Taxotere Question

[Sapmiami]

Is it normal for psa to go from 560 to 513, then go above 600 on just two infusions of taxotere. This the worst rollercoaster.

[Hex40]

Mine went down a lot the first treatment then up a bit then down a bit. It seems to take at least 4 or 5 treatments to get a clear trend.

[Sapmiami in reply to Hex40]

Thank you for the good info.

[AlanMeyer]

I'm not an expert but it seems to me that the patient is not benefiting from the chemo. I suggest asking the oncologist about the results. Ask him what he thinks the PSA numbers mean, what numbers he wants to see, what would indicate to him that the treatment should be continued, what would indicate that it should be stopped, and what other treatment he would prescribe, if there are any left to be tried.

I hate giving bad news, but chemo is a rough treatment that makes many patients sick. If it's not helping and if it's making the patient sick, then it may be better to stop it and try to get a better quality of life for the time remaining than to keep taking more.

I also don't like to urge people to run all over the world and spend time and money to try to find treatments which often don't work, but I think I'd be remiss if I didn't mention Lu-177-PSMA. It's an injectable solution containing radioactive atoms of Lutetium bonded to antibodies that find and bind to prostate specific membrane antigen (PSMA) and deliver radiation directly to the tumors. For a small number of patients, it can be a life saver, a real Hail Mary giving one, two, or possibly even more years. For others it does only limited good or no good. Unfortunately it's only available in the United States in clinical trials and otherwise requires travel to Germany or Australia. The patient needs to get a PSMA test first to see if he has enough PSMA to attract the radioactive molecules. If you want to learn more, type "177" in the "Search HealthUnlocked" box in the upper right part of the screen.

All of this is terribly hard on a patient and his family. It's very hard to know what to do. All I can think to add is that all of the people here care about each other and wish you the best.

Alan

[whatsinaname in reply to AlanMeyer]

Excellent post, Alan.

[Olivia007 in reply to AlanMeyer]

Thanks Alan for all the questions u suggest the other member ask his oncologist my dad has a appointment with an oncologist October 4th and u brought up some good ones I’m going to put on my list.

Have you been on chemo? I always hear that prostrate chemo is not as bad as chemo for breast or other cancers but I have no clue is it a walk in the park?? My dad is 82 so we will see what the happens thanks again

[AlanMeyer in reply to Olivia007]

I have never had chemotherapy. From what I hear from others who have had it, some tolerate it very well while others get very sick from it.

One thing I don't understand about chemo is why so many oncologists use high doses and offer little in the way of treatment for side effects. The standard dose is "75 mg/m2 IV over 1 hour every 3 weeks; prednisone 5 mg orally 2 times a day is administered continuously" (from drugs.com/dosage/docetaxel..... However I saw a clinical trial of 50 mg every two weeks that produced very similar results but with milder side effects, and I knew a man who was given 25 mg each week, had an excellent response, and claimed he had hardly any side effects. The three doses are the same total quantity of drug and, although I can believe that the 75 mg dose is the most effective, the others may be effective enough and much easier to take.

Your father should ask his oncologist about the different dosing schedules. He should also ask about whether he should have cold baths for his hands and feet, a cold cap for his head, and ice chips in his mouth. The cold is uncomfortable but if there's no cancer in the hands, feet, scalp, and mouth it will reduce the blood flow, and hence the drug exposure, to sensitive places and help prevent the long term damage that some patients experience. Other things to ask about are Neulasta to prevent infections (the chemotherapy temporarily damages the immune system), and Zofran (generic is ondansetron) or a similar drug to stop nausea and vomiting.

I wish him the best of luck - and a compassionate oncologist.

Alan

[Olivia007 in reply to AlanMeyer]

Thank you

[Sapmiami in reply to AlanMeyer]

Thank you! There is going to be a trial soon for 177. We tried jevtana , zytiga, radium 223, and clinical trial drug torisel and he is still on lupron . Not sure what else.... oh he has never taken xtandi. Thank you for your post. I am sure the Dr will call or we will see him in the next few weeks. We just got psa yesterday . I was so hoping taxotere was going to make it all go away

[AlanMeyer in reply to Sapmiami]

It would seem that if a patient has failed Zytiga he won't benefit from Xtandi, and that's sometimes true, but not always. I have seen reports on this forum from men who got several months or more of low PSA from Xtandi after their PSA went up on Zytiga. I'd be surprised if someone gets a full year but I think it's not impossible. It may be worth a try.

Best of luck.

Alan

[scarlino]

Mine decreased about 25% on first infusion but gradually went higher. Stopped after 5 infusions. Currently on Jevtana. Might add Carboplatin to it. You might ask your MO about that.

[Sapmiami in reply to scarlino]

He did jevtana initially before this. The Taxotere is given weekly in a lower dose. He had a reaction to regular dose in April two times with another Dr at different facility. This Dr suggested trying it again with double premeds and lower dose. So far its ok just not helping psa .

[dadzone43]

A disappointing response. Your dad and you need to discuss this with the MO. PSA not gling the way it should.

[paulcross4]

I did 8 cycles of Taxotere/Carboplatin. PSA came down from 275 to 57. Initial drop was higher that the later cycles. Side effect were tolerable and qualify of life good. Stanford gave me various medications to mitigate them. Overall effective and tolerable.

You PSA going up doesn’t seem right but what do I know

[j-o-h-n in reply to paulcross4]

Hello paulcross4, you ended your post with "but what do I know".... We had a user here who used to end his posts with "Of course what do I know".... His user Id was Nameless9999 and I think of him often. So you just made me think of him again. Thanks, he was a very nice guy and we all miss him.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/25/2019 5:45 PM DST

[ronnie1943 in reply to j-o-h-n]

Yes, that statement, "but what do I know " ? reminded me also of Nameless9999. Loved all his posts.. He was so kind and I loved how wit... He had sent me so many messages, even when my husband was in the hospital, he was there for me so many times...

I think of him often, he truly was a great guy I remember when his wife posted ... that he had passed.. Honest, I cried, it felt to me like we became like family...

[paulcross4]

Thanks John