Results after 5th Docetaxel infusion and just started 6th

[bellyhappy58]

The PSA had dropped from 0.217 to 0.164. This is good news. I was diagnosed on Nov2019 with PCa with multi mets on spine, lymph nodes and femur ( PSA 162). Started treatment on Zytiga, Zometa, Lucrin and PSA dropped to 0.232. Decided to start docetaxel in Aug with Zometa and Lucrin. The Alkaline Phosphate had also dropped from 87 to 80. LDH was little out of the range at 260, Haemoglobin continued was 13.0 slightly below range and Monocytes 12.5, which was slightly above range. But Onco was happy with the progress. All other indicators are within range.

Would like to hear the opinion from this forum on:

1) Onco has suggested that I continue to do some weight-bearing exercises as well as regular exercises like walking to strengthen the bone which he believes is healing. Will confirm in three weeks.

2) I did ask if I should consider radiation for the bone. Onco response was that we could consider if the need arises. He is not a huge supporter as he felt that radiation could harm the bone marrow.

2) Onco had suggested that I do PET scan as well as Gallium PSMA scan in three weeks to assess the overall progress and create a new baseline. He believed the results will show improvement vs the scan I did in April.

3) As indicated in the last posting, Onco suggested that once done with the 6th infusion of docetaxel, and the results continue to show progress, he is suggesting I will only need to Lucrin and Zometa.

The results seem to be going in the right direction. Looking forward to hearing inputs from this forum. God bless

[Tall_Allen]

I think you should talk to him about adding Celebrex to Zometa. Everything he says sounds fine to me.

[bellyhappy58 in reply to Tall_Allen]

What would celebrex do for my case?

[Schwah in reply to bellyhappy58]

mdedge.com/hematology-oncol... Reduced deaths 24%. Neither helped survival alone.

Schwah

[tom67inMA in reply to Schwah]

If I recall correctly, there was a statistically insignificant benefit when either was used alone. It could mean you need both to get a synergistic effect, or it could mean the study wasn't large enough to find a minor benefit when used individually.

My takeaway is that if you're in any pain whatsoever, seek out Celebrex, as it could help with survival. For me it's also been an excellent pain reliever.

[Tall_Allen in reply to bellyhappy58]

Provide a 22% increase in survival, while reducing pain. Send this to youur oncologist:

ascopubs.org/doi/full/10.12...

[Hidden]

I agree with everything except I don't see the need to do imaging, especially so soon. Based on your very low PSA, you know there has been improvement and some healing of mets, and the arrest of the cancer's progression.

Whenever I do any test, I always want to know how it will inform my treatment decisions. That's my opinion.

[tom67inMA]

Definitely do as much exercise as you can. It does strengthen the bones, improves mood and energy, and makes treatment more tolerable and more effective. I think of it as helping to tip the balance in favor of healthy cells.

[Cheerr]

Congrats. Dad is on Chemo cycle 4 now. PSA down to 0.195. The MO Has recommended the GA 68 PSMA scan post 6th cycle to compare results.

Btw, what was your initial Alkaline Phosphate at diagnosis ??

[bellyhappy58 in reply to Cheerr]

In the first 30 days after diagnosis, the Alkaline Phosphate ranges from 206 to 586

[Cheerr in reply to bellyhappy58]

A reduction to 80 from 586 is a excellent response. Congratulations

[elvismlv123]

Is Standard ADT not an option? while the drop in your PSA is spectacular it can be made much,much lower on 3xADT. Mine went down to .005 in just a few months on Casodex,Zoladex and finasteride. and it stayed that way for 18 months and 15 years later it 3.18. If you want more details write me back.

[TJGuy in reply to elvismlv123]

Hi Elvismvl123

That is a spectacular run. Where did you start at in regards to PSA, Gleason, DT. What was the initial prognosis. How did you get to very low, then I guess 3xADT to get to super low PSA. How long were you taking 3xADT. Have you been on any treatment (s) over the 15 year timeframe. How has the rise to 3.18 occurred. What do you see as treatment in the future?

It seems like you are on the road to out lasting the monster.

Congratulations and thanks for some insight to your success.

[elvismlv123 in reply to TJGuy]

Its a long script of stumbles and falls of a learning process which I hope everyone goes through in a good way. I went to a urologist and got a DRE which was ok.I was dxed in January of 2004 although my 4.7 PSA occurred in Dec of 2003 when I was almost 65. I had my first biopsy in January 2004. I had a GS of 3+4. I went to a bunch of doctors to find a treatment plan.

I called many persons of interest... mostly people who wrote books or centers of excellence. I got online with NTPC. I found a doctor in CA who had a protocol. His name is Dr Robert Leibowitz. His practice is Compassionate Oncology. He has a website.

He did a retrospective study with 99 men. He started a 3x ADT protocol which was finasteride 5mg, an injection of Zoladex once per month, and 3 x50mg of Casodex once per day. The URO wouldnt do the 3x 50mg so I had to go to a dr in NYC. It was Dr Lawrence Kempf on East 69th Street, I still see him. He had met Dr Leibowitz and agreed with his protocol. A couple of wrinkles to this were a Prostascint scan at NS hospital using mouse antibodies to find out where the cancer was and a second biopsy 3 months later at Sloan Kettering in their new clinic on East 68th street. My GS became 4+5. I sent a specimen to Dr Donald Gleason in VA. He said I was still a 3+4.

Thats when I learned that you cannot take any anti hormones and then go for a biopsy.

I was on Prostasol at the time. My PSA dropped in half with a low dosage. It made my PCA cells look weird. Naturally with a GS of 4+5 means many options disappear. (A pathologist from Johns Hopkins called me and asked if I was on Lupron.)

Its an awful condemnation to have a GS of 4+5. Also good outcomes go out the door. So for about 6 months I went on the Zoladex, 50mg of Casodex and 5mg finasteride once daily. In Dec of 2004 I went on 3x50mg of Casodex daily and also the other two items.

In August of 2004 my PSA was .05 and went to .005 later on. I got hot flashes but ok . I had a full time job. No bad signs of anything.I was a little anemic.

I went for a 3d color Doppler in Jan of 2005 at Dr Bard on 61st st in NYC. He didnt see any cancer and 6 months later the same. My PSA took a year to come up a little and every year it rises a little. My prostate is small.

I also found out recently that Finasteride suppresses DHEA and DHT. It drops PSA in half which most people say is a false reading. I dont think so if it suppresses those two PCa antagonists. It shrinks your prostate for sure. I didnt take it for a month and my PSA doubled. I have many of Dr Leibowitz's reports of patients so I know its true what he was doing. It was a very reliable treatment for many people. Today he has added different chemo with ADT. The original 3x ADT was for 13 months. Not 18 as I did. I added it to my first 6 months because only had access to 1 -50mg Casodex per day.

I have to say my cells are diploidal not aneuploidal. I think many overlook that important fact and everyone should have their slides checked for that difference. I think diploidal cells which look more like normal cells bodes for a better outcome.

I am on Long Island in the Westbury NY. area. I am 80 now going on 81.

I left a lot out of this report for brevitys sake.

[j-o-h-n in reply to elvismlv123]

Ok Elvis... get out of your blue suede shoes and tells us.. your age, location, treatment center(s), doctor's name(s). All info is voluntary but it helps us help you and helps us too.

Thank You,,,

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 11/29.2019 4:20 PM EST

[Zetabow]

Don't you mean diagnosed Nov 2018? hard to have 5 x Chemo's in a month.

I was diagnosed last Nov and they put me on Chemo almost at once and completed in May with good results. Why did you not start Chemo straight off (if it was Nov 2018)

I was told not to do any weight bearing exercises but the cancer did a lot of damage to the marrow in my Femurs, I do as much walking as I can manage 8-9km per day, the pain is a big limiting factor for me emotionally and physically.

[bellyhappy58 in reply to Zetabow]

Great catch...first diagnosed last Nov. ie Nov 2018.

The Oncologist wanted to assess if the cancer source was from Prostate and it is hormone-sensitive. Once that was ascertained, he wanted to bring the PSA down quickly and he did suggest chemo as well as the option of starting with Zytiga. I was reluctant to go ahead with chemo. It was only in July that he suggested that I should look at chemo even though my PSA had dropped to 0.232 as he felt I am pyhsically strong and I am of a relatively young age.I seek a second opinion and from a good friend as well as some of the inputs from this forum.

For weight-bearing exercises, I do not do any weight above my shoulder as i have 25% compression fracture between T12 and T13. Did some cycling and rowing exercises too beside walking. But I do listen to my body often . There are days, I just rest. But i must admit, all the exercises have helped me a lot. God bless

[Zetabow in reply to bellyhappy58]

Great to hear, at 55 years I was also diagnosed last Nov Stage 4 Gleason 9 and PSA 1386. The combined ADT and Chemo got PSA down to 0.028 by June and remained steady since then.

Stay strong

[bellyhappy58 in reply to Zetabow]

Great progress.... congratulation. Praise the Lord