Expectations on docetaxel: Hi, I maybe... - Advanced Prostate...

Advanced Prostate Cancer

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Expectations on docetaxel

Fdccs profile image
17 Replies

Hi,

I maybe being too anxious but I'm concerned about my husband. Started Zoladex 15th November. PSA was 167.

20th January, first PSA test after ADT and came down to 0.2. Just before starting chemo a few weeks later it was 0.3.

After first chemo it went back down to 0.2 the pre chemo rate.

After second chemo it's now 0.4.

Oncologist doesn't seem concerned. Could this be the start of a trend? I really hoped that at 0.2 before started that chemo would make it undectable.

TY

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Fdccs
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17 Replies
Tall_Allen profile image
Tall_Allen

It's very low - looks good!

Fdccs profile image
Fdccs in reply toTall_Allen

Ok thank you both. Deep breath

Fdccs profile image
Fdccs

Thank you

Shooter1 profile image
Shooter1

First 6 chemos. PSA will not settle. Dead cells release PSA also as they die. Stick with it. Your #'s look great.

tallguy2 profile image
tallguy2

I did the 6 rounds of chemo last spring and summer. PSA never went to undetectable. Lowest was 0.16. After chemo may I suggest a PET scan with Axumin to see whether or not there are mets that might be attacked with radiation treatment?

Fdccs profile image
Fdccs in reply totallguy2

Thank you so much. How are you?

Radiotherapy is planned afterwards

tallguy2 profile image
tallguy2 in reply toFdccs

I am well, thank you!

I did six months of a Taxotere and Adrimyacin weekly... and PSA fluctuated in that range for nine months after the conclusion of the trial before zpSA became undetectable. Perfectly normal.

GD

Fdccs profile image
Fdccs in reply to

GD, PSA has gone back down to 0.2! What changed in 9 months to get you to undetectable? Did you do something else afterwards?

in reply toFdccs

Fd.... Great on the PSA results. Keep kicking...... I believe two factors. The first, it just took time to kill the little bastards. Chemo and the other drugs damaged the walls of the cancer cell so that they could not reproduce and they suffered from cell suicide - apoptosis. Second, at the conclusion of the six month trial, the protocol called for continuation of Lupron and the addition of 50 mg of Casodex daily for two years. After nine months, Casodex was discontinued to see if I would have “Casodex Withdrawal Syndrome”. To wit, about 20% of the time, the withdrawal of Casodex causes PSA to drop. It did and stayed there. I continued with a Lupron/Eligard for four and a half years, then stopped. Note: I put my faith in my Medical Oncologist and followed his suggestions to the letter every step of the way.

Throughout this time I had monthly blood work, then went to every 60 days. Two years after I stopped Lupron, I went to every 90 days and two years later every 120 days. Last year I went to 180 day cycle, but felt uncomfortable, and asked to go back to every 120 days. I find it better for my peace of mind to test that often despite a round trip of 80 miles across Houston twice each period - one for labs and the next day for results. Oh, I could do it in one day, but hanging around for results for 5 to 6 hours in a day does not work for me..... :) I plan my day to avoid traffic patterns.

GD

Fdccs profile image
Fdccs in reply to

Thank you! I pray that we follow in your footsteps. My husband is having radiotherapy afterwards.

I'm just really nervous that he only has 1 more chemo to go and that perhaps the PSA is going up but the chemo is knocking it back down a bit so what will happen after chemo but I suppose this is something everyone here lives with

tom67inMA profile image
tom67inMA

Regarding "killing of the cancer cells goes on after the last Chemo", I've been looking for information on this and couldn't find any. Do you have any links or more specific information? I'm very curious having just finished chemo and still dealing with side effects.

RustyDakota profile image
RustyDakota in reply totom67inMA

One anecdote: My PSA continued to drop for three months after my last chemo. (The first time. I'm doing it again now. Good response again so far.)

tom67inMA profile image
tom67inMA

Ah, I see. I had read somewhere that cancer cells have a hard time moving docetaxel out once it gets in them, but didn't see any quantitative number as to whether it stays inside for minutes/days/months. If it does stay in the cells for weeks or months it would continue to kill for a long time. BTW, it seems treatment resistance occurs when the cancer figures out how to get rid of the docetaxel.

As for my PSA, it was dropping like a rock before chemo, from 216 to 1.93. At the end of cycle 4 / start of cycle 5 it was down to 0.02. Yesterday it was tested again, 4 weeks after my last infusion, and it was 0.02 again. The lab refuses to allow me to join "<" club, and I'm very upset about that. I do realize that going from 0.02 to 0.01 or "<0.02" requires another 50% drop, but given the free fall it was in earlier I had sort of assumed undetectable would be a slam dunk.

To stay somewhat on the original topic, Fdccs : I found this article earlier today: academic.oup.com/annonc/art..., which describes how PSA may initially go up during chemotherapy. There's some nice graphs of PSA response partway down the page.

monte1111 profile image
monte1111

After 6 mo. chemo and 19 mo. Xtandi my Psa went gradually from 59.9 to 0.1 for last 2 months. 0.1 this last Tuesday. Don't think I would worry much if it is 0.something. That's just me.

MelaniePaul profile image
MelaniePaul

Hi there, I can really understand your concern. However, this is really only a very small change and it may be due to different reasons that have nothing to do with cancer. For my husband, the PSA was one month 10 and the next 11 and then went down to 10 again. I don't think that should really give you great concern at the moment. Keep watching it though.

Good luck

Mel.

Fdccs profile image
Fdccs

Quick update, 6th chemo due on Friday and PSA is less than 0.1! Not really sure what that means other than underdectable

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