Tom seems to never have fully recovered from Taxotere - I still think Taxotere can permanently damage the immune system. Some say no evidence but if you look at clinical trials for Prostvac and other Immune Therapy prior chemo is a disqualification.
You have to wonder if Tom had taken the boatload of supplements (states never took supplements), most of us take, and no Taxotere maybe he would have been strong enough for Provenge and things would have turned out better for Tom. Scary Stuff.
Gus
Hmm, I also read a blog on the same site from a guy (aged 45) who took Taxotere and died 1 year later from a serious lung condition, which his family thinks was caused by the chemo. My Oncologist suggested it and made out the risks were minimal, but I'm skeptical. When I suggested that chemo damages the immune system, she said that was incorrect, but provided no evidence.
Please be cautious when condemning a proven drug with one unproven assertion. Yes bad things happen to good people. The same drug has also help some. Don't blame the drug blame the disease.
Just my opinion. I am not qualified to make an expert opinion on either the immune system or the biochemistry of Taxotere.
Bill Manning
I read the story you linked to. I don't think it says what you say it says.
The man whose name is Tom was diagnosed as symptomatic stage 4 cancer in 1996 and died in 2014. This is an 18 year survival. Well beyond the median length, as I understand it.
You say taxotere damaged his immune system. The story relates a number of side effects of his treatment, but none of them can be seen as damage to the immune system. Periperal neuropathy is a known side effect of chemo, and there is some hope that it can be mitigated by alpha lipoic acid.
ncbi.nlm.nih.gov/pmc/articl...
The fact that some clinical trials are not aimed at the population of patients who have received chemo is not a reflection on that treatment; it is a judgement that the procedure being trialed is not shown to best advantage in that population. In some cases, the exclusion criteria of chemo is a hold over as a marker for late stage symptomatic disease, since chemo has become standard of care in asymptomatic disease only a year and a half ago, and many studies currently in progress were designed well before then.
Raise your game.
Well lets see...Tom started taxotere in 2009....immune system crashed - 4 days in hospital - loss of strength in legs walks with cane - systemic infection - 4 units of blood - could not stand - what was the cancer doing during these times of immune suppression...and he is dead from a GS 7(3+4) which is considered moderate...
I don't need someone like you telling me to raise my game....I am 10 years out with a GS 7(4+3) and a PSA <.01 following my protocol...all without lupron, xtandi, zytiga, chemo and all the rest of that crap that leads to fatal CRPC.
Hi Gus, what is your current treatment plan if you could share please
thanks
jack
What is something that does crash the immune system? Aids. Do we see something along those lines? Opportunistic infection?
If I may ask, first congrats on those amazing numbers. What has helped you because undestandabke there's controversy in treatment, but I think most if us live to know the success stories like yours and how you approached therapy. Congrats again and many more.
I just talked to the N.I. H. in Bethesda, MD...as of now prior chemo is an exclusion factor for clinical trials of Prostvac..I am not saying I would not use chemo but it would only be as a last resort
I think vilifying any drug as being harmful for most or all who use it is foolish. Because one or a hundred people have an adverse reaction to taxotere is to be expected. Everyone is different and reacts differently to drugs, food, treats and all the things our bodies ingest. People dye from eating a peanut or an aspirin. We're all different and different things effects us in sometimes unexpected ways. Taxotere is prolonging my life and many others. Having stage 4 prostate cancer with bone mets is a death sentence and if I can prolong the end even one day I will.
Dennis
I see only one interventional trial for Prostvac - NCT02649855
clinicaltrials.gov/ct2/show...
That trial excludes prior chemo. I assume this is because they want to see how Prostvac performs "in the pre-chemo space".
I am on taxotere cycle 6 and have had a rough time, but my bone pain is gone and tumors not getting any larger, it seems to be working, when I ask my Onc doc about provenge
he tells me the company has had financial trouble and that they are not considered "main stream" and I am not eligible for it, now he did not mention that prior chemo can exclude me from possible clinical trials, I am with Kaiser Permanente and they do not seem to look outside the box, all they offer is "standard treatment" & "mainstream treatment"
so by the time we are done with chemo he say's he will help me find a clinical trial but he also says that we may revisit some older chemical treatments as well, and I will have some choices to make.
Your Onc is just not correct. Provenge is main stream and it is FDA approved. The company did have financial problems, mostly because of stock manipulation and abuse by one of the directors. They filed bankruptcy and have been bought by another company who is on sound financial footing. I am not sure why their financial condition enters into your doctors consideration. Their financial condition has nothing to do with the value of a treatment.
Joel
Dendreon was worth (sold for) $820 million two days ago.
I have read Tom's story before and frankly it is typical for those with Stage 4 Prostate Cancer selecting palliative treatment in hopes of longevity in the "waiting game". The miracle is that he lasted 18 years instead of the 2-4 years normally given at the time of his original Dx.
Tom's original biopsy report from January, 1996 confirmed a diagnosis of metastatic PCa which the MRI highly suggested. With a PSA 110, Gleason 7, Tom stayed with his Urologist and did not seek out a Medical Oncologist who specialized only in Prostate Cancer. It took him 10 years to seek a Medical Oncologist. And that my friends, sealed his fate.
His experience with Taxotere helped to extend his life, no more, no less. Compromised immune systems are an expected effect for anyone who undergoes chemotherapy regardless of the reagent used. To think otherwise, is like the little boy and the big bad wolf.
Gourd Dancer
My understanding of chemotherapy is as follows:
Chemotherapies typically work by interrupting cell division and damaging dividing cells. They are generally not "targeted" in the sense of only attacking tumor cells - though there is recent research in binding chemotherapy molecules to other molecules that do target tumor cells in the hope of delivering higher doses of the drugs to cancer cells and lower doses to other cells.
Some types of cells in the body divide fairly frequently and others much less frequently. Some frequently dividing cells include cells lining the stomach, cells building new hair, cells building new immune system T-cells that fight infection and, of course, tumor cells. Chemo tends to damage all of those cells indiscriminately, causing nausea, hair loss, compromised immunity, and reduced cancer. In the best case, the nausea will go away, the hair will grow back, and the immune system will recover, but the cancer, which is less able to repair damage, will grow back only very slowly or, in some cancers and some chemotherapies for some patients, not at all.
How badly a person is affected by damage to the immune system depends on the person's general health and immune system health; the dose, frequency, and chemo drug combinations administered; and other factors that may be specific to the patient and the drug. For best results, it's critical that the oncologist administering the drugs do a good job of dosing, timing, and adjuvant therapies specifically tailored to the patient. A good doctor can do a lot to get the maximum benefit and minimum harm from chemotherapy. A bad doctor can do just the opposite and even kill a patient with chemo drugs. Knowledge, skill, and experience count!
Nobody wants chemotherapy. It's unpleasant and can be nasty. It can cause permanent bad side effects. For that reason, it is typically not used if there is any better choice. But it can also be a life prolonger, a symptom reliever and, in some cancers, a real cure.
One interesting thing about chemo is that very aggressive cancers may be more subject to damage from chemo than indolent cancers - because very aggressive tumor cells divide very frequently. The more often they divide, the more likely they are to be dividing during a chemo cycle and be killed by the chemo. This is the opposite from other treatments that are often least effective on aggressive cancers.
Right now, I think chemo is one of the better tools in the arsenal against cancer. In the future, I hope it can be replaced by more targeted therapies that hit the tumor cells without hitting healthy cells. We'll get there someday, but in the meantime I think we have to use what we can.
Alan
So, immunotherapy is not a first line treatment,,and insurance bars, which is an issue and then any chemo prohibits the use if immunotherapy after? Is this correct?
What I have found is that prior chemo use is an exclusion in clinical trials of new immune therapy drugs...first line treatment is ADT...some studies have shown that combining chemo with ADT is more effective than ADT alone...I know what I would do...combine Xtandi with Immunotherapy, and only if that fails , as a last resort, would I do chemo.
I agree with you, but my father chose chemo listening to doctors and is on his 4th session. I wanted him to do immunotherapy. He also had fractures and fear so I think that's why he went so aggressively. Now he has a cold flu for 3 weeks and he can't get rid if it and a chemo burn that's very bad because the tec. Fd up
right now the only approved immno for PCa is Provenge and your father can still do that
Thanks gus. Xoxo
After reading about the roller coaster ride that Tome was on for so many years of multiple treatment regimens, I cannot tie this to Taxotere as the cause for his decline. I am 57 an have just completed a 6 treatment regimen of Taxotere at 3 week intervals after having a radical prostatectomy in May 2016. My Gleason score was originally 9 (5+4) and the tumor had not penetrated the capsule, yet one out of fourteen lymph nodes removed during surgery tested positive. So my diagnosis was T2C N1 M0. The Stampede study in the UK showed that the survival rate was enhanced for patients who underwent chemo therapy along with Lupron injections. I had two oncologists agree this was the best approach. My PSA is no less than 0.01 and I will monitor it monthly for a while.
I think the notion that chemo treatment is one of last resort is slowly being proven incorrect. It is too early to say what the long-term outcome will be. In Tom's case, he started out with bone mets and had already received ADT and then radiation and did not mention prostate removal (the source of the cancer). I think that he was much too far along to benefit long-term from any one treatment and the PSA testing was not helpful in telling him what was working or not. I have red many articles about the PSA being high without evidence of PC while in other cases there maybe a low PSA with advanced PC. PSA is only one indicator but we have little else to go on which makes the whole process very frustrating and unpredictable.
What happened to Tom very sad though he did live a long time after the PC was discovered. I think we all need to look at where we are in he progressions of the disease and do our homework on what treatments have worked for our specific set of conditions. Allowing doctors to keeping trying this drug and that while you are suffering more from the drugs than the disease may mean it's time to reevaluate both your treatment plan and your oncologist. If his PC was that advanced early on, then it's amazing how long he lived. However, it does not sound like it was a happy life. If I know my chances for recover are extremely low, I might be inclined to start traveling and enjoy my remaining days to their fullest with little or no treatment out that's just me.
I remember Tom, I can only hope to get the 18.5 years he got after what was likely a stage 4 diagnosis with a psa of 110, RIP Tom. I have 10 and a half years now, that would be another 8 years for me. At one point Tom was taking megace for a appetite stimulant , when he stopped he got a reduction in psa indicating the megace was feeding the cancer as had been previously noted as a possibility by the great Dr. O. Sartor. My expert Doc was not a big fan of provenge, provenge does not lower psa.
Dan
If I ever needed an appetite stimulant I would probably resort to medical marijuana, available as an option in my state. I thought I saw somewhere else that megace was not good. I'm on ADT. I wish I had an appetite inhibitor. I guess I have something for that -- my two arms -- just push away from the table.
I hear you on the appetite inhibitor, but I am glad you do not need a appetite stimulator yet, I am at a point where food taste a little different and I sometimes force myself to eat,I think You are right on using the marinol to stimulate appetite.
Dan
Yes, my memory was correct. Here's a caution about megace and prostate cancer: Adding to NOT prescribing Megace is this commentary by Dr. A. Oliver Sartor: “"Megace® is used at times for patients who have hot flashes, and at times for patients to boost their appetite. But in prostate cancer, Megace may interact with the androgen receptor, particularly mutants, and cause excessive cancer growth. And you can actually get responses by withdrawing Megace. I do not prescribe the use of Megace in prostate cancer patients (even for hot flashes), because I don’t know who has a mutant and who doesn’t."
I used Megace for years for hot flash suppression. I read this post a while back. Stopped taking Megace, had a small PSA reduction between tests, with only Lupron plus supplements. Could be the absence of Megace, could be the supplements (Zyflamend, POMI-T, Honokiol, Turkey Tail Mushroom extract).
Abiraterone finally working 
The Dietary Supplement Listing Act of 2022
Zytiga+Zoladex instead of Taxotere 
