Docetaxel 111(2): Had a meeting with... - Advanced Prostate...

Advanced Prostate Cancer

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Docetaxel 111(2)

Christor13 profile image
36 Replies

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

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Christor13 profile image
Christor13
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36 Replies

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.

Scruffybut1 profile image
Scruffybut1 in reply to

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

Daddyishealing profile image
Daddyishealing in reply to

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

in reply toDaddyishealing

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

Neal-Snyder profile image
Neal-Snyder in reply to

Wow. How did you do it, gourd_dancer?

in reply toNeal-Snyder

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.

MrJack profile image
MrJack in reply to

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

motosue profile image
motosue in reply to

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.

Christor13 profile image
Christor13 in reply tomotosue

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

RangerTug profile image
RangerTug

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.

Ca-Darrell123 profile image
Ca-Darrell123 in reply toRangerTug

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

DFZ4835 profile image
DFZ4835

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

Daddyishealing profile image
Daddyishealing

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

Scruffybut1 profile image
Scruffybut1 in reply toDaddyishealing

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.

bryson43 profile image
bryson43

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

Christor13 profile image
Christor13 in reply tobryson43

How are you finding the Xtandi?

bryson43 profile image
bryson43 in reply toChristor13

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.

Lakefisher profile image
Lakefisher

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

JoelT profile image
JoelT

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.

MrJack profile image
MrJack

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

Daddyishealing profile image
Daddyishealing in reply toMrJack

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

gusgold profile image
gusgold

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

Nalakrats

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

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

Neathuh1 profile image
Neathuh1

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.

Thank you

celler6 profile image
celler6

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.

Neal-Snyder profile image
Neal-Snyder

That's the spirit!

How did that guy do it?

Neal

MrJack profile image
MrJack in reply toNeal-Snyder

that's a good story

Daddyishealing profile image
Daddyishealing

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

Daddyishealing profile image
Daddyishealing

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

MrJack profile image
MrJack

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

esmitee profile image
esmitee

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 .

motosue profile image
motosue

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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