Memory loss with Docetaxel

[Pattycakepgh]

In November when I posted for the first time you all were so very helpful in making suggestions to help my honey when he began his Docetaxel chemo treatments on December 1, 2022. Your advice about icing his feet and hands, I believe contributed to his having no neuropathy. He has now completed five of six sessions, and other than fatigue and some hair loss, has had no other side effects until now.

I am writing to ask if any of you have had any experience with memory loss while using Docetaxel? We were advised about 'chemo brain/fog' and I anticipated the confusion he is experiencing in things like using his computer and his phone apps, and also doing multi-step tasks sometimes. But he is starting to have significant memory loss relating to things that have been part of his life for years. Here is one of several examples I shared with his MO last week........ While watching a PGA golf tournament as we do almost every weekend, Mike asked me, “why are we watching the same guys golf today who we saw golf yesterday?” I explained that golf tournaments are four days (Thurs-Sun) so we watch them golf all four rounds. He said, “Oh, ok”. At the end of the round on Friday he said, “So since four different golfers all have the same score, how do you know who won?” I told him, “they still need to play two more rounds, then on Sunday, if there is more than one person with the lowest score that there will be a playoff”. They showed one of the player's score cards, and he asked me, “what is that chart for?” I told him it was the golfers scorecard and what he scored on each of the 18 holes. .....Golf is something he has done for more than thirty years and all of this is something he knows very well being a person who golfs once or twice weekly up until starting chemo treatments.

I shared a few examples of this type with his MO and she suggested that this might be more than what they would attribute to chemo brain/fog. She said that the combination of Docetaxel with Eligard may possibly be contributing. She suggested they may want to have him see the Neuro team for an evaluation and baseline cognitive testing. Mike had no evidence of memory loss or this level of confusion prior to his fourth treatment on February 8th. He just had his fifth treatment this past Thursday and seems quieter and confused about more routine things. My questions are these, (1) has anyone experienced this? (2) Is it a temporary situation that once the chemo treatments are completed will this confusion and memory loss improve? I honestly feel like we worked to try to find the best treatment to help fight his cancer, but now question at what cost-to have him with these cognitive issues that may continue to get worse to the point where he can no longer remember where he lives, or people he knows or do the activities of life he has loved? I am trying to be hopeful that this is temporary.

Thank you all for the kindness and support that you share. Reading all your posts each day provide me with encouragement and hope.

[mypk]

I didn't have that when I was treated with Docetaxel and Leuprorelin (Eligard). But 'impaired memory' is mentioned as a possible (probably very rare) side effect in the 'package leaflet - Information for the user' of Eligard.

[Pattycakepgh in reply to mypk]

Thank you for taking time to reply. His MO mentioned the Eligard had that effect but since he had been receiving those injections since last March and this memory loss has come up so recently, she suggested that the Eligard in combo with the chemo may be a cause.

[Tall_Allen]

Docetaxel doesn't cross the blood brain barrier, so significant cognitive deficits like that are unusual. If it persists after docetaxel, you can talk to his MO about trying Nubeqa monotherapy (Nubeqa doesn't penetrate the blood brain barrier either), at least for awhile, and eliminating Eligard. If that doesn't fix the problem, the memory loss may be due to other causes.

[Pattycakepgh in reply to Tall_Allen]

Thank you Tall_Allen for your reply, the information you gave is very helpful and I will use it when I speak to his MO. I wish that I had posted this prior to Mike's appt last week because along with the Docetaxel treatment, he also received his every 90 day Eligard shot. So he will now have more of that in his system to possibly add to his struggle with this memory loss if it is the cause. Thank you again.

[tango65]

Having those memory issues he needs to consult with neurology to do basic tests like the MOCA test, and decide if further evaluation is needed. A brain MRI may be useful to detect micro or macro no eloquent infarctions.

Cardiologyshould see him to rule out artyhthmias, mainly atrial fibrillation which may cause microembolization of the brain.

Internal medicine should see him to evaluate hypertension, diabetes, high cholesterol etc.

[Pattycakepgh in reply to tango65]

I appreciate your reply and your suggestions. His MO did say that he may need to be evaluated by the Neuro team for cognitive testing and a possible MRI. He takes blood pressure and cholesterol meds, and his glucose on last week's blood work a was normal. He has a routine appt this week with his PCP and I will forward the blood work results from last week for his review, and discuss the cognitive issues with him. I will also ask if he should be checked by a cardiologist. Thank you

[Yank66]

My DH has some memory loss as well. His reasoning has taken a hit, too. Signs started before chemo. Neurologist said it is likely due to hormone therapy (nine years of it). Neuro ordered sleep apnea test, MRI, and suggested vitamin B6, B complex and iron supplements. Of all the side effects he’s had to deal with, this issue scares me the most. Our best to you.

[Pattycakepgh in reply to Yank66]

Thank you for your message. I agree, of all the things that he has been through this last year since diagnosis this does scare me most. As I mentioned in the post, we've tried to find the best treatment and to think he is improving related to his cancer, but declining cognitively is a sad thought. My Dad passed from Frontemporal Dementia and so I have experience in losing someone in that way. I appreciate your thoughts about the vitamins, he does take iron supplements and B12. I wish you both well in your journey.

[Hidden]

First I am not a physician; only someone who since 2004 with metastatic lesions in my spine. Six and a half years on Lupron/Eligard and nine infusions of Taxotere alternated with nine infusions of Adrimyacin over a six month period. This bastard disease hits all differently.

I note that you are 65; how old is your husband? Could he be on the cusp of cognitive disease! Your husband was DX’d with widespread metastatic lesions in bone and vital organs 14 months ago; all with a Gleason 9. He has a tough road to hold.

I don’t want to alarm you; however, realistically consider, my best friend from college with a Gleason 8 and similar manifestation, exhibited the same symptoms and three months later after a MRI on his head was DX’d with metastatic lesions in his brain, I assume on his nuclear bone scan it was whole body - head to feet.

I suspect that his cognitive decline is outside of ADT and Chemotherapy. Please listen to your MO and schedule a session with a Neurologist and have a brain scan done; it is time to rule out the bad stuff through diagnostic testing. Without, this is in the realm of pure speculation - even my uneducated comments.

I wish your husband the best in beating this bastard disease,

GD

[Pattycakepgh in reply to Hidden]

I appreciate all of your thoughts gourd_dancer. My honey is 79 and you have said things I have thought, is this unrelated to the cancer and could be cognitive disease. The only reason I thought there was a tie to the chemo/Eligard is because of the suddenness of its onset. He exhibited no signs of any memory or thinking issues prior to a few weeks ago. Since we were cautioned about the potential for chemo brain fog as a side effect, my first thought went to that. But when it seemed more long term memory situations, I shared the examples with his MO. We will pursue their recommendation of an evaluation with a neurologist. Sending good thoughts your way as you continue your journey with this disease. Thank you

[wagscure259]

Excellent suggestions by Tango65. PCP can do EKG to rule out arrhythmia at least preliminarily. These deficits seem considerable and a neurologist should be consulted asap and I know at MSK an MRI would be in order and would show any infarcts or rarely metastasis. Best to you both

[Pattycakepgh in reply to wagscure259]

Hello wagscure259, I appreciate your feedback. I did follow-up with his MO today to find out if they have submitted the order to have the MRI done. They said I should have been contacted by the scheduling team for an appt, but since I had not they would follow up with them to get it scheduled. They said they would also get an appt for him with Neuro team for an assessment, but that appt will be after MRI is completed so they have those results. I hope we are moving forward with getting some answers. thanks

[Shamrock46]

Our MO downplays any mention of memory issues, but finally admitted it would most likely be from Lupron. She also threw in that maybe my husband should have a neuro workup but he shut that down quickly. I notice little things like not remembering movies we've seen before, or not following through on a task like putting away dishes but forgetting to close the cabinet doors. She also said that he'd probably have other more significant problems before his memory loss got worse which didn't sit well with me. I still tell her I'm very watchful and won't want him continuing Lupron until it's too late to save him and his memories! Sometimes I think MOs don't really understand how debilitating and concerning SEs really are. Follow your gut instincts...the cure shouldn't be worse than the disease.

[Pattycakepgh in reply to Shamrock46]

Hi Shamrock, I too have been concerned that Mike would balk at a Neuro assessment, because he thinks he is fine. So since his MO brought up the brain MRI last week, I am going to schedule them around the time of the other post-chemo MRI and CT's that are already on the calendar. He himself did tell his MO that he sometimes gets confused about things, so I am just going to remind him that she suggested it and say this will give us more information about how his brain is being affected by the treatments. You are exactly right, the cure shouldn't be worse than the disease, but I think in many cases that is what happens when doing battle with cancer. I send you my and your husband good thoughts as you journey together on this path.

[Shamrock46 in reply to Pattycakepgh]

I wish you and your husband the same. It's a difficult path with many unknown trails. We can only do our best...and pray!

[j-o-h-n]

Well I explained myself in the prior post "psma Addition trial". I've been on Lupron/casodex for 15 years. I think I'm 86 years old.....and I forget NAMES, NAMES AND MORE NAMES.

Take your love-one to see a doc....

I would have failed those golf questions also....

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 03/08/2023 7:36 PM EST

[Pattycakepgh in reply to j-o-h-n]

Thank you for your message j-o-h-n, I followed up today with his MO and they had put in appt request for brain MRI and Neuro appt, but we had not been contacted. They apologized and said we would be contacted tomorrow. They want the MRI done so the results can be available for Neuro team. Hopefully Mike can be seen in the next few weeks. I smiled reading your golf comment! There are things Mike may not know, but golf is his favourite hobby! I will look for your post and I wish you well on your journey

[Hidden]

My husband didn't have chemo just the many types of hormone treatments over seven years. He had extreme muscle loss and suffered many falls. He also was experiencing dementia. After testing by a neurologist he was diagnosed with Parkinson's. After just a few weeks of medication his dementia has greatly improved, and it was quite bad before! He is walking so much better also. He has stopped the hormone drugs so that helps. He has fatigue and feels leg weakness by the evening. A previous brain scan showed evidence of some small strokes . He is also an insulin dependant diabetic. It's hard to know if some of these things are due to the cancer treatments through the years. He is not strong enough for chemo. Several doctors agree he would not do well on it. Now getting at home hospice care. This cancer and the treatment takes a toll, on everyone.

[Pattycakepgh in reply to Hidden]

Thank you for the message. We have been able to schedule a brain MRI and will then have an appt with the Neuro team for an evaluation at our cancer center. You are right this disease takes its toll physically, mentally and emotionally on everyone. It is hard to tell what other health issues are/were present, and what the treatments may have contributed to them. I send my prayers and positive thoughts to you and your husband.