Slow recovery from Chemo, Round 4, Session 2

[ontheroad589]

PSA 1124, Age 59, Stage 4, Dx 3-22-16

So after watching my PSA slowly climb from the nadir at 1.45 on 12/19/16, 2017 was a year of steady increases and a bunch of therapies tried, and failed. After my first chemo session of 6 cycles from 7/18/16 thru 10/31/16, along with 3 month Lupron shots and Zometa 4 times a year, my PSA fell from 658 at diagnosis to nadir of 1.25 on 12/19/16. So the chemo did it's job the first go round, and after that treatment was concluded my MO rechallenged with Casodex from February 17 through May. PSA jumped from 1.25 to 56 in 4 months. So we tried Zytiga, and that began on 7/4/17. By the end of the first month on Zytiga, my PSA had held steady at 58, but then the next month it doubled and then doubled again in September, so he stopped it and tried me on Xtandi. Bad idea- it made me very sick. Horrible fatigue, bad blood work numbers, and PSA doubling every three weeks - by November we were at 545. So beginning of December he decided to go back to Docetaxel for ten cycles, but my blood work was so bad (rbc around 5.5) I had to have two separate transfusions of packed red cells two weeks apart just to get the count up over 9. We started chemo back up on 1/22, hoping for ten sessions...PSA was 1400 when we started. After the first session, blood work showed PSA doubled again to 2755, then last two cycles it has decrease to 1425 and then again to 1124...not exactly staggering results.

I am on the following for pain management- 15mg ER Morphine twice a day

15mg Morphine IR for breakthrough

10mg Norco with Tylenol 2 pills, 4x a day

600mg Ibuprofen 4 x a day for inflammation

Still on Lupron every three months, Zometa every 6 weeks. Prednisone 5mg twice a day.

Flomax for urinary issues.

The first three sessions the recovery from the chemo was about 7-8 days...constipated and no real appetite but it was gone by the 8th day. This session, it has been 12 days and I am still really tired, not much appetite, and just a general feeling that I am just sick..if that makes any sense. There is an underlying feeling in my body that something just is not right....

MO is doing genetic blood work on the 16th after my nagging, he should have done it months ago in my opinion.

[gusgold]

The big mistake was the 4 months casodex and letting your psa go from 1.25 to 56...should have been put on Zytiga or Xtandi .....at PSA 56 you have a lot of cancer cells that are castrate resistant...you should be tested for AR-V7...the chemo might turn AR-47 off and Xtandi might work.

Gus

[ontheroad589 in reply to gusgold]

Gus

That is the goal - use the genetic tests to see if the AR-47 was a factor in the xtandi and zytiga both not working.

I agree he waited too long to do anything different after the casodex failed after Nadir...feels like we lost control of the cancer and will never catch up.

[MontyB]

Messaged you.

Take Care,

Monty

[Hidden]

You’ve been on the rough road with APC .. I hate to hear that you’re in such pain and in need of so many meds.... Sorry , I don’t have answers . I can only offer my prayers in hope that something good comes your way soon.. God bless you...