Docetaxel

[westjl2]

I had 6 sessions of Docetaxel in 2016. My PSA dropped to 1.5 and stayed there until it started rising again last year. Now is 11. My urologist said that they may give me Docetaxel again. I thought that a person could not take it a second time around? I see my oncologist January 31 who will advise me of options.

Has anybody gone for a second set of rounds of Docetaxel? If so were the side effects the same as first time?

Thanks,

Jim

[Tall_Allen]

You can keep having docetaxel until it stops working. When it stops working, you can try cabazitaxel (Jevtana).

[westjl2 in reply to Tall_Allen]

Thanks. That is good to know since I responded Well to Docetaxel last time. Usual side effects of bad 4th to 7th days after the Wednesday chemo and increased fatigue as the 6 sessions went on. But overall it was not as bad as some experienced.

[ITCandy]

Are you still in the Titan trial? I recall you were getting some nasty rashes which I remember was an observed side effect of Apalutamide so I'm guessing that you may have received the drug and not the placebo. If that's the case and you progressed, perhaps other second line ADT may not work and Docetaxel could be effective in knocking down your psa. I would definitely ask questions and explore all options.

[westjl2 in reply to ITCandy]

Thanks for your reply! Yes the rash got so bad again that last week I had to stop the Titan trial again (this is the 3rd time I have stopped) and am taking prednisone for 10 days to get the rash under control. I will probably go back on the Clinical Trial after 28 days but if I need more chemo I may no longer qualify for the trial. I would be all for more Docetaxel to knock that PSA back down it’s 🐀 hole. I took it well last time...although had to finally quite work by the end as the fatigue got too bad.

I have had 2 good retirement years since Chemo and Bone Mets are stable. Still on Lupron as well. But the PSA is now doubling ever 7 months so something needs to be done.

[westjl2]

I definitely want to keep on the Apalutamide as long as possible. The Titan Trial is evaluating how effective it is on men like me with MPC. Since I have never had radiation I am willing to take that risk with the scans. I am now on a 4 month cycle for scans...the next ones being February 5. For me the advantages of being watched closely outweigh the risks presented from the scans. But the trial will not last forever. I am anxious to see how successful it is on holding MPC in check...and for how long.

This is from the The National Center for Biotechnology Information: "Apalutamide is a novel antiandrogen that has been recently approved for men with nonmetastatic CRPC; its ability to improve MFS and time to symptomatic progression were demonstrated in the Phase III SPARTAN study. Resistance to newer therapeutic agents will inevitably arise, and potential mechanisms of resistance for apalutamide are already being delineated, specifically AR mutations. Both continued follow-up of SPARTAN and additional studies are needed to better understand how apalutamide will make the largest impact in the management of CRPC in terms of sequencing and potential use in drug combinations."

[dlestercarlson]

I had 13 rounds of docetaxel last year, then took a 5 month Chemo break. We started the Chemo again in November and just had my 4th treatment yesterday. I'll have 2 or 3 more then go on a Chemo holiday again for a couple of months till my Psa starts to rise again. It seems to be working the second time. Going the 13 months was too long the first time because I became really toxic . But we live and learn.

Good luck with your treatments.

Dennis Carlson

[westjl2 in reply to dlestercarlson]

Thanks Dennis...what was your PSA when you started up chemo again in November? What do you mean by being "toxic"?

[dlestercarlson]

My PSA had jumped up to 19.45, the highest it's ever been. Once you start the Chemotherpy, the drug builds up in your body each time you get another treatment. By the time I did the 13th Chemo treatment the last year, the docetaxel had built up so much in my body that after the last treatment, that I 0thought I may well have been dead. I've found that drinking lots of water helps flush the toxins from your kidneys and body. The new plan where I take the Chemo holidays more often will give my body a rest, get rid of the toxins, and keep the docetaxel working longer. Of course it's always kind of a guessing game with this cancer.

Good luck

Dennis

[westjl2]

Update....saw my oncologist. Got some good information...but a bit disappointing. She prescribed Zytiga.

1. She said if I get more Docetaxel now that Zytiga and ztandi may be less effective so I should wait to get more chemo after exhausting Zytiga.

2. She said that if I was in fact getting the Apalutamide, that the Zytiga May be less effective now. 😢

3. She said that xytandi is very similar to Apalutamide so I may get that rash again.

So I feel like some of the bullets left may either be blanks or just .22’s instead of 8mm☹️

But will keep soldiering on and enjoying every day to the full. 😉

[westjl2]

Just one more update...I found out that I was on a Plecebo!! So the rash was from something else. And they have closed the Titan Study and moved everyone who wants to onto Erleada. I do not qualify since I am already on Zytiga. But hopefully it will be another option down the road.