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Cancer: Prostate Message Board

Cancer: Prostate Board Index

[COLOR="DarkGreen"]Hi Terry,

I would like to extend my own welcome to the Board to you and your dad. :) I'll add some comments in green after excerpts from your post below. I'ver read through Gleason9's response and his good questions to you.[/COLOR]

[QUOTE=terryd23;4734425]Hi all,

Went to the urologist with my dad yesterday where it was confirmed that he had PC. While we pretty much thought that was going to be the case it still comes as a bit of a shock.[/QUOTE]

[COLOR="darkgreen"]That's the way it comes for almost all of us, even if we expect it. However, if you or a loved one has to have cancer, prostate cancer - for the vast majority of us and likely your dad - has a far more favorable course and survival rate than the other major cancers.[/COLOR]

[QUOTE]I only wish I had come to these forums before I went to the appointment as I would have a lot more questions for the specialist so I could get a better picture of what is going on.[/QUOTE]

[COLOR="darkgreen"]That would be ideal, but prostate cancer is a complex disease, including many different conditions of patients and associated therapy options. It would be hard to care enough before a diagnosis to be able to attend to, absorb, and remember the key points. However, now is the time to learn! I'm convinced that empowered patients and family have much better outcomes, not the least of which is a lot more confidence and hope.[/COLOR]

[QUOTE]Anyway my father is 71 years old and has lung problems as well as heart problems, aside from that he's in pretty good shape :D , but seriously....the doctor said because of his age and other problems curing the PC is out of the question and because PC is a slow growing cancer that it's would be best just to manage it.[/QUOTE]

[COLOR="darkgreen"]That makes excellent sense. While it is [I]possible[/I] to go for a cure, it is often [I]not worthwhile [/I]even if cure is achieved because of the price an older patient with other substantial health concerns pays in terms of complications from therapy and side effects. Moreover, managing the cancer is not a second rate option; in fact, with much improved hormonal therapy that is available today, many of us will succeed in controlling the cancer for many, many years, perhaps until the end of our lives, while having a burden from side effects that is lighter than the burden from other therapies that involve an attempt to cure. I have been dealing with a challenging case now in my twelfth year since diagnosis, and, thanks to being able to go on intermittent hormonal therapy, at the moment my side effects are minimal and not noticeable.[/COLOR]

[QUOTE]Now my father had a PSA test at the start of the year and he was a 54, he had another one a few days before the appointment and it was 50 so the doctor said it would be a good idea to either remove the testicles or opt for the hormone treatment. We decided to opt for the hormone injection and he was given an injection into his abdomen there and then.[/QUOTE]

[COLOR="darkgreen"]Those PSA readings are high, as you probably know by now, but they are far below the readings for many patients a couple decades ago just after PSA testing was introduced; those patients often had metastatic disease at the outset. Metastatic disease, not counting local spread in the neighborhood of the prostate, would be unusual for your father's PSA levels. (My own initial PSA at age 56 was 113.6, and my scans - bone, CT and ProstaScint - were all negative.)

It is surprising that your father's second PSA was lower than the first, especially as his PSA was high at the start. That's a good sign regarding the aggressiveness of the cancer, but it makes me wonder if he has some infection that is driving up the PSA level. Did the doctor talk about infection at all?[/COLOR]

[QUOTE]Prior to reading these forums I wasn't aware of a Gleason rating/scale or even if they use that here in NZ so I don't know where he is on that.[/QUOTE]

[COLOR="darkgreen"]Gleason scoring is now standard throughout the world, so you should phone or visit to get a copy of the pathology report from the biopsy. In fact, it is very wise to have the pathology slides reviewed by an expert who specializes in prostate cancer. You might not have such an expert in NZ or Australia, but the slides could be shipped to the US.[/COLOR]

[QUOTE]He did have a bone scan a week prior to the appointment and as far as the specialist could tell it looked like the cancer hadn't spread although he did say he wasn't a radiologist so he couldn't be sure.[/QUOTE]

[COLOR="darkgreen"]Is the scan going to be read by a radiologist? It would be a good idea to ensure that it is; however, the odds of the scan showing cancer are very, very low, even at your dad's PSA level. That's partly because the bone scan will only indicate possible cancer when the cancer involves about 10% of bone or more. That said, it is still a good sign when the scan does not show cancer. Also, while it takes a radiologist to get the best assurance of a sound reading, chances are good that the doctor would have spotted possible cancer; it's a good sign, of course, that he did not.[/COLOR]

[QUOTE]Now the urologist said that he should lose some weight and start taking vitamin D and calcium as the hormones could make his bones weaker.[/QUOTE]

[COLOR="darkgreen"]That advice is exactly right. Getting the appropriate nutrition/diet/supplements and exercise is important to giving us good shots at better outcomes with fewer and milder side effects. It would be especially important for someone with lung and heart issues. Perhaps the most serious common side effect of hormonal therapy is a decrease in bone density. The docs I follow, who are medical oncologists - the specialty that knows drugs the best, would want him to have a bone mineral densiy scan (done with a quantitative CT scan preferably, or a DEXA scan), and they would probably want him to be on a bisphosphonate drug along with calcium and a sound vitamin D3 supplement (many vitamin D supplements are inferior). They would certainly want his vitamin D monitored with a "25-hydroxy vitamin D" blood test. After eleven years of intermittent triple hormonal blockade, my bone density returned to normal (during the third "on" cycle of the drugs) with the aid of Fosamax for most of the years, then Boniva, and calcium and vitamin D supplements.

There are three books I think are superb for prostate cancer patients, but especially for patients considering or on hormonal therapy. Here they are:

"Beating Prostate Cancer: Hormonal Therapy and Diet," about 2006, Dr. Charles "Snuffy" Myers, MD

"Invasion of the Prostate Snatchers," 2010, Ralph Blum and Dr. Mark Scholz, MD (especially expert in dealing with side effects)

"A Primer on Prostate Cancer - The Empowered Patient's Guide," 2nd ed 2005, Dr. Stephen B. Strum, MD, and Donna Pogliano

I believe your father is probably on Zoladex now, or the equivalent generic, based on the shot into the abdomen. That group of drugs is known as the "LHRH-agonist class." It's possible that a milder drug, or milder combination, might be a better solution. It's also possible that adding generic bicalutamide as well as Avodart (dutasteride) or finasteride would be wise.[/COLOR]

[QUOTE]One question that I didn't ask which I regret is "how long does he have left"
I really don't know what the expected time frame of someone that is diagnosed with PC, any insights here?[/QUOTE]

[COLOR="darkgreen"]That is actually hard to answer in detail, but most of us will be a lot more interested in the big picture, and, for prostate cancer, the big picture is highly encouraging! The US has good care for prostate cancer patients based on a foundation of fairly widespread screening to provide early detection for most of us. Using US statistics, virtually [I][U]100% of low-risk and intermediate-risk prostate cancer patients are alive at the ten year point![/U][/I] :eek: :angel: :jester: :D Okay, so your dad appears to be a high-risk patient due to the PSA, though its not out of the question that most of that is due to an infection. [I][U]Well, 95% of us high-risk guys are also alive at the ten year point![/U][/I] :D Moreover, prostate technology is improving at a fast rate, and just in the past couple of years we have had several new drugs become available, with more following on their heels in the approval pipeline.[/COLOR]

[QUOTE]Also what supplements should I start buying for my father to help him along, he's currently on a few medications for his heart and lungs although I have found a herbal supplement which has really helped his lung problems but I would like to know what else I could buy to help things as with everyone else here who has loved ones with the terrible disease I would love to have him for as long as possible....

Thanks all for your help and replies..[/QUOTE]

[COLOR="darkgreen"]You already mentioned vitamin D and calcium. There are many good brands of calcium, but not so with vitamin D. Based on an expert doctor's recommendation, which he based on results in his clinic, the brand from Life Extension Foundation is sound. I have had excellent results with that band.

Quality pomegranate juice (8 oz. daily to avoid excess sugar), or a quality brand of extract capsule have been proven to help many patients. (POM Wonderful and Life Extension Foundation are two well-tested brands of capsules.)

Curcumin capsules, including agents to ensure absorption (a huge problem with curcumin) look helpful to us.

Lycopene in the diet, usually from cooked or processed tomatoes, looks helpful, though the evidence for this and other items below is not quite as strong as we would like.

Cutting out red meat and pork, but increasing fish and poultry, look wise. (Reduces arachidonic acid and saturated fat.) Several thousand IU of fish oil (not cod liver oil!) appears to help for prostate cancer and goes a long way toward reducing risk of sudden instant death from heart attack.

Drinking green tea (with a few drops of lemon juice to preserve potency) is easy to do and appears to help.

Selenium, 200 mcg daily - yeast based), and high-gamma type vitamin E (200 IU daily) appear to be helpful to some of us, depending on our genes.

In general, a Mediterranean diet appears best. Moreover, that is the only diet that has been tested in large clinical trials.

Exercise should include both aerobic exercise and strength exercise. Of course, balance and flexibiliy are also important, as is stress reduction.

Please keep in mind that I am repeating what I have read, researched and heard, but I am a fellow survivor with no enrolled medical education. The book "Beating ...", above, is especially excellent on diet, nutrition and supplements.

Good luck to you and your dad, and take care,

Jim :wave:

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