How old is your dad? One piece of advice is to somehow help him quit smoking (I assume it's tobacco he smokes?) We have several members here with G9 PCa, have a look around at their threads.

Hi Claire,

Welcome, glad you found us. It sounds like your Dad will probably get diagnosis of agressive PC (at least based on his Gleason), but given his PSA, I am pretty sure his bones will be clear, and that he will probably get a diagnosis of locally advanced disease. If this is indeed true, his disease can be controlled for many, many years. He will probably be put on hormone therapy, and that requires him going once every three months for injections. He should be able to handle that.

The challenge for him and you will be to add yet another chronic disease to already existing diabetes and heart condition. Neglecting diabetes does not sound good, and perhaps your dad could use some sort of counselling on how to cope, as well as how to treat his conditions (what his part should be in disease management). Is there a trustworthy doctor (GP or other), who believes in holistics (treating a person, not just a disease) who has a good reputation in your neighborhood, who is close, accessible, who will also accept that your father is not the easiest patient, and who will be able to at least provide basic service - first contact regarding all health conditions? So, for example, when your father comes in, he sees what tests are coming up, what medication he has used (or not used) and then reminds him of things he needs to do? And do you know why is he not caring? Perhaps it would be worth to treat any underlying depression to get more cooperation from him. All the best to you.

Hi

We are in the UK, I'm in London and my Dad is in Southampton, about 80miles apart.

My brother has been my dads full time carer for a few months now, he is very good at getting my dad to all his appointments and taking all his medication. But he hasn't been doing the research I have, he didn't know what a Gleason score was until I asked him for it. Dad's GP is very good however, he sees him pretty much weekly already.

I do not know the brand of tablet, or if they were advised injections were needed, I wasn't able to make the appointment, I will be there for the Bone scan on Thursday and will take copies of all the paperwork my brother was given then. I have the contact details of his Urologist. Dad hasn't been very forthcoming with the details, the calls so far have just him calming me down and making me feel better.

We have a holiday booked in Devon in May which dad is very excited about as I haven't been on holiday with him since I was a child, so he is focusing on that at the moment which is better than nothing.

Hi Claire, I'm here because my dad was just diagnosed too. I can't really give you any advice because i'm new to all this too but wanted you to know you're not alone. It's hard when the man you've always thought to be the strongest person on the planet has something like this happen to him. It's important for you and your siblings to be strong for him and all be in it together. Best of luck to you and your family. You all will be in my prayers.
-Amanda

Your dad is fortunate to have you supporting him.

The pills are probably Casodex, at 150 mg/day. Those taken alone as a mono-therapy are more common in UK and Europe than in the USA. Here's a link to a quick explanation of that anti-androgen mono-therapy. It may be a very good choice for one in your father's situation:

ANTI-ANDROGEN MONOTHERAPY

I would also caution greatly against any surgery for him. Even radiation therapy may be of limited benefit. The Gleason 9 indicates an aggressive case that can more easily spread (metastasize). Whether it has or not, and if so whether it is detectable or not, is hard to say.

The anti-androgen pills alone aren't considered as effective as using them at a lower dose (50mg) but in combination with an injection to stop testosterone production (leuprolide acetate (leuprorelin (UK)). Those injections can be had in 6 month doses, but they are rather costly (at least here in the US, about $3500 USD). My diagnosis was similar to your father's, but I was only 55 at the time. We did radiation too with curative intent, then 3 years of the hormone therapy.