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Hello My Father Is 99 Years Old And Was Diagnosed
Question: Hello
My father is 99 years old and was diagnosed in 2004 with local Prostate cancer and since then he was on lupron then zoladex injections every 3 months,casodex was added in 2016. The last 15 months his psa climbed from 23 all the way to 171, his doctor suggested to go for another line of hormone treatment either zytiga or xtandi and looking to there side affects i think xtandi has less harm on his health but giving to the circumstances of hos major health i have concerns about a second line of treatment, my father has heart disease and a border line of renal functions and he has been bed ridden since 2017 due to a broken hip and he has been in oxygen support during sleep time since 2018. Is going for a second line of hormonal therapy at his age and condition the right choice? If we decided not to go for further treatment what are his outcomes and life expectancy incase of his cancer, and if we decide to go for a second line of therapy which is the better choice between xtandi and zytiga and can it be a reduced dose for an example one pill every other day or so? I forgot to mention that father is asymptomatic in his current case. attached his last blood test results
Kindly advise
Thank you
Yaqoub
My father is 99 years old and was diagnosed in 2004 with local Prostate cancer and since then he was on lupron then zoladex injections every 3 months,casodex was added in 2016. The last 15 months his psa climbed from 23 all the way to 171, his doctor suggested to go for another line of hormone treatment either zytiga or xtandi and looking to there side affects i think xtandi has less harm on his health but giving to the circumstances of hos major health i have concerns about a second line of treatment, my father has heart disease and a border line of renal functions and he has been bed ridden since 2017 due to a broken hip and he has been in oxygen support during sleep time since 2018. Is going for a second line of hormonal therapy at his age and condition the right choice? If we decided not to go for further treatment what are his outcomes and life expectancy incase of his cancer, and if we decide to go for a second line of therapy which is the better choice between xtandi and zytiga and can it be a reduced dose for an example one pill every other day or so? I forgot to mention that father is asymptomatic in his current case. attached his last blood test results
Kindly advise
Thank you
Yaqoub
Brief Answer:
Yes treatment can start now
Detailed Answer:
Hi
Thanks for your query.
It is clear that your father is having a rapidly progressive disease now. However, it's not clear if he is having metastases in bones or other organs. I am not sure why he is on oxygen. You have mentioned that he is asymptomatic.
Still, considering the current rapid rise, I would suggest considering second line hormonal therapy. Xtandi and zytiga both have their share of side effects but xtandi doesn't require steroids to be added so marginally better. It's also not associated with cardiac problems but can cause seizures in 1% of patients. Dose of both is fixed at 4 tablets a day. However, there's some data on zytiga one tablet a day after food.
Very difficult to predict life expectancy without assessing the patient. In general, these drugs prolong life expectancy by 2 yrs on an average. But as he is bedridden with multiple other problems, this is likely to be on the lower side.
Hope this helps.
Regards
Yes treatment can start now
Detailed Answer:
Hi
Thanks for your query.
It is clear that your father is having a rapidly progressive disease now. However, it's not clear if he is having metastases in bones or other organs. I am not sure why he is on oxygen. You have mentioned that he is asymptomatic.
Still, considering the current rapid rise, I would suggest considering second line hormonal therapy. Xtandi and zytiga both have their share of side effects but xtandi doesn't require steroids to be added so marginally better. It's also not associated with cardiac problems but can cause seizures in 1% of patients. Dose of both is fixed at 4 tablets a day. However, there's some data on zytiga one tablet a day after food.
Very difficult to predict life expectancy without assessing the patient. In general, these drugs prolong life expectancy by 2 yrs on an average. But as he is bedridden with multiple other problems, this is likely to be on the lower side.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
hello again
It is not clear to us also if there are any mets because we as a family refuse scanning him inorder not to harmthe kidney with the scans,he is on oxygen because of his sleeping apinia.
Regarding the therapy is xrandi safe for him according to his general health? and about life expectancy i meant if he doesnt go for a second line therapy and stopped treatment how long does it take to the cancer to attack his vitals and kill him.
Thank you again
It is not clear to us also if there are any mets because we as a family refuse scanning him inorder not to harmthe kidney with the scans,he is on oxygen because of his sleeping apinia.
Regarding the therapy is xrandi safe for him according to his general health? and about life expectancy i meant if he doesnt go for a second line therapy and stopped treatment how long does it take to the cancer to attack his vitals and kill him.
Thank you again
Brief Answer:
Xtandi is generally safe
Detailed Answer:
Xtandi is generally safe. It can cause fatigue in many patients but I guess that is not a major factor in him as he is bedridden anyways.
Very difficult to predict life expectancy without assessing a patient first-hand. But considering rapid rise in PSA it may be 6-12 months without treatment. But it can certainly be more than this in his case.
Xtandi is generally safe
Detailed Answer:
Xtandi is generally safe. It can cause fatigue in many patients but I guess that is not a major factor in him as he is bedridden anyways.
Very difficult to predict life expectancy without assessing a patient first-hand. But considering rapid rise in PSA it may be 6-12 months without treatment. But it can certainly be more than this in his case.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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