Chemotherapy and PSA???

[Mrtroxely]

I started chemo treatment (doxetaxel)PSA was at 0.05

Just before Infusion 2 PSA 0.07

Just before Infusion 3 PSA 0.09

Just before Infusion 4 PSA 0.11

I tried asking my oncologist (no direct way to do this????)

I spoke with the oncology chemist who asks me how thing we're on chemo,

She says nothing worry about til PSA hits 1.0!!!

but I have tried to have conversation

If I'm having doxetaxel, that is supposed to kill my cancer, my cancer is emitting PSA

So my thinking is is PSA is rising (I know it's very small) consistently

Then doxetaxel istnt doing the job it's been given to me for?

Any one with any thoughts?

Advice or info would be appreciated???

[Spyder54]

Yes. You are killing off (many) PCa cells. It is known that dying, and dead PCa cells give off PSA. Many guys have discussed this over the past couple of years.

I wish you a good outcome long term. Docetaxel is one of the proven (in Human Trials) approaches to extend life. Hang in there. From what has been discussed the symptoms are cumulative. Hope you have read about ice packs foor feet, hands, and scalp, along with fasting 1-2 days prior to each treatment for less side effects?

Best of luck, Mike

[Mrtroxely in reply to Spyder54]

Thank you.This gonna be chemo 4 of 6...

Deal with most of side effects.

Bit of numbness now in toes set in....

Did read up on the ice pack stuff.

The diet and eating thing is all over place!!!

I'm used to chicken/fish/eggs, veg and fruit.

Chemo messes things up.

Any thing with vitamin c citrus tastes foul.

Artificial sweeteners taste awful

Cheap nasty real sugar makes things taste better.

Getting protiens and feeling full with allot of the vegan stuff is hard,

Diet all over the shop and keeps changing like the effects of chemo as go through cycle....

[Spyder54 in reply to Mrtroxely]

have been told sucking ice chips during treatment helps to relieve metallic taste and taste bud issues. To each their own on diet. “It all works, but nothing works well (curative)”. There was a Trial that proved cruciferous vegetables (broccili, cabbage, brussel sprouts, etc.) shrink tumor size. Mike

[Mrtroxely in reply to Spyder54]

broccili, cabbage, brussel sprouts, etc.These are the things I steer towards when early into chemo.

They usually taste similar to themselves.

Cooked baked potatoes tuna and fish also....

[Docker53 in reply to Mrtroxely]

My husband has had 9 rounds of Docetaxel and 1 more to go. His PSA also went up a point here and there for the first 4 or 5 infusions. The Oncologist said that is normal. It has been coming down steady. Was at 35 when he started and it's 20.5 now. Lost all hair and head a Beautiful full head of hair. It will comeback. His side effects had been mostly severe headaches after each infusion for at least 24 hrs. He did have a couple of nauseous moments and some dizzy spells. Are you on predisone 5mg two times a day as well? Hang in there it will get back.

[Mrtroxely in reply to Spyder54]

Also read your bio, but your push to remove your prostate.

I really think the freezing sounds like a good route????

Stick a freezy thing into bad bit of prostate.

Turn on some freezing stuff.

Supposed to be less damage to surrounding tissues and minimal side effects.

Also messes up the motherships communicatios to the metastasis???

[Spyder54]

after 7 NO’s from Surgeons, and 2 No’s from Radiologists, had SABR at Mem Sloan Kettering in NYC in January (11 mos ago). PSA has come down significantly ever since. New low nadir this month (26 mos since Dx). Pylarify PSMA PET in Oct., showed no PCa in prostate or bones. Same 3 lymph nodes still pos since first CT scan in Oct 2020, although all 3 smaller in size. Will deal with those next. Process. Mike

[hopefull99 in reply to Spyder54]

Looks like you are in charge of your treatments and making the right decisions - BRAVO.

[Tall_Allen]

Why did you begin chemo with such low PSA? Did more metastases show up on scans?

[Mrtroxely in reply to Tall_Allen]

Was told Pelvice/& hip socket was weakened from metasis, 2 areas.Original PSA 19/20

Gleason 9

ADT took down to below 0.07

Oncology wanted me start on chemo straight away.

I chose xandi instead but after a few weeks came of it due to not tolerating side effects.

So been on ADT for 2-3 months before chemo.

Now I've completed 3 cycles doxetaxel and start cycle 4 of 6 tomorrow morning.

They recommended radio therapy after chemo.

Think oncologist being agressive early with cancer?

But seems like the chemo is making a consistent climb in PSA???? only small but my head says PSA should stay same or reduce?

What's your thoughts???

[Tall_Allen in reply to Mrtroxely]

Chemo only works when the cancer is actively growing. Your low PSA shows no active growth. Maybe Zytiga is more tolerable?

[Mrtroxely in reply to Tall_Allen]

Now I'm confused!!!I'm having chemo.

I thought it was inline with hit cancer hard, like triplet therapy.

Oncologist recomendation.

I was under impression ADT makes cancer cells sleepy, inactive

Chemo/doxetaxel kills cancer cells.

But somehow PSA is going up?

I'm confused now,

[Tall_Allen in reply to Mrtroxely]

The idea behind triplet therapy is to hit the cancer from the start with ADT+docetaxel+zytiga or Nubeqa. It is never done sequentially.

[anony2020 in reply to Tall_Allen]

Also bone softening can be due to ADT. Right?

If so, RT may be overtreating.

[Tall_Allen in reply to anony2020]

No.

[Mrtroxely in reply to Tall_Allen]

So did bit more looking and thinking....

In your personal opinion, from all the info you've gained, all the facts you have seen.

1. Doxetaxel kills active cancer.

Question

Would giving just doxetaxel first before anything be more prudent if doxetaxel doesn't kill sleepy inactive cancer from ADT?????

Then start ADT

[Tall_Allen in reply to Mrtroxely]

No. As I keep saying, docetaxel only kills active cancer cells. There is no point to prophylactic treatment. I don't know how to say this more clearly.

[Mrtroxely in reply to Tall_Allen]

Weird? Yes you've saidBut your not being clear?

I'm trying work out what your pointing toward regards me

As you said starting chemo with such a low PSA??

prophylactic meaning????

: guarding from or preventing the spread or occurrence of disease or infection. : tending to prevent or ward off : preventive. prophylactically.

It's all prophylactic?

Maybe I'm not stating things clearly, or understand as you seem to?

Therefore I'm trying gain knowledge of my situation.

I started chemo with a low PSA, now it's raising in small measures during chemo

You asked me a question that is run as standard of care in UK? UK soc for high Gleason metatastic PCA

Chemo started around 3 months after ADT due to delay and change in treatment.

Your question statements point toward my being on chemo as inefficient?

So I hear what your stating about prophylactic and chemo only killing active cancer cells.

Am I needlessly on chemo?

[Tall_Allen in reply to Mrtroxely]

I wouldn't like my answer either if I were you. Don't shoot the messenger.

[Mrtroxely in reply to Tall_Allen]

Hah.Not shooting the messenger.

I'm learning ant trying understand.

So I don't have a clue what your answer is so I can look into it.

So.....

Can you be very clear without all the prophylactics and ambivalence then I'll be able shoot you when I understand.

1. Are you suggesting chemo isn't doing any thing for me.

2. Are you suggesting that if PSA is very low then not good use of resources to have chemo

3. With all that knowledge and years on this site what would you think was a good way forward....

Need to be proactive and find a way forward.

Ps, I got respect for your knowledge.

[Tall_Allen in reply to Mrtroxely]

1 and 2 - yes

3. Nothing to do until PSA hits 1.0

[TeleGuy in reply to Tall_Allen]

I understand the idea that chemo works best when the cancer cells are multiplying, but then how does triplet therapy work? In my case, my first round of ADT (2015) pushed my PSA to undetectable in a month. If I had added abiraterone and docetaxel, it doesn't seem like the docetaxel would have had many reproducing cells to attack. So was I not a good candidate for triplet therapy had it been in use back then?

[Tall_Allen in reply to TeleGuy]

Triplet therapy is only approved for de novo (newly diagnosed patients).

[TeleGuy in reply to Tall_Allen]

Yes, but if a de novo patient goes undetectable after a month of ADT isn't chemotherapy at that point superfluous just as you suggest the OP's chemo is?

[Tall_Allen in reply to TeleGuy]

PEACE1: "The first docetaxel cycle had to be administered within 14 days after randomisation and be at least 6 weeks after ADT initiation. Patients assigned to receive abiraterone received 1000 mg of abiraterone (four 250 mg tablets, orally) once daily plus prednisone 5mg orally twice daily, starting within 6 weeks after ADT initiation. "

ARASENS: "All subjects must receive ADT of Investigator’s choice (LHRH agonist/antagonists or orchiectomy) as standard therapy, started ≤12 weeks before randomization. For subjects receiving LHRH agonists, treatment in combination with a first generation anti-androgen for at least 4 weeks prior to randomization is recommended. Darolutamide or placebo was given within 6 weeks of randomization. Six cycles of docetaxel will be administered within 6 weeks of randomization."

[Mrtroxely in reply to Tall_Allen]

RIGHT!!! THATS IT!not gonna shoot you though!!!

You Americans love shootings....

thank you for your clarity!.

My oncologist is shit! I've known it from start, I've asked and questioned all the same questions previously....

My cancer nurse and the oncologist were kinda fear mongering me into chemotherapy!

' what if you don't have it!!! You'll have never known!!!'

I look n feel like a plucked Chicken, now my toes are going numb and a strong possibility I've been put through chemo due to a doctor just being complacent!

[Mrtroxely]

So originallyGleason 9 with mets to hip/pelvice

I was told by oncology

I was to start ADT

Then start chemo or enzalutamide

When chemo 6 cycles complete or stable on enzalutamide

Then start radiotherapy

That's what NHS UK has put in place for me.

Do you think chemo infective with a low PSA???

[Mrtroxely]

Started bicultumide on 1/6/2022 Decapeptyl ADT on 8th/6/2022

15?/7/2022 Then chose xandi instead of doxetaxel chemo.(had choice to try either, thought xandi would be lesser of 2 evils.....)

Had2-3 weeks on xandi then 2-3 weeks to flush out system to

10/10/2022 Then started chemo, first of 6 infusions....

I caused delay deciding on treatments....

Not sure when I found this site and seeing some other options....

What does it all mean?

Tall Paul kinda pointing to chemo not doing nothing to sleepy inactive cancer.

So maybe I need bail???

[Mrtroxely]

Think my short venture in to enzalutamide xtandi and indecision delayed things....

[dadzone43]

As others have pointed out, dying PCa cells are going to release PSA when they die. Take a deep breath.

[Mrtroxely in reply to dadzone43]

Thanks dude

[Mrtroxely]

Snap!!!They going of the analogy get it in me early.

Maintenance rather than fire fighting?

But I'm bit miffed now after the post I put up...

[Mrtroxely]

I've emailed them....I may as well post letter to Santa Nd ask him!!!

[TheWizardofWesley]

Man, I hope you are right about that.. cause my PSA is rising 5th round is Jan 3rd I hope I see a downward trend.. funny my MO has not mentioned any of this.. S>MH

[Mrtroxely in reply to TheWizardofWesley]

😬😬😬😬😬🫣🫣🫣🫣🫣🫣🫣🤒🤒🤒

Let's hope so, let's revisit January compare!!!

[Hidden]

First I knowvery little about the UK healthcare system. I am curious. My question is, are you taking chemotherapy and ADT? Of stopped ADT when you started chemotherapy

I ask because when I went metastatic in 2004, my first line was immediately an injection of Lupron following by chemotherapy and a continuation of Lupron. PSA was 32.4 when I started. Two months later 3.0 when I started chemotherapy. PS ranged from 0.5 to 1.0 during chemotherapy with ADT.

Anyway, I wish you the best and kill the little bastards.

GD

[Mrtroxely in reply to Hidden]

am getting ADT injections 3 monthly in arse cheek....And chemo now.....

[Mrtroxely]

No offence dude.All help questions are greatly received.

Not talking or expressing is bad...

[TheWizardofWesley]

Hey Mate... Hope you have a Happy Christmas, a Blessed and Bright Chanukah and a Happy Kwanzaa.. in other words,, I hope the coming season treats you and yours well...

Peace on Earth and Good Will to all men.& all that Jazz... but most importantly...

"LOW" Numbers...for guys like US

Peace out from the Wizard of Wesley Chapel, Tampa Bay Fl... AKA Larry The Wizard Siegfried on FB, feel free to friend me.. and I will hook you and anyone else on here to a Private Mens only Secret group on FB ie: A Reluctant Brotherhood.. It's place where we can safely Laugh, Cry and share experiences between men that have PCa without offending anyone who does NOT know what WE face on a daily basis.

Whew! that was a lot.. lol

Peace Brother

[TheWizardofWesley]

I know the feeling.. . After today's answer from my Team at Moffitt.. I know why people go Bonkers and walk in shooting.. (No I'm not remotely thinking about that).. but I sure get it..

[Mrtroxely in reply to TheWizardofWesley]

You Americans love a gun and a shooting spree.

Have you tried pillows.... Or leathe glove slaps!!! Like us English do....

Much more satisfactory

[Mrtroxely]

No offence Mrs dude.And thanks for asking questions, it always a help

[Mrtroxely]

Asked oncology Dr Brock as directly as I can....Had to email as no way to have dialogue....

Question to Dr brock

[Mrtroxely in reply to Mrtroxely]

Here's response to question.....This site seems to be a greater source of knowledge

Response