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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for prostate cancer metastasized to hips and sacrum

Answered by
Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

Posted on Mon, 9 Nov 2015 in General Health
Question: Thanks for asking how my husband is after you answered my question. I had peace after you answered and just waited until the next Oncology apt on Oct. 5th so thanks. He asked me yesterday for the first time if he was dying. I said, "Ultimately, yes, prostate cancer will kill you but neither of us know how long you have. Two weeks ago you did not want me to ask Dr. Kong about prognosis and 10/19/15 I did not have enough courage to ask." He was dx'd in 2005, and it metastasized in 2007. The PSA stayed down at a .6 after initial radiation for two years, and then increasing to 1.6 meant that it had metastasized to both hips and the sacrum. He's in the group with low PSA's and XXXXXXX 7 Ca. He has had chemo with Taxatere, then with Jevtana, and now with Mitoxantrone/prednisone. Also, has had radiation 5 different times (includes initial). He does not appear to be tolerating third round of chemo well. White blood cell count went to .6 and then he had Neulasta shot. Hemoglobin went from 8.9 to 8.2(9/21) to 8.4(10/5) to 8.1 (10/12) to 11.0 (10/19) after transfusion. Platelets went from 122 to 63 (9/21) to 70 (10/5) to 79 (10/12) to 75,000 (10/19). He is tired and weak all the time. Is independent to min A with FWW depending on where he is and time of day, but we forgot to bring the walker one day, and he was mod A X 2 getting him to the car. (I'm an Occupational Therapist, retired.)
Answered by Dr. Prakash H Muddegowda 9 hours later
Brief Answer:
Depends on response to chemotherapy and ability to tolerate it

Detailed Answer:
Thanks for replying.

Cancers are high unpredictable and can recur or transform or metastasize.

It is very difficult to talk about survival.

At present, Chemo is suppressing the marrow and affecting the blood counts. Increased risk of infection and bleeding is present.

Infection is a major risk during chemotherapy and with reduced counts can be life threatening. Managing the chemotherapy is very important now. If he comes successfully out of chemotherapy, then few more years should not be a problem.
However, failure to respond to chemotherapy or infection, at this point of time, will reduce the survival to less than a year.

More than the risk of death due to cancer, it is metastasis into bones causing fractures, affected marrow causing infections - morbidity risk is high. Need to be very careful about movements and infection exposure.

Avoid any risk of infection and concentrate on his nutrition. Keeping his morale up is very important.

Hope it helps.
Any further queries, here to help again.

Dr. Prakash HM

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

The User accepted the expert's answer

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