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My 70 year old father has had urinary symptoms for a few years, was monitored with annual urology appointments and PSA tests. His PSA was slightly elevated this year so they finally decided to do an MRI. Results were, as far as I understand, catastrophic. This will be confirmed in a biopsy but the scan showed almost certain cancer throughout prostate, seminal spread, lymph nodes, and masses in both femurs. I've read about metastatic PCa that reaches bones; I will try to make the best of the time we still have.
All of that said, at the moment my father's symptoms are basically only have to pee a lot and associated discomfort. He is working, exercises fairly regularly for a man of his age (cycling). His PSA came in at around 7 (though the 4k test was around 75%). I wonder if any of this is relevant or not-super-high PSA is immaterial once it has likely spread so much.
I of course want to get my father the best care. I suppose I'm trying to determine whether it's possible he will remain alive for a few years at least (I was making peace with taking the chances for Cat 4 five year you see everywhere, but those include people without bone mets) without suffering immensely. He is otherwise very healthy.