Today, received first infusion of Taxotere, while PSA <0.02...

[DarkEnergy]

I know there's been some recent posts about why Taxotere, but created a new post because I'm currently hormone sensitive. Diagnosed about 10 months ago, PSA 1000+ with large tumors extending prostate with extensive metastasis throughout pelvic area and lymph nodes involvement.

After 10 months of Lupron (3 months shots) with Zometa infusion, daily Zytiga/Prednisone, got to PSA <0.02!

So, why did I start Taxotere, obviously the cancer cells are hormone sensitive?

Because of the following rationale, about 5 years ago Zytiga was not given when hormone sensitive. And recently with Xtandi, not approved when hormone sensitive as well.

We know that - not all cancer cells that escape the prostate primary tumor are hormone sensitive. How many millions of cancer cells are flowing in the body.

ncbi.nlm.nih.gov/books/NBK2...

But, clinical trials have yet to "establish" or "negate" chemo efficacies for hormone sensitive prostate cancer patients. What about the other cancer cells, that are not hormone sensitive?

I'm just jumping the gun (pun intended)...

[Tall_Allen]

"But, clinical trials have yet to "establish" or "negate" chemo efficacies for hormone sensitive prostate cancer patients. "

That is incorrect. Two major randomized clinical trials, CHAARTED and STAMPEDE established that chemo adds significantly to survival in men with mHSPC.

pcnrv.blogspot.com/2017/06/...

[DarkEnergy in reply to Tall_Allen]

Hi TA,

Yes, know that, I'm all over the CHAARTED and STAMPEDE clinical trials. This was the conversation with my Dana-Farber team about "adding" Docetaxel.

ADT + Zytiga + Taxotere vs ADT + Zytiga,

findings, actually as you stated:

"It is possible that concomitant early use of Zytiga and docetaxel may have a synergistic effect on the cancer, and in preventing the onset of Zytiga resistance. This is pure conjecture and would have to be proved in a clinical trial. The downside is the cumulative side effects" - pcnrv.blogspot.com/2017/06/...

[MateoBeach in reply to DarkEnergy]

What I always ask: "Can I afford to wait until the clinical trials are complete"? We are each a trial-of-one and must make treatment decisions in real time based on incomplete information.

[dvcarola2]

Yey! You already started with chemo! Hope it works well with you with minimal side effects. All the best on your treatment George! Stay strong and stay undetectable (PSA) 😊

[DarkEnergy in reply to dvcarola2]

Hola Vikkie,

Yeah, I've joined so Docetaxel gang, so far no issues. But they say fatigue will start to set in after 3rd cycle. Although do detect a taste bud issue, may need to step up the species.

Perhaps, Docetaxel could re-sensitize ADT, so much happening, these days, compared to the last 10 years of prostate cancer treatment strategies.

[dvcarola2 in reply to DarkEnergy]

Yes food doesnt taste good for a few days so Dondee likes cold fruits during those days. And side effects gets bad as the chemo infusion progresses. But dont worry, you will get better and regain strength soon after. Wishing you the best!

[Schwah]

I did all the same things a you but added Celebrex since studies showed a22% survival advantage to those using both Zometa and Celebrex together

[DarkEnergy in reply to Schwah]

Yes!

Having Lupron and Zometa with the next Taxotere cycle, will ask to add Celebrex.

As the lower spine has arthritis, it lit up during the scans, performed a biopsy from T8 (heavy coverage), findings were not cancerous.

Thanks for the heads up!

[Hidden in reply to DarkEnergy]

That’s good, not cancerous. All of my joints light up . Not cancerous just heavy djd ..This set will poison those littles sobs right out of your body. I am

Imagining it so right now. This is going to knock ‘em out. The ol one two three four punches. Hang tuff my friend. God bless. Get through it!🙏❤️

[abmicro]

How much celebrex? I am taking that too, but just for pain.

[monte1111 in reply to abmicro]

I take 2 200mg a day. Trial was with 2 400mg a day, I believe. Last scan showed two degenerative discs, so will ask to double dose next time I see Dr. Do have lower back pain I thought was T-12 compression fracture. Something more to add to ongoing conditions. It is not light reading. Say you want it for arthritic pain.

[Hidden in reply to monte1111]

Mama😩compression fracture wtf? I have a non displaced fractured L-3 rib . 🤔 hmmm , thought prolia was to prevent this? My bones are a crumbling down. 😂

[monte1111 in reply to Hidden]

Yeah. Whatever happened to this bone is attached to that bone?

[Hidden in reply to monte1111]

It is true. For me at least it is a systemic collapse of joints not to mention bone density with no muscle to hold the project up . Besides that I’m alright. No pc

[Hidden in reply to monte1111]

I’m getting scans next month. A yr ago the Mo said that all of my joint are lit up . Ac and joint like clavicle and ones I haven’t herd of before? Prolia doesn’t help the joint at all. I can feel Every joint aching even my nuckles and feet .. but hey … I’m still . Just in a diminished form.🌵

[monte1111 in reply to Hidden]

I used to be 5'9". I think I'm 5'3" now.

[DarkEnergy in reply to monte1111]

Did you meant in inches?

Ay, caramba!

[monte1111 in reply to DarkEnergy]

Very, very funny. If you know how much that is in centimeters, j-o-h-n will give you a free gourd of your choice.

[Fairwind]

Dosetaxel can get rough....On day 3 after infusion, you can expect a heavy "Chemo Crash" which will take the wind out of your sails for a few days.. As you continue with it, the crash gets worse...Hair loss, neuopathy in your feet and hands which does not go away....Chemo is not a walk in the park..

[DarkEnergy in reply to Fairwind]

Yes, had to sign many papers confirming being made aware of side effects.

But, Neuropathy "like" symptoms may become acute condition if it occurs.

[Hidden in reply to DarkEnergy]

As long as it kicks the pc out. F it! I’d rather have crazy neuropathy.

[CAMPSOUPS in reply to Hidden]

Same here. Yes to neuropathy. No to PCa.At my chemo infusions:

Would you like a ice cap?

NO. ( I had/have skull mets so it was a no go anyway).

Would you like ice boots?

NO. (I didnt want any of those bastards escaping the chemo).

Feels like I am putting my feet in shoes filled with sand but I can walk so there!

Fingers are super sensitive to heat and cold but I don't care. I am here 2 1/2 years later.

[Hidden in reply to CAMPSOUPS]

“ soups up” ! I’ve yet to have the pleasure of chemo .I’m happy about that .. Great job just making it through it! I know the sand feeling , both Hands and feet .. 😎✌️

[DarkEnergy in reply to Hidden]

Chemo is best served with good Champaign, I can attest...

[bellyhappy58]

I will be starting Taxotere in a month time. Started treatment for PCa with multi mets since Nov with ADT ( 3 months interval ) plus zometa, Zytiga + prednisone.PSA was at 126 and now 0.41. As per what you have said, I am doing the Taxotere treatment for the same reason. Do keep me update on your progress and share your learning. God bless

[DarkEnergy in reply to bellyhappy58]

Yes, the idea is not let them settle, we got them on ropes, show no mercy these circulating cancer cells.

[Hidden in reply to DarkEnergy]

Off with their heads! Or tails? Or whatever weird form they’re in!

[DarkEnergy in reply to Hidden]

LOL, think they have head and tails, off with them to obviation !!!

[Hidden in reply to bellyhappy58]

Good luck 🍀 brother!

[j-o-h-n]

I wish you tons more success than the Mets are having.

"I'm just jumping the gun" when you were young you used to say "I'm just humping the young". My, how things have changed (for all of us).... Damn the torpedoes, Full Speed Ahead...

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 07/201/2019 6:56 PM DST

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

Clever, homeboy, and very real...

Regards,

DarkEnergy, formerly known as NYMets

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

😂

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

An oldie but a goodie?

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/23/2022 5:52 PM DST

[Hidden]

You started chemo because you have systemic disease - cancer cells traveling in your lymphatic and vascular system. Kill the little bastards and smile.

GD

[DarkEnergy in reply to Hidden]

Hi GD!

Exactly, it seems like many don't worry about circulating cancer cells. Only get concerned when the cancer cell finds a home and becomes a growing tumor.

Chemo is a no brainer...

[elvismlv123]

I havent heard that the body has different PCa cells in it depending on location. Cells get more aggressive and then hormone insensitive. Chemo was not effective againt PCa cells in the day. It wasnt used. It was an adjuvant therapy not a primary one. How it became primary is unknown to me.

ADT works but it has to be early stages and a punky cancer with no" balls "behind it.

I know that finasteride can control DHT and DHEA and lupron can zero out Testosterone and PCa doesnt like that idea.

[Spyder54]

We are one giant human experiment. I hope youre right!Makes sense to me, even though my Onco told me NO at .26 PSA. Said Taxotere needs active cells to be effective. Said would be of no benefit but would still get the ugly side effects. Said Taxotere right upfront or once Castration Resistant. While PCa cells in sennescence is of no benefit?

Mike

[CAMPSOUPS in reply to Spyder54]

You are correct and or your MO ha.Yep chemo attacks actively dividing cells, not cells in sensence which is typical when PSA low.

More "proof" of the chemo going after rapidly dividing cells is in the hair loss, and finger and toe nail changes that take place with chemo. Those hair and nail cells are of a category of faster dividing cells.

[Hidden in reply to Spyder54]

We are all just one giant collective Petri dish. Guinea pigs to be tested upon. 😳

[DarkEnergy]

"While PCa cells in sennescence is of no benefit?"

Yes, but you're assuming us humans are experts in biology, that we have diagnostic machinery that are 100% accurate in disseminating findings at the cellular level. Moreover, which cells are the cancer?

Consider this:

"When organisms grow, it isn't because cells are getting larger. Organisms grow because cells are dividing to produce more and more cells. In human bodies, nearly two trillion cells divide every day."

--askabiologist.asu.edu/cell-....

As you alluded to, chemo is like carpet bombing, although consider, I would not be here today without this bombing...

[Hidden in reply to DarkEnergy]

Bombs away!

[Spyder54]

Dark Energy,The fact that this post started 3 years ago (see date on initial post at top), and that you are still here discussing this experiment says something positive! Have you had other chemo since then? Are you still mHSPCa?

Mike

[DarkEnergy in reply to Spyder54]

Hi,

"Have you had other chemo since then?"

No, just that one time, which was bold at the time.

"Are you still mHSPCa?"

Yes, my PSA went from 2.17 (10/22/21) to 0.13 (1/21/22), so reduction in 3 months. The anticipation of my next blood draw, hopefully still hormone sensitive.

The rationale of stopping ADT, made sense, because if still hormone sensitive, then it's an opportunity to exploit PSMA PET/CT scan, so PSA 2.17 will be better than PSA <0.02.

Prior to my recent PSMA PET/CT scan, my treatment options negated Radiation Therapy, because my diagnosis noted "Extensive metastasis throughout..."!

Now, my latest chart uses the term: "A few..."...

[Hidden in reply to DarkEnergy]

Better than many!

[Spyder54]

Congrats Dark Energy, the experiment is working (for you-hopefully many others).Mike

[Spyder54]

DE, also note the Stampede Trial (think it is the H Arm) proved that men with fewer metastisis who had SBRT/SABR Radiation (usually 5 days), along with ADT + Abiraterone/Zytiga lived longer and had longer time before recurrence than SOC ADT alone. Perhaps you would now qualify with your fewer mets? Contact Dr Sean McBride at MSKCC in NYC to learn if yes. Mike

[DarkEnergy in reply to Spyder54]

Hi Mike,

Been on Abiraterone/Zytiga, then added SBRT. Actually, before SBRT got chemo (Docetaxel) as well.

My Dana-Farber team has been amazing with aggressive (leading) treatments. Leading because most of the treatments were in trial basis - SBRT was the game changer.

[Hidden in reply to DarkEnergy]

I’m pulling for you to KO this mother! 🤙🏽

[MateoBeach]

Yes, the "other cells", that are certainly there though unseen, are the reason it may be a very good idea to undertake Taxotere chemo exactly when your PSA has reached a very low nadir frim hormone directed therapy. It is called an "extinction vortex". Hitting the cancer with a second strike when its population is weakest. See my prior post on this topic, Evolutionary Dynamics Part II.

[Spyder54 in reply to MateoBeach]

Like the sound of “Extinction Vortex”!PCa Extinct is what we are all looking for.

Thanks Paul,

Mike