Chemotherapy

Question, is Chemo for prostate cancer using taxotere really a sensible treatment

is the benefit vs. cost (pain, sickness , health risk ) worth it?

I understand it will only add one year to my life if it works good but I have to endure at least 12 sessions, I don't see anyone singing the praises of chemo treatment

am I doing the right thing by using it? or should I just pull the plug and face the inevitable cancer is killing me and I will die. why prolong this suffering?

I'm sorry to sound so harsh, but from where I'm sittin it aint lookin so good folks.

39 Replies

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  • MrJack,

    I haven't had chemo. What I've heard from others varies. One man I knew had such a bad time from the first treatment that he and his doctor believed it was better not to have any more. Others have undergone multiple treatments and found them very tolerable. The skill of the oncologist administering the treatment may also make a difference since a good oncologist can administer ice at various places in the infusion process to reduce chemical uptake in sensitive areas that don't have cancer, and can prescribe drugs to combat the worst side effects like nausea.

    The same holds for benefits. I saw a report from one man that his PSA went from 128 to < 1.0 on chemo. Others get hardly any benefit at all.

    My suggestion would be to try it. Take it one treatment at a time. After the first treatment, see how well it reduces your PSA and your cancer symptoms. See how hard it is to take. If it looks promising, go for more treatment. You might get lucky and get a lot of benefit for little pain. Or you might be unlucky. For myself, I think I'd want to at least try it.

    I wish you the best of luck with it.

    Alan

  • thank you, I needed to hear that, I will keep trying, I have my second cycle in one week from now. I will give it a try, that's the only way I will know and it is the next recommended step, .

    wish me luck

    God Bless us all

    jack

  • My oncologist says we have a 3-leg stool--how I feel, what scans show, with PSA the least significant indicator. Mine goes up and down, sometimes by over 1000 points in 3 weeks with no apparent pattern or reason.

  • Many men seem to have a fear of chemotherapy. The ABC approach - Anything But Chemo!!

    Before I started chemotherapy, my medical oncologist said "I hope that you'll tell all your advanced prostate cancer mates that the side effects of chemotherapy aren't as bad as they think they're going to be." I gather that the side effects of older forms of chemotherapy were much harsher.

    When I started my docetaxel treatment, I didn't get many side effects -fatigue was the main one. What a surprise! - Fatigue seems to be the main side effect of any prostate cancer treatment.

    Like @AlanMyer, I get the impression that the reactions to chemotherapy vary depending on the individual.

    @MrJack - when you talk of 12 months overall survival, remember that this figure is a mean. 50% of men will survive for longer than 12 months; some of them for much more than 12 months.

    There are lots of things happening in PCa research. Somethings like Keytruda and Lutetium sound amazing. For me, I hope that Docetaxel might help me to be around when the next big breakthrough happens.

  • Again remember that the figure bring tosses out relates to Overal Survival and not Progressive Free Survival of the entire subset of treatment regardless of age and disease progression before treatment,

    Keep kicking the bastard,

    GD

  • More than anything else you need a positive attitude. It helps any treatment be more effective. I have also found that meditation and qigong/tai chi helps.

    My experience with chemo is not typical I guess, but it has been almost totally positive. Through 19 cycles I only had nausea (mild) on 2 days, and a little fatigue on one day.

    I know the cancer will eventually get me, but I am doing whatever I can to extend a high quality of life for as long as possible. If I had a great deal of pain, extreme fatigue and frequent nausea, my approach might be different.

  • Do some research on a low carb plant based diet and fasting while on chemo. Some of the major cancer centers are looking into this. In many instances it seems to help the drug be more effective.

  • Are there any specific studies or sites you can point me to as I believe in the nutritional aspect, and have seen it help other cancer patients. Any sites or study links would be appreciated. Have a beautiful day

  • Google low carb diet and fasting for prostate cancer. Thats how I found them. Also look for a book by Elaine Cantin and another one called Taking Control of Your Cancer from anothr author.

  • I've had 16 sessions of it! Various Chemos, did not do much. But we all react differently.

  • 16! wow. Good to know. How do you gauge the effect of the treatment?

  • Would not do it again. Just weaken yourself and immune system. In my case Chemo was never that effective.

  • I cannot speak to chemo because I did not have it. BUT I created this evidence-based Handout to help Reduce the Toxicities. annieappleseedproject.org/w...

  • I'm doing my third taxotere treatment tomorrow. The only issue I have had so far is about four days of being really tired......then it is back to working out, free weights and cardio. I think the avg advantage is 18 months.....that's the average. I'm going to beat that by twelve years.

  • Yes Sir, good work! I will try to keep up with you.

    jack

  • I believe that the rate is not valid for cancer treatment. A better figure is survival based on Progression Free Survival as opposed to Overall Survival from all of a population regardless of disease progression and age. I do know that the method used comes across as a demonization chemotherapy. People only read the 18 months, hear horror stories, and based their decision on the poorly explained concept.

    Note that the US Food and Drug Administration requires OS and not PFS because they publish the overall survival for the disease. I am sorry, I do not know what say the UK National Institute for a health and Clincsl Excelkence uses. I suspect that they are in bed with the US FDA and use that criteria for its decisions.

    One day, governments will get away from cost based decisions in treating cancer.

    Keep kicking the bastard,

    GD

  • I have written many times on this subject. Most of my posts are available if one Googles "Gourd Dancer Prostate Cancer". I am an advocate for early and aggressive intervention of chemotherapy after primary treatment as soon as PSA rises and mets develop. The reason? While the tumor burden is small and the body is strong and not wasted by this disease.

    Over 12 years ago by PSA exploded and subsequent scans revealed multiple mets. Faced with, according to standard thought, a life expectancy of 2 to 4 years, I entered into a six month chemo trial with an outstanding medical oncologist who is best described as a Prostate and Kidney Cancer Researcher and Professor with leading medical schools. In this case, the University of Texas, Baylor, Cornell-Weill, and then back to the University of Texas. In short, where he goes, I go. As a researcher in academia, he is cutting edge while some conservative practitioners prefer to treat with what some call the gold standard.....

    Six years and a half years ago, after continued undetectable PSA levels and mets that were resolved, I had my last Lupron injection - February 10, 2010. For four years I have been using Androgel, 4 mg every three days. My PSA continues to be undetectable and T ranges from 450 to 550. I have gone from weekly PSA draws to monthly, then quarterly, and now, every 120 days.

    When I started this journey, the good Doctor told me that researchers discovered how to kill cancer in 1978. The only problem was killing the cancer without killing the patient. The stories from the early years and a paradigm of using chemo as a last effort, I believe feed people's fear of chemo and quality of life as the cancer consumes its host.

    In my case, aggressive treatment has saved my life. The effects were minimal and tolerable. While no walk in the park, it is a decision which I made. Today no one can find any sign of cancer in my body. Am I cured, as a realist, it's a term we do no use. I will continue with three blood draws a year. In fact I look forward to reading the three pages of data generated from my blood and urine analysis. Lol

    Each of us have to make decisions on our journey and treatment. Who is to say what is right or what is wrong. I honor any decision made whether my bias tells me otherwise. Bias? Yes, early intervention using chemo, the right treatment professional, a belief in the power of prayer and good thought, and well wishes from all people from all religions across the world, dwelling only on positives and walking away from anyone who is negative, are some of the reasons in I enjoy a full life with my family and friends.

    I am cognizant that this group is world wide and a lot of people do not have the possibilty of the same treatment which exists at the Texas Medical Center in Houston, Texas.

    Keep kicking the bastard,

    Gourd Dancer

  • GD, in Dr. Amato's clinical trial, after the completion of chemotherapy, treatment with Casodax was initiated. If I understand everything correctly, this means that after the completion of chemotherapy, the clinical trial participants were on both Lupron and Casodax -- is this correct? Do you know if any of the trial subjects had been on Lupron previous to the clinical trial?

  • Ed, I'm not sure, but I don't think so. I had had a three month injection on May 5th and met him 3 weeks later. After listening asking question 2 1/2 hours later, enrolled. Because the Memoral Day holiday, I waited to have the ports Cathy put in. You can start chemo the the same day, but 4th of July was around the corner and he did not want a holiday to interrupt infusion, had my first infusion on July 5th.

    The trial is over and I remain in follow up; however, he has treated over 500 men since me. He does see new people at various stages of disease and he treats with essentially the same protocol.

    I continued the Lupron. When the six month treatment was complete in January, he added Casodex to the mix. I stopped taking Casodex in September because he did not like my response. Dr. A told me that 20% of the time when you withdraw from Casodex, PSA drops like a rock. I immediately had a lower PSA response and by the first week of December I was undetectable and have remained so ever since - even like I previously wrote when I stopped Lupron injections all together in February 2010.

    The conversation kinda went this way. Mike, I want to stop Lupron and see what response you have. I asked Dr Amato won't my PSA rise? He said that he did not think that it would. Then, he said if he was wrong then we would start the injections again. (ie., all upside and no downside). But if he was right, I could get away from the effects of Lupron. He was right. :)

    Keep kicking the bastard,

    GD

  • Thanks.

  • Great reply.....new encouragement for me.

  • What was the chemo? Mitoxantrone with prednisone?

  • No Martin. The regime was as follows:

    Each course of chemotherapy lasts for 8 weeks. Patients were treated in weeks 1, 3, and 5 with doxorubicin 20 mg/m2 as a 24-hour intravenous infusion on the first day of every week in combination with ketoconazole 400 mg orally 3 times a day daily for 7 days. In weeks 2, 4, and 6, treatment consisted of paclitaxel 100 mg/m2 intravenously on the first day of every week in combination with estramustine 280 mg orally 3 times a day for 7 days. Weeks 7 & 8 no chemo infusions were given. There were three courses. Additionally, 30 mg of Prednisone were given every day with 10 mg in the morning and 20 mg in the evening. And, I believe, Vitamin C, 500 mg, 3 times daily. Lab work was done weekly. PSA was done monthly. I took Zofran for nausea and it worked very well.

    Thought that I would share that five years after the chemo I had a total knee replacement. The staff medical oncologist was sent by to visit because my white blood cells were out of whack. I laughed and ask, Don't white cell get out of whack after chemo and he said yes..... Of course when did you have chemo? What for? What were you given? As soon as I said dozy and before I could continue, he blurted, "That will never work!" So I had my treatment plan brought over by my wife and gave him a copy. He thanked me and said that he was going to have to read up and get educated.... NOTE: Doxy is a real old chemotherapy drug....

    GD

  • yikes!

  • amazing story, thank you for sharing your experience.

    jack

  • Mr Jack

    Chemo treatment verys by individual just like all the other cancer treatment. I started taxotere late in 2011 the same year I was diagnosed with prostate cancer with bone mets. The chemo was no harder than some of the other cancer drugs I am taking. Please don't give up because of taxotere. We are fighting for our lives. How long we last depends on luck and willingness to fight back. Be a fighter like CERICWIN.

    Dennis

  • Good report. I do want to say that I took Taxotere with two orals one week and Doxyrubicin with two different orals the next week. Alternated for six weeks. This was one course. I took three courses over the six month period.

    GD

  • My PSA continued rising while on Taxotere. Slowed the rise, but not by much.

  • I am in the middle of my chemo now. It does rob me of my stamina and makes some food taste a bit off but most things in life are still OK. I want to stay around as long as I can to make my wife happy and the side effects of chemo are really a small price to pay for that.

    Additionally, extending life by a year may be enough for new treatments to become available which may give me even more time.

    Even with stage four metastatic prostate cancer, life is still good enough to keep going.

  • I don't know of a study related to use of docetaxel after radical prostatectomy. So if someone told you "a year" on average, they may have assumed that you were a previously untreated patient.

  • There is a study in Houston for adjutative chemo after primary treatment by Dr. Robert Amato. It is a short course designed to attack micrometastases.

    GD

  • very good.

    There is a quite interesting study just getting started at Johns Hopkins - oh but it is mostly for bone metastases, so if they are "micro", you couldn't get in, because they have to be detectable - at this point. No "preventive", although that is a possible great idea for the treatment.

    NCT02478125

  • Adjunctive. For example, after my primary treatment it was less than year before they landed and grew. That's it, you don't really know. I am a living example why one should jump on mets as soon as PSA explodes (indictive of mets). I did Chemo at about 45 days after the scans confirmed. Good luck.

    GD

  • Go for it @MrJack. . I had 10 cycles of Docetaxel (Taxotere) over 30 weeks when the Zoladex began to fail. Pulled me down to an average PSA of 2.0. No sickness, no pain, no bad effects. When discontinued I asked if I could continue, but I had received max dosage for England and body needed 4 month break. I really think chemo is a state of mind situation. I cannot fight cancer, I have learned to live with it and allow my Oncologist and the nurses to do do the fighting for me. My body like yours is the battleground, my brain is my rest centre. As I say, my bone mets around 20, pelvic lymph nodes, all sectors of prostate plus seminal vesicles and external base of rectum with PCa all helped by chemo. Tell yourself you will not experience bad effects but will only benefit! And please God you will.

    I have been in this forum for less than a week and am thrilled to read so much posivity and survival pride. Thanks.

  • I just received my first results from round#1 and my PSA went from 43 down to 11

    I just did my #2 round today at a 25% lower dosage and we will see what happens

    so far it looks like it is working for me, no one knows for how long, I would guess a year, what I was wondering is when it stops working does the psa go back up as fast as it came down?

    hangin in there wit the rest of yall.

    thanks

    jack

  • Hi MrJack. My chemo 8 months (10 cycles).After initial big drop like yours I remained around +-2.0. After 10 had 4 months nil chemo and only Zoladex and PSA rose slowly to 25.5. So not a great pace nor very high PSA. I believe I wrote that followed increase with Zytiga, drop after 4 weeks to 0.58. Further 2 weeks to 0.31. Next result in 5 days at end of month 2. Don't feel any different, never have from 200 initial to 0.31 but boy, the psychology of this has made me even more cheerful. Good luck MrJack and God Bless. David.

  • ok, thanks for the reply, I wonder does a successful run with chemo, does that reset the clock and make it possible to then go back and re use other meds that had previously run their course? like in my case Zytiga

  • My instinct is that Zytiga has reset my clock after chemo prepared the ground for it to work. Your sequence is different from mine. Am with Oncologist next week and will ask you question.....I am aware that a number of months without one chemo in some people clears the way for a burst of cycles with another. Till next week.

  • thanks Scruffy

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