Docetaxel 111(2)

Had a meeting with the Oncologist yesterday and informed him I wouldn't be continuing with chemo. I was supposed to have the second infusion today. He tried to convince me to continue. Initially I have agreed to meet him again in 2 weeks. Interestingly, it's been 3 weeks yet I had diarrhea again this morning. The Dr explained I had a large dose, as I was 120 kg (lost 5 kg in last 3 weeks) and 6ft. He showed me some stats on a study of docetaxel plus predisnone study. On average 18 months extra. As we know, there are lies damned lies and statistics. I don't understand if that means an average of 18 months life after 6 cycles. Or 18 months extra than if you don't have chemo? Can someone help here?

Interestingly PSA was .91. Lowest since diagnosis. Blood markers all good.

Chris

40 Replies

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  • He means that docetaxel plus predisnone gives a median of 18 EXTRA months of life. Google the E3805 trial. ascopost.com/issues/june-10...

    If your psa dropped to .91 and your white cell blood count and anc are good, think hard before you give up.

    It's in your hands, look closely and make sure you don't miss what your holding.

  • I had my 10 cycles of Docetaxel and my PSA settled at +-2. Then had 5 months with only my long term Zoladex which I still have but now added Zytiga and over past 8 weeks have dropped (yesterday) to 0.09. I consider that the chemo knocked out the ca. and prepped me for Zytiga I.e. a reboot. Don't give up on chemo too soon. Happy healthy Christmas...to all of us.

  • Think about this again. Forget the numbers. Median yes but it includes those on their last legs. I did chemo 12 1/2 years ago. Was Stage 4 with mets to L3 & T3 of my spine. Today, I am still undetectable. I took my last Lupron injection in February 2010. In other words I have had zero cancer drugs for almost 7 years. You are a Statistic of One!

    Look when I was first diagnosed, the numbers gave me 2-4 years to live. I kept looking at a life extension of about 15 months until it was explained to me that the universe included guys who were going to die soon no matter what treatment they had. Even included those who died as a result of cancer during treatment.

    Keep kicking the bastard,

    Gourd Dancer

  • Gourd dancer, you follow nutritional program in addition correct? congrats on 7 years working drugs. amazing .

  • Thanks. No. no followed nutritional plan, no supplementals - was not permitted in trial. Don't take any way. I just try to eat healthy.

  • Wow. How did you do it, gourd_dancer?

  • Power of Prayer from all religions, a great Medical Oncologist from Academia who has researched this bastard his entire career, and running away from anyone who was negative gotta stay positive through it all. Number one reason, started chemo within two months of the appearances of mets.

  • you are awesome , "a statistic of 1" I like that., sometimes I feel like an army of 1 too.

  • Gourd, how did you get rid of your mets? I used radiation to my pelvis. it's gone now. Wow, you're not taking Lupron? I've been on it for 5 years now. Aren't you afraid that it might come back ? What are you using to keep down your testosterone? Or you aren't using anything? thanks for your answer.

  • Been having fir agony shots monthly for 3 years. Still have them. Degarelix.

  • I have just had my 3rd infusion yesterday of Docetaxel + steroid.

    My first was horrible headaches, no appetite , horrible taste in mouth and ended up back in hospital on a drip for 4.5 days because of low blood count. I hardly ate for 3 weeks lived on hydrolites and water. I lost 6 kg in 21 days. For my 2 nd go they put me on 80% of the original dose. I had a slight headache first day after that I was fine put on 2 kg and am a different person. So far my 3rd is the same. The severe pain in my r hip is gone don't know what my PSA is yet was up to 62 when I started chemo. Bloods in 2 weeks. I am scheduled for 8 sessions st 21 days, however, this may be increased ? I would advise sticking it out, don't give up, we all don't know what is around the corner for us PC sufferers.

  • I agree with you. Hang in there you never know what is just around the corner

  • Chris

    Please don't give up on docetaxel. Let your oncologist adjust the dose for you and keep trying. We all know that every one has different responses to cancer drugs. Physicians adjust doses all the time to alleviate negative effects. It may take more adjustments to get it correct than one that works best. Cancer sucks and will probably take most of us on HealthUnlocked sooner or later. We all want later and if this chemotherapy means 18 additional months with our families than that's great. We all get discouraged and want to throw in the towel at times but we all are fighters. I refuse to give up to the cancer bully.

    Please please don't give up on docetaxel or living.

    Dennis

  • Chris, I support any decision you make if it's your truly informed decision and gut choice . on the other hand, your psa is now very low and its working. if the doctor said he gave you I very high dose and he's willing to lower it, give it a try. my dad has his 3rd session tom, and yes he's exhausted but he still works, for about 5 days he's down, and the rest he forges through. due to the high dosage and that you already started, though I was anti chemo , these men have proven the effectiveness of docetaxel. for the diarrhea, it's your body still trying to expell the poison. do not try to stop it as the body is doing the right thing filtering it out. the medicine also messes with the good flora in your bowels and overall bowel stability . enzymes and probiotics may help this to stabilize . the days my dad is in prednisone he feels great. if prednisone is in your new treatment plan, it's very likely with the lower dose plus prednisone your body will handle the medicine much better. tapering to the persons response is a great idea and if you feel confident in this doctors care, follow his advice for at least one more round to see because the lower psa shows its working, my friend . my dad's psa is at 16 and with Lupton and chemo dropping far slower so congrats on that victory . you did not suffer in vain . xoxo please keep us posted. we are all behind you to help you through

  • I am delighted your dad has continued. Good pressing on your part. I had another review yesterday of my Zytiga following my 10 cycles of chemo and am now at 0.09. That's a long way from my pre chemo of 200. I too will keep smiling no matter what. It's what we're all here for....each other.

  • you could ask for the dose to be reduced as happened in my case if side effects too much -standard dose is based on weight -I finally had 15 infusions before fatigue too over and the PSA stopped dropping so that was apparently a good result -if the chemo is successful it does extends ones life as it is one of the few treatments available for those unfortunate to have metastatic cancer -my understanding that the clinical trials of taxotere about 10 years ago showed a median increase in life expectancy of 3 months -in my case my PSA is 24 after 11 years of hormone therapy and chemo and I have started Xtandi

  • How are you finding the Xtandi?

  • no problems yet just some initial fatigue but have more energy than when on chemo and my initial blood tests are all ok -looking forward to see what it does to my PSA

  • I forgot to mention that my first infusion of chemo put me in the hospital for 4 days being administered antibiotics until my anc went up to 1.5. The oncologists simply lower my dosage and gave me a shot of neutlasta 24 hours after my next infusions. Get back in there and show the this disease who runs the show. It took me from a psa of 750 to .008 and counting. After your next infusion try something different, go for a long walk, etc. Think positive thoughts, cancer cells are dying and they don't like so they are causing minor problems as they die. Now get up and fight, kick some ass.

  • Someone starts telling me I am going to have an exact amount of extra life, if I take a certain treatment--I will pick up the Doctor and throw him out the nearest window. At 73 I still bench over 300 lb.--still body build without T--at 6' 198 lbs. of muscle, I can scare someone. Now I have actually done this but I could not get the Doctor out the window. It was another disease I was fighting. The point is do not take the loquacious words of one Doctor. Get a second opinion, and third. If not enough resources to get opinions where you live move on to a distant area to get extra opinions.

    I am well aware, that the new way to use Chemo--is to use it early on, and it has been effective, in obtaining undetectable PSA's when given early and starting where you are. But it has not been proven to be more effective than triple blockade ADT, or in some cases--there are men on this sight that can get their PSA to zero with a mixture of supplements, some using heavy exercise, and others enjoying a couple of glasses of wine for the grape skin, chemicals.

    So you have to be your own advocate, sometimes. Yes, I would have my leg removed if gangrene was marching up past my kneecap. Something's you cannot avoid. But your PSA is not 30 or 40 it is .19. Not overly great, but not so bad. Post surgery I was 8, like I did not have any surgery, yet I found a way to get to undetectable, without Chemo. Be blessed that you are where you are, and seek out others to gain more info. For what works for Joe, will not necessarily work for Carl.

    Anyway my thoughts.

    Nalakrats

  • Nalakrats,

    I beg to differ with you about your statement that chemotherapy is not more effective than triple blockade. It might be as effective in lowering PSA, but it is very clear that chemotherapy with ADT does extend life.

    We do not die from PSA, often we forget this simple fact. Some of us die from prostate cancer with low PSA scores and some of us continue to live despite sky high PSAs. I do admit that most men with sky high PSAs do have a terrible quality of life, but they do not die from their PSA.

  • Agree PSA does not kill you---But Chemo is not for all Pca, across all 30 different variants, and your Pathology does sometimes allow you to make a better choice. Know you Pathology and how it works with Radiation, or Chemo. Not all Pca can be treated the same for every age. Actually I talk about triple blockade--but I use 5 different drugs for Blockades--one is really a microencapsulated natural 5- alpha reductase antagonist. My Doc says no on Chemo--now that may be my age--73, but it is really the Pathology--we honed in on the Pathology and talked to the Drug Companies, that make Zytiga and Xtandi, Duke, UNC, Emory---and they said what little they knew about my Pathology, because of its rarity---do not do Chemo. The only accredited testing, concerning my Pathology, was done in S. Korea and all 157 subjects that had Chemo--or radiation after surgery--died in 18 months. Not good. We cannot generalize anymore. I have a Geneticist--very few patients have one. And I was warned if I do chemo I may turn on my AR-V7 Gene Splice--and if needing Zytiga or Xtandi--later--forget about it. They will not work.

    Nalakrats

  • Nalakrats

    You mentioned above that you use 5 different drugs for Blockades.

    May i ask what they are? I find your theory interesting.

  • I use a Vantas implant, implanted in the underside of my arm, that puts out Lupron at a known amount each day---so that Shots are not required, and is good for a year, sometimes good for 2 years but manufacturer says replace every year. Beats the hell out of shots and you do not get the menopause side effects--, still get brain fog--OK in order

    1]Vantas[my Lupron]

    2]Casodex

    3]Avodart

    4]Proscar

    5]DIM[Di indole methane]--From Bioresponse.com--this is the famous compound found in cabbage, broccoli Etc. that is said to be a cancer blocker. Go to Bioresponse and ask for their booklet, it is free--Dr. Zeligs is a Published Urologist at NCI--who developed this and gives it to all his Prostate Patients, and for those using high Dose t supplementation. There is a new 175 Milligram Product--I have been using the 150---4 pills a day.

    They offer support on-line--and I do talk to the Doctor when I have important things to discuss. The others are known

    Nalakrats

  • Thank you

  • Nal,

    I think you are right...I would only use chemo as a last resort...there are many studies that when cancer comes back after being treated with chemo it comes back very aggressive..and next option is coffin...the only choice is with or without memory foam

  • Well Gus, my Geneticist kind of made me stand up straight after an hour on the phone with her. Was not scary, just what we thought to be normal main stream, may not be. My Urologist, who has been doing Pca for 25 years-- I asked, if he had what I had and many of his other patients--would he do Chemo--no was his answer. Now that's a Doctor working back and forth with now a pretty big UNC/Mission/Pardee Cancer Clinic, in western N.C. and their Oncologists. When first starting my adventure--he said stay away from Chemo, if I can---that there may be time to use it down the road--but he is not a fan of it.

    Nalakrats

  • Nal, I could use a strong guy to throw some docs out the window myself lol ty for your good hearted advice and humor.

  • I had 6 cycles of docetaxel plus predisnone. PSA went from 70 to 1. Side effects weren't good but tolerable. Taste was a problem. The only thing that tasted OK were peanut butter sandwiches.

    Would I do it again? You bet! My doc says it's his job to keep me alive until there is a cure. My job is to give him every chance to do that.

  • Hi

    First I am saddened to hear of your situation.

    I am not a medical expert only only a patient so I cannot recommend or offer medical advice only give you the benefit of my experience and knowledge learned during my journey with PC.

    My profile contains my cancer and treatment history.

    Since I do not know much information about you or you cancer or even where you live it is difficult to comment so I will limit my response to general information.

    First thing is to disregard any discussion of median or mean statistics. Those are for the regulators and scientists. Keep in mind that those stats are a plot of a curve that may have a shape that indicates that there may have a long tail of patients with long term benefits. Anyway enough just disregard those numbers when making a treatment decision.

    Also psa is not perfect determining disease progression it is only a possible indicator. Especially in a case like ours where the cancer has invaded viscerally. Scans are the best way to track progression.

    When I was making any treatment decisions I would do as much of my own research as possible (I do not consider polling opinion sites like this research) and then get second and sometimes third opinions from qualified medical experts always from different institutions. I do believe that there is an institutional bias for certain treatments.

    Once I had the best information I would make the best decision for me. My basic philosophy in dealing with my disease was to try and minimize the disease burden and stay as healthy as possible with the hope research would catch up to me with a durable solution.

    To date I have never looked back and regretted a treatment decision.

    Now a couple of specifics

    Have you had a genetic profile done? This is important especially if you have the BRCA genetic marker.

    Have you had a biopsy of either the liver or lung mets? This is important to see if the disease shows signs of neuroendocrine disease.

    Finally quality of life is important and if in the final analysis make an informed decision and have no regrets.

    My best wishes to you

    Bill Manning

  • Hi Chris,

    I just took my cycle# 5 yesterday, chemo is working for me, not as good as I would like, but my pain from bone mets went away in my chest and my psa dropped from 45 to 4, then up to 6 now I am up to 10, I hope it does level off, I had a slight problem with diarrhea but no too bad, I also had problem with constipation, but I got through that, I also went to the hospital very sick day after cycle #1, we reduced my taxotere dose down to 80% and I seem to get through my cycles ok, I do feel very sick on days #3,4 & 5.

    keep fighting, and stick around

  • Days 3, 4 and 5 are my Dass worst as well and it let's up at 10 to 12 days a bit.

  • Hey Chris, I agree with you that figures lie and liars figure but please consider that if the average (or mean) increase was 18 months, some patients may have lived for an additional 10+ years. One patient I know was practically written off 20 years ago when his chemo failed and he is still living a full life today. IT'S ALWAYS TOO SOON TO QUIT.

  • I am a fifty one yo with mCRPCa. I started with radiation, but 6 mo later the PSA was doubling at a 5 month rate! So clearly Lupron failed. I was also on Xtandi to begin with but the side effects eventually precluded continued use. I have since switched my regimen to Zytiga, Prednisone and monthly firmagon and quarterly Xgeva. My cancer mets throughout my bones have shown no metabolic activity in over a year ( I get a C11 Choline PET at Mayo every 3 months. My regimen seems to be working.

    With regard to your initial question about Docetaxel, I was prescribed 6 rounds. I lasted two before I ended up with a near-death stay in the ICU where it was touch and go for the 9 days I was in a coma. I showed up in the ambulance at the ER with Acute Respiratory Distress Syndrome caused by pneumonia that quickly, within an hour or so, went septic and I could not breathe. Argument against? NO. I think even the limited exposure I got from two rounds aided in keeping the cancer at bay. If you can tolerate it, I strongly encourage you to take advantage. There are only a handful of things they can try once current chemotherapies stop working. I say leverage everything you can throw at this and chemo is a big one. I remain today with post-therapy PSA undetectable and testosterone at 3. Perfect environment to halt the progression.

    Either way you decide to go, I wish you well.

  • That's the spirit!

    How did that guy do it?

    Neal

  • that's a good story

  • Hi Chris . .I know this decision us weighing heavy on you. flip a coin. lol jut kidding. don't stay on the fence though you'll drive yourself batty. make a decision and for now trust that decusion. hope you had a happy holiday . in my prayers xoxo

  • I am on my taxotere cycle 5 and let me tell you it is no fun, a real bad one, six days later I am still sick in bed, went to hospital, they fixed me up sent me home in four hours felt good for six hours, then started feelin sick again, they gave me some ibuprofen / codeine

    codeine seems effective for me, I will keep that in my arsenal , wow what a roller coaster

    , but like the man said you wont know if you don't go, we gotta play that lottery of treatment options, and hope and pray for a win.

    peace to you all

  • Chris, One thing for sure, you have to make a decision. that's the part that sucks. I didn't want no parts of chemo at all, but after hearing my options, I choose to do it for many reasons. I did 10 rounds with mega doses each time. My ONC told me it was the best thing for me to battle this monster. My 1st and last 2 rounds were the worst. I had all the side effects as everyone stated already. After looking back, It wasn't as brutal as I expected.

    It wasn't fun, at all, But I managed to go through it for all 10 rounds. Plus, I worked everyday and only missed work on my chemo days......... Only because I have to work.

    Also, I'm a builder, I work outside alot and I went through winter, spring and SUMMER. Wasn't fun I have to say, but I did it, Maybe you could too? I know everyone is different, but I'm just giving you an example that it can be done. BTW, My PSA is .1 and I'm on Lupron. since chemo .

  • Perhaps one should go on a exercise regiment to strengthen his body to get it ready for chemo. I pushed myself to slow running after each infusion of chemo thinking that it will circulate the chemo throughout my body and hopefully run into the cancer cells if it was circulating in my body or settled somewhere in my body.

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