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I was sorry to read of your father's problem, Hank.
As you probably know by now, there are many varieties of prostate cancer - this article suggests that there are at least 24. It seems clear, from what you have said, that your father has one of the very aggressive forms.
Chemotherapy would seem to be his best option at this stage since it seems clear that the disease is now androgen independent - which simply means that the Androgen Deprivation Therapy (ADT) often referred to as hormone therapy is unlikely to be effective.
I believe it would be in his best interests to find the best oncologist specialising in prostate cancer that you and he can afford. You should be able to get good advice on this subject if you go to the Advanced Cancer Mailing List
Re: What are my father's choices (more than you will immediately know)
Don't know if you can travel, but in this case would be worth doing so for quality of life and possible best control of the PCa. There are many possible protocols even for mets type patients, personally I am not a fan of chemo..but there are many types of chemo/combo drugs and the newer Cabitzitaxel(jevtana) and this one out performed taxotere in studies. Many choices of chemo combos to consider if going that way.
Specialized onco-docs in PCa like Dr. Scholz (Calif.), Dr. Myers (Virginia) and others are the best at super high risk patients, they have the experiences and independence on drug protocols.
Dr. Scholz & Myers, using like: leukine+cytoxan+celebrex (maybe even with adding Revlimid) the results were superior over chemo therapies (same found by Dr. Myers). Chemo may have 40-50% response rate in your case, this would have around 60-70+% response rate)and side effects less than chemo. I know a guy using such and claims like about almost nothing in complaints for side effects.
Estrogenic drugs could help kill hrpca cells to some degree and DES even goes through your liver directly when being processed. Other drugs in this category are estradiol patches or gels, emcyt (used by Dr. Fred Lee on his uncureable PCa, still alive 30+ yrs. later using that drug). They also help bone density.
Stuff you could look into: Sandostatin (drug), or Zytiga, Provenge (vaccines), XL-184 (phase 3 trials)- (good on bone lesions), and still other drugs.
Radiological pharmaceuticals: Strontium-89 (Metastron), Radium 223 (in trials), Samarium-153 (Quadramet) These get into your system and can fight bone issues/mets to some degree also.
Just trying to add to the possibilities of things. There also are 'unproven' and novel therapies for all kinds of cancers, that would be up to the patient to contemplate. There are no simplistic answers here.
I am the patient of Dr. Bob Leibowitz since 13 years starting with PSA 32, 4 of eight biopsies were 100% interspersed with PCa, Gleason 7.
Primary therapy was Androgen Deprivation Therapy according to Dr. Bob for 13 months followed by a maintenance therapy which was not Chemo nor ADT. I spend 12 years in good overall QOL. In 2010 PCa was back (PSA 16, Gleason 8) and second line therapy was the so called "Three Prong Approach" according to Dr. Bob. Please get information from www.compassionateoncology.org.
All the best,
Christian
