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Chemo treatment/What happens after chemo?

Hello all. I hope everyone is doing well. Just wanted to give everyone an update on my husband. I had to take mike to the emergency room Sunday afternoon because he was having shortness of breath and thought his hemoglobin might have been low and he might need a blood transfusion (he’s already had 3). They doctor did a blood test which his hemoglobin came back good however he was worried that he might have a blood clot. The docs did a CT scan with contrast on his chest, which i immediately panicked Mike requested if he could also have a CT scan with contrast on his pelvic area which is where the majority of the cancer is. Good news is that there were no blood clots, I had to call his oncologist to find out the results of the CT scan with contrast on his pelvic area and if his chemo therapy was working. Yesterday we got the best news that we received since his diagnosis his oncologist said that his treatment for only being the 3rd round is working his cancer when he first came in was in size 2.1 centimeters and now it’s 16 millimeters. Since the cancer has metastasized to his bones we’re anxious to find if it’s gotten smaller there too so they scheduled a bone scan for next week. Mike is also on hormone injections every six months and casodex. His pain level has gone from a 10 to a 2-3 so he is responding very well to his treatment he gets severe hot flashes and some fatigue. So what happens after his chemo treatment is done he has another 3 rounds to go and it seems like his treatment is working very well so once he’s done what happens next? to keep his cancer is under control and doesn’t spread. Since his cancer has gone down in the pelvic area has it gone down in his bones too?

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Sounds like good news for him! My husband started Zytiga + Prednisone after chemo. He had a good response to chemo and has continued to have a good response with Z+P. He finished chemo a year ago and has been on Z+P since last March. He has also been on lupron throughout. I'm sure your MO will offer a next step after chemo is finished- I'd ask what the MO is thinking of for choices after your next 3 rounds. Enjoy the great news!

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I have just completed 6 cycles of chemo (docetaxel). I have been asked to do certain blood tests + F-18 DCFPyl scan to evaluate whether the chemo was useful. If the MO judges that the chemo was useful, he will ask me to do another 4/6 cycles of docetaxel.

If the chemo was not that useful, it will be Zytiga + Prednisone or Xtandi. I don't think I will be given a choice of Lu-177-PSMA-617.

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So happy for you both that Mike is responding well!

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That's wonderful news, you must be thrilled.

I am not sure about the current protocol, but I believe that your husband will have a break from Chemo after the sixth round of maybe two months or so and then do another couple of rounds. Or, if he hasn't had this already, he might be changed to Zytiga afterwards.

Let's see what the bone scan shows and how much or little the bones are still affected.

Best wishes and keep posting.

Mel.

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Is your husband still experiencing SOB? If so ask the doctors to test his lungs to see if the cancer metastasized to the lungs. Initially that got missed on my husband as nothing was showing up on an x-ray or CT scan. His SOB was a slow onset and gradually became worse as time went on. To the point he was in respiratory distress his O2 was down in the 70's by the time he was rushed to Emerg. After 3.5 weeks in the hospital and numerous tests, it was discovered during an angiogram that the cancer micrometastisized to his lungs. That means it spread like sand particles, so it doesn't show up on any scans.

My husband went on cabazitaxel which he responded great to, but was short lived.

Praying for you and your family!

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Thanks for the information I will ask. They did do a CT scan on his chest to look for blood clots and there weren’t any. I will call his oncologist to ask. My husband also has neuroendocrine differentiation on top of being dx with advanced PC with bone Mets. Which means he’s not producing enough white blood cells which is why he has the shortness of breath and had to get his hemoglobin checked when this happens if it’s below a 7 he had to get a blood transfusion. Since being diagnosed in November he’s had 3. The doctors say his Chemo treatments will make his white blood cells go down especially a week before he starts treatment. My husband goes to chemo every three weeks 6 treatments total he’s already had 3. They have him on carboplatin and etoposide one day one and days two and three on etoposide. Along with the hormone injections tralstar and casodex

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Great news. Fight that monster 🙏🙏🙏🙏

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Tell him to save his breath so he can give you a gigantic kiss tomorrow on Valentines Day.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 02/13/2019 2:51 PM EST

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Has his alkaline phosphatase trended down? A possible sign that cancer in bones has also trended down. I did 8 cycles taxotere and then straight to Xtandi. I think most go straight to Zytiga. All depends on your particular situation. You will surely have a bone scan after chemo. My alkaline p. went from a little over 200 to 63 last month. (2 years out) Best wishes.

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Have you asked your husband’s MO what the plan is after chemo? My husband is exactly where yours is treatment/time-wise and we just asked his MO at MD Anderson the other day this very question. (My husband also has SOB issues but he does have lung tumors.). The projection is to keep doing chemo as long as it keeps working and for as long as his body can withstand it. After that, potentially a few months treatment break then on to another type therapy, possibly Lu-177 trial or some other trial. It is also conceivable that they would order another type of chemo down the road or some radiation of tumors. At our last visit, Dr Corn did mention doing a biopsy of one of the lymph tumors in order to get DNA testing done on the cancer. Presumably, any results from such tests would aid in choosing the direction of future treatment. It is good to hear that your husband’s chemo is working and that his pain is greatly reduced. Blessings for continued improved health and prognosis.

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I did talk to my husband oncologist and she saw no tumors/cancers on his lungs. His SOB is due to the neuroendocrine differentiation that he has which causes him not to produce as many white blood

cells. So when he has SOB he has to go and get his hemoglobin checked. My husband goes in for a bone scan on Tuesday to see what’s going on so far into treatment since his CT scan showed good progress and we see his oncologist on the 25th of this month.

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Hi

Your husband had some good news

Good on him

My husband could only tolerate 2 of the six chemo treatments

But even now in conjunction with daily oral Cosudex and 3 monthly zoladex injections his PSA has remained low

His metastastases are extensive

Skull to knees in most bones

He feels well aside from fatigue and severe flushes

Pain controlled with Targim low dose morning and night and the occasional endone

Every day I read something new on the table

My husband is trying to keep his life as “normal” as possible

I wish you all the best

It’s so wonderful to have this site

People are kind

People want to help with comparison of drugs and responses

I have found this site to be so helpful with the anxiety surrounding this disease

Take care

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The palliative Doc gave me Venlafaxine (Effexor) and the hot flashes have nearly disappeared, if that helps.

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I will ask his oncologist about it..thanks

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I've had my Oncologist do that, but if possible, might want to go straight to your palliative MD , even if you have to make a phone call. Hot flashes are aggravating but avoidable.

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