Dad Has Advanced PCa - Please Help

I am new here and I am lost for help in determining what my dad has left in time. He is 87 and has Prostate cancer that has metastasized into bone cancer. Is in constant pain and on oxycotin and oxycodone. He is not eating and sleeps most of the time. His psa is 633.0. I cant imagine living like he is. Can you all tell me if this sounds like ha has much time? Doctor wont say and I need to inform the extended family. Please... share your thoughts,

Post Edited By Moderator (Tudpock18) : 6/28/2015 3:01:44 PM (GMT-6)

Thank you Jim. I am at my wits end not knowing what to do. He has lost control of his bladder and bowels and I have lyme disease and chronic pain and i am so afraid I am going to drop him getting him into the bath to clean him. I feel like i am failing him as i promised him I would not put him in a nursing home but I dont know how much longer I will be able to take care of him the condition he is in now. I just need a shot of reality therapy I am afraid. I thought I could do this :(

Diane,

It would help us if you could tell us what treatments your dad has already had, or even how long it has been since he was diagnosed with prostate cancer. There are treatments for prostate cancer that can work wonders but not always for very long. If he is newly diagnosed and hasn't had any previous treatment then hormone shots may help him a lot. If he has been struggling with it for a longer time and the hormones have stopped working for him then that would be a different matter.

We have a number of caregivers on this site who might be able to share their experiences and suggest places you can look of help with him.

Well, without getting too involved. about 6 or maybe 7 yerars ago he had some prostate issues but I dont know what they were and being the girl i didnt ask. 4 years ago he had this bad pain in his legs and a doctor who he is NOT seeing now ordered xrays and said he had Paget's disease and didnt want to take his case but said to see his reg doctor who then put him on hydrocodone. Over the next two years the pain got worse and worse and then in September he fell in his driveway and lay in the dirt in the middle of the night until he finally thought to use his life alert that I had gotten him. He fractured his pelvis, stayed in the hospital for 1 week and transitional care 2 weeks then came home with me. Since then his pain just kept getting worse and worse and when I took him to my doctor in the town I moved him to he ordered a bone scan with results that could be consistent with Paget's but when the pain did not get any better with stronger and stronger pain meds doc ordered a psa test. FINALLY someone was getting to the prostate issue that was long forgotten. That was last week and his number is 633. He is on oxycotin and oxycodone for pain which helps a little but he stays at around a level 6 or 7. I think he had prostate cancer way back when and no one treated it and I think he has had bone cancer since the pain started in his legs. This is just a hunch but in the past month he has gotten so bad that he sleeps around the clock. He has lost all control of bladder AND bowels and can BARELY walk to the potty where he just pees down his front. I feel like im losing it. I cannot take care of him because of my own stuff but if I had ANY idea of where he was in the progression I could make better choices for him. He isnt capable of making his own choices like he is. At 87 i want him to just go and be with his wife and mom and all those family members who have passed before him. I HATE seeing him in this condition and I cannot see how in the world he can pull out of this with any quality of life at all. But i am guessing all the time, every day. I just do not know. Thank you all so much for your responses and thank ypou for any information yet to come. I pray for strength. He has only been treated with one iv injection of bicarbonates?? I dont know if that is wrong but they use it for osteoporosis. He staerd on an anti cancer drug a couple of days ago and is scheduled for a hormone shot this Thursday. I dont even know it i want him to do it because I dont want him to feel worse :(( HELP!!! Please

Diane,

This is a question you need to ask your dad's doctors. You may need to ask your dad to sign a health care proxy if he hasn't given you one already. This will give his doctors permission to talk with you and may also (depending on the terms stated in the proxy) give you your dad's permission to make medical decisions for him if he is unable to do so himself.

I hope I'm not out of line by suggesting this, but it is possible that your father may qualify for hospice care. This is generally available if a doctor estimates an expected remaining lifespan of 6 months or less, and only your dad's doctor(s) can say if in their medical opinion this may be so. However, if admitted to hospice care and still alive and kicking 6 months later, a patient can be extended and remain in care. One case in point is the newspaper columnist Art Buchwald, who hung in longer than his doctors expected and even checked himself out for a final summer vacation in Martha's Vinyard before returning to hospice.

I'm suggesting you look into this because from what you write you are stressed, over-extended, and putting your own health at risk. I speak from experience having done hospice at home with both my mother-in-law and my own father, and also because my wife was a hospice volunteer for quite a few years. In my experience, once in the hospice program, help arrives in several forms. There should be nurse visits a couple of times per week and additional visits by a home health aid who helps with bathing, changing sheets, etc. They can arrange for the loan of a hospital bed with all of the adjustments that help a patient stay comfortable and also wheel chair, walker, etc. if needed. When my mother-in-law was in hospice at home (our home) the hospice also sent volunteers once or twice a week, which made it possible for my wife and me to go out for a couple of hours to dinner or a movie, which really helps as a stress reliever.

I'm not a medical professional and I'm not saying your dad has only 6 months to live -- even his doctors can't say that for sure one way or another. But the physical deterioration you describe--not eating, much sleeping, loss of bodily functions--is familiar and is not inconsistent with a pattern of rapid decline.

Jim

Sorry you need to be here. It is a difficult situation and I understand why the doctors can't really say. None of us can really say much long he might have.

The hormone shot will help with the pain and likely will make this better not worse.

Sadly, I have to agree with the folks above, a good hospice program would help him and you cope with the situation. There is so much they can do to help everyone, your dad, you and the rest of the family.

We're here if you need us,
Andrew

Hi Diane,
I am so sorry you need to be here, but this is a good place to come for information and support. Your Dad is very lucky to have your concern and care, but you must find a way to get yourself some relief and assistance if you are to remain healthy enough to continue to help him. You will find it helpful to take a notebook with you to his next appt and ask a lot of questions. Prepare some in advance from reading through some of the threads. Read through Sue Saddened thread to see what those of us caring for advanced patients have tried and for support. Best wishes to you, dear.
Beth

Diane -

You didn't say whether your dad is a veteran of one of the U.S. armed services or not, but at age 87 that would mean he was a young man around the time of World War 2, so I'm going to assume that he likely was in the military at some point during that era.

If that is the case, then, yes, there are government assistance programs available through the Veterans' Administration that he could well be eligible for. Not just "hospice" programs but "palliative" (terminal condition not required) programs as well.

So if he ever did serve in one of the U.S. military branches and was honorably discharged following service, then he is likely eligible for those programs.

For more information, take a look at:

www.va.gov/GERIATRICS/guide/longtermcare/Hospice_and_Palliative_Care.asp#

Dianne , please see if you can put care in place.Home care would help you imensly. Where ever your Dad has been getting any kind of care from fine out if they have a social worker who can direct into a place to find help. This is just too much for any daughter to deal with .I don't know how you are coping? . There are signs when cancer is very late stage that the oncologist should explain to you. The main thing to remember is Drs can't know just when is any ones time. My husband is 64 and his current psa is 2,389 and is stage 4 . They told us he has 2 to 4 months left to live but we don't buy into that scenario. We are doing everything we can to survive. Some people are lucky to have good medical care and from what you have posted your Dad really has not. I hope and pray you can find some help. Keep us posted and if it helps at all know within your heart you are amazing and you have gone above and beyond In caring for your Dad. P.S home care will help with catheter care because even using a catheter will help him as well as yourself. Take Care. Sue XOXO💙

Hello Dianne,

I understand completely how you are feeling, I too am struggling to cope with the down hill slide my Dad has taken.

I wasn't sure if I should post a reply to you but I feel I need to tell you that before Dad started his 3 monthly hormone injections he could hardly walk, taken into hospital because he couldn't pee, and was in a great deal of pain.

The hormone injections gave him 6 months of good quality life, pain went and he was back to walking pain free. I would certainly advise to try the hormone treatment.

Chemo thearapy was used once the symptoms came back, this also improved Dad's quality of life (not as much as the hormone). He has managed 2 years since being diagnosed with ups and downs.

We are not in a good place now and have run out of treatment options. Dad isn't eating, even though he tries hard he just cannot eat. walking very unstable and can only manage short distance around the house he is in a lot of pain. He had spot radiothearpy 3 weeks ago but it doesn't seem to have helped. Today he is due to have a bone infusion if his bloods are upto it.

If we had our time again would he have the treatments the answer is yes during the 2 years he has had some really happy times and good quality of life. He hasn't given up and is still fighting with all his might but every day he grows weaker. Keep intouch with this site it has helped me so much to understand what treatment is available and how it affects different people. Sharing with others in the same position also helps so much.

Keep fighting,
Theresa