Chemo again -- after all other treatments for advance PCa

[Caring7]

My husband is about to start taxotere again, about 4-1/2 years after he did the 6-courses at the beginning of his diagnosis. In the first two years he went through just about everything (Xofigo, Provenge, then Xtandi, and squeezed a few months out of Zytiga). Bugger cells have found their work arounds.

So what's up now? He's really bummed about "chemo for the rest of his life" (unless a clinical trial becomes available -- we're eyeing some -- or some new drug). Once again, no one seems willing to provide a prognosis of any kind. I get that but it also makes things hard to deal with in some ways.

Anyone else who has been here -- experiences, thoughts, whatever you want to share, much appreciated.

[dmt1121]

I have not been through as many medications yet, though I have been through chemo, Lupron and now taking Zytiga.

I think we all experience the feeling of finality of our disease more intensely than other times due to finding out about a failure to respond to medication, metastasis, etc. It is also very hard not having any kind of timeline to work with because most people are told is it could be many years. " I have a patient who has been on Lupron for ten years...."

We all know the statistics and what is being studying for treatment and we all know, that even today, progress is slow. In your husband's case, I would be inclined to get a second opinion from a prostate cancer team at a research hospital to see if other options out there that have less side effects and have a better success rate.

I hope you find something that will work for him and that your support will get him through the tough times. We don't know how much time we have, so I try to enjoy every moment and stay involved in life as much as possible. It is helpful to be involved in activities that are engaging to keep my mind off of the PCa.

Good luck!

[Caring7 in reply to dmt1121]

He does see an "uber-oncologist" and unfortunately that's the recommendation. Really, he's done everything! But hoping for a trial, maybe VISION after some of this chemo. Funny - I always recommend people find a research oncologist to work with -- so I think that's a great idea!

[NWLiving]

Bill did cabazetaxel and Xtandi after the first rounds of dosetaxel, lupron and provenge failed. He was diagnosed 4 3/4 years ago. The second round of chemo had more nausea and tired than the first. But we’ve had a good 6-8 months just on xtandi and lupron since then. He is not in pain and is active. His PSA has been slowly rising (1.6, 1.9, 2.3, 2.6, 3.4, 3.3 with monthly readings) so I’m anticipating chemo again at some point. Sooo, we’ve had some really nice months after the 2nd round of chemo. How is his health/activities generally?

[Caring7 in reply to NWLiving]

Activities are OK -- works part time, does stuff, but he has been more tired past few months. My suspicion is that round 2 of chemo will be harder on him but I need to just let go and let him go through it as he wants.

[Magnus1964]

Has he been on casodex? Also, has he been tested for gene therapy?

[Caring7 in reply to Magnus1964]

Casodex was a long time ago (sigh!) He has had gene testing and will get some more. Foundation Health found maybe a strand or two of BRCA2 which might qualify him for a stage 1 clinical trial down the road if a different genetic test shows something more definitive. Thanks for suggestions.

[Tall_Allen]

Which clinical trials are you considering? The VISION trial?

[Caring7 in reply to Tall_Allen]

Yes VISION. He needs this second round of Taxotere first -- partly because they'd prefer it, and partly because it will take months to get on VISION. We are hopeful for that trial though!

[TL1111 in reply to Caring7]

Can you please share more about VISION trial or a link? My father is also in the same boat. Has tried almost everything except Provenge because Foundation One found he didn’t qualify. Although his doctor said he can still find him the drug if he still wants to try it but he thinks it will likely not work on him.

[Stegosaurus37 in reply to TL1111]

Try ClinicalTrials.gov for info on VISION. I may be going on that if I flunk TRITON II. I'll find that out tomorrow. It is very frustrating when you try Treatments A-X and nothing works. I've only been on therapy for a year and a half and my cancer is resistant to everything.

Just keep on keeping on. Remember, attitude is everything.

[Caring7 in reply to TL1111]

I haven't heard of exclusions for Provenge. If insurance will pay for it, I say try it!

[larry_dammit]

Wow sorry to hear the monster is back, keep up the fight 🙏🙏🙏🙏

[j-o-h-n]

I'm nosy so would you please tell us his location, age, treatment center and doctors?

Voluntary of course. Thank you. If you will respond please do so in a future post (not today and not to me).

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/31/2019 3:16 PM DST

[Caring7 in reply to j-o-h-n]

We are in Hawai`i which has nice weather but poses some challenges. Like if he does consider the VISION trial he will have to figure out a way to live in SF (or somewhere) for three months or more. He was 52 at diagnosis, 57 now, but diagnosed at Stage IV with distance mets and a really aggressive tumor. After about 2 years, we knocked it down pretty good. So 3 good years. He's done everything, seriously, which is why we are facing chemo now, and trying to strategize for clinical trials. In addition to a good MO here in Hawai`i, he also sees an "uber-oncologist" at UCSF, which has been really great for us. And the MO here is happy to work with them. Husband is a veterinarian and I have some medical background, too, so we're pretty aware of everything (sometimes too aware I think!).

We do believe in Good Humor. We have some old (very old now I guess) Far Side and Bloom County comic books that we bring to chemo.

[Kevinski65]

I've taken Zyflamend for prostate in the past. I'm stage 4 , Gleason 9, doubling time 5 months, M1 level. I'm 7 years out on Lupron and Xtandi. I had to stop because I'm in clinical trial at NIH. They supply the Xtandi. I'm not a health care practitioner but I think Zyflamend lengthened the Xtandi.

[Caring7]

wow - we thought Joe had a good run of just over 2 years on Xtandi, but 7 - that's great!

He has now failed both Xtandi and Zytiga -- thus the chemo. And the Zylfamend is contraindicated during chemo, but thanks for the reference. Perhaps someone else can use it. Mayo clinic had an info page on Zylfamend.