Docetaxel now or later...

[Karirudy]

Saw the MO on Friday after scans and because the PSA has gone up from 3.8 to 6.2, she is concerned that the ADT is losing effectiveness. Scans look the same but it doesn't mean the cancer isn't on the move. She did say I could take 3 months (my wife and I travel from Mexico to Phoenix every 3 months) to "wait and see" but last night i ended up in the ER with chest and back pain - apparently bone pain that I hadn't felt since I first started ADT. I had decided to go home but now I want to talk to the MO. On Friday she said that sometimes "we have a window of opportunity" to tolerate the Chemo (6 rounds, 3 weeks apart) which would be the reason to start now. We are building a house - in the final months so because I was feeling good I wanted to return but now I'm wondering if it would be best to hit it now. She also said I would be a candidate eventually for LU177 but I have to do two treatments first - i'm not there yet.... Last night was a wake up call...

[tallguy2]

Do the chemo and ask your MO to add abiraterone per the results of a recent clinical trial PEACE1 ( see Tall_Allen’s posts).

Best wishes!

[Hidden]

I would do the chemo, but I've done it already and expect to have to do it again. It's fairly tolerable for most so nothing to be concerned about. You'll likely do just fine on it.

It's good to alternate anti-androgens like Xtandi with chemo rather than just switching to a different anti-androgen.

Wishing you the best in your decision.

[DarkEnergy]

I took ADT, Abiraterone, Zometa and Docetaxel (11/1/2019) at the same time. Currently on a treatment break since 11/2020 with current PSA 1.10.

Will repeat all treatments if necessary, Docetaxel was well tolerated, would take it again without hesitation.

[Shams_Vjean]

My MO started me on docetaxal Chemo almost immediately after diagnosis withStage 4 PCa with Gleason score of 10 diffusely metastasized over skeleton and skull. I had already begun ADT. He told me that recent studies were suggesting earlier Chemo intervention in situations like mine seemed to indicate longer overall survival times than if Chemotherapy was delayed until all other treatments ceased to be effective. I.e., perhaps a net gain of about 1&1/2 or more additional years as opposed to 6 mos. added.

Of course most everyone’s situation is different, so ultimately the outcome for each is hard to predict. Chemo hasn’t been easy on my 68 yo PC infested body and definitely changed what I’m able to do during treatment; but I’m thinking the ‘front loading’ is probably a good investment for the long term outlook.

Good luck!

[Woodstock82]

I concur with the above. I think it is better to do the chemo early and hit the cancer hard while you still have the physical resources to tolerate the treatment more easily. The side effects are not pleasant, but they weren't as bad as I feared they might be.

[j-o-h-n]

Greeting Karirudy,Build that home..... remember: measure twice, cut once..... Just for info sake. I'm fighting Pca and a Lung melanoma. Keytruda has worked on my Lung cancer...... Ask your M O if she can treat your Lungs with Keytruda....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 6:05 PM DST

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

She mentioned that I wasn't eligible because of the Genetics... I hope it is working well for you. and Thank you.

[j-o-h-n]

Too bad.

It's working great....... that's why I mentioned it....... Anyway, watch out for those splinters..........

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 09/22/2021 6:54 PM DST

[Bowk]

When diagnosed PSA 425 stage 4 Mets I immediately started adt then doxetal front end loading recommend it