Previously on HealthUnlocked ... I started ADT in May 2017 with PSA of 7.5 and a single positive lymph node in the pelvis. 2nd line ADT (Casodex) started in Nov 2017. By Christmas PSA was 47 and I had 5-10 lesions in liver and multiple spots in the mysentry. I was scheduled for 10 rounds of docetaxal starting 29 Dec 2017.
This week - I got results back after Round 5. Thankfully I am getting a good result so far.
PSA after Round 1. 24
After Round 2. 7.8
After Round 3 3.6
After Round 4. 2.8
After Round 5. 2.0
I am going to Peter Mac tomorrow for Round 6. So far, I have tolerated chemo well, I have been putting on 5kg between each round (prednisilone makes you hungry!!) but I fast for 4 days around each infusion, and lose the weight again. Only issue is peripheral neuropathy in my toes. It started after cycle 4, it has not abated since cycle 5 (20 days ago) and MO debated whether to delay tomorrow's infusion. I said - no way - I would rather have neuropathy than PCa. MO said that that is response from most people and agreed to go ahead. Said that first 6 rounds are important, and we can space out the next 4 rounds if neuropathy doesn't improve.
So the trend is in the right direction, let's see how long it lasts.
But this damn PCa seems to come in many flavours and you never know what will happen next. I had blood taken for DNA repair tests, no defects were observed so there is no specific treatments I can use based on this. MO advises that next treatments are likely to be hormonal - abiraterone or enzalutamide I guess. But since I am already hormone-independent I don't know how much this will help. Since I failed ADT within 3 months I asked MO if I have ARV7 splice variant. He said that not likely otherwise I wouldn't have such a good response to chemo. And since I have visceral mets but no bone mets I also asked does this indicate neuroendicrine differentiation - same answer, not likely based on good response to chemo. So I asked - what is cause total resistance to ADT and PSADT of 1 month, prior to chemo. And the answer was - we don't know. So what are we gonna do next? Well, we will just try a few other drugs .... I would love to think that doctors know what is going on and treat the underlying issue but for the meantime its just routine standard of care treatment. What else can you do?