Castration resistant prostate cancer - Starting Jevtana with Prednisone in a few days

[afhhr]

Dear all,

I am new to this page. I joined weeks ago but have not been able to make any posting. The posts from everyone in this group is very encouraging and uplifting. It has given me enough information regarding my Dad's case.

My Dad has castration resistant prostate cancer. He has already done surgery over 20 years ago, and has tried Zytiga for about two years until it stopped working. He was placed on Xtandi which put his body through hell. His doctor had to stop the medication and gave my Dad a few months to recover. He was then placed on ketoconazole and prednisone. But he reacted badly to it after a few months. He had electrolyte imbalance, seizures, etc.

His Oncologist started him on Taxotere and Dexamethazone on August 2015. He was okay until September 2016 when he had an infection and was in the hospital for about a month. He completed his 10 rounds of chemo in April 2017 and has been a chemo holiday ever since. Meanwhile his PSA has been steadily increasing.

We went to MD Anderson for a second opinion and we met with a fantastic doctor who is a genitourologist. They ran comprehensive tests and the doctor actually showed us the images of where the cancer was on my Dad's bones - Lumbar thoracic, a few scattered on left shoulder and right shoulder, his left pelvic, a few scattered around his ribs. And then he said that his adrenal glands were bigger than normal with lesions.

He suggested that my Dad be placed on another round of chemo - Jevtana. My Dad is in his early 80s. Since the last Chemo in April 2017, my Dad has been on Physical Therapy and he is getting stronger and stronger.

He starts Jevtana with Prednisone on March 2nd. I have been scared because I took care of my Dad for two years almost throughout his chemo therapy sessions and thereafter. I have read how some reacted to Jevtana and yes, I understand that every body is different. I want to be strong for my Dad and I tell him everyday that he is going to be ok.

Please can someone tell me how they found Jevtana taken with Prednisone? I will really appreciate it.

We are strong Christians and pray everyday. I know that there is nothing God cannot do. Please feel free to share your experience.

This forum has been extremely helpful. Thanks ever so much.

Kachie

[Dan59]

Kachie, I just had my first treatment with Javenta/Cabitaxol 11 days ago,I am 61 years old, so younger than your Dad.If your Dad made it through 10 rounds of docetaxol, he is tougher than most.Did he get Nuelasta while on docetaxol? What was the infection he got when doing docetaxol? I have been doing prednisone 5 mg twice a day, and I got a nuelasta shot to keep my white blood cells up. I did not really have any real side effects, other than a day of bone pain from the nuelasta shot. I took claritin and advil to combat the side effects of nuelasta. For Me it was easier than docetaxol,I also did about that many docetaxol.I am only through one session so far and go again I think March 5. I wish you and your Dad the best, We are all here for you, I will be here if you have any questions.

May God Bless You and your Dad.

Dan

[afhhr in reply to Dan59]

Hi Dan,

Thanks ever so much for getting back to me and I appreciate this forum honestly. My dad did not take any shot of neulasta during docetaxol. His white blood count was always really low but will pick up again before the next chemo treatment.

They could not figure out where the infection came from after all the tests. He had several doses of antibiotics and got better only by the grace of God.

Right now, he starts the jevtana with prednisone but no neulasta. We don't know how his body will take the Jevtana but we are praying that God would sustain him as He did during the docetaxol cycle.

Thanks ever so much and if you have any updates, please share. I love my Dad very much and want him to be here much longer. I pray they find a cure for this terrible disease to take this nightmare away from families.

Again, thanks ever so much for the support

[Dan59 in reply to afhhr]

I did not do Nuelasta with docetaxol either, But my white blood cells were a little compromised due to recent radiation, it is my understanding that Javenta may be a bit harder on the whites than docetaxol, I think that may be a good question for the Doctor. I will pray that God will sustain him through this too.

Dan

[afhhr in reply to Dan59]

Hi Dan, I wasn't sure if I mentioned that my Dad did not use neulasta for docetaxol. He had 4mg of Dexamethazone prior and after docetaxol. and he was on zyrtec throughout the 10 rounds of chemo. We will mention giving my Dad neulasta during his doctor's visit this week.

I have received tremendous help from this group. I remain ever grateful.

[Dan59 in reply to afhhr]

I also did dex during docetaxol, not sure why it is prednisone for cabitaxel, though I did speak to a Man on this list who did dex with Javenta.

[afhhr]

I figured as much. So what does the prednisone do then?

[afhhr]

We will ask the doctor about giving my Dad something for his whites while on jevtana. they recommended ten rounds for my Dad. Is the Jevtana helping you? I pray that you get through this and come out stronger. It is well with you.

Take care and continue to keep strong.

[Dan59 in reply to afhhr]

I beleive the prednisone is given to boost the energy level, It also has antitumor effect and to combat possible allergic reaction, and help with edema. This is one link I could find. sciencedirect.com/science/a...

I would suggest calling the free hotline provided by the Prostate Cancer research institute, they will provide an advocate to answer questions. The number is 800 641 7274. I will be here for future communication or questions in any way I can help.

Dan

[BigRich]

Thank you Dan for the link. It was a well written article.

Rich

[ctarleton]

Hello Kachie,

You have been a real Trooper to have been with your Dad through so many treatments already. As you know from his prior chemo, they will do a lot of monitoring of his blood work and symptoms as he starts this new chemo, Jevtana.

Of course, not every dire thing that is possibly mentioned in the Full Prescribing Information for any chemo agent is likely to happen in any one individual case. But, it is always good to have at least some ideas about symptoms to immediately report, or test/lab results that really need to be within certain levels, etc.

Here's a copy of the original Jevtana info, for your independent reference purposes:

accessdata.fda.gov/drugsatf...

I'd note any places where it referred to men over 65 years of age, or any frequently reported adverse events, or any key blood markers that would require an intervention to reduce or temporarily stop the treatment dose, etc.

Also, you may see a mention of "G-CSF" in the prescribing info. This article describes some of those agents by types and brand names.

cancerresearchuk.org/about-...

I hope your Dad does well with his treatment. You mentioned that you and your Dad are religious. MD Anderson has Spiritual Support Resources on staff.

mdanderson.org/patients-fam...

They also have Advanced Cancer Support Group(s) available (if not for your Dad, for You).

mdanderson.org/patients-fam...

Charles

[afhhr in reply to ctarleton]

Thanks ever so much. This is absolutely helpful. I appreciate the support.

[Daddysdaughter]

Hi welcome! I just like you have been with my father to every treatment. He has just completed 3rd round of Jevtana and carboplatin. He is 78 years old and has been tolerating it pretty well. We were much more afraid of it till after the 1st infusion. The worst side my father got was constipation. We know now from experience to start laxative and high fiber diet earlier. He also gets decadeon- steroid for nausea and prevention of allergy as well as 16mg of Zofran (anti nausea). We also have him ice his hands and drink a cold beverage while infusion running (or suck on ice cube) to prevent loss of tastebuds and finger neuropathy. I wish you the best of luck! So please request neulasta for White blood cells it significantly decreases chances of infection. Take a Claritin or Zyrtec 2 days before- till 2 days after he injection to prevent long bone aches and joint pain. Lots of hugs! Stay positive and strong!!

[afhhr in reply to Daddysdaughter]

Thanks so much for these tips. I am taking notes honestly. I have been very afraid because of the side effects I read about Jevtana and considering that my Dad already finished 10 rounds of Docetaxol, I was worried because of his whites. But God is in absolute control. I cry sometimes when I see my Dad confused at times due to loss of electrolytes.

Thanks so much for all the help in this forum.

[j-o-h-n]

To quote you:

"I love my Dad very much and want him to be here much longer. I pray they find a cure for this terrible disease to take this nightmare away from families."

OUR PRAYERS ARE WITH YOU.

j-o-h-n Wednesday 02/28/2018 7:23 PM EST

[afhhr in reply to j-o-h-n]

Thanks ever so much John. I do appreciate this. My Dad starts his new treatment tomorrow. I try to tell him that everything will be okay. This forum has been great honestly.

Thanks once again.

[j-o-h-n]

He WILL be okay.

Good Luck and Good Health.

Thursday 03/01/2018 6:17 PM EST

[afhhr in reply to j-o-h-n]

Thank you ever so much. So far so good. He had Jevtana on the 2nd with a shot of dexamethazone and now on a 21 day prednisone until his next treatment in 3 weeks.