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My 70-year-old father was just diagnosed with Stage IV prostate cancer. Gleason score of 9 (4 + 5) and T1c. Cancer was found in all 12 biopsy samples (3 had perineural invasion). Bone mets were found from skull cap to the femurs (worst around pelvis). Extensive left para-aortic adenopathy and nodes in iliac chain. Calcification found in spleen and right adrenal gland.
My father is in acute kidney failure (think it's due to prostate enlargement since no cancer was found in kidney). Left kidney has severe atrophy. He will see the nephrologist in 2 weeks.
Today he started treatment with Firmagon and Xgeva and will be taking Prosteon.
The urologist said cancer could not be cured but could be treated. He did not mention anything about radiation therapy or other treatment options. Just that he wanted to start with ADT.
I have the number for the doctor and my parents told him I would be calling with questions. What questions should I be asking? Also, is there any hope for my father? Do you think he can have any semblance of a quality life? And what might the future hold for him?
The standard protocol for his case will be hormone treatment but a prostate cancer center might also try docetaxel. The response to hormone treatment is a good indicator as to how long he will live. If the PSA goes down below 1.0 and stays down for a year or so then he probably won't die from prostate cancer. This is assuming a few more good drugs and treatments come out over the next 5 years as have over the last five years.
It is important for him to be very fit, keep his weight at the high end of normal, eat a heart healthy diet and join a support group.
You should see a great improvement in his health on the hormone treatment drugs he has just been given. The doctors don't know how he will respond to the hormones, some patients respond very well and stay well for quite a few years, and others not so well.
After the hormone treatment drugs there are other new treatments that are available so he shouldn't assume that he will die of prostate cancer yet.