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Posted 12/18/2015 10:36 PM (GMT -7)
Hey folks.
It's been a while. I'm doing well. After several years of treatment and even more years now in remission I am approaching year 10 in pretty good shape. A lot of people know me here and know my dad has been running a high PSA and Dx of local prostate cancer at G6. He's 82. 79 at Dx.

When I was diagnosed I was a 44yo guy with advanced PCa. No family history. Well it's my dad's turn. So woohoo at least he had family history? He has to jump off active surveillance and into a therapy choice. Now I pointed out his age. The thing is that he's a very active guy. Swims a mile a day and golfs like a 14 handicap. His PSA is on a high doubling rate now and it's time to head it off.

I recommended that he look at all options and I suggested that brachytherapy and stereotactic approaches might be right for him. He has a history with diverticulitis and EBRT might be a bit risky. I led with surgery and I still believe that was a best choice for me. But my dad is enjoying life and I think with his normal sized prostate he'll do well with leading with radiation.

To all...Make educated decisions. Share and compare. This is not a race! It's a brotherhood. And in my case I little closer. :-)

Peace to all. And a very Merry Christmas!

Happy Holidays!
Posted 12/19/2015 1:53 AM (GMT -7)

Tony Crispino said...
But my dad is enjoying life and I think with his normal sized prostate he'll do well with leading with radiation. ..

I saw a quote here attributed to Dr Snuffy Myers "I only recommend surgery to patients over 70 (versus radiation) if they bring both parents with them to the consultation."

Hate your Dad is having to deal with it, but I for one think you have him headed in the right direction.

Hope you both have a nice holiday season.
Posted 12/19/2015 5:17 AM (GMT -7)
Tony, sorry to hear about your dad. But, as you know better than most of us, he has a bunch of great non-surgical options. Hope all goes well.

Jim
Posted 12/19/2015 5:21 AM (GMT -7)
Sorry to hear about this Tony. I've read enough about you to know, he'll have great guidance, and no doubt, great support.
Posted 12/19/2015 5:36 AM (GMT -7)
..... a good son. All the best.
Posted 12/19/2015 6:01 AM (GMT -7)
All nice comments. Thank you guys!
My dad also needs to have arthroscopic rotator cuff work done. I told him take care of that first. He has yet to see a radiation oncologist and I told him to take his time. Planning for the treatment will take a month or so. He'd do better getting that shoulder back for the return to the swimming and golf. that loves.

I saw on the InfoLink some interesting data today for men on AS with PSA between 10 and 20. I forwarded it to him and shared it here. The reason I don't feel good about staying on AS is the continued rise and the family history ~ moi. But this has to be his choice. I'll just keep feeding him the data.

AS and high PSA's:
prostatecancerinfolink.net/2015/12/17/active-surveillance-for-men-with-psa-levels-up-to-20-ngml/

Stay well all! And Stay Positive!
Posted 12/19/2015 6:12 AM (GMT -7)
Tony,
Sorry to hear about your Dad. He could not have a better advocate in his corner than you. I sitll remember the advice I rec'd from you on my first post on healing well when I was sacred of what was ahead.

Merry Christmas to you and your Dad.

Don
Posted 12/19/2015 8:49 AM (GMT -7)
Good to hear from you. Sorry to hear about you father. With you to help him, he'll do well,
Andrew
Posted 12/19/2015 10:34 AM (GMT -7)
Tony--

Thanks for checking in and letting us know about your dad. He should do well with whatever non-surgical options he chooses. I hope all is well with you, Ruthie and rest of your family. Keep us updated on your dad.

Merry Christmas and a Happy New Year!
Posted 12/19/2015 11:20 AM (GMT -7)
Tony,

While it's nice to share things with your parents, PC isn't one of them.

As you know, Klotz believes that the only valid reason for coming off AS is if Gleason 4 becomes the dominant component. If your father can be monitored periodically with mpMRIs read by a really good radiologist, there may be no rush to come off it.

There is a concern about surgery in 82 yo men - the anesthesia may cause lasting cognitive deficits. Also urinary function doesn't heal as quickly as in younger men.

I know that diverticulitis is not a contraindication for SBRT. The dose to the large bowel is very low anyway, but especially if the RO knows about the history of diverticulitis and sets that as one of the dose constraints. As you know, the only way to know for sure is to ask the specialists in each therapy.

- Allen
Posted 12/20/2015 5:14 PM (GMT -7)
Hi Tony, sorry to hear about your Dad, he will have a few decisions coming, taking into account his age etc.

My best regards to you and family.

Mal.
Posted 12/20/2015 9:28 PM (GMT -7)
Hi Tony, Sorry to hear about your dad but he doesn't seems like a typical 82 year old and certainly you want for him to continue to be mobile and enjoying his life as much as possible. He has a good example and advocate in his son. Hoping for the best results for him.
Merry Christmas to you & yours,
Susan
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