Hello -

My father has advanced prostate cancer. For the last 3 years he has participated in pretty much every prostate cancer therapy that's currently available, including some clinical research studies.

It has been suggested to us that from this point forward we should put a larger focus on pain management and that we should explore radionuclide therapy. Could you elaborate on this suggestion, please?

My dad has been receiving pain medication for about 8 months now: he started with Novalgin 4 x 30 drops and Tilidin Ratiopharm Plus 4 x 20 drops, but has since moved to Fenatyl-TTS 50ug/h patches, which he replaces every 3 days and Actiq for treatment of pain peaks. In addition to the morphine he takes Ibuprofen.

He experiences pain mostly in the bone areas where the cancer has metastasized: between the shoulders, in the rib cage (7+8) and down in the lower back and pelvis area, from where the pain spreads into his legs.

My father is currently not under the care of a pain specialist as his urologist believes that he can manage/treat the pain equally well. I am, however, less confident. My dad experiences stomach sickness frequently - especially since the Fetanyl patch strength was doubled (about 4 weeks ago). As a result, he doesn't want to eat any more and is getting weaker by the day.

What suggestions do you have?

Thank you,
Tahoma