Oncology (General Cancer)/Prostate cancer

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QUESTION: Any advice will be much appreciated, thanking you in advance for any guidance.
My brother is now 56yrs, he had his prostate removed a couple of years ago now.
He had problems and was diagnosed with this cancer after having symptoms for 2 yrs missed and brushed aside by his doctor.
Apparently the cancer has spread to the bladder, and stomach lining, I am not sure to what extent.
So during the past six months arrangements have finally been made for him to have radiation treatment.
He has just finished his course of radiation which was I think for 30 sessions.
He obviously has side effects, and is extremely fatigued which was all expected by him.
His concern is that the specialists say it will be 5months before they can be sure of the outcome of the radiation treatment?
He is very down at present understandably so.
I said I would try and find out for him why this is case.
He is obviously worried that the cancer is spreading, and 5months is a long time to wait, and he's scared that with this long wait his prognosis won't be good.
Could you please enlighten us, as to what the big wait is for? and how this affects his chances of being cancer free, or will it be worse if the radiation has not worked, or more advanced even?
Thank you for your precious time , kind regards Teri xxx

ANSWER: It's very unusual for prostate cancer to spread to the stomach lining, so I would wonder if it's a different kind of cancer (misdiagnosed) or whether your brother didn't understand what he was told.  I would like to help but to give a good response, I need to know a) did he have hormone treatment (castration, or some medication) after the surgery. b) did he ever have a bone scan; is there evidence of bony metastases?  c) what did they radiate?  the bladder, the stomach, the pelvis?  
If this is really prostate cancer and the only place they found it was the bladder wall, then he may do reasonably well.  If it is widespread throughout his abdomen, then things don't look good at all.  It does take a few months to get an idea of how well the radiation would have worked.  Unfortunately you have to be patient.  Let me know the above so I can be more accurate.  

---------- FOLLOW-UP ----------

QUESTION: Thank you for your response, its greatly appreciated.

Firstly I Apologise as I didn't  give the correct information in my first message to you
I was unsure of how long it was since my brother had his prostate removed, he has confirmed that it was 5 yrs ago.

In answer to your questions
a) No he had no hormone treatment or castration or medication after surgery
b) He had 2  scans  a few months ago which were clear (unsure if bone scan) ??
c) He has had 20 sessions of radiotherapy on the outer wall of the prostate.

When he had surgery he was told that there was just a bit on the outer wall that they couldn't remove,and that it may not grow.

When he was first diagnosed his PSA was 3.5 and very slowly went to 4.8.
After surgery his PSA was 0.5.
He has had regular check ups and PSA counts since his surgery.
His last PSA count was 2 this was prior to the radiation treatment.
He is extremely anxious about the long wait, because of his low PSA

Could i ask on his behalf why the bit left could not be removed?? and is it possible to have it removed?

thanks a million for your advice xxx

Answer
If his psa went from 3.5 to 4.8 over a period of one year or more, he will probably not die of the prostate cancer.  As for the radiation issue, it sounds like the doctors are trying to cure him, given the likelihood that the disease is limited to the bladder wall.  Nobody would want to do surgery in this circumstance.  If you tried to remove just the cancer, you would probably leave some behind.  If you removed a big chunk of bladder or the whole bladder, there would be a lot of problems which would affect quality of life.  Radiation to the tune of 30 treatments is a curative intent dose, and I suspect he will do very well.  Hope this helps.  

Oncology (General Cancer)

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Donald Higby, M.D.

Expertise

I can answer almost all questions related to the treatment and natural course of most kinds of cancer, especially cancers of prostate, colon, lung and breast.

Experience

I have been a practicing medical oncologist for 36 years, and have been chief of service at a major medical center for 25 years. I've also done research in cancer treatments.

Organizations
American Society of Clinical Oncology

Publications
New England Journal of Medicine American Journal of Medicine Journal of the American Society of Clinical Oncology Hematology Transfusion Medicine

Education/Credentials
MD, Stanford University Internal Medicine residency, St. Louis University School of Medicine, St. Louis, MO Medical Oncology Fellowship, Roswell Park Cancer Institute, Buffalo, NY

Awards and Honors
America's Best Physicians, last 14 years

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