Hi all,
Looking for some shared experience. After 4 infusions of docetaxel, complemented by prednisone and monthly degarelix the scans show increased Timor size and quantity in lungs and liver. The oncologist cancelled tomorrow's chemo and I'm going for biopsy.
Is there anyone out there with similar experience? Is it the beginning of a swift end?
Chris
Hi Chris, I will be looking for results after next chemo to see if it is working for me. How do you feel? What kind of psa are we talking about? Have you ever used xtandi or zytiga. Hang in there you are not alone. I do believe there is also another chemo called cabotaxel. What are they doing the biopsy for, possibly genetic testing, they have had a lot of success with certain genetic types in prostate cancer. Try not to worry and enjoy every day.
Dan
Dan,
I feel fatigued. Interestingly PSA is not a factor. It has been .9 for a year and is steady. I need to do the biopsy and see what the Oncologist says...I haven't used any of the drugs you mentioned yet.
At least I get to taper off the prednisone.
Cheers
Chris
Chris, PSA is very favorable, You still have the option to try zytiga or xtandi or first one then the other, you could get years out of these drugs, I did. I am not so sure what they think they see on a bone scan is what is really there, I think often what they think they see on a bone scan is not what is there, it is all interpretive and sometimes they are fooled by degenerative bone disease. I do not understand how you have progression with that low a psa, unless possibly it is small cell that does not produce much psa. and then you still have xtandi and zytiga which are oral meds
Chris. Did they do a CAT scan as well as a bone scan? The bone scan wouldn't show soft tissue malignancies.
the CHAARTED trial did not use prednisone.
Chris. Talk to your oncologist about Docetaxel combined with Carboplatin. What hospital are you receiving care from? The drugs Dan mentioned are part of Androgen Deprivation therapy. Have you been given Lupron? Where in the US are you?
I think in the original studies that got xtandi and zytiga approved it was done in the post chemo setting. h ere is the paper from 2012 nejm.org/doi/full/10.1056/n...
I took Docetaxel with Carboplatin . My doc said it's better together.
How were your side effects taking that combo, I know it can be tough
Tougher than the first time on docetaxel alone
It knocked my PSA down. So...it worked, but side effects were tough .
Chris,
I'm sorry to hear about the chemo outcome. Obviously, it's not a good sign. If degarelix isn't working then Zytiga and Xtandi probably won't work either, but if you haven't yet tried them, they might be worth a shot. They might give you some response.
I think if I were in your shoes I might volunteer for a treatment clinical trial if you find one that looks promising and that you qualify for. You don't have much to lose with them. The ones that I'd be most interested in might be the checkpoint inhibitor type immunotherapies like Keytruda. In one trial with 10 PCa patients, three got outstanding responses of PSA < 0.1. Three out of ten is not great odds and we don't yet know if those odds are representative or why those three did well, but it's better than nothing. However I am definitely NOT an expert in any of this. You'll have to ask your doctor about it. If he's a prostate cancer specialist, maybe he'll be able to advise you.
Whatever happens, I urge you to make the best of whatever time you have and not give in to despair and depression. Resolve to make the best of the time that you have and to do what you can for your family or friends. You're still alive and there's no reason to give in to death until it takes you.
I wish you the best.
Alan
Alan,
Degarelix has worked famously. Bone mets all but gone after three and a half years treatment.
Docetaxel hasn't worked.
Chris
Here is an older study on cytozan ,which is a common agent in Oncology, ncbi.nlm.nih.gov/pubmed/145... Also in the Keytruda that Alan spoke of another 3 Men had stable disease at 8 months, stable is good. here is the link to the keytruda study. personalgenome.com/wp-conte...
I had 13 cycles of docetaxel before it stopped working and more cycles first with cabazitaxel then a combination of docetaxel and Carboplatin. Now I am on bipolar androgen therapy with encouraging results through 2 cycles. Through it all I continue to be pain free and remain on the lookout for next steps when they become necessary ( hopefully in the distant future). You still have options post docetaxel. I had both Zytiga and Xtandi before moving on to chemo.
I wish you good response with the next treatment.
Good Morning Chris,
Ask your Med Onc for the Guardant360 liquid biopsy. It requires only 2 vials of blood and 2 weeks later you will have a genetic profile of your cancer. Results will also indicate the drugs which will be most effective against your specific cancer.
Never Give In! There are many treatments options available.
Best Wishes.
Wow, what is this Guardant360 liquid biopsy? Something new? You took it huh? Normally I was told before that when I do my biopsy, give the material to the genetic lab to test to profile to find which chemo will work best to kill my cancer. Sloan Kettering took the biopsy 4 years ago so I don't know if they can use it now to get a genetic profile of my original biopsy. But no worries if this liquid biopsy can do it. What a breakthrough.
Google Guardant360 and you will be amazed at the power of this diagnostic tool. Dr. Charles "Snuffy" Myers ordered mine and because of result, I began taking the oral drug, Lynparza.
Best Wishes.
Chris,
I got about 5 years (including a 1 year vacation) out of Lupron before becoming castration resistant. I next did Provenge but liver metastasis is exclusionary. Zytiga has worked for 42 months. I too have lung mets and bone mets. Hang in there man
So you're 9 years as a survivor now? No Xtandi yet? Gee, I am taking Lupron, Xtandi and Zytiga now. I wonder how long those together will give me. Always on the worry what the blood work will show rise in PSA and I got to go on a new therapy.
Hello gentlemen, I have bone mets too, and as soon as I took my first round of doxetel / taxotere my bone pain went away immediately that has been about eight months, then it stopped working and psa began to rise again up to 21, I just started on my second and last chemo drug option which is Jevtana, I just took my second round yesterday and my new blood work is good my psa is now 6, so I will see how long Jevtana works, I am hoping for at least a year.
I am also doing ADT/HT using Lupron, anyway I feel pretty good, just weak and foggy brain
I had to retire from my job I'm 59yr and just want to relax and have fun for a couple more years first, thanks to all who support this group, it does help to have a place to go and talk about this
look for a support group in your area.
take care
jack
I would never raise the white flag without studying Leibowitz's/Compassionate Oncology's website. He has a long history of turning short death sentences given to men by the big national cancer centers into a decade or two.
I have tumors in liver, lungs and bones. I have had 14 infusions of Docetaxel and Carboplatin as well as being on Degarelix and Prednisone. My understanding from the onc at MSK is that the combination of Docetaxel and Carboplatin works well on the cancer in the soft organs like the liver and lungs while the Docetaxel alone is OK for the bones.
Docetaxel only partially successful
Abiraterone vs Docetaxel
Docetaxel
pluvicto + docetaxel 
