Posted 2/20/2018 8:38 PM (GMT -5)
(1) can RT help? You didn't tell me enough about his treatment history to answer that. I will assume he never had any prostate treatment (neither surgery nor radiation) and never had radiation to his metastases.
He can have radiation to the prostate - it is called "debulking." no one knows if it really accomplishes anything, but clinical trials are ongoing, and so far, it looks promising. It would probably involve whole pelvic radiation for him. If he is having urinary difficulties, surgery might be better.
He can also have radiation to certain metastases (I'm guessing he has many). The goal is not to prolong survival, but rather to relieve pain, and prevent fractures and spinal compression. It only requires 1 or 2 treatments. It is usually only done on weight-bearing bones.
(2) What drugs are affordable?
Forget about enzalutamide (Xtandi) or abiraterone (Zytiga) or any of the drugs approved in the last 5 years. The affordable drugs are:
• bicalutamide - an anti-androgen like enzalutamide. Should be taken with tamoxifen to prevent breast soreness and enlargement.
• ketoconazole - prevents the adrenal glands from manufacturing androgens, similar to abiraterone
• estrogen patches - stops the manufacture of testosterone. It also might eliminate hot flashes and prevent loss of lean body mass.
• physical castration (orchiectomy) - a LOT cheaper than the injections that prevent testosterone production.
• docetaxel - his doctor may have stopped using it if your father's blood was compromised by it.
• low-dose prednisone - has good anti-cancer effects while it lasts. He will also feel good while taking it. But it isn't a drug he can stay on for a long time, and he has to taper off slowly.