General Discussion

Stage 4 Gleason 9 (out of 10) metasticized to the spine and a few other places. It’s incurable, but it can be managed. Treatment has really evolved over the past ten years. My husband is still here 5 1/2 years later. He had state of the art radiation therapy, followed by ADT (androgen deprivation therapy). ADT suppresses testosterone, which the cancer feeds on. He has an every three month ADT shot combined with a daily regimen of pills. The side effects are not pretty (hot flashes, night sweats, impotence, fatigue, mood changes, possible anemia, etc.), but clearly worth it. Chemotherapy is still an option, but he hasn’t needed it yet. There are (or at least were) experimental therapies being worked on as well.

The thing I find surprising is that Joe has access to the best healthcare in the world and he was diagnosed at at stage 4. Routine annual PSA testing should have shown a rise in his PSA level, at which point he would have had a prostate biopsy. Unfortunately, my husband got caught in a twelve year time frame where annual PSA testing was pretty much discontinued. Surprise! Diagnosis of stage four PC went up and annual testing was reimplemented. It’s possible that Joe could have an especially aggressive form of PC (e.g., ductal) that presented suddenly.

Don’t give up hope yet. Joe’s PC is hormone sensitive and he may well have a positive outcome. The biggest problem, unfortunately, may be his age and possible frailty.