I posted here in early August that my PSA had fallen to 2.33 from 16.51 in January, after 38 fractions of radiation + Cassodex + Eligard.
In early October, my PSA has risen to 8.7 and a PSMA test has indicated several extra mets to bones and left shoulder. A small nodule in the left lung as well.
What should I take now ?? Zytiga or Chemo ?? Or both. If both, why so ??
Many thanks for any help offered.
Chemo - because of the visceral (lung) met and the other distant mets. Men with multiple mets had more survival improvement with docetaxel compared to men with fewer mets. Also, you can finish 6 rounds of docetaxel and move onto Zytiga in just 18 weeks, whereas if you start with Zytiga, it may be several years before you can move onto chemo.
I actually did both but Tall’s suggestion is a little safer way to go and if you can start Zytega in just 18 weeks that’s not bad.
Schwah
Thanks very much, Tall_Allen.
Is there anything that one takes along with the chemo to mitigate its side effects ?
Thanks again for all the help.
I've heard that ice bags for the feet and hands can help prevent neuropathy, and sucking on ice chios can help prevent dysgeusia. They make scalp-coolers too to help prevent hair loss. But that's a LOT of cooling - so make sure you have some warm or heated blankets to keep your core warm.
Some MOs give Leukine prophylactically to prevent neutropenia, others give it when there is a sign it's needed.
Thank you very much, Tall_Allen.
I did what Allen suggested above in addition it is good to have a mild laxative on hand, as well as some immodium, I ate smaller meals to prevent constipation immediatly following infusion , kept fingers on ice to prevent fingernail problem. Watch your blood numbers closely, and if you get a fever of 100.5, call the doctor even if it is in the middle of the night. I never had any real problems with 6 cycles of docetaxol.
Thank you very much, Dan.
Hi I posted here a while ago about my chemo experience. Unfortunately I didn't do any icing, my hospital 'doesnt do that' and as a result I have mild peripheral neuropathy in my feet. Vandy69 posted here that B6 helps with this.
The other key things to do IMHO
1. Diet. I am on a plant based diet. Hasn't slowed down disease progression but all health indicators improved significantly (cholesterol, triglycerides, blood pressure all reduced). You want your general health to be as good as possible before you assault your body with toxic drugs like docetaxal.
2. Exercise. Do as much as you can. Exercise mitigates against fatigue. It seems counterintuitive but the more exercise you do the less fatigue you get. If you feel tired dont lie down get on your feet or on a bike or whatever it is that you do.
Fasting. I fasted for 2 days prior to chemo day of chemo and day after chemo. Theory is that when you fast like this, normal cells go into hibernation and suffer less from chemo toxicity.
I went through 9 cycles of docetaxal, no nausea and no fatigue. Even though I was walking 6-8 Kim a day I managed to put on 9kg of weight while doing chemo. Prednisone is the enemy of a trim body.
Good luck and keep fighting!!
Thank you very much, Hazard.
We were just at a seminar where the preventative measures for chemo were discussed. The nurse mentioned that bags of frozen peas are excellent for use as chemo ice packs.
There was also a daughter on here who organized a wonderful post with suggestions for chemo prep so if you search chemo preparation or something to that effect it would be helpful to you.
The nurse also could not stress enough that a chemo patient needs to stay well hydrated. Sometimes can request IV fluids beforehand.
Thanks very much, mjbach, much obliged.
I just finished my 3rd infusion of Docetaxel and so far it has not been to bad. I do ice my feet and hands and wear a cooling cap. I have not had any neuropathy but my hair did start to fall out. I got a crew cut and while it is thin it still covers most of my head. I also keep ice chips in my mouth to help with taste buds. I do have some fatigue days 3 and 4 after an infusion but if you can force yourself to do something active, it really helps to mitigate the side effects. They give me Zofran and steroids to reduce nausea as well which have worked out well. All in all, I anticipated more side effects than I have actually experienced, so keep a positive attitude, keep active and before you know it it will be over.
Thank you very much, kmack57. My first ever session of "chemo" is scheduled for Tuesday, 23rd October, 2018.
To be completely honest, when I was detected with metastatic prostate cancer in late February, 2018, I never thought that I would be stricken by several mets and would be headed for "chemo" just 6 months later. Live and learn 
Cheers Guys.
Tall_Allen, you mentioned that there may be a multi year wait to move to Chemo after you have had Zytiga. Why is that?
I am currently on Zytiga, but it is having very limited effect - at 6 weekly intervals PSA has gone from .86, to .81 to .76
When that finally fails, I had assumed I would be heading for Chemo. Being in Australia, I cannot move to Xtandi, Apalutamide or Provenge, so options are limited.
Appreciate your advice.
Chas
My husband had 7 chemo treatments and then 4 months later put on Zytiga and then 4 months later Zytiga quit working and had 3 Provenge treatments then 1.5 months later was back on chemo again and had 6 chemo treatments. His last treatment was Sept. 20th and he just this week started Xtandi and then next month he's starting Xofigo treatments.
Zytiga Not Working
Xtandi v Zytiga v Docetaxel
Zytiga 
Cassodex OR Zytiga????
Chemo with docetaxel?
