After 11 years, dad has started chemo for the first time

[PHnerd]

Hey all, dad was diagnosed in Feb 2012 (removed prostate right away), metastasized to the coccyx in 2019. Been on Zoladex (for life), Zytiga, Xtandi, etc. Now that his PSA is very slowly increasing (been going up since 2019 from below 0.30 to now at 2.0+), his oncologist recommended we enroll him in a Lu-177 clinical trial. He got randomized to the chemo arm and will be receiving docetaxel every 3 weeks. He had his first session on Nov 29 and will be getting his second in a few days. Anybody here been through this? Did the chemo work? For how long before the cancer came back (if at all)? And any suggestions for managing side effects? Thanks!

[FormulaRob]

hey there,

So from your bio I see it spread to pelvic bone In 2019. What was the reasoning to not do chemo at that point?

Does he have a low Gleason score where cancer takes very long to spread ?

[PHnerd in reply to FormulaRob]

I’m not sure. But they pursued radiation immediately which drastically lowered his PSA. Since then, he was on Zytiga and Xtandi and though the PSA is low, the onc said it might be worth it to start chemo now. My understanding is the onc wanted to exhaust other means of treatment before chemo.

[Ronnie7C]

Side effect from my 1st chemo session was pure hell. For 2 days after the session, things seemed bearable, then from 3rd day onwards the side effects were unbearable. Even my teeth seemed to ache. That lasted for another 2 agonising days.

After the 1st session, my wife did some research and came across article supporting the idea of undergoing a Fasting Mimicking Diet (FMD) just prior and after each chemo session. You definitely need to check this topic out on the internet. The theory is that by fasting (actually it seemed more like starving yourself), this would cause the good cells in your body to going into a hibernation type mode, whilst the cancer cells in the body would continue to stay in high-active mode (since this mode helps the cancer spread aggressively within your body). Then when you start the chemo infusion, the drug works primarily to destroy the high-active cells (i.e. the cancerous cells) whilst doing only minimal damage to the hibernating cells. That’s the danger of chemo; it can cause damage to good as well as bad cells.

Anyway, I drastically limited my food intake 2 days before my 2nd chemo session and continued it for the day after the session. Just like before, the 2 days after the chemo session, everything seemed perfectly normal. On the 3rd day, I felt a bit bad but nowhere in comparison to the effects from the 1st chemo session. Essentially, the chemo side effect where much milder and my recovery period was much faster. Also discover that taking Anti-histamine tablet the day before, the day on and the day after the chemo session as helped to sail through the session. Following the routine, each chemo session become noticeably easier and easier.

The FMD involved a fasting diet (target is about 700 calories/day) taken during the week of chemo (3 days prior + day of chemo + day after chemo). I hope you have the same success if you decide to try this routine. Please let me know the outcome of your session.

The chemo did work to reduce my PSA but don't get too hung up on only the PSA score. Keep monitoring overall health readings/scores.

Good Luck

[rsgdmd]

I'm 8 weeks out from my last (6th) chemo. It wasn't as bad as I expected. Side effects for me (& everyone is different) were fatigue and achyness on days 2 -4, constipation; started losing hair about 10 days after 1st round & had my wife shave my head; thrush every time. Day after each round I felt fine, due to the steroids. Zyrtec helped with achyness. Used ice packs for hands and feet but still got some peripheral neuralgia.

I'd suggest lots of hydration day before, day of and for next couple of days. Even if tired, try to get some exercise - short walk, lift light weights. I ate a lighter than usual diet day before and day of, but no fasting. The chemo did bring my PSA down but I'm still waiting for my white blood count to come back to normal. Good luck.