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Help - T4N2M1 treatment

Hi all,

My father, 76 now, has been diagnosed last week with aggressive Gleason 9 (4+5) prostate cancer (PSA 45) that is locally advanced in the pelvic area and has metastasised to the bone. So far the tumour has reached the rectum, the bladder, two lymph nodes and 3 locations (iliac bone and hip bone).

The urologist has started Casodex (Bicalutamide) for 2 weeks before starting the first shot of Zoladex.
The oncologist is suggesting an adjuvent therapy with a first cycle of Docetaxel chemo to go with the hormone therapy.

I have put my dad on a vegan + fish diet with lots of pomegranate, turmeric, green tea etc.. Been doing a lot of reading and still have a few questions for the experts here:
1- what do you think of that treatment?
2- what kind of side effects are usually encountered with Docetaxel?
3- Is radiation (proton, cyberknife) completely out of question now?
4- I know it depends on many factors but what kind of life expectancy can one expect with such a disease?

Any input is appreciated!

Thanks

RaFr

Re: Help - T4N2M1 treatment

Hi RaFh,
Hello and welcome to YANA. First up let me correct a misconception on your part, There are no experts here, only men with prostate cancer who may be able to offer some support and guidance. As you no doubt understand, your father has advanced PCa disease, therefore in all likelihood he will most probably die from the disease. However modern treatments should provide a reasonable quality of life over the coming years. Where it not for the organ involvement (bladder and rectum) management of the disease for say 7 to 10 years is not unreasonable. The organ involvement cloud's the issue somewhat, a medical oncologist opinion is warranted.

So to the questions you raise;

- Re the vegan diet, if you think it will be beneficial fine. It certainly will not do any harm. Just make sure the iron intake is adequate.

- The treatment modalities offered (ADT and Chemo) are entirely appropriate in my view. Early introduction of Docetaxel should be very beneficial in extending life. Consider them as first line agents for treating advanced metastatic disease.

- Most men cope very well with Chemo these days. Side effects for the most part are very manageable.

- Radiation for curative intent is no longer possible, but in future you dad may well be offered targeted radiation for metastatic hot spots in bones for pain relief.

A brief bit of wisdom if I may. More often than not the angst displayed by loved one's coming on here and posting questions is not shared by the parent. Remember your dad is in his twilight years and his perception of his situation may not be quite the same as your's. Try to focus on what your father's wishes may be. If you don't know what they are, then some frank discussion is warranted.

best wishes,
john

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