Hi,
I joined my father this week for his most recent appointment. He is 5 years post diagnosis and his PSA has started to rise after 2.5 years of stability on enzalutamide and before that 6 rounds of doxetaxel + ADT.
His recent scans have showed some enlargement of pelvic lymph nodes which is most likely the reason PSA has been rising since Jan 2022. It was determined that a change of treatment is needed. The MO's fellow discussed that the MO would likely make a decision between Cabazitaxel vs Docetaxel. When the MO came in she decided since my dad tolerated Docetaxel quite well that she recommends starting with that for 10 rounds starting in Dec. We asked if we could go on a trip beforehand which she encouraged saying "you should do some living before chemo, it's important to go into that with a strong and healthy mind." I thought that was pretty great that she encouraged that. I asked why 10 rounds versus 6. She said the 6 rounds was a modified protocol that was taken from research done in 2007 (ish) on 10 rounds. I am curious how MD's select between these options. She mentioned he'd start with Docetaxel and then that leaves other options for later.
Does anyone know more on what the difference is between these two chemo's? Has anyone else done 10 rounds of Docetaxel after having done the same chemo before a few years prior?
Rock on Cabazitaxel!!
Docetaxel 
Cabazitaxel failing- what's next?
Cabazitaxel, Abiraterone or Enzalutamide?
Docetaxel, Chemo in general
I will be interested in the input you get here with your post.
I will start 10 rounds of Dox next week. I had 6 rounds 3 years ago. Zytiga no longer working has led to chemo next week.
Cabazitaxel seems to be easier on us as far as side effects but surprisingly I learned that it is actually harder on the bone marrow (blood production) than Dox.
I have a lot of bone mets. But my lymph mets can't be discounted either. I was told too that I tolerated the Dox 3 years ago well and it worked well on my bone and lymph mets and would be a good choice again. That I likely still have the cancer cell sensitivity to Dox as I had 3 years ago.
I am getting my Dox in a unblinded trial. If I had been in a different arm of the trial I would be getting Ra-223 (Xofigo) with my Dox but I was not put in that arm of the trial. Dox was looking like my next treatment regardless so no harm no foul in my mind. Cab or Dox was always on my mind as my potential treatment when Zytiga stopped working as chemo will hopefully knock down my volume of cancer again and re-sensitize it so other treatments will be beneficial afterward(Provenge,Xtandi?, Xofigo?,Pluvitco?, etc.). If fingers crossed Dox brings my volume down it will be interesting to see if no added treatment until progression or add something right away. One step at a time though.
did you use ice packs, chips, etc. during chemo? I haven't done it yet but may next year. If so, I may ask about the details if doing that. Thanks
Actually no I didnt use any ice. For my head I had/have skull mets so no way was I about to not let the chemo get to my skull.
As far as hands and feet I think my panic mentality being just diagnosed with a high volume of cancer was "let that chemo flow everywhere".
The very tips of my fingers may or may not be a little more sensitive to cold and heat not sure.
My toes and distal ends of bottom of my feet are pretty much numb but not a big deal.
Being poisoned was an interesting phenomenon. Most of my toenails looked ugly and finally fell off about 7 or 8 months after my last chemo infusion.
Only food that didnt taste right during chemo was black olives otherwise everything tasted good. Lupron and chemo brought my appetite back (which I had lost) into full food cravings and pleasure in eating which was a major relief.
ok thanks. I know some posters have mentioned ice gloves/booties and ice chips. I'd like to avoid nerve damage if I can, but I'll read up on it some more.