Docetaxel and deterioration

[BrentW]

My oncologist last Tuesday informed me that:

1. The drug I am on, Xtandi, is going to fail. The is hoping it will manage the rest of this year and the next.

2. After that, all she has in her armoury is docetaxel, with 6 - 10 cycles spaced at 3 weekly intervals.

She expressed concern that, as I have been receiving ADT since 2004, and as this has been heavy on my organs, she is worried that my liver and kidneys will not be strong enough to withstand the chemotherapy. Can anybody give any advice on how I can strengthen my liver and kidneys while I wait?

[Tall_Allen]

It seems like a good reason for not waiting. Email her this:

thelancet.com/journals/lano...

[GP24]

An alternative is Pluvicto. This works well in combination with Xtandi.

[spencoid2]

I don't think you can heal your kidneys and liver quickly. But if nothing else, if you do drink alcohol, stop. If you take any drugs that are hard on the liver and or kidneys stop them if you can, of course not if they are crucial to your health. Look up the side effects of any drugs you are taking and see if they are tough on your kidneys and or liver. This includes over the counter drugs like NSAIDS. They are absolutely horrible for you to take regularly. Also consider stopping drugs like omeprazole which prevent you from digesting good food. Change your diet instead. No pepperoni pizza.

[BrentW in reply to spencoid2]

Thank you, spencoid2. I shall do all I can to address these matters. Right now, I must admit, I feel fine, and my liver and kidney function are normal. I just want them in tip top shape before we start any nasty stuff.

[spencoid2]

Sounds like a good plan. This stuff is nasty and anything you can do to improve your general health is probably good.

[jfoesq]

If you don’t mind explaining, I am curious by what you mean when you said ADT “has been hard on my organs “.

[Seasid in reply to jfoesq]

Good question. I believe it is only hard on my bone health and maybe could cause prediabetes.

I was wandering the same as you.

[BrentW in reply to Seasid]

Sometimes I can only go with what I am told. . . .

[Seasid in reply to BrentW]

How your bone health is doing? After 5 years on ADT my bone T score is -2.5 (or worse) that is my concern now. I am drinking coffee and my liver looks ok now.

[u302000]

Brent,

Hello I am Buddy from Charleston SC. We recently returned from a visit with Friends in Peterbourough. I am retired now but we had work in East Kilbride, Darby and Bedford.

Sounds like you have been recently diagnosed mCRPC like myself.

I was PSA 13.4, Gleason (5+5) 10, T2bN0M0.

I have been on ADT, Eligard, since 9/2021, and had

Proton Therapy 12/21-2/22 at U of Florida Proton Therapy Institute.

PSA dropped to 0.02x for a year after the Proton Therapy

This February my PSA started to rise and is now at 25.4.

I started Xtandi February and it has not shown any sign of reducing my PSA.

If you read the paperwork that comes with Xtandi, the trials for my background are not very promising, like 36 months vs. 32.4 Overall Survival, OS, drug vs. placebo for one trial and less than a year on another. Not so impressive but best of the choices on our NIH mainline treatment plan. Here in the US we have to follow the money and the influence of Drug Manufacturers is aways an issue.

In the States the next mainstream step is Chemo which I do not want to take.

I am a retired engineer and have done a lot of reading and research

To find the source of the PSA i had the PMSA-Pet scan done. It is able to pinpoint Prostate Cancer, PC, where ever it has spread in the body via a newly approved nuclear drug given by IV which seeks out the smallest bit of PC, attaches to it and radiates long enough for the PET scan to pick it up. This is very recently approved here in the States. One company built on this seeking out and radiating to come up with LU-177, Pulvicto, which has like a seven day half life and a short distance of of radiation to kill the PC cell(s). The Therapy is 6 sessions, six weeks apart. Pulvicto is US FDA approved as on 3/2022. Another drug company, Point, has what seem to be an improvement on Pluvicto called LU-177 PNT2002 which has US FDA Fast Track Approval. The Treatment with this one is 4 IV sessions, 8 weeks apart. The stated benefit is less overall radiation

[j-o-h-n in reply to u302000]

Great info, thanks Buddy...

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 06/17/2023 12:01 AM DST

[u302000 in reply to j-o-h-n]

Hope it helps.

Cheers,

Buddy