Hi Pannika, it is good to see you and your father are on top of things.
PSA readings as low as your fathers can be a little misleading in that
there are variations, especially at low levels. Also, it is a fairly
accepted position that three consecutive readings do represent a
pattern. Albeit, the differential of .01 and .09 between 0.03 and 0.04
and then 0.13 are very low even though mathematically they have
tripled. There are many papers on this subject if you go to the
Sloan-Kettering web site and surf through the links to read literature.
Work with your doctor to see if he needs to resume hormone therapy, but
personally, I would recommend one more reading.

Rich

Dear Anna,

I don't know enough about your dad's numbers to give you a
"perspective."  I am here because of my husband and his situation is a
bit different.  But I do hear the anguish in your voice and I want you
to know how much I understand it and feel for you.  There is nothing
worse than seeing the big, strong father who has always protected you
and who lights up like a christmas tree every time he sees you lying
there helpless.

Just keep on making inquiries and advocating for your father as you are
doing now and tell him every chance you get how much he means to you
and I'm sure he will have plenty to say to you back.

My own father had a stroke and seemed unable to speak until one day I
said to him "I love you" (in 2 languages). He responded, "I love you,
too", clearly and without hesitation. (The  doctors would say this was
some kind of "automatic" reaction but we family always know better,
don't we).

Most amazing:  I used to sing to Father sometimes in the hospital
because it relaxed me and one day while I was doing a familiar tune
this mute man suddently burst into song himself, enunciating each
syllable, each note, in a loud clear baritone!  The nurses thought this
was a miracle of biblical proportions and said isn't it amazing what
love can do.  It had to be love because it sure wasn't my singing (even
spouse says I have spirit but no instrument).

I wish you and your father the best and if you need support or info
come back here . . . you will find some wise people ready to help.

Leah

Anna,

I'm not an expert on any of this, but it may be time for
your doctor to consult with a different kind of expert.

Urologists and radiation oncologists are specialists who
may be very good at what they do, but are not necessarily
specialists in hormone therapy.  They have a basic
understanding of it and are usually the doctors who
prescribe it, but there are some specialists, i.e., "medical
oncologists" whose specialty is treatment of cancer
with drugs.  Most of those are not specialists in prostate
cancer, but some are.

Your Dad might ask his primary health care provider or
urologist if they can find such a specialist in your area and
give him a referral.

If your Dad has failed primary treatment, there is a good
chance he will die of the disease.  But there are options in
treatment that may prolong his life for years and make the
rest of his time more pleasant and comfortable.

Some issues that a specialist might be able to address
include:

If and when should he resume hormone therapy?

Should he use single, double, or triple androgen
deprivation? (There are up to three different kinds of hormone
treatment drugs which can be used singly, in combination,
or in alternating sequences.)

Should he try intermittent hormone therapy - though that's
not a decision that can be made now.

Should he try chemotherapy?  There are some trials now
underway using combinations of hormone therapy and
chemotherapy.  The theory is that, while chemotherapy
is only effective for a short time when given late in the
course of the disease, it might have more effect if given
early.

Should he consider any clinical trials of new therapies?

If he resumes hormone therapy, should he be considering
any treatments that mitigate the side effects?  (I found
physical exercise to be essential to me when I was on HT.)

Your Dad's current doctors may be excellent and may have
good answers for all of those questions.  But if they don't
perhaps they can find a specialist for him who specializes
in just those sorts of things.

Best of luck to you and your Dad.

   Alan