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and he's PSA1047 now and he took for inti hormones medical with hormon injections every monthly but the PSA increase last month was 200 and he's dr change his hormonal medical but we when to other dr he's said he should take chemotherapy treatment light one but he's old dr he said that chemotherapy not suitable for him and we r confused we start for him chemotherapy or no pls advice us he can't make decisions coz he not considered person

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Abeermrza. As Church mouse said prostate cancer with bone metastasis is a very painful condition and the patient can linger in this condition.You did absolutely the right thing getting him help and pain relief so he did not have to suffer. The loss of a loved one is never easy so be comforted that you had many good years before the disease progressed any you put him through the added discomfort of chemotherapy. may you find peace as your father has.
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Thank you dear to your words and your sympathy. actually were tough days for us and a sense of guilt harbor because we admitted him to the hospital and about the morphine doze was behind all other doctors and doctors outside the hospital specialists Said it was to much for him . and right we should be thankful to God that he was with us all these years and We were selfish that we wish to stay with us more and more . I wish he's in better place with no pain as u said thank u again dear
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Abeemirza, I'm so sorry to read of your sad loss. It sounds as if perhaps your father had had a low grade prostate cancer for a long, long time - the sort of which doctors sometimes say 'you'll die with it, not of it' - but that unfortunately, because he lived to the great age of 90, the cancer did eventually spread to his bone and become much more aggressive.

That meant that you as a family, having lived with a situation that caused no problems for many years, then had very little time to adjust to his acute illness and take in all the information. It must have been very upsetting to see such a rapid deterioration, and feel that there were decisions you had to make under pressure.

In that last month, although you felt that your father had been well up to the point where he was given pain relief, it was absolutely necessary for his doctors to control the pain, and the pain of metastatic bone cancer is notoriously intolerable. To leave a fragile 90 year old without sufficient pain relief would have been neglect to the point of torture. His doctors had to weigh the risk of leaving him in pain against the risk that the morphine would suppress his awareness and other organ functions. Sometimes, there are just aren't any right answers; but I'm sorry that you as a family are left feeling that the morphine harmed your father.

I think you are right to focus on the consolation that he is in a better place, and especially that he is free of all pain and disease. It will take time to get over the shock and grief of the last few months, but looking back - not so far, after all - to happier times will help. Hugs to you, wishing you and your family comfort.
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Thank you for your answers and your cooperation .
my father died on 28/2 .may God to heal all of ur patients.
I believe that the morphine was too strong it a cause of death.
One of the doctors gave him a high doze of morphine once and then my father had no response of anything no eating no talking he talk only few times that he's going to die and few words .they cut morphine and gave him only hardoll but still no response after 2 weeks from morphine he died .before we went to hospital he was talking laughing eating but he had pain mostly at night .but when we sent him to hospital had these problems and Heart failure.cuz all the dr said the morphine doze to much for him.we had and having hard time.and I wish he is in better place
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To add, our GP also did his best and my dad lived a good life although we always wanted more time.
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This story is real--

My father passed almost three months ago– from congestive heart failure and metastatic prostate cancer. I wanted to briefly tell his story in an effort to maybe help some of you here. My father was a wonderful person. My family and I will miss him dearly but we will be ok. I was his full-time caretaker the past 2 1/4 years. He was 90.
Around 10-12 years ago his PSA was up, our GP (now deceased) told him to watch and wait. Most men die of other causes, he was older already. My dad refused to visit a urologist.
In mid-2009, he had difficulty urinating, went to urologist, diagnosed Gleason 7, metastatic stage 4. Was in his bones/lymph nodes. A few nodules, both PSA upper 60’s, went to 1-2 with hormone therapy.
He started hormone therapy—it worked well for a few years—around 3.5. He then started taxodere? A few infusions made his forearms weep with a few blisters. He stopped that treatment. At a point in time he was on XGEVA to strenghten his bones. He read about the possibility of the jaw socket issue and decided to stop that after about two years–it was rare to get jaw cancer but since he took calcium supplements and his bones thru the density test were strong he stopped that. My dad also had atrial fib for over 20 years and with his age hardening of arteries. Smoked while in WW2 until 40 years old.
The next medicine was Xtandi which worked for about 2 1/2 years and well, no side effects on him. The bone scans took away his cancer out of the lymph and spine, etc .temporarily. PSA went up every month and he finally switched to Zytiga his last medicine with Prednisone. My dad’s only other meds were for blood pressure and tamsolusin for urinary, etc. 4 months ago, my dad couldn’t urinate due to the prostate growing. He had an ablation which didn’t work since he had a non-functional bladder—due to advanced age….found out after the ablation…a catheter was for life, etc. Basically the urologist shaved a moderate amount of tissue off a fully cancerous organ. Everyone told my dad to get this procedure but me. I wanted him to wait a year, etc. and try to live with the catheter (GP, oncologist, urologist cardiologists)–all said this was ok to do, etc. Gave him heart clearance…he was under 45 minutes…walked around the house and to dr appts the day–week of. He turned 90 early November same time of this procedure (ablation). 2 weeks later he for the first time develops fluid on the lungs, he has a minor heart attack around Thanksgiving…the drs mention congestive heart, etc. He gets another episode of fluid early December. One dr. takes him off the chemo for a few days, another puts him back on, etc. The next several weeks were a nightmare..i was visiting 5-6 hrs a day at the nursing home (for rehab)–and then hospital where he spent his last 10-11 days, etc. What went wrong over this timeframe, etc. He continually felt “weak”—everyone kept using this word “weak”—he couldn’t walk now, couldn’t stand, was bedridden. Felt he was dying (his words)—around early December, etc. wanted to lie down all the time, rest didn’t stop him from fatigue…he sort of ate less, drank less became dehydrated. Lost weight, slept more…again, this is his last 5-6 weeks, etc. The drs kept doing echo cardiograms,etc. Around his last 3 weeks, he was too “weak” to sit up in a chair or bed, etc. It got progressively worse…his last 10 days, our GP kept telling me he would not make it thru the weekend etc. etc. so again, I had this vigil at the hospital, etc. We wanted to bring him home —he was too weak to come home, etc. per the nurses, finally he signed into hospice 3 days before, he had to then be weaned to another medicine, etc. oral versus injection…3-4 days before he died, he was in alot of fluid buildup pain, they started to give him morphine his last 2 days. Our GP told me the last day he would go today or tomorrow and wouldn’t understand me. An hr later, I asked him to open his eyes, he opened one. I asked him another hr to do the same he lifted his eyebrows, etc. He responded to me 75 minutes before he died, etc. So the GP was full of ….I left telling him i would be back there early (and all the good things, loved him, etc.), got him that week all the religious things we believe in, annointing of sick etc. prayers thru hospital chaplain, etc. Told him to be strong, etc. He was, etc. If I wasn’t clear —-he didn’t die of prostate cancer but it apparently weakened his system and also his heart issue (and maybe the ablation) contributed (atrial fibillation). It seems all of this started with the Zytiga and Prednisone. It could have been his age, coronary artery disease, etc. I never thought i would lose my father within the past 6 weeks so fast. In hindsight maybe we should have stopped the chemo…his ending PSA was low 40’s. Our oncologist was the only decent physician that was kindhearted and concerned, etc. to me and my dad. My mother and I missed him alot and hope he is in a better place. I got him last rights on time.
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My friend just went through this with her dad... He passed away 3 years ago. His cancer spread too. He had some special radiation on his neck because the cancer spread up there, and it was causing too much pain. They tattooed him on his neck so every time he went in, it was already marked. Pin pointed the spot exactly. Now, her dad went through his cancer gracefully. He invited everyone over, saw all his kids, and made the most of it. My dad had liver cancer, and he basically didn't want anyone to know....I know when dad was diagnosed, it was very hard for me to accept. All these years, he always was afraid of the big C...yup it go him. Now, we my FIL got cancer, he was more religious than dad, and his saying was, no one gets off this earth alive. Yup, he told that to his 8 year old grand child.... but I know when it gets to the bones, and lymph nodes I don't think chemo will help...
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Thank u dear we will see I don't want chemotherapy but ihave mother and brothers I afraid tell them my opinion I will send them our chat they decide
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Sunnygirl, PSA is prostate specific antigen. Normally it is below 4, so over 1000 is extremely high.
abeemirza, Chemo is hard on the heart. It can also affect liver or kidneys. For my husband, who had a heart attack at 42, chemo was not an option even at age 47. Radiation was given instead for his melanoma. It worked.
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If he is able to understand and make the decision to proceed with tests and treatment, then I would let him decide. If he can't then what would he have wanted? Who has been chosen to be his representative?

Unless he is incompetent, then the doctor has to tell him and listen to what he says. If hot, then they usually ask the family. The family should go with what the person wanted.
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he can walk and dr not telling us wich stage he is I don't know I am in different county and about think some times he think well sometimes no and if we tell him about he's real conditions he will not be able to continue live like all what he think he has from getting old only he knew from befor the he had cancer but I think he ignores it even bad things happen to him he ignored he has .but he lost wight and sleep a lot he can walk .sorry for my poor language.
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What you really need to be doing is discussing with his oncologist what the odds of chemo are of stopping the spread of the cancer. Metastasis to the bones is very serious, and it might be that at his age the chemo would be so overwhelming he might suffer more, yet the cancer might not be stopped.

Is he able to stand, to walk, or is he confined to a wheelchair? Has anyone raised the issue of brittle bones b/c of the metastasis?

Seems as if there are 2 doctors involved; look to your oncologist as he/she will have more experience with specific chemo regimens as well as the likelihood that it could slow down the cancer. This is not a situation in which you want to rely on a general practitioner or primary care doctor.

Chemo is difficult on anyone, let alone someone who's 90 years old.

Ask also what stage is his cancer. Stage IV is serious, and with the spread to his bones, there might not be much chemo could do except weaken him and make him more miserable.

If chemo isn't going to have a reasonable chance of slowing down the metastasis (spread) of the cancer, then chemo could make him more ill than he is now, even with the use of anti-nausea drugs.

You might also, for your family, research to see if there's a Gilda's Club in your area and go there for support from others who have dealt with cancer. It's a very good organization, and in my area, has extensive support for individuals and their families dealing with the cancer experience.

You write that he can't make decisions b/c he's not considered a "person" - do you men he's not able to think clearly and be responsible for himself? Was he able to execute an advanced directive giving someone authority to make decisions for him?
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I don't know what the PSA is, but I can't imagine a 90 year-old person undergoing chemotherapy. I'm not familiar with chemotherapy, but it sounds bizarre to me for a person of this age.

Is your father competent to make his own decisions? Did he indicate previously what he would want in this type of situation?
Your post seems to indicate that he may have dementia.

I have read recommendations from the American Cancer Society. They don't recommend cancer screenings for people who have terminal illnesses, like dementia.
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