I figure I will run out of my lucky remission with Zytiga and move on to the other fun rides.
Who has had experience with Docetaxel?
Who has has experience with Radium 233?
I only have one oncologist, whom I like, and these are the two things he has mentioned.
What are they like? How do they feel? What advantages did you give you?
I guess I am asking, in my anxiety -- How afraid should I be of these?
I want to be just the right amount of afraid.
Thanks.
I just wrote a post about my best friend , 83 years old, who had Docetaxel treatment for 6 sessions . No problem with his blood work . First 5 , he had fatigue between the 3rd and 5th day following treatment and slow loss of hair. I was after the 6 th treatment. He had a bad case of edema, pink eye , loss of taste and fatigue .
Not sure if 83 years old is the oldest man using chemo or not .
I dunno either. Thanks for the info.
I second HPpurple
Docetaxel side effects (for most) are tolerable.
Flu like symptoms for several days after premeds wear off (starting at about day 3).
My husband had carboplatin added to his chemo and the side effects of that were significant. He has a primary (not treatment emergent) type of chemoresistance related to unfortunate genetics.
Good luck with Zytiga. It can work a very long time!
Zytiga 250mg on day 14 so far no s ide e defects. What are the determining factors of ‘working a long time’?
OK Don Cisco. We have to take good care of you so you can continue to grace us with your poetic insights and musings. I don't seen enough details of your treatment history. What is your Gleason score from biopsy? Did you have primary treatment with surgical prostatectomy and/or radiation? Have any scans to identify metastasis sites in other locations? Lowest and current PSA measures and how fast it is rising or is it stable?
Now based on your MO suggesting Radium 223 (Xofigo) that is for treating spread (mets) to sites in bones. That is often best seen or verified on an Axumin (F18 PET) scan. Have you had that? If so what sites of metastasis did it show? That would be a very good reason to consider the Radium 223 treatment.
In addition you should be on some treatment to help strengthen and protect your bones because you are on ADT and you have PC. I prefer denosumab for this that has two "flavors" a lower intensity one called Prolia and a more intensive regimen called Xgeva. The other way to go for bone protection is zolendronic acid (Zometa). Depends upon your insurance coverage which way to go.
As for docetaxel (Taxotere) chemotherapy, yes this is probably going to be in your plan for staying alive as it does extend survival. Also, after the Zytiga/prednisone stops working, a course of docetaxel may restore responsiveness to the Zytiga again. Also switching from prednisone to dexamethasone for some helps extend the responsiveness to Zytiga.
The Chemo is typically given in 6 doses (cycles) at 3 week intervals. So you are through it in 15 weeks. But it takes some time to recover from the fatigue, etc. That can be a slow process as chemo can really wipe you out before your done. but you can get through it as so many of us have. Other side effects you can search here. But it also builds character and deepens poetry!
That's a lot -- thank you.
Started when I could not control urine in 2016. Thought it was "enlarged prostate" -- the benign kind. I was wrong. I was diagnosed in Feb 2017, stage 4, Gleason of 4-4 (8). PSA of 346. Urologist couldn't even get his needles to stick in me, and quit after 3 tries.
I did get the CT-scan, which showed mets mainly in my spine, but also in other joints. A few in my lymph glands, atop my kidneys. Also, as I understand it, in my bladder or kidney -- couldn't self-catheterize. Rod just hit a wall about 10 inches up there.
(Needed three kidney stent operations to keep kidney working. Stent now removed -- the cancer was no longer in the lymph glands.)
Spent nearly a year just on Lupron infusion. When my PSA started rising, I added Zytiga, and it has kicked ass for the last 2 years.
I get Zometa infusions about every 4 mos.
Along the way I have had two radiation treatments, two weeks each, when resistant cancer buds started to peep out from my spine, causing painful "electric" shocks. The radiation ended the electric pain both times. They tell me I am not "radded out" -- I can go that route again if need be.
Testosterone as of Sept 2019 -- <5
PSA as of Sept 2019 -- 1.9 ng/mL
This all I can find at present. I feel "OK." I can walk, lift objects under 15 lbs., help in the kitchen and annoy people on HealthUnlocked.
I didn't mean to annoy. I was just excited to be among my dying kind.
More (vague) data:
CONDITIONS
Difficulty coping (finding)
Drowsy (finding)
Emotional stress (finding)
Hypokalemia (disorder)
Insomnia (disorder)
Neuropathic pain (finding)
Pain due to neoplastic disease (finding)
Palliative care (regime/therapy)
Secondary malignant neoplasm of bone (disorder)
If you have any mets in dangerous areas on your spine (or any other place) you really need to consider burning them out with radiation.
Otherwise consider perhaps LU177 or ACT225 PSMA treatment. Though you will need to be carefull with your kidneys.
Hmm, I've had two separate radiation sessions to burn aggressive emerging parts of tumors -- emerging from a rib, from a shoulder area, and from the neck. My radiation doc seems very skilled, and very targeted. But no suggestion of burning all the spinal mets.
I meant just the ones that might be located in dangerous spots.
Once you get metastasis, the conventional wisdom is that localized treatment is at best, wasted sword motion.
But if you have a tumor impinging on something important, that's the exception to the general rule.
It sounds like your docs are targeting what they think are the dangerous locations already.
I was afraid of Docetaxel chemotherapy before I started, I think that's fairly normal. I found the side effects to be quite tolerable, although I wouldn't say it's nothing. I'll tell you one thing. I just had the flu last year and that was WAY worse than the worst days of chemotherapy. On the scale of typical things we have to deal with throughout our lives, I'd say each cycle is somewhere between a cold and the flu for the first week, then the next 2 weeks are pretty much back to normal. You do get tired of it after a few cycles, but it's over soon enough. And if it's working, you also feel better from that too. This might sound crazy, but I did get some satisfaction knowing that even though I was suffering, the cancer was suffering more. It also gave me a focus and immediate goals to get through each cycle, get tested, etc. You feel like you are active and doing something instead of just waiting. I did miss that aspect after chemotherapy was over, although you really are tired of it by the time you get to the end.
I have already decided I will do it again. For me, the fear of it was much worse than the actual. There are ways of dealing with the side effects. It's worth doing and it's probably the best treatment you and I have for that time when Zytiga becomes ineffective.
I love this part:
"This might sound crazy, but I did get some satisfaction knowing that even though I was suffering, the cancer was suffering more."
Thanks, this makes me feel confident I can do it -- when such time comes.
At what point did you start zytiga?
I started Zytiga about a year and 5 months after diagnosis when I became castrate resistant. I was considering starting it after early Docetaxel chemotherapy was completed, but 3 doctors said no. A fourth has since said he wouldn't do it either.
Hi Cisco...I start six hits of Taxotere next Thursday (1/9/2020). The port goes in this Friday. This will be my second chemotherapy experience (first time was for a different cancer). I expect it’ll be tolerable, but not pleasant. Hit me up from time to time over the next 4 months...I’ll let you know what my experience is...
I will do that CRK2 -- thanks
I discussed Docetaxel with my oncologist. She advised against it, as cognitive impairment is a very common side effect, and is often permanent. I found the cognitive effects of Lupron completely intolerable. On Zytiga without Lupron it is far better but still pretty bad. Given that history, she suggested holding on Docetaxel and is looking into immunotherapies I might be eligible for.
Docetaxcel is a golden medicine for many advanced cancers,It hopefully gonna shrink the masses and reduce psa...of course it has many side effects that varies individually but some common side effects are alopcea,muscle aches,diarrhea or constipation,nausea ,dizziness and some bone pains but hopefully you can come over with these side effects.My dad was on Docetaxcel for 10 cycles he had these side effects but his disease remission encouraged him to tolerate the side effects
These are the comments and concerns about chemotherapy in the treatment of prostate cancer by a real expert ( a MO with clinical experience in the treatment of this disease):
grandroundsinurology.com/dr...
Good article ...
If Jevtana (cabazitaxel) doesn’t result in neuropathy, why wouldn’t you use that agent over Taxotere (docetaxel)?
Dr. Dorff: Because insurance typically won’t cover it. Head-to-head, they were compared in the FIRSTANA trial, and they were equally effective; one wasn’t much better than the other. So, insurance companies can say that Jevtana (cabazitaxel) is not more effective; it’s equally effective. Taxotere (docetaxel) is a fraction of the price because it’s off-patent, and Jevtana (cabazitaxel) is actually approved specifically in post-Taxotere (docetaxel) patients, so it’s off-label to use it first-line. You can make a case when you have a guy with neuropathy, but even if you have a guy without neuropathy, you sure would like to leave him without neuropathy at the end of his treatment.
We start to see the neuropathy around dose five. If you stop, it’s more reversible, but if you keep going, that’s where it can become permanent, and so again, when we’re getting to how we can enhance the efficacy, if we could get more doses in without being limited by neuropathy, maybe we would do better with the drug, or maybe we just avoid the neuropathy, have equal efficacy and patients suffer less. There’s two ways we can win.
I do have a concern about neuropathy for my next adventure with Docetaxel. Neuropathy does tend to be cumulative so I am hoping that I can switch to Jevtana if it is necessary. Jevanta does have a bigger myelosuppressive "footprint" so just need to be aware of that.
I already have diabetic neuropathy. Docetaxel sometimes makes it worse. I read.
Some residual neuropathy in the feet seems to be the only lasting effect of my taxotere treatment 2 years ago. But excellent response to the chemo makes that a small blip on the radar. If/when I do it again, I'll likely try to keep my feet, hands and scalp iced down during infusions.
Huh!
I had the 6 docetaxel treatments in 2018. Fatigue was the main issue, although I maintained my exercise regime and worked part-time. I never had nausea. And the Neulasta on-body injector is a must! Try flavored waters such as Sparkling Ice. This helped me stay hydrated when plain water tasted terrible.
I had just finished my 6th and last infusion of Docetaxel in late Nov. The initial fear for me was unfounded. I had some tough days especially between 4th and 5th day after infusion but it quickly get better after that. Do make sure you drink a lot of fluids before and after infusion. Pls, do exercise as often that your body allows. If you could do some weight-bearing exercise ,even better. Eat moderately in a small portion. Have a support system inplace,whther it is friends or family. God bless
Wow . Good for him.
What to expect with mets and no treatment
Advice on radiation treatment?
Lutetium-177 PSMA - A new experimental treatment
Proton Treatment Scheduled
