I was diagnosed with prostate cancer 2 years ago. I have been on ADT (Firmagon) for two years, along with abiraterone and then Xtandi until no longer effective.
I am presently taking a PARP inhibitor Lynparza (olaparib) which has kept my PSA low for 9 months. However, my last PSA jumped from .7 to 1.7 this past month, so my oncologist is recommending that I start docetaxel.
I am reaching out to the members of this blog asking you to share your experiences with docetaxel, the good and the bad and any alternatives you can suggest. Admittedly, I am hesitant to start chemotherapy.
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shipoo
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"Admittedly, I am hesitant to start chemotherapy.", why?
No doubt, the stigma with chemo is brutal, Hollywood has a lot to blame, as they depict actors that took chemo look like Zombies.
Consider, that Docetaxel is approved for Metastatic Hormone Sensitive Prostate Cancer (mHSPC), so a first line treatment, likely because of the short term toxicity. Look into the CHAARTED Trial, it will ease your concerns.
My PSA <0.02, and yet was overjoyed that I could have Docetaxel (Taxotere) treatment! The side affects was manageable, loss of hair and taste buds affected with some sores inside the cheeks. About 3 months after my last chemo infusion, hair was growing back fast, the tastes buds and cheeks all good.
I would take Docetaxel again any time, Prostate Cancer is evasive and deadly. Combinational modality therapy - means hit it hard with all weapons!
No problem with taking 6 cycles of Docetaxel. I was also scared of it until after the first cycle.
All chemos are not equal though and Docetaxel for prostate cancer is on the less difficult end of the spectrum.
For me, it wasn't any worse than a 5 day cold for the beginning of each infusion. Yes, you feel crappy, but we've all been through that. I never even used my anti-nausea meds. After the first week, the second two are normal. From what I've read, my experience is typical. Most tolerate it well.
I don't really know since is was an optional treatment to add to ADT at the beginning. I'm hoping it helped and just went by the statistics of the clinical trials. The main thing for me was thinking that if things went bad for me, I might be regretting not having done everything I could have.
So far, I've done well overall, 3 1/2 years out from diagnosis with stage 4 so who knows where I'd be if I hadn't done it. I would definitely do Docetaxel again if I had to do it over.
Me too, should have said earlier in my response to this thread. That the anxiety of awaiting for the side effects to settle in, was the worst part!
After my second infusion, was like, OMG, when will the vomiting begin, what about the nerve damage (Neuropathy), the chronic sensation of pins and needles, the fever, was informed had to check my temperature throughout the day. If temperature approaches 100 f, call 911, if you can.
But, after my hair fell off, the useless taste buds and mouth sores, began to calm down. Actually, became a smoothie and salad chef pro...
I always have to compare chemo to other things I've endured in my life. We've all been through worse. I had flu the and Norovirus the year before last and was thinking how much worse they were than chemotherapy. I never used my anti-nausea meds for chemo, but ran for them when Norovirus struck. Unfortunately I was too late and vomited so many times I was in pain. The thought of chemotherapy is more frightening than the actual experience. Yes you feel crappy, but feeling crappy isn't something to be afraid of.
I had my six infusion of docetaxel from mid Aug 2019 to Nov2019...three weeks interval. To tell you I was not apprehensive is an under-statement. The blog here has many useful people who can provide and share their experience. My experience are as follow
- Prepare well...physically, shaved your hair really short three weeks before first infusion...this set u up mentally to accept what is forthcoming
- On the day itself, eat very light meal...some has suggested that u dont eat...
- If u have close friends ,share with them and ask them for help..I have friends that drove me to and from the treatment...Some of them even stay with me during the infusion
- On Day 4 or 5 after Infusion, u feel like crap...like the 'motherof all flu' hit u...but it will pass in two days and you will feel a lot better.
- Rest you must but dont be couch potato...go out and exercise ...I walked about at least between 3 to 5 miles a day...and go to the gym to do some weight-bearing exercises. You will feel better
- Pray and ensure that you have GOD with you in your journey.
I had 9 sessions of Docetaxel and like the others here, I went through the standard side effects. I began chemo within a few weeks of my DX and starting ADT. Collectively they shrunk my tumours and dropped my PSA from 50 to 0.03. My advice if you choose to go ahead with chemo, is to try to eat something at your normal meal times, drink a bit more water than usual, go for a 20 min walk everyday and give yourself permission to rest. They will probably give you steroids, which for me kept me awake. I learnt that taking a sleeping tablet really helps. All the best, 😎DD.
My chemo's side-effects were frustrating - weight loss, fatigue, muscle weakness, and pain- on occasion debilitating but the treatment was a success, if limited. This was my third line of defense after my initial dx in March 2017. I had a RP in May 2017, ADT Sept 2017 - August 2019, and SBRT Dec. 2018. By the way, if you decide on chemo, you may want to ask about Neulasta a bone marrow stimulant aiding in the production of white blood cells. As has been said again and again, everyone's experience is different.
During this period my exercise regimen (rowing, weight-lifting, and yoga) tanked. With great difficulty, I was able to walk 3-4x daily. With the consent of my MO, during chemo I did cryotherapy (cold therapy) on my hands and feet and ice chips in my mouth; and fasted for five of the eight infusions. Due to dehydration from vomiting, two days after each chemo infusion, I returned to get an intravenous saline solution with Zofran. For all my problematic side-effects, I would do chemo again, primarily for two reasons: It worked and doing it made me eligible for other treatments (see below).
Results: After 8 three-weeks cycles of chemo (docetaxel), my PSA decreased to 1.3 from 16.8, bone mets stabilized and some shrunk. The planned 9th cycle was cancelled for two reasons: diminishing beneficial returns and concerns about COVID-19. At the end of my eighth cycle I developed a DVT in my upper left leg. In late June 2020, about three months after last cycle, cancer reactivated. My PSA increased: 2.2, CT scans revealed bone mets remained stable but enlarged lymph nodes around lungs. I am now on Xtandi.
One major reason my wife and I decided on chemo from among the treatments available to us in September 2019 was that it would "open the doors" to other treatments or trials. Currently, I am participating in a CAR T-cell immunotherapy and scheduled to start the process to re-infusion next week.
My SE’s were pretty rough, not bad after infusions 1-3 but 4-6 got progressively harder. I was glad when they were finished, felt like a really bad flu for a week afterwards. Hair loss, mouth sores, loose fingernails etc. I still have neuropathy in my hands and feet. The good thing is that my hair grew back thicker and I no longer have a bald spot, so ya, there’s that😀.
I had chemo as part of early upfront treatment per CHAARTED, my PSA remains undetectable 6+ years later, I’ve also been on ADT and had my prostate radiated/debulked. Looking back, I’d do it all over again in a heartbeat given the results, going forward however I’m not so sure, it would depend on the circumstances.
Thank you for your honest opinion. Sorry to hear some side effects remain, but glad you benefited from the treatment
Do not fear chemotherapy. 2004 - nine infusions of Taxotere alternated with nine infusions of Adriamycin for six months. Systemic treatment - it’s better early on when your body is strong and your tumor burden is minimal. Everyone has different degrees of side effects. What is important is that you are killing the little bastards.
Sorry, not at all. Some do well; some not so. Me? I entered a chemotherapy with hormone therapy trial within six weeks of metastatic lesions. I did well. However, everyone is different. The numbers back in 2004, were very different - 2-4 years; maybe five. There are a lot of silver buckets in an oncologists arsenal today. Good luck.
Had 6 sessions, only side effect was dry nails and a very little fatigue. I watched the diet, never had nausea, only once when I had a fried piece of meat, they give you stuff in case but only used one pill. Still, have them just in case I have nausea from eating the wrong things. I would do it again without hesitation, never hesitated the first time either, not as bad as years ago as they have refined the process.
1. Neulasta is a standard addition to Docetaxel. Some say it is the real cause of the flu like symptoms (mainly joint and muscle ache) that everyone experiences for a few days in the first week after infusion. Claritin taken for 4-5 days starting right before the infusion, does wonders here.
2. Peripheral neuropathy can be minimized by soaking fingers and toes in ice during the infusion. Wish I had known that at the time, because I have some minor permanent neuropathy.
3. Nausea is a rare side effect.
4. More common side effects are discoloration of nails and skin rashes. These go away after you’re done with the infusions.
I continued to work while taking Docetaxel, and while it wasn’t always easy in the week after the infusion, it got done.
Don’t be. Versus radiation I will take docetaxel all day long and I have done both. That said my starting point was 212 psa and multiple pubic bone lesions. That was 4.5 yrs ago. psa today is 0.1 after recent radiation in March. About to take a holiday from Zytiga and Lupron. 😎
My body tolerated Taxotere very well 3-4 years ago at age 65, and my PSA is still undetectable. Each infusion was the same - energy dropped from 10 to 5 a couple days after infusion, then climbed back to 10 within 5-6 days.
Docetaxel, when given with 20Gy of pelvic radiation for palliation, lowered my PSA (60-1) for 6mo earlier this year ( I have numerous bony mets). Side effects moderate: short term ones predictable and manageable. My long term SEs less pleasant - peripheral neuropathy to both legs and part of hand, despite plunging appendages (most of them at least) into ice during infusions. It has substantially impaired my mobility and I will not have it again, despite very few alternative options.
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