Chemo with docetaxel?

[Arcticfox44]

I recently posted about my experience with Zytiga, and the proposed switch to Erleada, which I haven't yet tried, partly due to cost and difficulties of getting it in Cyprus, where I live. One specialist has proposed starting chemo with docetaxel. My PSA recently rose to 38 from 27 and the stereotactic radiation I had in Cyprus last May (2021) for left and right side abdominal lymph nodes appears not to have worked. I will be 78 at my next birthday, 15 July 2022. I am on Lupron or Zoladex shots every three months. I'd be interested in views of the best (and worst) case scenarios expectable from chemo with docetaxel. Supposing my PSA is about 50 when I start, how much might chemo knock it back down, and for how long? My inclination is to try Erleada first, despite the obstacles of cost and availability.

[Tall_Allen]

Chemo next, definitely. Always better to alternate chemo and hormonals, and you've already had Zytiga. Focus on imaging, rather than PSA. If you have a PET scan before chemo, it will hopefully improve after 6 infusions.

[Vishwa1890 in reply to Tall_Allen]

Hi Tall_Allen , is the hormonal that you are referring above is Zytiga (I know chemo is Docetaxel)? My father is 76. He was on Abiraterone (Zytega) for about 10 months before his PSA started to rise and he started docetaxel when his PSA is at ~20. So, I kind of related his case with the original post.

Also, many thanks for all your work, you have been a great strength to the people in this online community. Your advises are spot on and relatable.

[Arcticfox44 in reply to Vishwa1890]

Thanks but what has happened with his PSA on docetaxel?

[Vishwa1890 in reply to Arcticfox44]

Thanks. Yet to check his PSA after docetaxel.

[Tall_Allen in reply to Vishwa1890]

The OP has already had Zytiga and is contemplating Erleada.

[Vishwa1890 in reply to Tall_Allen]

Thanks.

[Arcticfox44 in reply to Tall_Allen]

Thanks a lot. Very useful feedback.

[Bodysculpture]

I had an excellent biochemical response to docataxal I found it tolerable and I recommend you exercise as best you can prior to during and after treatment it helped tremendously 2 years post treatment

Looking back

I am very grateful

Still get niggles here and there but the pain I remember so vividly is gone

Back to work

Back to training intensely

Arcticfox44

You got this my friend

[Arcticfox44 in reply to Bodysculpture]

Thanks. I hear you about exercise. Need to do more whatever I'm on.

[Rolphs]

6 months from diagnosis just completed Docetaxel (PSA was 930 when I started). Began Enzalutamide this week and have been on Degarelix from the beginning. Like Bodysculpture I think ambitious exercise regiment really helped me to live with the Chemo. In general tolerated Doce quite well, biggest side effects for me were water retention and some tinnitus. I was able to do mostly aerobic workout almost every day. I have extensive PC in my bones especially pelvic area and did palliative radiation, and I think the workouts also helped me recover faster and improve mobility. Current PSA 27.

Best of Luck AF44!

[Arcticfox44 in reply to Rolphs]

Thanks very much. That's some drop in PSA. Best of luck.

[IdGump]

I am 73 and had proton radiation therapy in 2016. Held psa down for two years then lupron and Zytiga. That combination worked for about another two years. Then moved to Lupron and Xtandi. PSA in creased to 46. Still on Lupron and just finished my 6th infusion of Docetaxel. Sice effects: Very weak, eyes water constantly, nose drips, loss of balance, no appetite and the biggy is the nasty taste in your mouth that taints all foods. Hate to be a big baby but it is nasty. Upside, my psa dropped to 30 after 3 infusions, then dropped to 14 after 5 infusions. If I do the math, after 6 it should be zero. CT scan and bone scan tomorrow and psa will be checked next week. I am guilty of not exercising through all of this. I walked close to a mile when I could but wish I had been more diligent in exercising. I wish you all the best.

[Arcticfox44 in reply to IdGump]

Thanks. Again, I hear you on exercise. I need to develop a serious routine.

[Leader4077]

I started Docetaxel in January 2021 after rising PSA. Originally diagnosed and treated in November 2004. I was 77 years old and completed 6 full cycles. There is research out there shows chemo FIRST before 2nd generation hormonal s like Zytiga, Erleasa, etc. is optimal… Worked for me……….7 consecutive PSA drops down to 2.98 in June of 2021……C-11 Choline PET scan at Mayo showed 11 of 12 bone lesions greatly improved…….go for the chemo.

Mike in Seattle

[Vishwa1890 in reply to Leader4077]

Hi Leader4077 , my 76 YO father started docetaxel on October 2021, after using Zytiga for an year prior to that. His PSA was ~ 20 in October 2021, now today’s PSA test shows it is 98. Does this mean Docetaxel is ineffective? You seem to have started it in January and saw reduction in PSA in June. Do we have to wait that long before we actually see the good results of docetaxel? Tall_Allen , could you please your insights on this?

Thanks

[Leader4077 in reply to Vishwa1890]

HelloI am unaware of anybody’s PSA remaining higher as you continue with 6 cycles. While not an MD, I have read here and other sites that the killing of cancer cells by the chemo CAN pour them into your bloodstream raising your PSA in the early phases……..that happens to some after the first or second cycle…………stay the course, hormonal don’t kill cancer directly……….they block certain androgen processes feeding cancer. Docetaxel KILLS cancer.

Leader 4077

Mike in Seattle

[Vishwa1890 in reply to Leader4077]

Thank you, Mike. That gives some relief and hope.

[Jac_J]

Chemo should reduce PSA. Im 55 and fit and healthy. My PSA was 138 in February. Eligard reduced it to 38 by July. 4 Docetaxel infusions reduced it to 8 by October. I will probably try radiation or Aberaterone next year.

Side effects are tiredness / weakness and not much much else for me. Im also anemic now which is reducing my endurance by a lot. My endurance is slowly getting better but it will probably never fully recover imo because of ADT's.

[j-o-h-n]

YaSou Levendie.... Sorry I cannot answer your question but I want to wish you:

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/18/2021 10:14 PM EST

[kcareer]

I had 6 rounds of Chemo, and I was placed on Lupron. My PSA went down from 117 in December 2016 to 1.07 now. My PSA continued to come down, now it is undetectable. The side effects are fatigue, peripheral neuropathy, watery eyes, runny nose, loss of balance, and lack of appetite. You can fight the neuropathy with a drug called gabapentine. This drug is helping me tremendously. I also try to exercise when I can. I hope this is helpful.

[Arcticfox44 in reply to kcareer]

Thanks! Very encouraging.