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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2006Bone Metastasis
I turned 83 on September 4. After five or six years of watchful waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to 80, during most of which time I took Flomax and Proscar (which failed to inhibit to any meaningful extent my continuing BHP incontenence), My urologist last May decided to do a biopsy. Result - adenocarcinoma positive with Gleasons of 4+3 for most cores. Total body bone scan revealed "multiple osseous metastases." Since then I have received three injections of Trelstar Depot (accompanied by IV doses of a bone strengthener which I think is called "Zometa"). My PSA immediately dropped to 2.3 then further down to 1.2. Anyone care to suggest a prognosis. I will add that due to severe osseoarthritis I can walk only with a walker, and that I have had moderate emphysema (supplemental 02 24/7 at 1 liter/minute). I have regular checkups by a cardiologist and pulmonary specialist. Should I be seeking an opinion from an oncologist? My urologist seems to think things are pretty much under control if my PSA remains low (lowest its been for many years). At my age, should I be worried? > I turned 83 on September 4. After five or six years of watchful > waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to [quoted text clipped - 7 lines] > dropped to 2.3 then further down to 1.2. > Not a pretty picture; I'm sorry to see that the disease has progressed so far. The treatments (txs) are palliative and not curative. The PSA, however, has improved substantially and may very well improve further as the Trelstar tx is continued. (snip) > Should I be seeking an opinion from an oncologist? My urologist seems to think > things are pretty much under control if my PSA remains low (lowest its been for many years). At my age, should I be worried? > Yes, I think that there is cause for concern. For one thing, if the bone mets develop further despite the Zometa, pain could result. I strongly recommend consultation with a medical oncologist. A uro, unless he's unusually well-prepared, is a surgeon at best. What is needed here is a cancer specialist, an oncologist. See the Resources link on the authoritative website of the Prostate Cancer Research institute at: http://prostate-cancer.org/index.html Many (but not all) medics who specialize in PCa are listed. Their pages on advanced PCa should also prove helpful. Also: attendance at a local chapter of the PCa support group UsToo! should be enlightening. Members will likely have recommendations re: med oncs. Chapter listings will be found on their website at: http://www.ustoo.com/ Good luck. Regards, Steve J "We must tailor the treatment to the nature of the disease. We must listen to the biology." -- Stephen B. Strum, MD > I turned 83 on September 4. After five or six years of watchful > waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to [quoted text clipped - 13 lines] > things are pretty much under control if my PSA remains low (lowest its > been for many years). At my age, should I be worried? I agree with Steve that you should seek advice from a medical oncologist skilled in the treatment of prostate cancer. It seems to me that your urologist might have done a biopsy earlier given the rate at which PSA was increasing, although he may still have recommended WW as opposed to aggressive therapy at your age. It is quite possible the end result would have been the same. The therapy you are under may clear up your bone metastases, and make you feel quite a bit better. Such therapy doesn't cure the disease, but it can keep you going for quite a long time. If the current treatment fails, an expert may be able to come up with another treatment which works. You may end up dying at a ripe old age of something else with your cancer rather than from your cancer. Good luck. > I turned 83 on September 4. After five or six years of watchful > waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to [quoted text clipped - 13 lines] > things are pretty much under control if my PSA remains low (lowest its > been for many years). At my age, should I be worried? > I turned 83 on September 4. After five or six years of watchful > waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to [quoted text clipped - 13 lines] > things are pretty much under control if my PSA remains low (lowest its > been for many years). At my age, should I be worried? > I turned 83 on September 4. After five or six years of watchful > waiting, with my PSA went from 2 to 4 to 7 to 10 to 17 and finally to [quoted text clipped - 13 lines] > things are pretty much under control if my PSA remains low (lowest its > been for many years). At my age, should I be worried? What do I have to look forward to? |
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