What to expect from chemo, if doesn't work what is next?

[Judymin]

Hi my husband started this awful journey 8 1/2 years ago at age 52 with gleason 8, psa 22. He had radiation, then we treated with Dr. Snuffy Myers, had Avodart, Firmagon, later on to Zytiga which worked for almost 3 years. Now Snuffy is retired, see a new oncologist, scans show some slight elevation in pelvic lymph nodes, bone scan negative but psa now up to 30!!!. started doxetaxol 1 infusion so far, now losing hair, felt bad for 3 days after then not bad. Next infusion is tomorrow. What can we expect? Does anyone go into remission after chemo? Will he need to be on Lupron for life? Hair loss already, so expect a bald man soon. He was to do Provenge however developed large clot in jugular so the doctor was afraid to try the Provenge so decided to go on the chemo directly. I am petrified at this point, so far he has kept going, still exercising, but I always thought chemo was the end...thanks all

[Dachshundlove]

Hi Judymin

If your husband has a good response to chemo, his psa will become less than 1 or undetectable. Lymph nodes should shrink. Some people respond really well and experience a durable remission from chemo. Other people experience a stabilized disease. And some do not see any benefit, or their disease progresses.

I hope chemo works well for your husband!

I’ve met a few people who were able to be off drugs for many years after a good response to chemo (one man 8 years and counting).

[Lynsi13]

Hi Judy! I'm really sorry to hear about your husband. For my dad, chemo was just the start of his journey back in 2015. After he completed came out in November 2015, he did remain on Lupron and has been on it successfully since. Only recently, over four years later, has his PSA begin to inch upward. His oncologist is suggesting we tried provenge at this point. That is all set up we are just waiting for insurance to do its thing before we get it rolling. When we were at my dad's last appointment she seemed to think that the chemo was still working, in the a sense that it had knocked the cancer down so hard that it had yet to recover. So for us chemo was certainly not the end of the line! In fact, once he got past the side effects and difficulties from the chemo itself, he went on to feel better than he had in years!

[CRPCMan in reply to Lynsi13]

These people who endure this are really brave.

[Zetabow]

Diagnosed 12 months ago Stage 4 Gleason 9, PSA 1386, Lymph nodes and Mets to every bone, they hit me with combined Chemo and ADT, my PSA went right down to 0.28 in May and and has remained at that level.

Don't think it's the end and attitude goes a long way to fighting this, so keep positive

[Judymin]

Thanks so much

[TNCanuck]

Hi Judy. Chemo (Taxotere) can be very tolerable and ultimately have a huge impact! I've posted an article on what to expect and how to avoid the bad stuff several times. Just search "Avoiding chemo side effects - Taxotere". If you can't find it, let me know and I'll re-post. Wishing you the best!

[Hidden]

Has he had a recent biospy done for molecular testing? Our prostate cancers mutate over time and some of those mutations have targeted treatments available.

I discussed this with the doctor at my appointment yesterday and he was saying how recently he has been doing a lot more biopsies for this purpose.

He has the possibility to retry one of the second-line androgen deprivation drugs such as Zytiga or Xtandi after chemotherapy. He might regain sensivity. There is also a second-line chemotherapy (Cabazitaxel) that could be tried if the first line Docetaxel is not effective.

Another agent, Radium 223 (Xofigo) is available although it only goes to the bone mets. A new targeted radioisotope LU-177 is looking promising so far and in the process of being approved. It is also available outside the US, but you'd have to travel and pay out-of-pocket.

And of course, there are clinical trials.

Wishing him and you the best.

[CRPCMan]

Lupron is the culprit not the solution.

[tom67inMA]

If he's still exercising tell him to keep at it and do all he can. I've heard tales of men who've ridden their bikes quite some distance to get to their chemo appointments and then back home afterwards. I ran as much as I could during chemo and walked on the days where running was too hard.

I'm convinced that exercise makes treatment more effective. Best of luck!

[Tall_Allen]

His hair will regrow. Much better off with chemo earlier. Too bad he couldn't have Provenge with it.

[vandy69]

Good Friday Morning Judymin,

I have had 16 infusions of Docetaxel/Carboplatin chemo combo over the past 2+ years. After each of the first 2 rounds of 6 cycles, we have rechallenged with Xtandi which had earlier failed. In the most recent round of chemo, I continued to take Xtandi throughout the first 4 cycles and PSA dropped from 48 to .2! Scan results were so good that no need for last 2 cycles of chemo.

Best Wishes. Never Give In.

Mark, Atlanta

[Judymin]

Thank you so much!!!!

[j-o-h-n]

No blanket statement but there are many posts here with advice which you may want to followed while getting the Chemo....Use the search option to view the many posts....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/15/2019 9:02 PM EST

[tallguy2]

With a Gleason of 8 your husband should continue his chemo. It may eventually fail him but extend his life nonetheless. There are still more tools in the toolkit, including second gen ADT and a second round of chemo. Plus clinical trials and the advent of precision medicine.

Yes, I am on ADT for life, as may be your husband. Please support him through this and remember he loves you.

[judg69]

Judymin, chemo is Not the end. I was on heavy chemo for over 2 years : 4months taxidere (docetaxol) and cisplatin , then 22 months avastin and Alimta . I lost my hair and didn’t care, I survived and in the process beat the odds of 10% survival stage III A/B lung cancer With the above chemo, maximum radiation and surgical removal of my top right lung lobe I survived. It’s now 7 1/2 years since my lung cancer diagnosis. I was diagnosed with Gleason 7 ( 4+3) prostate cancer one year ago and completed maximum radiation for that and also 6 months Firmagon hormone treatment. I am still vertical ( well, mostly anyways ), and enjoying life to the best of my abilities. Your husband is stronger than you think, and combined with your strength it is likely you have many years together yet to come. A positive , forward -looking attitude is essential and I wish your husband successful treatment and both of you many happy years together to come. With Best Wishes to You Both, judg69