Advanced Prostate Cancer

Chemo Concerns

Hello Everyone, I'm new to this site. My 63 year old husband was diagnosed with metastatic prostate cancer in January, 2015. He was initially given oral meds (Casodex, Zytiga and Xtandi). He's due for his 4th cyle of chemo (Taxotere) in the coming weeks. His PSA has gone down to 26; however, the side effects have become progressively worse (lack of taste, fatigue, achy, hair loss, etc.) The hardest part is the uncertainty of it all. Doctors tend to be rather vague at times. Can anyone shed some light on what we should expect in the weeks after chemo therapy has ended? How long do patients typically mantain a lower PSA after treatment?

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Xmas,

I have not done chemo because I am not convinced of its efficacy. Has your husband had genetic testing to determine why Zytiga and Xtandi stopped working. These 2 drugs should have driven his PSA to <.01 It appears your husband has mCRPC . Which is probably why chemo was added to the mix. IMO if his PSA does not drop to <.01 I would look at clinical trials of new agents in the pipeline.

Gus

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I am assuming he was also on either Lupron or zolodex while on casodex xtandi and zytiga ,and that these meds bought his testosterone level to near 0. That being said , I am going for my 9th cycle and new scans next week, my hair is growing back minus the gray. I have chosen to go with the treatments proven to increase survival before I go experimental. I have been sucking on ice cubes as much as possible during taxotere /docetaxol infusion to decrease damage to taste buds, I also ice fingertips and feet to avoid neuropathy. I am not sure where to go next, perhaps take a break and try to maintain with xtandi, hoping quercetin will resensitise the cells that were resistant to xtandi,. After taxotere there is another chemo called Javenta,and there is xofigo (rad233) which is a raiopharmacuetical that is known to reduce pain from bone mets that also has a survival benefit. Here is to a good response to the chemo he is doing on the next one which will be after his 3rd, I have heard that it is common not to get a response till even after the 2nd chemo. I wish you and Him the best.

Dan

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I agree with Dan. I do not expect to be off chemo until it does not work. Do not worry about the PSA. The important issue right now is if the cancer is spreading and that can be found out with CT and bone scans. If ADT is not part of Xmas' drug mix I would ask the onc why it is not part of the mix.

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Chemo followed by radiation kept my PSA stagnant for about 18 months. The steady minimal rise in PSA did not spike until 5 years after.

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Over thirteen years ago at age 57, I was very aggressive in fighting metastatic Prostate Cancer. I asked one question to my Radiation Oncologist. Both gave me the same answer. "If you were in my shoes, what would you do?" Response was to find the best Medical Oncologist that I could find that specialized in Prostate Cancer, not any other Oncologist like Lung, Breast, Liver, etc. someone who is not a generalist and on the cutting edge of Prostate Cancer research.

I took a six month chemo trial as soon as mets were discovered. Reason - I wanted to kill this bastard while my body was strong and the tumor burden low. It worked. Search on these pages posts my Gourd Dancer.

I was able to cease Lupron injections in February 2010 and remain undetectable. I take no supplements or other medication except for 4 mg of Andogen twice a week to replace the testosterone that I lost. All scans are clear.

Walk in the park? No, but what are your alternatives? I existed on Zofran for nausea. I stayed out of the sun and the summer Texas heat. I had some hair loss; in fact I lost the wave and curl that I once had. My hair grew back very fine. Several nails warped. Remember that chemo works by killing cells that rapidly divide - mutated cells, hair, and nails. Because I also took 30 mg of Prednisone a day for the six month period. Zero milk products. Zero supplements to prevent interference of trial results. Food tasted terrible and metallic. I gained weight. Prednisone has Prostate Cancer killing properties. Ice chips helped with Thrush. Neurotrophic side effects were manageable. My framevif mind was that I an introducing poison to kill cancer cells, deal with it. It is my only chance to survive.

I managed to work about 12 hours a week as my employer was very understanding. I also took 12 mg of Viagra three times a week to maintain and grow blood vessels after brachytherapy and IMRT radiations. It worked. My idea as after trauma. There is a significant loss in blood circulation to the area. I shared with my Medical Oncologist and he said that it won't help and could work as it makes sense.

Finally I stopped using a Urologist after initial diagnosis and changed to two Radiation Oncologists and then after mets within a year, I changed to a Medical Oncologist from academia who was a Researcher; i.e., a metastatic Prostate Cancer specialist.

I firmly believe that a positive attitude is paramount. I stayed away from all who were negative. I received Prayer Requests from across all religions and accepted them with humility. When I started the metastatic journey, my Medical Oncologist was positive and told me that he could extend my life at least ten years. At five years and then ten years he extended it another ten years. At thirteen years, he told me that at age 70, that he can not find any sign of cancer in my body and that I would died of something other than Prostate Cancer.

I recognize that I am atypical of the people in this group, but I also fired the big guns as soon as I had confirmed mets to L2 & T3 of my spine. My reasoning as simplistic as it is was according to the "experts", I had two to five years to live and would die of this bastard. To me, that was unacceptable as I am and remain a Statistic of One; meaning that regardless of what the stats indicate fir others, my Statistic is the only one that matters.

Keep fighting the bastard,

Gourd Dancer

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I finished 9 cycles of taxotere at the end of last year. My eyebrows returned in February, and my psa has remained undetectable. I have more hair(and less gray!) then before. I am on Lupron through December, then we'll see.

I had ok and bad cycles during chemo, 3 was a memorably bad one. I stopped neulasta after that one. I found that I got used to some aspects, side effects came and went, and other parts like fatigue just seemed to get worse.

As far as side effects, I discovered eating a bit of salt made everything taste tolerable and I highly recommend pain killers or muscle relaxers for sleeping the worst nights.

I believe in hitting it hard up front. Hang in there!

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I agree after taxotere is jevtana .again fatigue nausea .ask for IV fluids for days after treatment .made my husband stronger .our last hope was xofigo for bone pain .i wish you well .ask dr questions .take a notebook .you should not feel that your dr is being vague ..ask point blank questions ..this is the love of your life ..

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