Is Chemotherapy the last and only treatment for CRPC?

[ronton2]

I am sure this seems like a confrontational question but I left a recent visit with my MO feeling confused and fearful. I was left with the impression that chemotherapy was the end game and that it might only provide a minimal survival benefit.

[Tall_Allen]

Certainly not. It is often not used early enough. When "saved" for the end, the benefit is minimal and the side effects are much worse. Any MO who tells you that really hasn't kept up with the field.

[ronton2 in reply to Tall_Allen]

While ADT is working, should chemo be added? When is the most beneficial time to start such therapy. I am confused by the timelines and outcomes.

[Tall_Allen in reply to ronton2]

Chemo can be started within 2 months of starting ADT.

[Bjry in reply to ronton2]

I started Zoladex late July 2018 and commenced Docetaxel in mid September 2018; for me the clinical trail evidence was overwhelming. The combined treatments have a big impact on life expectancy, what is not to like about that. My PSA went from 152 to an eventual nadir of 0.06.

[ronton2 in reply to Bjry]

Thanks for the insight, Bjry

[Hidden]

That's a crock. They basically told me the same thing six plus years ago when I went through chemo. My body's lymph nodes were a cancer factory and I had 5,6 mets on my bones. "Don't worry you have two good years to live." Fast forward six years, no lymph node involvement seen, one met on my spine that has been stable forever. Currently my PSA is <0.1 and I plan on living another six years just to spite those statistician wackos. If you believe everything they tell you, you will worry yourself to death. Now I'm no doctor but I feel that starting the show with chemo was the best thing I ever did. You might want to get a second opinion to ease your worried mind. Your just starting, cheer up buddy.

[ronton2 in reply to Hidden]

I am getting a much clearer idea of when to begin chemotherapy. I am cheering up thanks to responders like you, Noname.

[Magnus1964]

Chemotherapy gives a chance of total remission. In some cases it may not be indicated. As for myself I have never had chemo. I've had a few doctors recommend it. But I managed to avoid it these past 28 years.

[ronton2 in reply to Magnus1964]

Appreciate your reply, Magnus. I believe I have been given some less-than-accurate information. This site is the best!

[Burnett1948 in reply to Magnus1964]

Magnus1964. Burnett1948 are you low volume PC? I have been told because I only have one met lymph node outside my pelvic floor I am low volume and kemo can’t be justified.

[Magnus1964 in reply to Burnett1948]

I would be considered to have low volume Pca. There are doctors that believe radiation and chemo are the only way to kill cancer, even low volume Pca. I have encountered a few. My feeling is chemo for Pca is a last effort.

[ronton2 in reply to Magnus1964]

I think I am in the same category, Magnus. So far, ADT is managing my disease.

[Burnett1948 in reply to Magnus1964]

The difference between High & Low is the number of Mets I understand. Your journey has been very successful in that you are still with us after 28 year. I was first diagnosed in 2005 so that’s 15 years. I’m on hormone; 4 shots so far. So what should I do to match you?

[Magnus1964 in reply to Burnett1948]

Have you changed your life style since being diagnosed? Vegetarian diet, vitamin D3, yoga or meditation (guided imagery)?

Do you view your cancer as a gift? Do you feel like your getting more out life since your diagnosis, thankful for every day?

I believe these things all help in some small way. Your attitude towards life is important. As a few philosophers have said,"know thyself" " the unexamined life is not worth living". I am a proponent of Psychotherapy.

[ronton2 in reply to Magnus1964]

Yes, to most of that, Magnus. In the main, having cancer has transformed my thinking about living in the now and not worrying about the future. I am early to bed and early to rise, take very long and vigorous "awe" walks daily with my partner and dog and count every day a blessing!

[Burnett1948 in reply to Magnus1964]

I have practised guided meditation daily for many years following Williams&Penman. I eat skinless salmon and chicken with vegetables mostly cauliflower & broccoli. I eat oranges; bananas & apples. I eat Chicken salad sandwich’s for lunch and marmalade toasted bread each morning. My wife has had me taking D3 (2#1000)with one mK tablets. I’m increasing my exercising. My PSA has come down from 4.4 to .025 after having 4 hormone needles since late August 2020. Question: how much D3 do you take?Burnett1948.

[Magnus1964 in reply to Burnett1948]

I take 5k of vitamin D3 in the winter and 1k in the summer.

[ronton2 in reply to Magnus1964]

I am going to up my Vitamin D with a consult with my doctor. Thanks, Magnus

[ctarleton]

I noted from prior Posts that you may have already been on Zytiga for a while.

If you may not have ever seen them before, these NCCN Advanced Prostate Cancer Guidelines for Patients may give you some ideas for further research and/or to discuss with your doctor, or, especially, an advanced prostate cancer Specialist. Note especially Chapter 8 and Guides 11, 12, and 13.

nccn.org/patients/guideline...

One of the chemotherapies may be just one of several options.

[ronton2 in reply to ctarleton]

Really appreciate the link you provided. I plan to print several pages. The explanations and suggested treatments very helpful. I am on ADT now and have halted disease progression but want to know what is in my future. Many thanks, ctareleton.

[Doseydoe]

Just to add to your responses, I agree that you should do chemo early. I was dx on Xmas morning 2019 and commenced ADT that day. Four weeks later, I started chemo (docetaxcel) and ended up doing 9 shots. I started 20 IMAT (60gy) radio sessions three weeks after I finished the chemo and today, I officially went off ADT. So, the combination of those treatments worked to get my APCa under control and time will tell how long it lasts. 😎 DD

[dockam]

Ditto to the other posts. In 2015 @ diagnosis with PSA at 840.2, GL 7(4+3) and a few GL 8 in an 18 core biopsy, mets to L Ureter lymph nodes - MO said was perfect timing as CHAARTED trial results were dropped. Did ADT (Lupron/Casodex), then two weeks later - Taxotere. MO saved my skinny brown *ss by telling me "Dr. Kam I'll continue to give you chemos, until you tell me to stop, or the #s plateau)He gave me nine more for a total of 15 in 2015. Summer 2017, hit a nadir of 0.1

Fast Forward to Jan 2020(made 5 years with #stageivpca, despite a 28% odds)

Started Abiraterone and only got to 4.1.

Then PSA went from 5.2 to 9.2 in a month. Started Zytiga. PSA still rose

😭

Now gonna rechallenge with Taxotere, 6 years after Dx.

"The cancer's back, and you're gonna be in trouble. Hey la Day La, the cancer's back)

Have to refumigate the house again (body) for pests

youtu.be/fEfLMod-Wqk(Not working as expected?)

Fight on y'all

Randy

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

To view the video click on the name of the video on the top left of the video (in white lettering).

SEE ABOVE........

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 01/09/2021 10:57 PM EST

[ronton2 in reply to j-o-h-n]

I can't get that tune out of my head. The lyrics keep repeating.🤣

[j-o-h-n in reply to ronton2]

I can't get those girls out of both of my heads....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 01/10/2021 1:40 PM EST

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

😂youtu.be/v3j9bAVqt3c(Not working as expected?)

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

If you wish to play the "Goin' out of my head" video above, simply click on the title (in white lettering) on the top left portion of the video...

FYI

Little Anthony and the Imperials is an American rhythm and blues/soul vocal group from New York City founded by Clarence Collins in the 1950s and named in part for its lead singer, Jerome Anthony "Little Anthony" Gourdine, who was noted for his high-pitched voice. In addition to Collins and Gourdine, the original Imperials included Ernest Wright, Glouster "Nate" Rogers, and Tracey Lord, the last two of whom were subsequently replaced by Sammy Strain.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 01/10/2021 2:22 PM EST

[warreng9241 in reply to j-o-h-n]

Little Anthony originally sang with the Chesters " The fires burn no more". I met him in the '50's in a Bklyn subway station (good acoustics), when a fellow serviceman who was an old friend of his, introduced me.

[j-o-h-n in reply to warreng9241]

I'm from da south Bronx so Bklyn was a foreign country to me.....But do you remember the Chords from da Bronx (Sh boom sh boom).

Anyway you and I are walking (no more running for me) down the same path....

I'm 87 and been fighting the "mother" for 22 years....

So Greetings and yes singing in the subway always sounded great until an express passed you by and you were on the platform in a local station..

BTW small trivia.

If you lived in BKlyn and you were goin to Manhattan, you said "I'm going to the city".

If you lived in da Bronx and you were going to Manhattan, you said "I'm going downtown".

You can take the man out of da Bronx but you can't take the Bronx out of the man....

Happy trails to you..... and keep fighting da beast....

p.s. Guess on my part, You were born Sept. 2, 1941?....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 03/25/2024 7:30 PM DST

[ronton2]

I am beginning to understand when to use Chemo. Thanks, Randy, and plan to resume your resistant status.

[Acirol]

I’m currently on Lupron and Zytiga/prednisone and am switching gears to chemo next week... I really can’t wait to begin and see the improved results... I stay positive because I want to...

[Burnett1948]

No

Thanks again