Chemo (docetaxel) and the PSMA 68 GA PET-CT scan

[whatsinaname]

I will be taking my sixth cycle of chemo (docetaxel) 140 mg on the 4th of February, 2019. Should there be a certain number of days that should pass before I take the PSMA 68GA PET-CT scan ?? So that the effects of the chemo are not too pronounced ?

I was thinking of taking the PSMA 68GA PET-CT on the 9th of February, just 5 days after the chemo on the 4th of February. Please advice. Many thanks in advance.

[Tall_Allen]

Are you tracking progression? I'm not sure if the PET scan can detect anything that soon after chemo. What's the rush?

[whatsinaname in reply to Tall_Allen]

No rush really. But, if I wait the MO is almost certain to extend my 6 cycles of chemo to 10 or even 12. They are fairly mercenary here in Bombay, sadly.

Also, if the chemo is not helping, then why infuse more poison into my body ? Why not switch to Xtandi or Zytiga ?

How does one track progression ? The mets increased greatly between the middle of Jan, 2018 and the middle of October, 2018 despite Casodex, Eligard and 38 fractions of radiation. I have been on chemo since the 23rd of October and continue with Eligard.

Thank you for replying to me & please once again let me know what you think.

Cheers, Tall_Allen.

[Tall_Allen in reply to whatsinaname]

The first line is the biomarkers - PSA and bone alkaline phosphatase. If they are increasing, then imaging may be informative.

[whatsinaname in reply to Tall_Allen]

The PSA levels are neither rising nor falling. The "bone" alkaline phosphatase levels I must check. I'll report back in a while.

Thanks again, Tall_Allen. You are THE BEST.

[drsridhar53 in reply to whatsinaname]

Very similar to my story. Six months each of Zytiga and Xtandi proved a waste of time...PSA went up from 4 to 12. In Nov 2018 PSMA G 68 showed widespread malignancy, PSA 12,8 but not so much in the bones. Doc at Apollo started Chemo with reduced Taxotere, only 110 mg per sqm. There was a remarkable improvement of pain and discomfort in the soft tissues around throat and neck almost immediately. But Taxotere is hard on the body!!! I am through 4, and shall be having 6 by mid Feb. Doc wants PSA taken only six weeks after the 6th infusion.

[whatsinaname in reply to drsridhar53]

Hi drsridhar53,

Has your doctor firmly decided that six cycles of Taxotere is all that he wants to give you ?? My doctor has told me maybe eight or ten or even twelve infusions depending on how I feel and how well I tolerate it. Also, PSA levels will be considered and most importantly the PSMA PET-CT scan as to whether the mets have increased, decreased or remain the same.

Had I taken my PSA levels more often (not listened to the doctors) I would have realized that my PSA had almost trebled in under 2 months earlier. A PSMA PET-CT scan then showed that the mets had increased a lot. I could have started on Taxotere earlier. I will now do the PSMA PET-CT scan about 14 days after finishing my sixth infusion of Taxotere on the 4th of February. PSA tests I will do every 10/12 days or so. Since, I am not on insurance and pay for everything myself, getting the tests done does not depend on the doctors recommending them or otherwise. I can arrange for the tests to be done within 48 hours usually.

Good to know that your pain has decreased with Taxotere. Hope it continues that way and maybe even improves further.

All the very best.

[drsridhar53 in reply to whatsinaname]

I am not sure if chemo, particularly Taxotere works so sure shot with CA Prostate as it does with with other cancers. If it shows no reduction of PSA and no improvement in the PSMA G68 scans is it worthwhile Continuing? Oncologists fall back on Chemo when nothing else, e. G. Zytiga Xtandi work. It seems to me a matter of desperation. But then what is the alternative?? The sobering thought us that none of the "new" Medicines extend life by more than 5 to 8 months on the average on trials. CA prostate is a slow killer. You live on because it is slow not because of the treatment.