Seeking some information about advanced prostate cancer

[anonymous98]

I'm asking on behalf of my father, who has just informed me that his prostate cancer has come back and is "in bones and glands" (English is not his first language). Presumably stage 4? Sorry, this may be incoherent, as I am a little shocked.

He told me via email because we are not on great terms. He was very unpleasant, to put it mildly, to my mother during their marriage and subsequent divorce. We have a fraught relationship and would argue frequently when I saw more of him. My mum is ill too and I do not want to expose her to further stress with this. I am also very vulnerable at the moment - mental health is abysmal and I am awaiting treatment for panic disorder and severe depression.

I am young (20s) and rather stunned at the prospect of my parents dying sooner than expected. Prostate cancer does seem to have decent outcomes; however, once it is in your bones, I imagine it is incurable/terminal. There seem to have been cases of men living with incurable prostate cancer for a while e.g. several years, but my father does not take good care of himself, lives in a developing country etc. and so I'm not optimistic.

Just a little dazed. Please - any information would be appreciated and will help me to make a decision re: if/when establishing contact. I am pragmatic and would appreciate any info, even if it is quite blunt. Thank you.

Sorry, I probably sound quite harsh in my post. Just really stunned and overwhelmed. He was diagnosed with prostate cancer several years ago but it seemed to have been dealt with. I think this is made more confusing by the fact that my dad is, frankly, kind of a bastard.

sorry to hear this OP. It is not curable in the bones. The outcome depends on the treatment plan..My DF has the same (Stage 4 outside prostrate in the bone). He’s been diagnosed over 18 months and still well. Had radiotherapy and two lots of hormone treatment. One (aptalutimade) is cutting edge just licensed on NHs so that has made a big difference. Regular blood tests and scans so far under control. But .. he’s followed all guidance, looked after himself, gets this latest very expensive (via NHS) treatment. It’s not curable - they are just keeping it at bay for now, we don’t know for how long

There is lots of information online. Try Prostate Cancer UK website for straightforward explanation. If its spread to an area outside the prostate then its known as metastatic and unfortunately that is usually a bad sign. But actual prognosis could vary a lot. I'm sorry you're in this situation. Even for an older person its still a shock.

On a practical level has your father made a will and expressed his wishes regarding arrangements in the event of his death? Is he able to access treatment where he lives, and what have his doctors said about the outlook? I don’t mean to upset you but its much better to know he has planned ahead than be left with a mess of paperwork in the midst of grief.

Just take some time to process your feelings. It is possible to be angry/upset with someone and feel sorry for them, or not. Obviously this will be bringing up old feelings too so take it easy.

What you decide to do with the news is up to you but do take your time and ask those around you for advice, and obviously put yourself first. You don't have to reply. You can just send a holding reply explaining that you're not to well yourself at the moment and leave it at that while you take it in and understand your position.

In terms of prognosis, who knows? It will depend on the treatment that is offered in his country, if he is eligible for it and if he decides to go with it. If he does then everyone responds differently unfortunately.

Not curable. With good care somewhere like the marsden, some can last 5y or so. Most much less. Hope you are ok.

Thank you. I hope your father continues to do well and sorry to hear he is also dealing with this illness.

Try this Macmillan forum for people in your and your dads position, I found it very helpful when my DH was diagnosed.

https://community.macmillan.org.uk/cancer_types/prostate-cancer-forum

Thanks. Unfortunately he is rather dysfunctional and will be in probable (understandable) denial about his death. He lives in a Middle Eastern country and I imagine treatment is not the best. He says he is receiving hormone therapy but probably not radiotherapy. Suspecting there is not going to be a will or anything. It's all such a mess really.

Hormone therapy works really well, radiotherapy won't work once it's no longer local and neither will surgery. Chemo would be the next step if the hormone treatment doesn't slow it down or stop the progression.

if he's got money then treatment probably good.

Oh okay, thank you. I am pretty ignorant about prostate treatment tbh. Most people I know of who have had cancer received chemo/surgery/radiotherapy, so I assumed that was the default.

In the UK you can now sometimes get radiotherapy if you have a small number of metastasis outside the prostate.
I think it might be called SABR.
Contact the nurses on prostatecanceruk website for more information.

My dad has been diagnosed with this. Hes 88 and is having injections and taking (i think its called Bitualcomide)

My DH has this. Diagnosed 2 years ago. We don't have a prognosis as it seems everyone is different, how well they respond to the treatment, how long the hormone treatment keeps working etc. If you Google it will tell you that average life expectancy is about 5-6 years but according to posters on the Prostate Cancer UK forum many people have lived more than 10 years and still going. Obviously we hope to be in the 10+ years group! Incurable doesn't necessarily mean terminal OP and your Dad could have many years left

Thank you everyone. He seems to be responding well to hormonal treatment.