The bolt from the blue which is advanced PCa... And beyond

Thanks Lyn. This makes sense. He was diagnosed out of the blue less than six months ago and he had immediate HT and chemo and responded well, if the PSA is anything to go by. I think I just panicked and thought surely it hasn't got worse already? Though of course we know nothing is guaranteed. 

Mrs MAS

Edited by member 27 Dec 2019 at 16:58  | Reason: Not specified

All the best for your husbands scans. My father (77, Gleason 9) has just finished his 6 rounds of chemo. Tolerated chemo well, and PSA went down from 300 to 0.4. Was also then told he would likely have radiotherapy, but radiotherapy by the Clinical Oncologist was then cancelled after CT scans showed some mets in the bone, which apparently were 'shown up' after the chemo.

We hoped for the option of radiotherapy too, but seems to be off the table now, though I will be double checking with the Snr. Oncologist when see her in mid Jan

Will follow this thread, and best wishes to you both

Hi, we were also surprised.  He has done really well on chemo (tolerated 6 cycles with little to no side effects, and PSA down from over 300 pre chemo to 0.4 post chemo). Did so well, that he was told he would have radiotherapy.  We were told that the bone mets discovered on CT scans post chemo were not 'new' mets,  but instead were highly likely to be pre-existing (non detectable) micro-mets that are now showing up, as have been 'illuminated' by the effects of the chemo.  Mets described s tiny and scattered (more than 5 but less than 10). Were told this happens, rarely.  Difficult to get our head round this, but it seems Radiotherapy is now off the table, as would do more harm than good.  Interested to know if anyone else has experienced this (bone mets only showing up/being illuminated 'after' chemo?).  Whether worth pursuing a second opinion on the appropriateness of Radiotherapy?

Will explore this further with Oncologist next week, but expect he will now remain just on hormone therapy / Prostap until it stops working, and then I expect Abi or Enza will be the next option.  We will ask also about Xofigo (Radium 223) as I believe this is effective when there are bone mets - however I understand it can now only be administered 'after' chemo and also after Abi or Enza.  We will also ask about Apalutamide as a treatment option as my Father is 'metastatic hormone sensitive' and would like to know if Apalutamide has this license.  Interested to know others perspectives on the appropriateness of Radium 223 and Apalutamide, given my Fathers position (aged 77, Gleason 9, otherwise fit, PSA was 322 but now 0.4, but bone mets now found).  All the best to you

No my husband had the 6 sessions of chemo and never had any GI issues during or after.  Every one is different.  We were told it was a common side effect however during, but not that long after.  Do hope it clears up soon, he must be miserable with it.  So sorry!  

Just an update from us. My husband has had his post chemo restaging scan and we had the appointment for results today. The lymph nodes have shrunk and his psa is 0.57 the lowest its ever been.

They were very happy with him The next step is radiotherapy. Its not yet been decided whether this will be 20 or 37 fractions and also whether to include the pelvic lymph nodes as well as the prostate. The planning session will be around end of March so I may be coming back with more questions!

Edited by member 21 Feb 2020 at 18:46  | Reason: Spelling

It sounds like they are just making sure they hit everything including lymph nodes hence 37 sessions rather than 20. They will hit the prostate with a certain dose and the lymph nodes will be hit with a dose of radiation too.
These links might help

https://prostatecanceruk.org/prostate-information/treatments/external-beam-radiotherapy

Thanks for the advice Lyn and for Shelagh for your good wishes. 

Double checked and treatment is going ahead next week. 

Shelagh, how's Rob doing?

Edited by member 21 Mar 2020 at 12:42  | Reason: Not specified