Fit or unfit for chemo (Docetaxel)?

[olloreda]

As many of You know, my father (66) was just diagnosed with mPC, with widespread bone mets. He is already on Leuprolide/Bicalutamida, and we are thinking about chemo or Abiraterone.

Because of Covid19 his MO hasent seen him, just his test and results. She was concerned about two things before going for chemo:

A) My father has lost weight during the last two years. He has been always thin, and his normal weight was around 60 kg/132 lb, with a height of 1.71/5'7" (BMI=20.3). He is now 1.5 kg/3.3 lb under the lowest BMI range, with 53.5 kg/117 (BMI=18). He didnt lost all that weight because of the cancer, but for economical reasons we changed our diet two years ago, and start to eat more healthy, with more fruits and veggies, and less industrialized products (I myself lost around 4 kg, and his wife too).

B) His platalets count has been low during the last four months, always between 90-120. Red are on the lower limit, and white seems to be normal.

She (MO) is not giving us a final decision yet (until he see my das and check again blood test), but taking those things in reference, she seems to be more inclined for Abiraterone or "waiting three months to stabilized" before chemo.

I remember that we are in Venezuela and chemo is for free, while Abiraterone we would have to buy the generic in India and hopefully get some donations from here and other groups. So, whatever the way, it seems next move will be at least together with his 2nd 3-month Lupron shot.

What do you think? Which is the Best criteria to decide wheter one person is fit to chemo or not and what are the risks if someone not fit receive Docetaxel?

[Tall_Allen]

He sounds undernourished. Probably some red meat in his diet may help. Also, some high-calorie drinks that are used in hospitals to prevent wasting.

[olloreda in reply to Tall_Allen]

He has been eating almost 6 times a day since december, very good diet with fruits, veggies, oatmeal, grains, chicken and fish at least 4 days a week and the other three with any kind of beans, lentil, etc. Eventually a low-sugar cake, yogurt or something in between foods.

He has been stable since a few months (Even before treatment and with a severe hematoma-infection after a vitamin injection in march, already resolved), and I think most of the weight loss are from 2019.

Since I have read no red meat diet is better, he just have ocasionally, one or two times a month.

Which kind of high calorie drinks? You have a reference to see?

Thanks!

[Tall_Allen in reply to olloreda]

I don't know what brands are available there. In the US, there are high-calorie high-nutrition drinks like these that you can buy in any pharmacy:

ensure.com/

[olloreda in reply to Tall_Allen]

Yes, we have those here...most of them imported, including ensure! I Will check on the pharmacy when I go out...

Any thoughts about chemo criteria? Do we have to resolver this weight issue first?

[Tall_Allen in reply to olloreda]

His oncologist will evaluate his blood tests and his performance status (ECOG or Karnofsky) before deciding if he is a good candidate. It isn't usually any one factor, although evidence of myelosuppression, liver or kidney failure might be deal breakers.

[olloreda in reply to Tall_Allen]

I would Say My father is between 80-90 in Karnofsky, and 1 in Ecog. So far no evidence of liver ir kidney problem, but worry about myelosupression, specially platalets.

Lets see what she says...maybe better Abiraterone, a biweekly chemo or less dosage.

[tom67inMA in reply to olloreda]

Don't forget that calories are important too! If the body isn't getting enough energy, it will conserve it by reducing immune function and slowing growth and repair. Cancer generally ignores signals that control growth so it will continue unabated while the healthy tissues whither. Low blood counts could be one result (note: conjecture on my part).

I'm of the opinion that eating healthy foods only matters once the body has sufficient calories and nutrients. Chemo can be very hard on the digestive system. I eat lots of junk food and sugar during chemo because it's what my body can digest. It hasn't stopped the chemo from working for me.

[olloreda in reply to tom67inMA]

Yes, I think you are right! I am always worrie about not feeding the cancer, but I guess first we have to be sure that his body is receiving enough calories and energy. The good thing is that he is with a very good apetite and so far eating what he wants (but in our house there are more healthy things than not healthy).

I have read so many things about diet and SE of ADT (sugar levels, cholesterol, etc) that maybe I forgot that cáncer can grow anyway. I think we have to Focus on calories, and maybe some supplements like Ensure.

Good to know chemo still working with not so healthy food.

Thanks!!

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

Tell him to eat a healthy mediterranean diet... Don't put all your eggs in one basket.... let him eat some red meat.... Concentrate more on his meds.....and procedures.... Viva con Dios..........

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/24/2020 9:25 PM DST

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

I Will... good idea!! Gracias

[larry_dammit]

My dietitian told me when I was diagnosed to eat anything I could eat to keep my weight up, they said that the cancer would make its own sugar from anything I eat . I have limited red meat, eat lots of chicken,pork and fish, and ice cream , I’m 43 months into stage 4 having done chemo (taxotere) the first thing then on to Xtandi since. Don’t let him loose anymore weight, he will need it for the chemo. Fight that monster 🙏🙏🙏

[olloreda in reply to larry_dammit]

We Will go for it! Also I think when you are aware of this situation, it is very tough to stop eating what you like...always balance food and with nothing in excess I think would work...I would do everything just to know that my father is gonna be with us 43 months and counting...

Thanks and keep fighting!!

[monte1111]

I'm a fan of father eating whatever he prefers, at least until his weight is back up. I had lost 10 pounds before I started chemo treatment. The cancer had taken my appetite away. I gained the 10 back plus 20 more. Go figure. I ate cheese and crackers as midnight snack. Some say dairy is bad for cancer but has lots of calories. I drank 2 Ensure's and threw the rest away. Didn't like them. Neighbor drinks them by the dozen. I was almost 67 when I started 8 rounds of chemo. Chemo side effects are usually not that bad. Mostly annoying. Once every 3 weeks. So for most, 6 times 3 is 18 weeks and you are done. And you can't beat free. You wouldn't be adding financial worries for a while. On the other hand, if the virus is a problem where you are, Abiraterone may be a better, or may be the only choice you are offered. Hospitals are not a good place to hang around right now. (At last count, 7 nurses at my hospital had got the virus.) I have 4 friends who are RN's or work in Dr. office's. They didn't sign on for this, I hope they all get huge bonuses. We can't even hug the people we love. What a world.

[j-o-h-n in reply to monte1111]

"We can't even hug the people we love."

I tried to, but my wife said "NOPE, not the neighbor" (party pooper).....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday, 04/26/2020 2:33 PM DST

[monte1111 in reply to j-o-h-n]

I tried to hug my neighbor, but he went in and came back out with a shotgun.

[j-o-h-n in reply to monte1111]

I bet he's isn't FRENCH..........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday, 04/26/2020 2:51 PM DST

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

Only the French know good love............

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday, 04/26/2020 252 PM DST

[monte1111 in reply to j-o-h-n]

He may be ... he dropped it and ran.

[j-o-h-n in reply to monte1111]

If he ran then he's probably Polish..

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday, 04/26/2020 3:39 PM DST

[j-o-h-n in reply to monte1111]

That's assuming he ran away from you and not towards you.......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday, 04/26/2020 3:43 PM DST

[monte1111]

I assume you like Polish sausage and coq au vin. I'll stick with steak and potatoes.