Docetaxel after rising PSA

[Elites88]

Hi, Normally I will begin a docetaxel cure (6 x 3 weeks) in a few months (PSA is rising a lot after 4 years of Zytiga). Do you have an idea of the efficacity ratio of such a treatment ? Thx

[Tall_Allen]

What is an "efficacity ratio"?

[fish7days in reply to Tall_Allen]

Looks like he is asking for opinions on how effective the treatment may be, maybe experiences.

[Hidden]

Elites88,

I have not had that therapy yet so I cannot comment on my personal experience.

Generally speaking though my sense of things is that it will not cure you, but has the potential to knock back your cancer for a period of time, and that time can vary widely.

How long it works can vary from hardly at all to years and I am not smart enough to know why it works so well in some guys, and not at all in others.

If you are about to start treatment, I have read about guys wearing an ice cap to help prevent hair falling out, and they also keep their hands/feet in an ice bath during the infusion to help prevent neuropathy.

Good luck to you!

[Muffin2019]

This is my second round of this drug in 5 years, hair thinner, very little facial hair, taste buds act up but better a week and half later. No neuropathy or tingling in hands and feet. Skin is dry so holding things with my hands can be an issue. Good luck and God bless.

[Ian99]

Good comment from sszyszkiewicz about the cooling treatment. I expect to move onto Docetaxel at some point so have been researching the topic. I have neuropathy in the feet from chemo for a previous cancer (not PC) 10 years ago, was unaware of this at the time, but can confirm the side effect is real.

You may find it more practical to use frozen socks and mittens; kits are orderable online. Depending on your country health service this kind of cooling treatment may not be part of SOC. But nothing prevents you from using it for your own benefit.

You may also want to look at fasting during chemo. Available data show that periodic fasting, a form of intermittent fasting, may have the potential to improve the effectiveness of chemotherapy, and decrease treatment-related side effects. This link gives some insight:

pubmed.ncbi.nlm.nih.gov/347....

In any case, you should consult with your oncologist on this topic as it may not be advisable in all cases.

The patient advocates on this site will put me right if any of this is inaccurate. Hope it helps.

[Cateydid in reply to Ian99]

my Joe bought himself an electric foot bath to soak his neuropathy-ridden feet in. That, plus gabapentin, and compression socks, seemed to help.

[Ian99 in reply to Cateydid]

People are affected differently. I have it equally in both feet, it’s always there but I have become used to it. I do not know your solution but if it works for Joe, well done !

[PeteLG]

After Zytiga, then Xtandi failed, began docetaxel: stopped after 5 treatments when PSA hit 889. Everyone is "n of 1?"Pete

[Shamrock46]

When my husband first started Xtandi the MO said "it will work until it doesn't because the cancer will always find a way to outsmart it." That's, unfortunately, the sad fact about treatment as PC is ultimately incurable. The Xtandi/Lupron has bought us 9 years since original diagnosis in 2014 first recurrence. Right now he's off all meds since PSA has been doubling and other meds/treatments are off the table due to cardiac issues. Good luck with your decision for treatment. Hope it works better for you.

[catsup in reply to Shamrock46]

I am in a similar situation. Diagnosed 2014 , PSA doubling . As of now no treatments as suffered heart attack a month ago . ONC wants to was it until heart strengthens beefier resuming chemo. What is your husbands planned future treatment?? The doctors are not going to let him fade away with no effort to fight the disease??? Would appreciate knowing what’s next for him as I can pass it on to my ONC.

[Shamrock46 in reply to catsup]

He stopped Lupron/Xtandi in April due to worsening SEs which he refused to tolerate any more. He can't take Abiraterone due to cardiac problems. He's really had a rough time with multiple SEs since initial surgery in 2014 and says he's sick of feeling so awful. He has bloodwork scheduled at end of June and sees MO the following week to discuss the findings after being off meds for 3 mos. I was hoping that would start to lessen the fatigue the plagues him but it seems to be getting worse as well as what he calls discomfort (won't say pain) when sitting/walking. His MO prescribed Tramadol for pain but he says it doesn't help much and is only thinking about asking for something stronger since he's leery about dependency/SEs from opioids. His cardiologist said at last visit a few mos. ago that his CHF is stable but he's also gotten much more out of breath upon any activity. He sees him a few weeks from now as well. Prognosis is poor at this point but we're waiting to get through both appts.

[Shamrock46 in reply to catsup]

My husband also had a silent heart attack and was asymptomatic until tests showed blockage in arteries during pre-op testing for knee repair in 2010. That's led to 1 stent in 2014 and an implanted defibrillator (has never gone off) in 2018 when he had an endarterectomy. We were told that the silent heart attack caused the death of 1/3 of his heart so it's hard to know if current symptoms are caused by heart or PC...or both. We've been told that if his condition worsens he needs to see cardio team to shut off the defib.

[Pattycakepgh]

My sweetie used these cold therapy socks and gloves during his treatment after someone here on this site recommended using them as he was getting set up and during infusion to help prevent neuropathy. They were easy to transport in a small cold bag and he never experienced any neuropathy, so we are giving these credit for that help.

amazon.com/gp/product/B09W5...

[dhccpa in reply to Pattycakepgh]

No ice involved? Just freeze them and bring them to chemo?

[Pattycakepgh in reply to dhccpa]

I kept them in the freezer over night to chill them. When we were leaving for the appointment, I put them in a soft side freezer bag with a large zip-lock bag of ice to keep them cold until we got there (sometimes that was a few hour lapse). They were still frozen and worked great for him. He never had an issue with any neuropathy, and while we will never really know if they were the reason, after using them the first time and getting a positive result we just decided to keep using them.

[dhccpa in reply to Pattycakepgh]

Thanks very much

[NEHOG]

Sadly for me, it did nothing positive, and instead caused a lot of (permanent) side-effects that I still suffer from over a year after treatment ended. Not to say that it will not work for you, but my suggestion is once it stops being effective it may be an idea to discontinue treatment if you oncologist. I did not and regret that decision now...

[PSAed in reply to NEHOG]

Can you share what permanent side effects you experience?

[dhccpa]

I've never heard docetaxel described as a cure for metastatic PCa. Are doctors now saying that?

[tango65]

If you are requesting info about median overall survival, these are the results of one of the original largest RCT:

nejm.org/doi/pdf/10.1056/NE...

The situation has change a lot in the last 20 years, so survival is better.

Chemo may re sensitize the cancer to anti androgens and you could continue previous therapies, then there is Provenge, Xofigo, Lu 177 PSMA treatment, and tailored treatment against specific mutations of the cancer, such as Olaparib, rucaparib, keytruda etc. There are also multiple clinical trials, which can help to prolong life.

In general, after failure of new anti androgens the way to go is chemo, or Lu 177 PSMA if the insurance will covered it without having chemo first.

[Hidden]

Per scans the docetaxel did not shrink the cancer but the spots did not get larger. Finished the chemo treatments 3months ago. Had 3 SBRT treatments on 2 spots a month ago. Will do PSMA scan in about 6 weeks. Then will decide on when to start Pluvicto.