Am I Giving Up Too Easily?????

My Father who is now 82 1/2 - has had diagnosed prostate cancer since July 1995. When diagnosed his levels were 72. At the time of diagnosis he had just turned 73. He had several other medicial conditions and the Doctors said - we will do hormonal therapy - cause something else will get you 1st. Well, guess what - that something else DID NOT get him first!!!

His prostate cancer was managed by hormonal medication (pills) until 2001 - which then they switched over to Lupron injections every 4 months which worked for about 18 months to 2 years and the levels started to rise again. Did a bone scan in June - levels were elevated above 200. He felt good - so changed nothing.

By October he was in horrible pain. Found that the cancer spread to his bones, lymphs and lung. Tried ketaconzaole which only made him sick and weak. On 11/14/04 he was given 1 week to live w/ PSA levels at 3725. It is now 3/9 and he is still kicking but getting weaker every day. The Doctor said try chemo - 10% chance of extending life - no cure - side effects were just too much - he has weighed 125 pounds for 20+ years at 5 feet 11 inches - he is now down to 99 pounds. He Cardiologist told him to eat whatever he wants - and he does - as long as he eats.

Am I just giving up to this "terminal" diagnosis by not trying any of these natural redemdies that are out there? Or better diet? Or should I just let him enjoy? Since it is hormone refractory prostate cancer - there isn't a lot that can be done anymore - very sad.....thoughts?????

Also what is the highest PSA level that you have ever heard of????

I have metastatic PC which is currently controlled by Lupron for the last 3+ years. Your father has done extremely well, probably well beyond the norm. This is just my personal opinion, but with a PSA that high and the degree of involvement of the PC, I doubt if there is much medical approaches can do, just as you say. What you can do is love him and be supportive and help him be as comfortable as possible. And hopefully you and he in conjunction with his doctors can be sure he is getting all the pain medication he needs to avoid the pain, assuming that is what he wants. When you know you are going to die soon, the love and support of family and friends feels incredibly wonderful and nurturing. Good luck to both of you.
Pat K

Thank you for your reply. I am glad that the Lupron injections are working for you for the last 3 years and hope that will continue.

When you found that you had prostate cancer had it already metasized or where you on treatment -when it spread? I think as long as you have not been on hormonal treatment for years - the Lupron injections can really keep the cancer @ bay for a LONG time!!!!

My Father was also receiving monthly IV's of Zometa for the bone cancer starting in October -but this month he was too weak to leave the house to get it. I have tried everything to have them done @ home - but the Oncologist's Office will only allow a Home Infusion company to infuse @ home and the Home Infusion companies around us are NOT medicare certified. So its either stop the Zometa (which I do believe has helped) - or pay out of pocket - Zometa is $970.00 - and Home Infusion Services & equipment cost about $600.00 - I am not sure at this point is the Zometa is a $1500.00 benefit.

Now trying to decide if its time to put him on hospice. Horrible decision. Sometimes the help would be nice - but I don't like giving up. Since October he does need assistance with everything - with the exception of feeding himself. Its really a full time job. He is weaker and more tired. Last week he had a really bad week - and I was convinced it was time for hospice - he has perked some - he can stand now with his walker and my help - and eating again.....

Just hopsice seems so final.......

Thanks for you encouragement about the HT (hormone tx). I had a prostatectomy in Oct. 2001 and at that time the ca had metastasized just slightly. It was at the margins of the prostate in several places and in one lymph node and the Gleason score was an appalling 9-10. Very scary. But I have been doing great. I am only 65, and very active. I show almost no PSA.

Anyway, re your dad: Realize that no matter what you do, you are not "giving up" on him. You have cared for him for a long time and will continue to do what you can do until the end of his earthly existence. As far as hospice, that's a hard decision for everyone from what I hear. You are a smart and thoughtful person, and I am sure you have thought about most all the options. Seems like that decision should be based on your capacity to care for him at his stage and as he deteriorates further (which he will, and probably soon), his own wants (which you haven't mentioned), your options re using other caretakers (like relatives), his finances, etc. Some people really want to die at home, and others feel badly about being a full-time burden to their caretaker(s) and would prefer to be in hospice. Hospice is generally a very caring place where folks nearing the end of life can get all the help that they need all the time from very caring and experienced professionals. Not a bad option when you think about it. And you would still visit him of course.
Re the infusion therapy: My limited knowledge about this says that it may help the symptoms on a very short-term basis, like days or a few weeks, especially for someone at your dad's stage. Or it may not help, and cause a lot of nasty side-effects.
Hope all this helps some in your deliberations.
Pat K.

Janet,
My stepfather had a painless and dignified death with care given by a hospice organization in his home. Both he an my mother spoke very highly of the care that was given, and my mother has made donations to the organization since then.

You might ask your local hospice organizations about care in the home.

Hello,

I just read your posting. I just found out
y dad's PSA level was 1236 and Now it is 2000. Bone scan and Ct scan indicates that the cancer has spread to bones and lymph? I am really worried does this mean this is terminal?