Welcome G.

I'm not a doctor, but I always say, figure out your life expectancy
without prostate cancer before you decide to treat it.  A man likely to
die of other causes within maybe 10 years should probably consider not
getting any drastic treatment.

Check with your doctor on life expectancy with prostate cancer.  Also,
this question has come up before, and there's some information in this
group's archives.

jimhoney
not a doctor
P.S. Get your PSA checked annually.

Near 80 Years old, Gleason 9, no metastasis to the bone
My father was just diagnosed.
Suggested treatment is castration (doctor's recommendation) or other
hormone therapy.
Can anyone just give me some random thoughts. Other possibilities? What
to expect? Life expectancy?
Thanks
============

Life expectancy?  that was the question i ask when my father had pca and
never got an answer.  that is probably the same answer you will get,
because they will tell you that pca is so unpredictable.

what kind of health is your father in now?  that makes a lot of
difference.

Suggested treatment is castration  - well, that saves those 1600 dollar
shots ever 3 months.  does the same effect.  don't know what kind of
insurance he has.  maybe that is why the doctor feels that way.  

Can anyone just give me some random thoughts. Other possibilities?

sure.... did they give him a stage?  if they believe the cancer is still
inside the prostate,  then i don't see why he couldn't have radiation
treatments.

if it has escaped out of the prostate, the shots or castration is the
only thing left along with drugs such as casodex or chemo.

bottom line - enjoy him, make movies, have him tell you about the family
history so you have a video of him in his natural state and a treasure
to keep.  take him out and travel.  do those  things you've been putting
off with him.  tell him you love him and say those things while he is
alive.  and enjoy him.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

I am not a doctor and can't give you expert advice.  I recommend
that your Dad get a second opinion from a prostate cancer
specialist as soon as he can.  Even if the doctor who recommended
castration is a prostate cancer specialist, it's still a good idea
to get a second opinion when a serious, life threatening condition
has been found.

Please take what follows with a grain of salt.  I'm no expert.
But here is the situation as I understand it from my layman's
perspective.

As I understand it, most men with Gleason 9 die within 10 years,
typically in 5-6 years.  How long your Dad lasts will depend on
how far he is in the process at the time of diagnosis.  His
current PSA is a good indicator of that.  If the PSA is low, say
under 20, then there's a chance he could even be cured by
radiation.  If the PSA is higher than that, then treatment
aiming at a cure is less likely to succeed.  However even if the
PSA is low, treatment for Gleason 9 cancers has a limited (but
non-zero) chance of success.

If the PSA is high, in the hundreds, then your Dad is already
well down the path with the disease and metastasis is almost certain
even if there is no evidence of it yet in the bones.  In that
case he may develop symptoms in the next year or two and die
another year or two after that.

Hormone suppression, either by drugs or by castration, can
make a big difference however in prolonging life.  How much
time it adds depends on how hormone dependent his cancer is.
Francois Mitterand was diagnosed with metastatic prostate
cancer in 1980 and lived until 1995 on hormone therapy.

If it were me, and if I were in otherwise good health, I'd
want the following treatments:

1. If my PSA was low enough that there is a good chance the
disease is still local, I'd want radiation.  External beam
radiation takes a few hours of preparation, followed typically
by a 10 minute a day treatment for 8 weeks.  There is no pain,
no hospital stay, no risk of infection, and limited side
effects.  The most common side effect is difficulty urinating
due to swelling of the prostate tissue around the urethra.
This usually lasts for 3-6 months and then goes away.  More
serious side effect are possible however.  XRays are potent
damagers of the body and wouldn't be effective if they weren't.

2. If testosterone suppression is warranted, either as an
adjunct to radiation, or because radiation is not indicated
due to high PSA or other indications of metastasis, I'd prefer
drug treatment to castration.  I'd prefer this for three
reasons: a) It's not certain that the cancer is highly
hormone dependent.  If hormone drug treatment doesn't work
it can be suspended.  But if castration doesn't work, there's no
going back.  b) There's no risk of surgical complications.
c) The idea of castration is not appealing to me and may
not appeal to your Dad.

I don't know if the side effects of hormone therapy are
better or worse than the side effects of castration.  A
doctor with experience would need to be consulted to find
out.

The main thing now is to find a good prostate cancer specialist
for a second opinion on all these issues.  There's an awful
lot of men being treated for prostate cancer by people who
really aren't experts at it and shouldn't be doing it.

Best of luck.

    Alan

Prostate Cancer in an 80 year old is often a nuisance and nothing more.  At
that age, PCa grows ever so slowly that one may often expect to die before
the cancer manifests itself.

However, that 9 Gleason is nothing to ignore.  You did not post his PSA,
which is also a very important determinant on what should be done.

Chemical castration is Lupron (probably).  Lupron causes the body to stop
producing testosterone.  PCa consumes testosterone in order to grow.  Stop
the testosterone, stop the PCa.

It's potential side effects are many, hot flashes being the worst in some
cases.  There can also be moodiness, forgetfulness, bone density issues,
etc.