I'm sorry about the difficulty your dad and your family are having with his prostate cancer. (I just returned from a vacation and read this thread through your post #6.)

I've read the good advice you've received on palliative care, but there still may be some options for control of the cancer.

As an eight year veteran of hormonal blockade for a challenging case (no other therapy other than supportive nutrition, exercise, stress reduction, and bone density support), I've learned a lot about hormonal blockade. I'm convinced that blockade only with an LHRH-agonist drug -which I'm assuming is the lucin (probably Lupron in the US) is simply inadequate for many of us. That's because all of us make some testosterone via the adrenal glands, which are not affected by the LHRH-agonist drug. An "antiandrogen" drug like Casodex, flutamide or nilutamide is needed to help block the effects of testosterone made by the adrenals. While most men make only about 5% of normal testosterone via the adrenals, it can be up to 40% in some men, which would wreck an attempt at hormonal blockade if the antiandrogen is not used. Moreover, some men clear the LHRH-agonist extra quickly, so there is a gap in coverage. There too, blockade is inadequate if the schedule of injection is not tightened up. The trick is to test to see if the testosterone (and perhaps the LH hormone) are under proper control, but many doctors do not seem to be aware of that. Moreover, finasteride or Avodart can be used to prevent the conversion of any remaining testosterone to DHT, a far more potent fuel for the cancer.

In short, your dad still might be able to benefit from well-done hormonal blockade. However, blockade is typically not as effective in men who are already metastatic, like your dad. The Zometa is a good move. It is probably helping somewhat. Other approaches involve drugs like leukine, and there have been some dramatic responses in well-advanced patients like your dad. One book that describes some of these approaches in easy-to-read language is "Beating Prostate Cancer - Hormonal Therapy & Diet," written by Dr. Charles Myers and published in late 2006.

About the wasting: my current main drug is thalidomide (Thalomid), and I've educated myself about its properties. Among other things, it is known for helping prevent or reverse the wasting away that often accompanies late stage cancer. There are a number of issues with the drug, and it is extremely tightly controlled (and expensive, without insurance) in the US. Revlimid is an improved version but is even more expensive.

I hope your dad finds something that works or at least achieves good palliative relief.

Take care,

Jim
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Old 04-21-2008, 05:56 AM   #8
dusty49
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Re: Whats the next step

Thankyou for your reply, my dad is recently in hospital, as he has lost some usage in his legs, the doctors have told him it is coming from his spine as the cancer (mets) is taking over. Apart from Zometa infusions every 8 weeks, dad is also at the moment on dexmethazone, oxycontin and oxynorm. Pallative care will be organizing his home to make his life a bit easier for him, they will also have 3 visits a week to see how he is doing. My main concern at the moment is my husband and I live with my dad, the reason being my dad would not move so we moved in with him. With dad not having his mobility i am concerned as i dont think i could lift him on my own (as my husband has heart problems) let alone get him to the shower or toilet. My dad does not want outside assistance, as he thinks we will manage, but I dont think we will. Pallative have also offered to provide all equipment necessary for my dad including a hoist if necessary, I am just so concerned that this is going to be very hard on my dad and also on me, I really dont know if i can do it, as dad refuses to go into full time care, and i will also give up my job to care for him. I just dont know what is the next best thing to do for all of us.
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Old 04-21-2008, 01:04 PM   #9
shs50
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Join Date: Aug 2006
Location: NJ,USA
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Re: Whats the next step

Does Australia have home health aids who will come in and help attend to your dad's daily needs, bathroom, bathing ,etc? Also have you looked into Strontium 89 to control bone deterioration and fractures?
Installing a hoist or interior lift is an excellant idea if you plan to care for him at home. Also bringing in a hospital bed would be useful since it has sides to prevent rolling out and can be elevated in various ways to simplify eating and sitting up.
The painkillers you're now using will eventually lose their effectiveness as he develops tolerance and the pain progresses so you might plan on the use of a morphine pump which he can control with measured doses as needed. They're manufactured to prevent overdosing. Your Dr. can arrange and advise. Is he now in hospice care?

Last edited by shs50; 04-21-2008 at 01:05 PM.
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