My MO says he feels I might not need the additional 2 infusions based on blood work and other makers. He has gotten my PSA down to 0.25 from he says in the hundreds. I never saw a lab report stated that but I did see one that said it was 30. I've been on Xtandia for 3.5 months and had docetaxel four times. Took a real hard hit from the fourth infusion with rashes and fatigue - going for a pet scan next week to confirm. Had mets to the liver and did regional chemo to the liver, was done Sept 6, 2019, that regional infusion was equivalent 300 times the strength of one systemic infusion. This treatment probably saved my life. Two biopsies since of the liver show no cancer cells. I welcomed him saying we can cut it at 4, but feel maybe we should chase the PSA down even more - or would the Xtandi keep it low and be a contributing factor in my fatigue?. Any thoughts would be appreciated. The MO is one of the most highly respected in NYC, practicing for over 35 years. Thanks..
Stopping docetaxel at just 4 per Dr -... - Advanced Prostate...
Stopping docetaxel at just 4 per Dr - good move or not?
Hi Fran and thanks - what is your profile?
If the side effects are tolerable, I would continue. You said your PSA is at .25 which is great, but has it leveled off or could it still be going down?
It's been proven that more cycles give better overall survival. I remember how i felt after 4 cycles so I can imagine I would have been relieved if my doctor said I didn't need more. I think the effect of those extra cycles might not be immediate, but might delay progression longer.
And as Nal said, the normal course is 6 although for patients with CPRC the number of cycles is often higher.
Thanks, Gregg -- still mulling this over and will see the doc next week.. best
Had 9 cycles of chemo. adding Xtandi at #5. Got PSA to 0.120 by # 7 and leveled out there. Xtandi alone made me an invalid after chemo ended. Had to cut Xtandi to 80 mg to recover and have a life. Still at 80 mg and PSA still 0.120/0.130 range for last 18 mo.
Will do Nalakrats - do you think most get to nadir with chemo alone? Doc is hitting me with both the chemo and xtandi at the same time, actually started the xtandi abiur a minth before chemo started.... ouch, and i wonder do most on chemo alone expect to hit nadir?
My taste buds might be coming back tiny bit, boy would it be GREAT to taste a Starbucks dark roast, a glass of white wine and a slice like the old days - yet to do that since I started chemo.
the doc can always do more docetaxel if your PSA starts misbehaving. enjoy your break!
Hi Len, would you please elaborate on the " regional chemo to the liver" ? Is that the same as chemo embolization ?
Also how was your fatigue levels after the liver hit ?
I'm curious because I've just had SIRT treatment to the liver and suffering badly with fatigue. That was about 3 weeks ago and I'm due to start cabazitaxel next week. Really glad your liver mets seems to have responded so well and now I'm wondering whether I should go the chemo embolization as well ?
Good news
John
John - not sure if they are the same...
After the hit to the liver I was fine...the hit to the liver was with chemo, a lot of it and I don't believe it's the same as SIRT.
I started Xtandi at the same time I had my liver treat with direct chemo - about a month later I started the chemo - that's when the fatigue kicked in, along with loss of taste. Wish I could have a cup coffee, a slice and glass of wine...But my weight held on eating, grains, fruits and veggies.
Bet to you and thanks... fight on!
Thanks Ken, I believe you had what's called chemo embolization where I had radioembolization . They injected chemo into your hepatic artery whereas they injected yttrium-90 into mine., and lots of it. Wasn't prepared for the fatigue I've got to tell you. I've returned to exercising and focusing on trying to get a decent sleep.
I sincerely hope your liver mets are gone for good ; now that's a great success story in itself, and definitely gives me encouragement.
Sounds like the coffee is brewing and there's a nice red that's got your name on it.
Take care
John
My understanding is that scientific studies were done trying to figure out the optimal number of docetaxel treatments and the conclusion was six. If you can handle the side effects, I think I would have the last two treatments. Good luck to you.
Thanks, Mark - will talk again next week to my MO --- that 4th hit was difficult with the rashes, flashes, nose bleeding a bit, etc. Perhaps it's the combo of the chemo and xtandi - the MO who I trust will guide me correctly and have ideas - right now he is saying we '' stop at 4 and stay on xtandi. Thanks and best to you. Ken..
Best of luck to you too. I did find the fifth and six round of docetaxel to be more difficult than the first four. The amount of fatigue seemed to be cumulative. It was when I started to get neuropathy in my toes and it began to impact my taste buds. Nonetheless, I got through it and those side effects went away once the chemo was done.
Unless you have co-morbidly problems or other medical problems, I would recommend continuing to receive chemo until your PSA is considered undetectable at <0.1.
Admittedly I am biased. As long as your body is strong enough to withstand the poison infused, kill the little bastards.
GD
thanks..will see mo on thursady...
Suggest asking your MO about holding the Xanti ADT temporarily to reduce side effects so that you may be able to tolerate the other two chemo cycles
Thanks.... thought about ding that as well... thought both adt and chemo might be a bit too much..
hey ken— where did you receive your arterial chemo treatment? would like to know just in case i wanted to seek a second opinion for my dad.
PSA stable? Good? Bad? 
Good News after first chemo - is it sustainable?
MO wants to switch me to Xtandi---I Need advice
Jevtana failed, next Lutetium-177
