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This question was answered on Wed 12, Mar 2008 06:06pm by Dr Heinrik M, MD

Prostrate cancer - Terminal prostate cancer spread to bones


    
Asked by urquhart (Male ) on Wed 12, Mar 2008 01:29pm

high my dad has a very agressive prostrate cancer, he has been told it is terminal as it is spread into his bones now, can you tell me what the psa count is capable of going up to?, at the moment the latest test is up 100 to 257. how long is his estimated life span ? thank you Richard.

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Answer by Dr Heinrik M, MD  on Wed 12, Mar 2008 06:06pm:

Hi Richard, I’m sorry to hear about your father’s condition. There is no clear panic value for PSA in his case. For early disease, values of 10-20, raise suspicion of clinically silent bone metastasis (this point however is irrelevant in his case). I think you are placing too great an emphasis on the PSA value. The value doesn’t correlate with survival. At this stage, one of the practical uses of this would be estimate response to therapy (even this would have limitations on how well it would correlate with outcome) Other indices to estimate response to therapy would be his symptoms changing with therapy. The expected life span would be 2 years on the average. If he is still up and about with no symptoms of the disease at all, he would have a good chance of reaching this mark. Among the things you need to discuss are the goals of treatment at this point (in the absence of symptoms, some patients choose no treatment, others would choose treatment and aim for disease stabilization; the bone metastasis may be in a critical region in which a fracture would lead to paralysis – so this may need to be addressed early). The second question is the timing of therapy, and the side-effects of the selected treatment whether or not the balance would likely impact on an acceptable quality of life.

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