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Hello My Father Is 99 Years Old With Ischemic Heart
Question: Hello
My father is 99 years old with ischemic heart disease 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 and his cardiologist shares the same concerns with me. 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
I forgot to mention that father is asymptomatic in his current case.
Kindly advise
Thank you
Yaqoub
My father is 99 years old with ischemic heart disease 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 and his cardiologist shares the same concerns with me. 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
I forgot to mention that father is asymptomatic in his current case.
Kindly advise
Thank you
Yaqoub
Brief Answer:
Average life expectancy in CRPC is 18.24 months
Detailed Answer:
Hello
Thanks for writing again .
I have gone through ore previous discussion on the issue of your 99 years old father who is under treatment for advanced Cancer of the prostate He has been on LHRH antagonist and Androgen antagonist since 2 years .
However his recent rising trend in spite of adequate doses of these drugs (Chemical Castration )is an indication of it being a what is called as Castrate Resistant Prostate Cancer .
As a protocol it is a routine practice to switch to other drugs to lower down the testosterone levels which includes either Enzalutamide or Arbiterone .But these drugs have very adverse side effects which make the life of a patient more miserable than any help of prolonging the death for few months .
.
In view of his other issues like cardiac and renal problems and he being bed ridden had he been my father I would not go for these drugs .
I understand your concern and sentiments for your father However if left untreated his expectancy of life would not be of a much difference as compared to with giving these drugs.
Thanks and Regards
Average life expectancy in CRPC is 18.24 months
Detailed Answer:
Hello
Thanks for writing again .
I have gone through ore previous discussion on the issue of your 99 years old father who is under treatment for advanced Cancer of the prostate He has been on LHRH antagonist and Androgen antagonist since 2 years .
However his recent rising trend in spite of adequate doses of these drugs (Chemical Castration )is an indication of it being a what is called as Castrate Resistant Prostate Cancer .
As a protocol it is a routine practice to switch to other drugs to lower down the testosterone levels which includes either Enzalutamide or Arbiterone .But these drugs have very adverse side effects which make the life of a patient more miserable than any help of prolonging the death for few months .
.
In view of his other issues like cardiac and renal problems and he being bed ridden had he been my father I would not go for these drugs .
I understand your concern and sentiments for your father However if left untreated his expectancy of life would not be of a much difference as compared to with giving these drugs.
Thanks and Regards
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
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