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.
