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He is an ex marathon runner (over 100) plus ultra runs. I'm saying this as he doesn't have the body of a typical 80+ year old.
He and his wife have always been into alternative medicine so, although he will begin taking Casodex asap, she may want to try a complementary treatment. He seems to be into some level of denial at present.
I don't have further information re: his diagnosis in terms of any further spread. Hopefully, that hasn't happened. His PSA was 133, no Gleason score yet - at least I don't know it yet.
There is a Dr Bob Liebowitz in L.A. they might see - he seems to be associated with Dr. Snuffy Myers.
Don't know where to go from here. Any advice greatly appreciated.
It is not clear what your relationship is to this man, but no one can give you any real guidance on the information you have provided because it is simply too vague.
Although there are no "Rules" for prostate cancer, it would be unusual to be diagnosed with bone metastases with a PSA as low as 133 ng/ml. Such events are normally asociated with PSA levels over 1,000 ng/ml, although of course it is possible that a lower PSA could be involved. One of the problems with diagnoses of bone metastases by scans is that they can be confused with wear and tear and old breaks. If this gentleman has been running marathons and ultra marathons for many years, the prospect of wear would be signficant.
Here are some of the issues that I think need to be explored before moving much further in the process of assessing status before deciding strategy:
1. How did the diagnosis come about? What were the circumstances that led to the bone scan that identified the metastases?
2. What is the history of PSA levels. It would be unusual in this day and age for a man of 83 not to have had a series of PSAs over the years.
3. Has a biopsy been done? If so what was the result?
4. Have second opinions be sought on all results to date?
