Deciding on Chemo or alternatives ? - Advanced Prostate...

Advanced Prostate Cancer
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Deciding on Chemo or alternatives ?


I'm new here. I have recently progressed on Lymparza which lasted 3.5 months and was never really very effective. Prior to Lymparza I was on Abbyaderone for 11 months. My Oncologist has mentioned Chemo as the next standard of care for me. I'm wondering how effective it will be relative to the side effects from using it. Can anyone tell me their experience with Taxotere ? I have read that if you have a negative ARV7 test that Enzalutamide might still work. If I have a negative ARV7 then perhaps I could get a few months from Enzalutamide before starting Chemo. Can anyone comment on that sequencing strategy? My doc seems to be pushing me toward Chemo.

14 Replies

I’m one of those guys who has moved from a abiraterone to enzalutamide (with a detour through radium 223). I’m about six weeks into the enzalutamide, and my PSA is falling. Does your MO specialize in urogenital cancers?

Hello Yost,

Thank you for your reply. Great news that you PSA is falling.

I'm curious if you have had Chemo therapy in the past and if so how did that therapy work for you? It's my understanding that ARV7 status can be predictive of the success or failure of enzalutamide vs Chemotherapy. I'm at the crossroad of choosing Chemo now or seeing if i can get any mileage from enzalutamide or other medication first. I have a rising PSA and feel a great deal of urgency to make this decision fast.

My MO is Dr Alan Bryce from Mayo Clinic in Arizona. He specializes in prostrate cancer. I think Mayo is a relatively conservative organization and tends to sway you in that direction as well. Dr Bryce is saying my next line of therapy is most likely Chemo.

I am just a bit conflicted because of the stigma of Chemo being the drug of last resort. I'm learning now that may be a false perception and that the earlier you get onto Chemo the better the results. I just don't want to miss any opportunities that may be available to me at this juncture.

Thanks for your interest and input! Carl

Earlier chemo is being shown to be successful. I have not had chemo yet. I’ve been on this journey for a number of years, so I’m a guy for whom chemo is a late treatment. If I were newly diagnosed, I would definitely consider it.

Thanks Yost. I appreciate your input.

The two newest "fads" are;

1. Starting the show with lupron and chemo.

2. Starting the show with lupron and Zytiga.

3.5 years ago I had them pump me full of chemo right off the bat. What a blast!

Had my wife give me a buzz cut and went out and bought some cool looking shades to wear. (It was summer). Never once puked, etc. I continued to maintain my normal exercise routine, etc. I continued life as usual. The best part is the chemo really worked. It carpet bombed my entire body, I could feel it killing everything in sight.

Other men have a bad reaction to chemo. Sick, weak, can't hardly eat, etc.

Good luck with your choice, I'm sure other members will give you links to the treatment methods I typed up there.

Thanks Bill. Good to hear that you got and continue getting a good result from the Chemo early on. I have not been exercising for almost nine months due to the bad experience with Lymparza. It made me so weak and stiff that I could hardly get around. I'm usually a farily athletic person with biking and hiking and work outs three times a week. Now it's sitting and TV most of the time. Since stopping the Lymparza I seem to be recovering my strength and feel like I could get back into the swing of excercising. Hopefully, if I go onto Chemo it will not hold me back from being more active.

I didn't have any problems with chemo. I will do it again if it can help me.

Chemo really helped get my PSA down to .19 and pretty much eliminated my pain. I wouldn't be afraid of chemo, it may be the best treatament available for you right now. It might also resensitize you to ADT drugs.

From what I've read, there are better chances switching from abiraterone to enzalutamide than the other way, but in general there's cross-resistance between the two so you might not get much out it.

Good luck with your decision.

Thanks Gregg, I'm starting to get more comfortable with the idea of starting Chemo next. From what many are saying your point regarding reactivating Abby or enzalutamide after Chemo seems to be pretty well established. It's really a bonus in a way. All the best to you on your journey.

Well, that is from my point of view a difficult question and difficult decision to make.

Maxybe just a few thoughts...

The side-effects of Zytiga and Xtandi can be difficult to tolerate as well as the side-effects of any Chemotherapy treatment.

Your body will probably tolerate the Chemo better the sooner you start with it. A few months more on any other drug may further weaken your whole system and perhaps the cancer then has time to spread to other parts of the body.

My husband did not tolerate Taxatir well at all. But then I have heard from many people - also here on the forum - that they didn't have many side-effects at all.

Good luck with whatever you decide.


Thank you Mel.

Chemo is working for me. Had to do something. Pelvic pain increasing, PSA ran amuck 2 months after all Radium 223 treatments finished. After 2nd Chemo, PSA dropped a little, then after 3rd when from high 20's to 10, and pelvic pain went away and I can walk without a limp. Side effects were minimal. Side effects are exaggerated on the internet, but still no cake walk. Question is, what happens after Chemo fails? Perhaps I will get a good remission before it fails.

Thank you for your input and I hope you have fantastic long lasting results from your Chemo.

Good Tuesday Morning Carl,

I have been in this battle for six years (please see bio for complete treatment history).

I went through all drugs first, then radiation, and most recently chemo with Docetaxel/Carboplatin. Chemo dropped PSA from 10.8 to .4 and reduced lesions in liver.

Now using Xtandi as a rechallenge after chemo and, by the grace of God, it has been working for the past 4 months.

Best wishes. Never Give In.

Mark, Atlanta

Thank you for your response Mark. I'm so happy to hear you are having good success with Xtandi after Chemo. That's great news!

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