In hospital with neutropenia following 1st cycle of Docetaxel. Considering discontinuing Docetaxel, is that reasonable?

[Jay-kud8]

Gl 5+4 Adjusted PSA at diagnosis of 27 ( was on Dutasteride) cT2 N1 M0 . Pelvic and para aortic nodes on PMSA PET scan .

Started on ADT in October 22. PSA < 0.03 in January after 3 months of ADT, pre starting Docetaxel.

8th day following 1st dose of Doctaxel, fever, landed in hospital with severe neutropenia. Will be in hospital for 3-4 days. On antibiotics and G-CSF to improve counts.

Have trepidation about continuing with Docetaxel. Should I just stay on ADT and Enzalutamide?

[GP24]

You can add Abiraterone, Apalutamid or Enzalutamid to your ADT and discontinue the chemo. The combination of ADT with these drugs should provide about the same benefit as a chemo.

[Gl448 in reply to GP24]

"Have trepidation about continuing with Docetaxel. Should I just stay on ADT and Enzalutamide"

She says in her post he's already on Enzalutamide, so your suggestion to replace chemo/docetaxel with Enzalutimide doesn't seem to fit.

If his doctor thinks chemo is warranted, as Tall _Allen mentioned the chemo can be managed.

My chemo sessions will all start with labs the same day, a doctor's visit afterwards, then a tailor-made mix of drugs to address the labs. Blood transfusions immediately after chemo are also on the table is blood counts are out of whack.

[Jay-kud8 in reply to Gl448]

Not on Enzalutamide yet only on ADT with Decapeptyl injections ! Long chat with the Oncologist, who put forward a convincing and reassuring argument to continue with Docetoxel chemotherapy followed by Enzalutamide and radiotherapy.

I think I will take his advice.

[Gl448 in reply to Jay-kud8]

OK, I misread your post. Sorry about the confusion.

My feeling is that chemo kills active cancer cells, ADT+whatever only starves them out until they stop working and you move onto the next combo.

Best wishes for the next chemo sessions going better. My second one is next Tuesday.

[leebeth]

Your doctor can simply add a growth factor (like Neulasta) to your routine to promote WBC production. Your dosage will also be adjusted going forward; that’s standard. My husband was hospitalized with neutropenia from Jevtana/carboplatin and went on to receive 4 more cycles without any further neutropenia.

Best of luck to you!

[mysticmini]

Definitely ask for Neulasta to be added. Didn't have first cycle, and like you ended up in hospital. Had Neulasta added for round remaining 6 rounds and it was a game changer. Tolerated remaining rounds with minimum side effects.

[Tall_Allen]

Discuss having Neulasta (or whatever brand of G-CSF you had) before each infusion. Also take Claritin or other antihistamine.

[Jay-kud8 in reply to Tall_Allen]

Thanks, Take Loretidine 10mgs just before chemotherapy? Or continue for a few days?

[Tall_Allen in reply to Jay-kud8]

Ask oncologist before taking anything. It can help counteract an allergic reaction to Neulasta.

[JD-guy]

I did not have Neulasta for my first infusion, ended up with Fever and went to the ER. Was able to get it down. After the rest of my chemo infusions, I went home with an injector on my arm that gave me Neulasta about 27 hours after my infusion. What ever you do, to help keep the WB count from dropping is a good thing is what I was told. This is just my experience. Chemo was challenging but I would not stop it, if you can make it thru.