Docetaxel day 4 pain - is it normal? Possible fever?

[Jdhanoa]

Hi all,

My dad has stage 4 metastatic prostate cancer, diagnosed March 2023. He's on zoladex, darolutamide and had his first injection of docetaxel this past Monday (May 15). He was feeling normal the first 3 days but mid day 3 (yesterday) he got really fatigued and felt extremely achy in majority of his joints. We checked his temp and it was 38.2 and over 38 is considered a fever. We called the oncologist and he said to give tylenol and to watch through the night and if fever persists in the morning to go into emerg. We checked his temp again this morning and it was 38.3 and he was still in a lot of pain. We went to emerg where they did a chest x-ray and blood test. White blood cells and x ray came back fine. Blood culture results will come back tomorrow. He is back home now but still in pain.

It's hard to see him in so much pain. I was wondering if this type of pain is normal for docetaxel? All over body aches (legs, shoulder, lower back), headache etc. He is finding it difficult to even walk around too much.

I am also wondering if anyone else has experiences fever during chemo and if it is common?

Thank you

[TeleGuy]

Did he end a course of steroids on Day 3, leading to a crash on day 4? That’s typical, but you can taper off the steroids a little more slowly and come in for a soft landing.

Did he get Neulasta to stimulate his immune system? If so, did he take antihistamines like Claritin to help with the pain reaction?

No guess on where the fever is from.

[Jdhanoa in reply to TeleGuy]

yes his last dose of dexamethasone was on the 16th evening. How do you recommend tapering off the steroids? And no he didn’t get Neulasta - what exactly is that? Thank you

[TeleGuy in reply to Jdhanoa]

Steroids: from watching people on this forum, the recommendations from docs go all over the place. Last fall I did a combination of docetaxel and carboplatin so this is different from what your dad was doing. My doc prescribed dexamethasone, and I did a total of 16 mg the day before and the day of treatment, 6 mg the next day, then 5, 4, and 2 on successive days. Everyone is different but this worked the best for me make the first day off them less of a crash.

Neulasta is one of a class of drugs that are given to stimulate the immune system to help avoid neutropenia. The drug stimulates your bone marrow to work overtime and can cause pain, for which they tell you to take antihistamines. That was my guess as to your dad's pain, but that was wrong if he didn't have it.

There are other threads going on regarding docetaxel with lots of good suggestions, however I don't have a guess as to the pain and fever your dad has.

[spencoid2 in reply to TeleGuy]

thanks for the summary. i was lucyk to have no additional pain. if i did the first thing i would do it take some morphine (or the strongest pain meds you have) while figuring out what caused the pain and definitely report to your MO immediately. They know your situation more than we do and might have some ideas.

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

ispot.tv/ad/dBNp/neulasta-o...

TV commercial for Neulasta

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/23/2023 10:05 PM DST

[Peeffervescence]

I finished chemo in mid February. In my experience, I had pretty bad aches and pains after the steroids wore off on day 2 or 3. I was also very winded and was exhausted by walking from the couch to the bathroom. These side effects lasted about 6 days for me and then I started improving over the next 2 weeks. It seems counterintuitive but I feel like getting out and walking even short distances helped me recover and at a minimum improved my mental state.

[RoseDoc]

The pain is very typical. Begins 3-4 days post infusion. Pickle juice works well, along with Tylenol. It gets better with subsequent doses but still occurs.

[j-o-h-n]

Pain is never normal, unless you're married to my ex-wife.......

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 05/21/2023 4:51 PM DST

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

LOL!!!😅