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Advanced Prostate Cancer
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Third Round of chemo

Maybe it’s the combination of Eligard and chemo or maybe it’s that each round of chemo gets tougher? This round I feel really rough for the third straight day. I have the next two weeks to recover before the 4th round out of 6. I would love to hear others experience so I can get some idea of what I can expect the next three rounds.

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Rick , had 6 rounds of taxotere, the chemo wasn’t bad but the dread was the Neulasta shot the day after it put me down . Hang in there it got easier for me except for the anxiety. Fight that monster 🙏🙏🙏

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Thanks! I am not getting a Neulasta shot, I will ask about that.

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The Neulasta shot or PEG GRAFEEL 6-mg shot as it is called here in Bombay is absolutely necessary to keep the bad effects of chemo to a minimum.

It is usually administered within 24 hours of a chemo infusion.

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The chemo does build up each session - sorry to say. Do all you can to rest. The first week is usually the worst and then the next two weeks are OKish.

If you are feeling really depleted, your blood counts might be going down and Neulasta is meant to counteract that - so worth checking.

Note -- they push Neulasta because it's only one long-acting shot (that's good in most cases!) but my husband felt too bombarded by it (it was a few years ago so I can't recall exactly) - but he actually requested to get Neupogen, which is the same medicine in single-day doses. It means going back to the doctor to get the shots each day - up to 10 days, but he only went for 3-4 until he started feeling better. Onc was OK with this. And it seemed to do what it needed to do, although my husband is always on the low/negative end of blood counts.

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Thanks for the info on Neulasta and the effect it had on your husband, Caring 7. Yes, the purpose of Neulasta is to stimulate the growth of white blood cells which are diminished by docetaxel (chemo).

A google search says that Neulasta also decreases the incidence of infection by treating neutropenia.

Thus far, I have had no problems at all with Neulasta, touch wood.

Thanks again and Cheers, Caring7.

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I have had 4 cycles of chemo (docetaxel) thus far. I have had no nausea at all, no pain in the fingers, legs and feet, no dysentery, no loss of appetite at all, no incontinence at all.

But, hair on the head is falling (50% gone).....still not bald because I had a good crop of hair. If the falling hair continues, I will be bald shortly. The quacks say it will grow back, but I am skeptical.

I still have two more cycles to undergo, maybe eight more, depending on the results as well as how well I tolerate the treatments, soooo I am keeping my fingers crossed.

All the very best, RickW.

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My husband lost a good head of hair but it did grow back . It was curly when it regrew and still is . Took a couple of months to come through after the chemo finished but looks good now . He had to resist shaving it off at first , he had got used to being bald !

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Thank you for that piece of information. If my hair eventually grows back, I will be delighted. Provided, of course, it grows evenly and is mostly the black color that it was. Beggars cannot be choosers, I figure :-)

While I am not cricketmad, I follow cricket avidly. It is a real pity that Australia (now) and the West Indies (for some time now) are not the forces that they once used to be.

Thank you once again, cricketmad, for the dope on hair growth after chemo. If it is so difficult for me (at 62+) to suddenly lose ones hair, it must be terrible for women on chemo. My heart goes out to them :-(

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My hair fell out before the second round. I am just exhausted all day and I am not sure if I can keep working.

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Hi RickW,

My eight hour session of chemo goes like this : a) 2 hours of solid hydration (taken intravenously). b) 2 hours of anti-chemo medicines (taken intravenously). c) the actual chemo (taken over two hours intravenously). d) A final round of hydration (over 2 hours intravenously). The next day, within 24 hours of the chemo infusion, the Neulasta injection is administered by my local GP.

Then there a whole host of drugs, ointments, gels that my MO has prescribed in case of necessity. So far, I have not really had to use any of them.

Yes, getting tired usually happens. But, its not that debilitating, usually.

I wish you all the best for your future cycles of chemo. Please talk to your MO.

Cheers, RickW.

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Whatsinaname, Are you combining with Eligard? Maybe that is why I feel so worthless?

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Yes, I have been continuously on Eligard since the 12 of March, 2018 till date.

First, Eligard 22.5 mg for 3 months (12 March, 18 to 12 June, 18).

Then Eligard 45 mg for 6 months (12 June, 18 to 12 Dec, 18).

Then Eligard 45 mg for 6 months (12 Dec,18 to 12 June, 19).

My first cycle of Chemo-- docetaxel began on the 23rd of October, 2019.

I think the main reason why you are feeling so screwed up is that your MO has not been giving you proper hydration (before & after chemo) & more importantly he has not given you anti-nausea, anti-dysentery etc, etc, drugs intravenously. Also, you have not taken the Neulasta injection after chemo. A secondary reason could be that chemo + ADT affects you more than it does others. This can happen as we react to different drugs differently.

Please talk to your MO and see what he says.

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I lost eyebrows and eyelashes. They never grew back due to lupron.

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Yes, Sir, that is why I am skeptical about people telling me that I will grow back ALL my fallen hair :-)

It might happen. Or it might jolly well not happen. No one knows much about this disease anyway.

I too have been on Eligard since the 12th of March, 2018 continuously. However, Eligard caused no hair loss for me. Its only this bloody chemo that's screwing up things.

Cheers, Lombardi24. Things could be worse :-)

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My husband has had male pattern baldness for a long time (since a pretty young age) and had hair transplants. He lost his hair around taxotere #2 but it grew back. he wore a hat and had a little fringe of hair in the front and back. he did lose eyebrows and armpit, chest, general body hair -- he was medium "swarthy" -- the hair on his head grew back, no problem, though it went through two phases. During the first his hair was like a model's -- he liked that! Then it got kind of curly.

Much of the male/testosterone fused hair did not grow back -- kind of early puberty amount of hair now. He did taxotere very shortly after starting Lupron (less than a year) so it's hard to know what was chemo and what was hormone deprivation. My guess is the chemo accelerates the hormone-related hair loss and then it can't recoup.

We had a bit of fun finding him hats . . . we take what we can get for fun.

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Thanks for that information, Caring7.

Yes, it is essential to have a good sense of humor when dealing with these kind of problems :-)

All the very best, Caring 7.

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I had 13 rounds of Chemo before I went on a Chemo Holiday. What I found that the first was pretty bad and towards the end it got worse, especially 12 and 13. I think mainly because your body gets more toxic 'with the more rounds of Chemo you have. I just started up again and last week had my 3rd round of Chemo for this cycle. My doctor is planning to do the Chemo for 3 months then give me a 2-3 month Chemo Holiday and then do it again. I think that this is a good plan. I've found that once I understand the side effects, I can prepare ahead of time so that they are not so severe.

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Excellent strategy, dlestercarlson. But, is the chemo actually helping you ?? Meaning, is the cancer getting killed ?? Is your PSA falling ??

For all the toxicity that one imbibes through chemo, is there any visible, verifiable payoff ?? Otherwise, why go through it at all ??

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Rick I did six rounds of Docetaxel, my infusion day way Wednesday and I felt pretty good on Thursday, then started to feel fatigued as the days went on with Sunday being the worst. Then things would improve from there and by the next Wednesday I felt pretty good. Kevin

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Kmack57, were you combining with Eligard? I have taken Eligard on and off for the last 24 months and it kicks my butt, maybe my fatigue is from the Eligard?

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I am on Lupron, have been for about 7 months now.

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I had 6 rounds of taxotere back in 2015, each round got tougher, especially the last two. Felt like a really bad case of the flu, lost all hair, finger nails got loose and discolored, mouth sores, chemo brain, etc. I was also given Neulasta which is used to stimulate the production of white blood cells so your immune system doesn’t get wiped out. It causes really bad aching in your bones because the marrow is working overtime. 24 hour Claritin available over the counter helps tremendously with this, it was a tip from the onco nurse, worked really well. Neulasta does not relieve the other side effects of chemo.

My hair grew back better than ever, however I still have SE’s from chemo, neuropathy, immune system damage, etc. but PSA remains undetectable and I’d do it again if I could go back and we’re given the choice. Hang tough you’ll get through it!

Ed

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In my experience with taxotere, it got a bit worse with each cycle, so that by the 6th, I was overjoyed to be done and swore I'd never do that again. But hey, my PSA has been undetectable for a year, and if need be, I'll agree to go through it all again in a minute. Neulasta wasn't necessary for me, and while I didn't have real nausea, my stomach was a bit unsettled at times. It is REALLY important to stay hydrated. I had trouble doing that despite my best efforts, since even plain water tasted horrible to me. They started IV fluids a couple of times between cycles after about the 3rd. My hair grew back (curlier and grayer), fingernails and toenails are back, and about the only side effect which is still with me a year later is just a bit of tingling in the bottoms of my feet. So hang in there. After it's all said and done, the unpleasantness will fade from your memory, and the good effects will still be helping you fight this SOB disease.

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I drank a lot of those zero-calorie, fizzy flavored waters during and after chemo...at least there is some taste compared to tap water and it kept me hydrated.

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Thanks tallguy2 for the fizzy flavored drinks! That is exactly what I needed. Water is yuck and Gatorade too flat. The fizz and the flavor hits the spot.

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Rick, put your left foot in front of the right foot and keep moving on. Your choice is simple. Stay positive knowing that you are killing the bastard.

GD

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I had 8 cycles. About 3rd day feel crappy and stay that way for about a week. Does get a little worse after each one. And after 8th felt crappy for 2 weeks. Did not have to work during this. You are half way there! Was given dexamethasone tablets. For day before and day of infusion. Never used the nausea pills they gave me. Had Zarxio shots for 3 days after each of the last about 3rd cycle. White blood cell count had dropped to 2%. (Similar to Neulasta. And made legs ache even when you were just sitting. Hated them more than the chemo.) Fingernails were screwed up but ok now. Lost 2 big toe nails after chemo, almost ok now. Lost almost all hair but ok except for mustache. Have very annoying foot neuopathy that appeared after chemo was done. Imodium if you have diarrhea problem. But Lupron/chemo brought psa from 59.9 to 1.7 before last chemo. And now Lupron/ Xtandi has slowly brought psa to 0.2 for last 5 months. Was given 1 and a half to 2 and a half and then told many years. Been almost 2 years and feeling pretty good. So nobody knows. Just grab that tiger by the tail and don't let go.

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Hey Rick,

I know you may not think so, but you’re actually doing very well!

I finished a 6 cycles at 3 weeks intervals course of chemo in 03/2018 at the Mayo Clinic in Jax, FL. I didn’t do Neulasta, and my white blood cell counts never dropped below the threshold where my M.O. thought it was necessary. I also did it without the “cooling cap,” gloves, or booties...not sure if they would have helped minimize the hair loss, nail issues, and neuropathy, but you may want to consider them.

For me, the side effects were not fun, but they were tolerable and fairly predictable. I learned to expect them, and be ready to deal with them, using OTC meds for diarrhea, constipation, etc., and an Rx for Ondesetron for nausea, which was minimal. I even bought (and sometimes wore) some Depends for the periods I was more likely to have diarrhea. I usually felt ok for a couple of days after each chemo treatment, then slid downhill until I hit the nadir, where I felt like crap for several days, then started feeling better, with about a week of “good time” before I went in for my next chemo session.

The side effects did get worse with each treatment, with #5 & #6 being the worst and somewhat longer lasting. But, I was still able to golf and do normal ADL’s on my good days through the whole ordeal. I didn’t go bald, but I lost some hair along the way, but it has since almost totally grown back...with a little wave I never had before the chemo 😎. I had some brittle nail issues, also resolved, and some residual neuropathy in a few toes on my left foot and in my right thumb, also pretty much resolved, all within the space of under 9 months after finishing the course of chemo.

Everyone I’d different, so your experience may be somewhat better or worse than mine. Best wishes to you!

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Thanks Litlerny! So far my blood counts have been good. I remind myself that it could be worse. Good to hear you would do it again, that gives me hope. Golf in Florida now I am envious!

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Absolutely, Rick. You will be just fine. And, yep. I’m golfing 3 days in a row this week, so there is life after a Stage 4 PCa Dx and the related treatments.

From the posts in here, you got a good idea of what you might expect, and how to prevent or minimize the side effects. Hopefully, yours will be minimal. Best wishes to you while you finish the course of chemo.

My M.O. at the Mayo in Jax did not want to do Neulasta unless absolutely necessary. Like all drugs, Neulasta has its own set of caveats and side effects, and it is really expensive, although Medicare and most private insurance plans cover it. He mentioned a threshold level of WBC’s where he would consider it (sorry, but I can’t remember the numbers). He kept close track of my white blood cell and related counts through the chemo process, and ( without Neulasta) they never dropped into the danger zone. Like Monte1111 I got dexamethasone before each treatment, and was given dexamethasone pills to take on the 2nd day after each cycle.

God is great. Life is good. Have a great day! 😎 🏌️⛳️

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The effects of chemo are cumulative, but chemo treats each person differently. I took a nap just about every afternoon but limited the naps to 1.5 hours so I would sleep each night. I agree with other posts...the neulasta gadget costs 4X the chemo but probably kept me out of the hospital. It pumps up the white blood cell counts. It is one of those miracle drugs that you should be using. The side effects are easily managed with generic Alleve and Claritin.

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Thanks for the Extremely helpful tips! I will get through this one day at a time, it’s a journey!

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I lost all the hair on my head.... but I grew a full beard.... now trying to find out how to flip my head upside down (or downside up ---- whatever).

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 01/14/2019 5:54 PM EST

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Your comments always make me smile. Thank you!

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