My stepdad has advanced prostate cancer that may have spread, need help

[liberalhistorian]

My stepdad is 64 and in the advanced stages of an Alzheimer's-related dementia. He had a biopsy October 10 for prostate cancer, and it showed that it was advanced. The biopsy should have been done a couple of months ago instead of the dipshit doctors wanting to wait and try antibiotics to see if his PSA would go down, but that's another thread.

He had a bone scan yesterday to see if it had metastasized to his bones. My mom and I believe that it has, in all liklihood, done just that. She said that after they'd done the scan they came back in and did some x-rays of his back. I suspect that they may have found something suspicious in that area in the scan. I don't see how it can be advanced and not have metastasized. Mom's decided not to have any kind of radiation treatment, so they decided against the test to see if it's gone into his lymph nodes, since it's a long, grueling test and the doc said that if she's not gonna do radiation then there's no point in the test. We also agree that, as bad and as sad as it is, it's also a blessing in disguise, since it will, in all liklihood, spare him and us from those awful final stages of Alzheimer's. And the good thing is that he doesn't even know what's going on, he doesn't know or understand that he has cancer and he wouldn't understand it if he was told.

Apparently, treatment presents a real problem because of his advanced dementia. Mom's also decided against most treatments, and I agree. His daughter is having a bit more of a problem with that, but she's not helping in any way with his care or financially or anything like that. She'd rather pull a blanket over her head and just not deal with it, she's not even been able to deal with his Alzheimer's these past several years. Must be nice to have that luxury of just not dealing with things if you don't want to do so. My mom also can't come to my wedding now, that's in a few weeks, since it's several states away and she doesn't know what to do with him for the week or so it would take.

I guess I'm just needing some support from people who are dealing with this and who know the emotions we're feeling. I've had friends with cancer, but none this serious and they survived. My stepdad will probably not survive. So, how do you deal with this? And is the fact that they came back and did some x-rays of his back after the bone scan a bad sign?

[JohnnyLib2]

1. Sorry for the slowness in responding.

Did you post on another forum recently?

My father in law had that combination several years ago. He was older and able to understand, though not remember, so it was emotionally painful in another way. Mother in law (MIL) had to face it all, much like your Mom.
It was heartbreaking, but we backed her (their) no-treatment decision and basically hung in, did what we could from that point. In hindsight, we feel pretty good about supporting them to the end. The pain medication was effective and he/they/we had some good hours all the way, including the day before. I believe MIL felt in her heart that she had carried out marriage vows to the very end. Good people. Hope this sheds some light on one example.

Have the bone scans come back?

[liberalhistorian]

2. No, the results haven't come back yet.

How long do such things usually take? And is the fact that they took x-rays of his back after doing the bone scan something to be worried about?

I agree that your MIL did the right thing. I think it is, though, a very personal decision that is really up to each individual and/or couple. I just hope we don't run into any family flak over it. If we do, I'll tell them where they can put it, since his family, including his daughter, hasn't helped my mom one damn bit these past several years.

[knitter4democracy]

3. More x-rays probably aren't good.

Results from a radiologist usually take around 48 hours at our hospital, so the results might be back in his doctor's papers stack. If your mom hasn't heard yet, she should call on Monday and have the nurse go through his stack and find the results.

Man. That really sucks. If it's in his bones, that's really painful, so his doctor will have to deal with that and make sure that his other meds don't go wonky from the pain meds. It is kind of a blessing in disguise, but it's also awful because of the pain. I'd make sure that everyone knows about the pain so that they don't just assume he's just being more cranky than usual.

And I'm so sorry about her not being able to come to the wedding. I know that our adult day care is really good--does she have something like that in her area? His daughter could take care of him in the afternoons and evenings while he's at the day care facility. I teach at ours, and most of my students have dementia of some sort, but the schedule, classes, music therapy, and other fun stuff keep people pretty happy all day. He might really like it.

:hug: What a horrible situation. :(

[liberalhistorian]

5. Well, the bone scan results

came back CLEAR!!!! Which was a pleasant surprise, since the docs had expected it to have spread to the bones already, given the advanced state of the cancer in the prostate. For now, it appears to have stayed there. Although, if she continues with the no treatment except for monthly hormone shots, I'm not sure how quickly it would spread or what they would do to prevent it. They took x-rays of the back after the scan because they did, indeed, see something at first; it turned out to be extensive arthritis in his back. Given his life-long back problems, we're not surprised in the least.

His daughter lives three hours away and has never bothered to help with him, so I don't expect that to change. She's "overwhelmed" with it and is having difficulty dealing with things, so her response and way of coping is just to put her head under a blanket and ignore it. Must be nice to live life that way, too bad mom doesn't have that option, grrrrr!!!!!

[knitter4democracy]

7. Well, I can understand being overwhelmed, but . . .

There are times when family's more important. I'm still massively thankful that my MIL dropped everything and came up to help with my surgery last year (even though I got a bit irked by her behavior after I got home). She could've said she was too overwhelmed with her other stuff and her own health problems, but she came and sat with me so my hubby could sleep and take care of the kids at home.

Maybe a short note on how much she's needed right now? Sometimes that can get through when nothing else does.

I'm so glad that it's not in his bones. That's amazingly painful, according to Hubby. That's a blessing. I do think your mom's making the right decision, though, to go lightly on the treatments. It makes sense, given his other health problems. With this diagnosis, though, can she get a home health aide to get a break from time to time?

[riderinthestorm]

4. I don't have any advice

just a hug. :hug:

I believe you and your mom are making the correct decisions on his health care though. Pain relief should be your primary concern from here on imho.

Why will you mom need to be away from her husband for a week, for your wedding? Can she just abbreviate her participation so she is there for the important 3 days: day before, day of, day after?! And make sure she is armed with a cell phone and responsible caregivers on the other end?

The adult day care situation is wonderful. I've had direct experience with that with my own grandmother and would have felt very comfortable leaving her there for most of the days that I would be away, with a responsible person to care for her at night....

Good luck.

[liberalhistorian]

6. Well, I live 1,500 miles away and it's too expensive

for her to fly and she can't find anyplace that will take him right now, they all have waiting lists. He's too far gone to accompany her if she drives, and we don't know what to do with him here because all the places here are booked up and unavailable as well. My dad and stepmom aren't coming as well, so now I'll have NO parents at my wedding. :cry: :cry:

[knitter4democracy]

8. Oh no! That's awful!

That's so unfair and wrong, isn't it. :hug: Maybe you could have the videographer set up something so your parents can watch it online live?

[flamingyouth]

9. I'm really sorry for you and your family.

It's a terrible situation. My heart goes out to you. :hug: