Docetaxel not working, fractured hip and pelvis

[robbo262]

Hi- I haven't posted in a long time as I was doing OK. Aside from rising PSA, I now have pathologic fractures of hip and pelvis. Finally got to the point where I had to go on chemo, and now having passed third infusion had bone scan and CT scan of chest, pelvis. Chemo not working, and now have new tumor in liver, the plan is to go on Carboplatin next week. I have 2 teams of oncologists, one at Dana Farber. They recommend not giving up on docetaxel, but combining the 2 treatments as they have experience with the combo treatment working. Anyone tried that?

Also, my local academic med center in NH will not do surgery on my hip/pelvis until I am finished with carboplatin due to risk of infection. Also, they want to make sure that am having good results, as they feel why put me through surgery if I only have a few months to live. I am in agony, pain meds not doing a thing for me, I can barely ambulate and am really afraid of falling. Has anyone had hip replacement, pelvic repair in the middle of chemo?

Thanks to you all

[Betmar]

Hi Robbo

My husband was diagnosed in 2015 with Mets to bones and liver. He did dox and carboplatin right away and it took care of it at that time. He has since been thru it all including radium 223 in April. In July he started jevtana and radiation to his hip since his psa was going up fast and scans showed progression. He fractured his hip at the end of September. They will not do surgery and what would that do anyway? He is on crutches at this point and is healing ok. Can you get around with crutches? He is no longer on the chemo since it wasn’t working. He is now on a targeted therapy to match his braf mutation. Let me know how you are getting along. A hip break is tough but you can heal from it! Thoughts and prayers to you. I’m glad their combining the 2 chemos. It really does make a difference! The carbo targets the liver Mets.

[Tall_Allen]

My friend is using a different taxane, cabazitaxel (jevtana) with carboplatin when he was diagnosed with multiple liver tumors. It is shrinking them markedly. He receives Neulasta to prevent myelosuppression. If you know docetaxel isn't working, why not switch to Jevtana? That's exactly the situation it was approved for.

Are you taking a bone strengthening agent (Zometa or Xgeva)? How about Xofigo?

[abmicro in reply to Tall_Allen]

Sorry to hear of this warriors battle with pain and his treatments that may not be working like they should. I saved your comment. The combination of cabazitaxel (jevtana) with a white cell stimulation like Neulasta (or possibly Leukine) + carboplatin is exactly what I am going to push for when I get to that point. I am arming myself with information in advance so I can push for the treatments that I believe will work when others fail. Finding a good MO to go along with drugs you want is not easy.

FYI--I was on Leukine in 2005 and had a great response to it when combined with Ketoconazale and patches. I never got sick with colds, flu, infections, or anything else when I was on Leukine and my cancer remission lasted more than 2 years with that combo. I tapered it off after a year to lower doses and the Leukine 2 weeks on and 2 weeks off, and had good control, but 2nd year PSA started going up very slowly and I had to start thinking about other treatments, which I started the 3rd year of my remission.

I am a fan of white cell stimulation while on powerful cancer treatments because they can prevent a deadly infection while doing chemo and may even help a little to battle the cancer. I did Taxotere 2 years ago, but I was NOT on white cell stimulation. A week after every infusion, I would start to get a sore throat like I was starting to get sick, then a week later my throat felt better. I think my white count dropped to a very low level a week after the infusion and then recovered somewhat 2 weeks after the infusion. I asked my MO to prescribe Leukine injections 250 mcg daily a week before each infusion for 7 days before the infusion to boost my white count. I told him that I was on Leukine before in 2005 but 2 weeks on and 2 weeks off for a long time. He refused. That MO quit at UC Davis. Good riddens. To prepare for the future, I need to find an MO to go along with the drugs I want in the future to give me the edge in this battle. Not an easy job to find a good MO.

[robbo262]

Hi and thanks to everyone who answered. It is somewhat reassuring to know that some of you have had good results with having liver mets. I don't think my hip is going to heal on it's own as I have multiple fractures to the acetabulum (socket) and now have tumors on the head of the femur as well. I also have a fractured pelvis, all of these are pathologic fractures. I get around with a walker and cane when in tight quarters, though I can feel my hip joint wobbling around. NH is a medical marijuana state but I dont like using it during the day as it makes me too sleepy and goofy. I do have good results with a couple of puffs before I go to bed, combined with dilaudid to let me sleep all night. During the day I am on lots of opioids but they only provide limited relief. I get a neulasta injection the day after chemo and am also on Xgeva.

My local cancer center is very conservative, unlike Dana Farber which seems to me more willing to go out on a limb. My Dana Farber doc says they do combined therapy all the time, but I will know on Monday or Tuesday whether the local place will go along with it and then we'll have to decide if we are going back to DF for treatment if the local place refuses. I have found in the past that the local MO gets his nose out of joint when I tell him what DF recommends, so I hope this time he will go along with the combined therapy. I will keep you all posted this week after I find out what the verdict is.

Keep up the fight folks

[j-o-h-n in reply to robbo262]

Now isn't it the shits when "your local MO gets his nose out of joint when you tell him what Dana Farber recommends". What a small minded ass he/she must be.... Tell your MO you're looking out for YOUR life not his ego...Smack him/her with your cane....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/01/2019 5:07 PM EST

[robbo262 in reply to j-o-h-n]

Hi John

There have been a few times where I did want to smack him.

[j-o-h-n in reply to robbo262]

I know the feeling..... ditto with my wife...........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 12/01/2019 9:13 PM EST

[vandy69]

I was diagnosed with 20+ liver lesions in September 2017 (already had multiple lymph node mets since diagnosis in August 2012).

Immediately began chemo with Docetaxel/Carboplatin combo. Have now had 2 rounds of 6 cycles and 1 round of 4 cycles (16 total infusions).

Between rounds did a rechallenge with Xtandi and last 4 cycles was chemo PLUS Xtandi.

For me, this treatment has worked. PSA down from 48 to .2 and liver lesions 50% smaller.

Hope this helps.

Best Wishes. Never Give In.

Mark, Atlanta

[robbo262 in reply to vandy69]

HI Mark thanks for writing. Your news is encouraging to me. It sounds like you have a very aggressive MO. Keep strong!

[Leader4077 in reply to vandy69]

How are you doing now?

[scarlino]

I have found that sometimes insurance will not pay for the Carboplatin because it is considered “experimental”, which is nonsense. It is not as expensive as Jevtana or taxotere. I’ve had to pay for it because insurance doctors won’t approve. 😡

[robbo262 in reply to scarlino]

HI Scarlino thanks for responding to my message. I have been incredibly lucky so far, my insurance company hasn't balked about anything, including Zytiga at 10k monthly. They even waived the copay. I have insurance through my work pension.

[Zensailor]

I was diagnosed in August 2016 with PSA of 689. Spread to hips, pelvis, spine etc. They , UC medical, radiated my hips immediately before chemo Doxitocele.

I have used that chemo twice 6 months then about a year later again for 5 months. It really hammered back the cancer. They are combining it now with other things.

Hang in there...try to get the best advice you can.

[robbo262 in reply to Zensailor]

Zensailor thanks for the hopeful response. In fact the hospital today approved the combo treatment