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Advanced Prostate Cancer
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Chemo round #11 and fighting.

Well I am on Chemo round #11, after nine rounds on taxoteere , I was switched over to Jevtana, and my PSA went down from 24 to 3.6 after the first dose, now slight trend upward to 3.8 and I just took my second round of Jevtana, feeling a little sick but it will pass in four days and I will feel better, when Jevtana stops working my Onc Doc thinks we will try a form of radiation , till now I have had no radiation at all, I forget the name of the radiation drug/treatment.

thanks

Jack Bishop

So Cal.

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Jack,

That is so good to hear, you are tougher than most to get through that many rounds. Great to hear of your good response, especially to Javenta after docetaxol. I am right behind you as I go for round 5 of docetaxol this next Tuesday. I think the form of radiation you are talking of would be possibly xofigo/radium 233 which is actually an injection. Keep up the good fight.

Dan

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Not to argue the point Dan, but I think Xofigo is for painful mets. My last Uro, when I mentioned mets in my spine, etc., he immediately sent me to see my radiologist. Fortunately, my hemoglobin was too low to begin treatment. When I saw my Onc, he was flabbergasted about the Xofigo, and instead put me on Xgeva, which supports bone health, and I assume it kills PCa cells. At this juncture of Jack's treatment, after all the chemo he's been through, I doubt more chemo would be advisable. IMHO

Joe

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Joe , Xofigo is an alpha particle radiopharmaceutical , and not a chemotherapy. According to Dr. Sartor (in link provided ,by Gus 2 days ago, and repasted below) it is much more tolerable than chemo, also see that Dr Sartor suggest there is more going on than just pain relief. Dr Sartor was the principal investigator in the original trial for xofigo. must read Gus link on sartor /xofigo.

prostatepedia.net/blogs/pro...

You are correct in that it is indicated for men with bone pain due to metastatic disease. Which is why I did not get it when Oncologist suggested it, as I believe it can only be used for one cycle of treatments and I had no bone pain, so kept in back pocket for when I had bone pain.

I am currently also on xgeva , and had a long history on zometa. Zometa and xgeva are indicated for prevention of fractures due to metastatic disease, It has always been my opinion that my long time use of zometa prevented my metastatic disease from growing in Bone by making it infertile soil for cancer grow. Sartor put me on 3 month zometa back in the day rather than every 4 wks to lessen risk of ONJ.

Joe , I hope you are enjoying your day.

Dan

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After I posted, I did read that is was an alpha particle, the first of it's kind used on us guinea pigs, which does alleviate the pain and attacks the cancer as well. On the other hand, Xgeva is a bit more opaque. It supports bone health, but is vague on it's cancer killing ability according to what my brain comprehended from the website.

And, about my day...Hot flashes, horrible.

Joe

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Sorry to hear about the hotflashes Joe, Its almost 80 here today.

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Have u tried estradiol patches twice weekly ? They're good for hot flashes

Bob

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No I haven't Bob, but I'll look into it. I have tried several meds and herbals, but none worked. One med put me on a hell of a roller coaster ride that wouldn't let up. Six weeks.

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Estrogen patches helped me with hot flashes back in the day, I also got a long time psa response and stable disease from climera estrogen patches( .1 mg 6 out of seven days prepped with alchohol for treatment)) after 4 successful rechallenges, in the end I think I had withdrawl response. I think the dose for hot flashes is 1(.1mg patch per week). Estrogen has been a common therapy for APC for a long time. The oral estrogens had blood clot risk, controlled by blood thinners, but the patches not as much due to not being absorbed by the liver ( OCKRIM studies on google scholar.) On a side note having some estrogen in the boday, as one guy described it , "It was the only time in my life I could win an argument with the wife"

Going to order some birm

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I don't know, but mu Onc Doc has been ok so far, and no two prostate cancer patients are the same, I did read that the rad 233 is absorbed in the same way that calcium is absorbed into the bones, and it only radiates out a short distance like less than a mm. what have I got to lose , ill try it in the name of research.

jack

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Jack,

I thought it was interesting when Sartor suggested that adding it to zytiga could create a synergistic response when used with xofigo/rad 233. Looking back you did pretty well with zytiga I wonder if it would be worth a re challenge when you get ready to do xofigo. I like the way you are getting ready for your next move! And that is really an amazing response you are getting to Javanta now, I hope it drops down even further and stays down for a long time! Xofigo has already been shown to increase survival.

Dan.

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yep gotta keep trying, I think I read something like 14mos extended between the placebo group and the rad233 group, we will keep fighting I think for a long while.

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You betcha we will Jack!!

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On Lupron when psa rose for several years with good control, shot every 6 months or so. From Sep 16 at 4.5 went in steps to 76 in March. Stopped Casodex which only used for less than a yr, started Zytiga and prednisone end of Mar; blood work 4/24 with PSA at 34. Lupron back in too. Some bone pain gone after 2 weeks using Norco.

Bobby happy!

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Hi Bobby, I had bone pain bad in my ribs, I thought I had muscle strain and began treating it as costrochondritus , muscle strain, and it never would get better for weeks

so we started chemo and it went away the next day, that's when I learned the bad effects of bone mets can be very painful, I am now pretty much pain free except for the occasional other locations like hips and thighs , but I use very little Norco 1 or 2 5mg ea per day, and an Ambien to sleep every other day,

good luck, keep up the fight.

jack

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Hey Jack, this may sound like an odd question, but can you recall which came first, the pain, or discovery of the mets? I've had mets for a couple years now with no pain at all. The only real pain I have is my wife. yuk-yuk

Joe

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Yea, for me it was the pain that I at first thought it was strain and stress related, now I wonder if the Doc knew before me sometimes I think I have to pry information out, I did not think Mets at first maybe denial. it was obvious when after two days after the chemo the pain was gone, so I was happy with that part. anyway carry on. take it easy on the wife.

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Joe

I feel your "pain"!

Bob

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Jack

I'm getting axumin scan next Thursday after rising PSA to 2.3. Looking for source of recurrence. What was your PSA when you first felt pain from bone mets?

Bob

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my bone pain started at PSA 23, and it jumped up to 45 in one month, then we did my first Chemo docetaxel and I had relief the next day. and my next PSA a month later was 11.

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Mr Jack that's great news. So pleased for you.

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I had 13 cycles of docetaxel before switching to Jetvana. The latter didn't work very well for me because it was so similar to docetaxel. There are other chemo to try post taxanes. Stay positive and keep fighting!

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thank you

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Hope you get some relief very soon and a good outcome!

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update: the last four days about mid day I have been getting severe stomach pain, feels like acid in the stomach, but its also accompanied by pain on my right side ribs and lower back, so I am worried and concerned as to what may be causing this, my palliative care doc has given me some antacid medication, so I will wait and see how tomorrow goes, I'm ok right now but when this pain hits there is nothing I can do but start popping pills, and waiting for them to kick in, sometimes takes an hour to get pain relief. so I guess I need to be more proactive and anticipate a little better, and remember to eat small light meals and above all else " Relax" ;-)

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I've read that Jevtana is about as effective as Taxotere as a first line chemo treatment, but Jevtana is often effective if the cancer is Taxotere resistant. It's more commonly used as a second line chemo. It sounds like it's working for you so that's great. Hope it keeps going well.

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May you find some joy in all of this madness. Hang in there.

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