metastatic prostate CA

dear doctor,
my father was 61 when he was first diagnosed with prostatic CA with bone mets. Now he is 64 and still moving about with his braces, though he still have episodes of pains esp in the back. He have had radiation,hormonal therapy and  3 cycles of bisphosphonate, 1 cycle of chemotx (taxotere). His next follow-up will be 2 weeks from now and he is due for another chemo + bisphosphonate. In your own opinion doctor,how far should we go as far as his treatment is concerned? He seems to be relieved of the pain with the treatment he is having now. It`s just that the treatment is very expensive here in PI. Do you think he will live in the next 2 years?
thank you so much.

[Ketan K Badani]

It is difficult to estimate prognosis in your father's case with metastatic prostate cancer after multi-modal (more than one) treatment approach.  You should make sure that his back pain is not causing leg weakness/numbness as this could be a problem (spinal cord compression) that needs more immediate attention.  If his PSA's and bone scan results are stable on Hormones and chemo, then one would assume that he is responding well and should continue the course of treatment.  Prostate cancer can respond well to hormone therapy, and although hormones do not cure the cancer, it can offer longer-term  results.  However, in some instances, the cancer can become resistant to hormones (hormone-refractory prostate cancer) and this can be quite challenging to treat.  Taxotere has been shown to improve survival in these patients, however, the long term success rates are quite variable.