Why Abiraterone over Docetaxyl

[konichiwa12]

I am fortunate (I think!) to have been put on Abiraterone after becoming mCRPCa as I have private care whereas the normal treatment by NHS in the UK would be Docetaxyl. I have read that docetaxyl can eliminate all cancer including bone mets and Abiraterone (Zytiga) only halts the progression/spread. Is this correct? I am told that cancer is back in seminal vesicles so will these be tumors? Every time I get a pain in my back I get worried!!

[Doseydoe]

Gday, I've just had my 7th Docetaxel shot as the first 6 didn't kill all the PCa cells. I'm hoping by the time I finish my 9th shot that it does kills them all. My oncologist explained it this way. If you poured chemo into a petri dish full of PCa cells, not all of them may die. Understanding why they don't is the challenge. All the best, 😎DD.

[tom67inMA]

There have been anecdotal reports of abiraterone killing cancer here on the forum, though it's not clear if they were killed directly by the drug or the immune system taking advantage of the cancer going dormant.

Chemotherapy rarely kills all the cancer. It's usually more like peeling an onion, with each cycle taking another layer off. The drug may not be able to reach parts of tumors with poor circulation on the first try (exercise helps with circulation, and there's emerging evidence that it makes chemo more effective), or the cancer cell may not try to divide while the drug is in your system, and of course, some cells may have developed resistance to the drug. So multiple cycles are used, each one killing some percentage of the cancer.

My recent personal experience with carboplatin + etoposide is that the first two cycles produced dramatic reductions, while the last 4 cycles had a more modest effect but did appear to eliminate the cancer from my liver.

One final note: a "lesion" in a CT scan after treatment could be active cancer, dead cancer, scar tissue, or some combination of all three.

[konichiwa12 in reply to tom67inMA]

I think it was active cancer from a Gallium 68 PMST scan

[DarkEnergy in reply to tom67inMA]

Hola Amigo,

"There have been anecdotal reports of abiraterone killing cancer here on the forum..."

I'm one of them, the post (Lupron injection) CT Scan showed extensive necrosis in pelvic area. Had a tumor extending the prostate glad, which was invading the bladder wall - causing severe pain during urination. In just a "few' days after ADT, the pain subsided and the area eventually showed dead tissue (necrosis).

Although, Taxotere (Docetaxel) will induce Apoptosis, nice reads on the subject:

intechopen.com/books/curren...

ncbi.nlm.nih.gov/pmc/articl...

[Tall_Allen]

They both kill many cancer cells and they both slow progression.Unfortunately, neither kills all the cancer cells. They are very much equivalent in the amount of cancer control they provide.

It seems like your cancer is very radio-resistant and hormone resistant. You might ask your oncologist to biopsy one of your bone metastases to see which kind of prostate cancer you have. There are a few treatments that are unique to some of the results. You should also ask for a germline genomics test.

It is very common to attribute every ache and pain to the cancer. How could you not?

[konichiwa12]

I have had a foundation-one liquid biopsy and no biomarker or genomic samples were found. I will ask about the bone met biopsy. I have nurse visit tomorrow then follow up call with Onco after PSA result. He said ablation treatment may be possible after Covid settles down. He had said previously this was not possible as it was too close to sphincter.

[j-o-h-n]

Hang nail.... Must be cancer....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 07/09/2020 5:24 PM DST

[ritchiek]

The NHS in England is no longer recommending Docetaxol before Enzalutamide ( Xtandi ) & Abiraterone ( Zytiga ). This is because NICE is less keen on starting Taxane chemo during COVID-19.

[Chugach]

Abiraterone worked for me for a year without really any side effects. Docetaxel worked only 2 months and made me sick and bald.

You do what you have to do.

Get the genetic test Tall Allen recommended. It can open up options.

Stay Strong

[konichiwa12]

As I said in my reply to Tall_Allen I have already has the genetic test.

[JNunes]

My father has prostate cancer with bone and ganglion metastases, and in addition to hormone therapy he started chemotherapy.

The initial treatment with radiotherapy was not effective in controlling the disease (I don't know if he would already have what here call "micrometastases", because at the time of the diagnosis it would be located, and supposedly the treatment was a success; the radiologist said to my father forget the prostate and think about his hypertension).