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Does my father need chemotherapy?

Q: I trained in India but currently practicing in the UK. My father, who is 74 years old, lives in India and has been diagnosed with prostatic cancer a year ago. A bone scan showed widespread metastases and his PSA was above 20. He was treated with orchidectomy, calutamide, bisphosphonates and radiotherapy. Recently he became clinically jaundiced, his LFTs were abnormal (bilirubin: 4.8) and ultrasound showed multiple liver secondaries. I understand that some drugs have been found to be effective and comparatively safe in this situation like Mitoxantrone. What would you advise and would you be willing to see him as a private patient if necessary? I look forward to hearing from you at your earliest convenience.

A:The patient in question is a hormone refractory cancer prostate progressed while on calutamide and he will be a candidate for chemotherapy. Presently the most effective drug is Taxotere, which is usually combined with presdisolone or estramustine hydrochloride. The other option is mitoxantrone prednisolone combinations that can also be given. But taxotere combination has been found to be better in comparison to mitoxantrone combinations.


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