CA Urinary bladder and prostate - liver metastasis - cehmo regime

My father in India, age 72, is postoperative case of CA Urinary bladder and prostate and now presented with liver metastasis ( below are the details). As of today he is doing quite well meaning he is driving around have good apetite & had not lost any wieght though lately his TLC count has been increasing and have high pulse now and then. My questions are
1) what are my options in terms of available treatments
2) is prescribed chemo regimen the best option

Please  respond ASAP he is going to start chemo from tomorrow...  Thanks so much

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Date – 01/12/08
CT Whole Abdomen – 01/12/08
CT examination after oral, I/V and rectal contrast administration.

( Follow-up case of Ca bladder with Ca prostate. Underwent TURBT on  07/10/07 and radical cystoprostatectomy with ileal neobladder on 07/13/07. USG done outside on 01/09/08 shows hypechoic lesion in right lobe and cystic lesion in right iliac fossa)

Liver reveals a well defined hypodense lesion in right lobe. IHBR are not dilated.

Gall bladder, spleen, pancreas, bilateral adrenals and kidneys are normal.

Right iliac fossa reveals a well defined cystic lesion measuring 3.8 x 3.4 cm anterior to iliac vessels and  an other cystic lesion measuring 3.9 x 2.7cm posterior to iliac vessels possibly lymphoceole.

Urinary bladder and prostate are not seen ( history of surgery)
Neobladeer appears normal.

Measurement Right hepatic lesion 6.4 x 5.3 cm

Suggest : FNAC correlation

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Date: 01/15/08

HISTO PATHIL & CYTOLOGY
INTERVENTIONAL FNAC

Site of Aspiration : CT guided FNAC from hepatic Lesion
Material : Received 6 Slides
Microscopic Examination : Cellular smears show malignant epithelial cells arranged in discohesive  cluster and placed singly cytoplasm is indistrict.

OPINION : Positive for malignant cells. Metastatic carcinoma in K/C/O CA Bladder and prostate
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Date 01/16/08
Heamtology
Peripherial Smear
RBC Series : Predominant cells are normocytic normochromic. No nucleated RBC seen. No M.P seen
WBC Series: Leucocytosis with neutrophilia(89%). No toxic granules seen. No immature cells seen.
Platelets: Slightly reduced in number. Few giant platelets seen.
OPINION: Leucocytosis with neutrophilia and mild thrombocytopenia.
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Chemotherapy regimen 3 weekly palliative chemotherapy

Inj Gemcite 1gm IV on D1 & D8
Inj Cisplatin 40mg on D1 & D8
Q3 weekly x 3 cycles

[HeinrikMD]

Hi,
There are two options for chemotherapy, there is no advantage of one over the other in terms of the effectiveness in controlling the cancer. The Gemcitabine and Cisplatin represents a less toxic combination, and hence patients are able to handle it better (the other combination is MVAC methotrexate vinblastine doxorubicin cisplatin). The original regimen uses gemcitabine on D15 as well, if the patient can tolerate the D1 and D8 well addition of the D15 may help maximize the use of the drugs. The recovery of the blood generally limits the use of chemotherapy,  if the use of supportive medications (filgrastim, lenograstim) to improve recovery times is available to you - this may also help improve tolerance and avoid complications. Some doctors feel that most elderly patients are really helped by the addition of these supportive drugs.  
Stay positive.