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Uncle passed from prostate cancer in his 60s. My Father was diagnosed and treated by radiation only in his late 60s/early 70s and *knock on wood* doing well. Great grandfather had it rampant in his 80's, and in the bones. He lost his life from complications of a broken hip due to prostate cancer in the bones at 89. Really, I get the general aspect of a balancing act, but I need some help!
If anyone can share, I'd really appreciate it...
Close cousin has a transplanted Kidney, got prostate cancer did radiation, but prostate cancer spread fast and furious to the lymph nodes and kidney. Now looking at dialysis and non-functioning kidney, and chemo to deal with the prostate cancer.
Is there any hope for him to fight the prostate cancer with chemo (he's in his 60s), and then deal with the kidney issues down the road (even if he has to do dialysis for a some time)?
Talk about super difficult situation. First you might consider contacting some of the artists in oncology of PCa for their opinion, like: Strum (retiring), Scholz, Sartor, Myers, Leibowitz, Vogelzang and some others whom treat the super high risk scenarios.
I would consider looking at other things than chemo, Dr. Scholz (also Myers) has a newer protocol for high risk and mets type patients: leukine+cytoxan+celebrex and is getting some decent results. I am not saying you will win the war, you might win more time or quality of remaining time perhaps. I know a guy using this and doing well for 4 yrs. now, he probably was not a known mets patient when starting, but did fail Lupron and other drugs prior. With possible kidney shut down issues, that could in effect trump PCa...so super difficult scenario.
Do look up info on Rapamycin it is used in organ transplants to resist rejection and other factors and is also found to be an mTOR effective pathway to inhibit in PCa, more is being studied on this for PCa. You would have to search around and read about it, question your future oncology doc if this is useable somehow within his scenario...I don't know and merely a wild-ass-guess. They probably used it on his first transplant. This drug comes from fungi type thing found only on the Easter Islands...how bizzare is that on earth? Found it and found useful in organ transplant scenarios, just shows how bizzare finding things on the planet actually are. I wish you strenght in this fight.
This is a close relative, but feel I'm being invasive especially given the complications he's exhibited, so I'm walking a fine line of sharing my research with him. Direct suggestions from you guys who've been there done that seem to be much easier to present.
I can't tell you how much your suggestions of a complicated case allowed me to research possible treatment options. If this was my father, I'd be at the chemo appointment in the morning with some serious questions before starting chemo.
Just out of curiosity, would you think this might be a possible scenario of possible treatment?
1. Kidney Transplant - Pretty much given up saving it to fight the PCa, BUT... have to stop immunosuppresents to treat the PCa, but could be on Rapamycin as a possible immunosuppresent to do double duty of kidney rejection and fighting the PCa? Might save some kidney function with this immunosuppresent?
He's on dialysis and foly catheter right now, kidney still partially functional. Would love to think the Rapamycin could save the kidney and work on the PCa at the same time. Not sure if that is too optimistic?
2. PSA rose on hormone therapy post radiation therapy. Yet, I've seen some interesting articles about why hormone therapy might fail from Myers articles and options to treat.
3. Uncle passed from Prostate Cancer back in the 90s... I know things have changed, but there is a cloud of "just a matter of months" mentality around here. He's only at at PSA level of like 8-10 and only in metastasis in the lyphnodes. However, the pelvic lyphnodes have caused SIGNIFICANT swelling in one leg and the scrotum. Dialysis has helped the leg swelling.
Is there anything he can do about the scrotum swelling?? This is definitely causing quality of life issues.
There is always some hope, even if it is only a glimmer at times.
The situation you describe is a complex one and certainly beyond the ability of any lay person on a site like this to give you definitve advice.
Rob has suggested a list of doctors who might be able to help and I second him in his post. Most of those doctors are prepared to look outside the square for solutions for specific cases, rather than apply the 'golden rule' of their specifci beliefs which regrettably is the medical standard in so many cases.
Thanks for the information. I researched the drug combo and some of the papers the onocologist have written and printed it out for him to review. I've always been able to count on this site to point me in the right direction.
