My dad has spine metastes frm primary prostate cancer, terminal, indefinate hormone therapy...Whats average prognosis please?
Depends how long. How long on hormones? If just started the cancer may respond for average of several years. If he was already on hormones for long time prognosis is worse months to a year or two using other option such as different drugs or chemotherapy. Not cureable at this point just delaying progression. Some are offering Provenge (sipuleucel-t) but it's new and not known how effective, this is a vaccine type of therapy.
Still some options. I assume he has failed hormonal treatments. If his age and physical condition permits, there are some options. The oral hormone pill zytiga (abiraterone acetate) and chemotherapy (if a candidate then taxotere usually) can be considered. For the spine metastases radiatin can be very helpful in pain control. Average survival is widely variable after hormones have failed can vary and is in the range of 18-20 months.
Mets prostate cancer. The 2 year survival of the average person with bone mets is 40%. This may range from 6 months to 10years depending on the aggressiveness of the cancer (high gleason score:8, 9, or10). Intermittent therapy is sometimes used depending on initial response. Talk to the urologist or oncologist for what is right for your dad.
My dad is 68 years old. Recently, he was dignosed with advanced prostate cancer with skeletal bone metastasis. What kind of hormone therapy shall he use? Is orchiectomy ok?
Yes. Orchiectomy is nearly instantly effective in reducing testosterone levels and can be done as an outpatient. Alternatives include injections (lhrh agonists) to reduce testosterone levels. These are relatively expensive over the long term, but preserve the testicles which is why many men prefer this option. Surgery is permanent whereas shots can be withheld, but permanent may be best with bone mets.
Disagree... As mentioned orchiectomy is permanent. There are other chemical options, including estrogen therapy as well as drugs which de-stimulate the pituitary from making lh and fsh. No direct proof confirms that testosterone per se is a cause. It may more be 5-dht. Men who lack 5-a-reductase do not get bald or prostate ca. Therefore drugs that block conversion to 5-dht may be used in tandem.
D/W your oncologist. Many options available for metastatic prostate ca- medical and surgical therapy. Orchiectomy can be done and will be for sure decrease testosterone permanently. Anti androgen tx like- Lupron (leuprolide) injection, oral casodex- or the newer oral agents that are more sensitive like x-tandi, abiraterone- are available. Not too forget- vaccine & chemo are available as well. Pls d/w oncologist in detail.
Orchiectomy OK but. The standard of care is an lhrh agonist (such as lupron, zoladex) injection combined with a drug taken by mouth called casodex. The Casodex should be used for a minimum of 1 month and then can be stopped. The advantage is that these injections can be as little as once every 6 months. Alternatively, a drug called Firmagon (degarelix) (an lhrh antagonist) can be given monthly without the casodex.
Sometimes. Hormone therapy may be used temporarily in conjunction with radiation therapy for intermediate and high risk prostate cancer. In addition it may be used in cases of more advanced cancers for palliative reasons. Most prostate cancers are hormone sensitive but may "escape" these effects during cases of long term use.
Possibly. A hormonal related medication called a gnrh analog or Lupron (leuprolide) is use with prostate cancer.
Sometimes. If there is metastatic disease or trying to shrink the prostate down prior to radiation. We use a medication called a lhrh agonist. One of the ones we used is called zoladex (goserelin). It blocks the hormone testosterone.
It can. Androgen deprivation therapy (adt), or hormonal therapy for prostate cancer, seeks to eliminate androgens like testosterone which can be fuel for prostate cancer cells. Eliminating these hormones can have a major effect on sexual function, such as decreased libido and erectile dysfunction.
Tradeoffs. Hormone therapy as it is called is actually the process of reducing male hormone levels either chemically or surgically. It is highly effective as a means of controlling prostate cancer, but long term use can cause reduced bone mass, weight gain and possibly cardiovascular side effects. Without the therapy however, there would very likely be more severe possibly lethal prostate cancer issues.
Maybe. Long term therapy with testosterone blocking agents such as lhrh agonist drugs can cause significant fatigue. In patients with high degree of fatigue, mental confusion can be a side effect. Regular light exercise both physical and mental is helpful in many cases.
Hormone therapy. It can.
Generally - No. Hormone blockade (hb) can cause many problems but they tend to be time related. The longer on hb the more the problems. Hb often makes pre-existing problem worse or accelerates some problems. Hb itself rarely causes "confusion", more often it can cause depression, fatigue, and emotional changes. Only older men on hb for a very long time tend to have true cognitive dysfunction.
Unlikely. Unlikely, first other causes like metastasis etc to be considered for mental confusion, before implicating medication.
Yes, rarely. For the most part, the hormone blockade would not cause confusion. The hormone blockers can make any pre-existing condition gradual worse but they are also reversible. That said, after giving this therapy to >1000 men, only once have I seen someone with pre-existing mental disease have serious rapid worsening. This was fixed by stopping the hormone blockers.
Possibly. Hormone therapy for prostate cancer, especially over extended long term can cause significant fatigue. This can lead to some degree of mental confusion. Regular light exercise, both physical and mental can help to combat this.
In some cases. Hormone therapy for prostate cancer, especially over extended long term can cause significant fatigue. This can lead to some degree of mental confusion. Regular light exercise, both physical and mental can help to combat this.
Having advanced prostate cancer and on hormone therapy. How long a wait till tumor shrinks to a workable size does 8 months sound?
Prostate ca. What do you mean by workable size? The response to therapy-. In this case- hormonal therapy will be individually basis. Majority'll respond well and you can see this by following your psa as the level will go down. Now how long it will take to become normal- it varies, and will depend on the tumor burden. Some imaging like a bone scan or ct scan periodically can be used to monitor the response as well.
"Advanced" Ca P. How "advanced? " what stage (at diagnosis)? What grade of tumor? Bilateral disease? Peri-neural invasion? What was your starting psa? Is your acid phosphatase level elevated? Was a bone scan/ct pelvis performed? What "hormone" treatment are you receiving? What is your performance status? Co-morbidites? Voiding problems? Bony pain? Too many questions - you need to speak directly with your urolgist.
See your doctor. Hormonal therapy comes in many forms. Apparently there is no set time for how long it needs to have a significant effect. Sometimes removal of hormonal therapy causes shrinkage. But advanced cancer is usually not localized to the prostate, and surgery might not take it all out. At any rate, it is up to your doctor when or if the prostate is small enough for surgery or whatever he/she will do.