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Dr. David
Dr. David, Board Certified MD
Category: Medical
Satisfied Customers: 42787
Experience:  Board Certified Physician
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My dad has advanced prostate cancer that's spread to the bone,

Customer Question

My dad has advanced prostate cancer that's spread to the bone, he was diagnosed in December last year. Although he's dealt with it well and is having homone injections, the last 3 weeks he's had a severe athritis flare up. Started in elbow, then spread to knee. He was given prednisone for a week. Since then he had had the most awful side effects and had gone from a strong 78 year old man with strength and fight into an anxious, depressed, man who's scared to be left alone, wakes up from very little sleep he manages to get, with panic attacks and can't breath. He's basically a mear shell of the man he was. Also is eyesight has practically gone as his glaucoma levels have risen rapidly. He finished the week week course of steroids almost a week ago and severe depression has very slightly improved, but he now has severe flare up in one ankle, one knee from knee to foot, one elbow and one wrist. The pain is unbearable and he's losing the will and fight to live since crying on phone to doctor thurs ( 3 days ago) practically begging for help, just to be told take 2 tramadol and come to surgery on Tuesday. Now he cannot walk and will not ask for medical help til Tuesday since his doctor basically poo pooed his cry for help. I'm at my wits end what to do and basically want to know can I seek help on his behalf? Can I request help by ring mcmillan care? Would they liaise between oncologist and doctor to find why he's having severe flare ups since having homone therapy? Sorry this may be a bit rambled but I desperatly need some advice. Please help me in anyway possible. Thank you. Claire
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. David replied 2 years ago.
Dr. David :

This is Dr. David

Dr. David :

I am sorry he is having such bad arthritis.

Dr. David :

hormone therapy takes away all testostrone out of his system

Dr. David :

and this can worsen arthritis pain.

Dr. David :

he needs to get his uric acid levels checked to make sure he doesn't have gout flair ups.

Dr. David :

steroids may or may not help his joint flair ups.

Dr. David :

he might need stronger nacrotic pain pills to help his joint pains.

Dr. David :

or even steroid injections into his joints.

Dr. David :

he might decide not to continue on with anti-testosterone therapy if it causes too much inflammation of his joints

Dr. David :

he could also have bone mets close to joints causing pain in which he needs palliative radiation therapy to areas of bone metastasis to help decrease pain.

Dr. David :

has he had a bone scan to show where his bone metastasis are?

Dr. David :

hello?

JACUSTOMER-d7hnpk8c- : I'm not 100% sure what bone metastasis means, but I know that his cancer has spread to his spine and pelvis. It's reassuring to know why his athritis is so severe lately though. He had homone injections in his stomach as they told him cancer is too advanced for chemo or radiotherapy. If he stopped the injections would this help ease athritis flare ups? But would it make cancer spread faster? He was coping well before this and hoped for a good few years ahead of him, but now he doesn't want to live as he has no quality of life. Would he have to be admitted into hospital for steriod injections and would they give him the same awful side effects as predisone have given him? I am so grateful of your help as we feel as if we are being left to get on with things alone
Dr. David :

bone metastasis means the prostate cancer spread to bones like spine and pelvis.

Dr. David :

there is no cancer too advanced for palliative radiation therapy.

Dr. David :

radiation given over 1 or 5 days in areas of bone pain can decrease bone pain.

Dr. David :

that is the purpose of palliative radiation therapy.

Dr. David :

yes, stopping his anti-testosterone shots could cause his testosterone to come back and this could cause his prostate cancer to grow faster, but could help his joints.

Dr. David :

steroid injections do not have to have him admitted.

Dr. David :

steroid injection side effects are much more focused to the area of injection and don't have as much systemic side effects.

JACUSTOMER-d7hnpk8c- : His next apt with oncologist is in December, does his doctor need to make earlier apt or can we try contacting her ourselves? And finally, in your honest opinion, what would you suggest we do first thing in morning to start ball rolling to help free him from this pain. Thank you very much
Dr. David :

yes, you can try to contract the oncologist yourself.

Dr. David :

ask his doctors to check his uric acid level.

Dr. David :

try ibuprofen to see if this helps his joint pains.

Dr. David :

he should be icing his joints as well.

Dr. David :

have him avoid alcohol for now and no smoking.

Dr. David :

he can try glucosamine to see if that help his joints.

Dr. David :

I hope this helps

Dr. David :

let me know if you have other questions.

Dr. David :

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Dr. David :

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Dr. David :

http://www.justanswer.com/medical/expert-dr-david/?rpt=3800

Dr. David :

is my website if you need to reach me again.

Dr. David :

thanks for using JustAnswer.com

JACUSTOMER-d7hnpk8c- : You have really helped so much and I shall finish now and make payment as I'm more than happy with the help you have given. One last thing, should he rest the joints or try to move them ?
Dr. David :

if he is in severe pain, then rest

Dr. David :

if he can bear to walk and move his joints, he should try to walk and move if he can.

Dr. David :

don't forget to leave positive feedback below

Dr. David :

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Dr. David :

hello?

Dr. David :

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Dr. David :

hello?

Dr. David :

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