Discussions that mention zometa

Cancer: Prostate board


My dad was diagnosed with prostate cancer in September 2006. The cancer had left the prostate so it was to late to operate. 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. the doctor gave him Frusimide for fluid retention and told him to come back and see them in 2 months, and that was it. I was just so shocked, he has gone from 3 weekly visits to 2 monthly visits and said to dad that it is all palliative from here. I know what palliative means, but i just dont know what is going to happen from here. 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.
[QUOTE=dusty49;3511774]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
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.