Chemo with Docetaxel - side effects

[Bret5]

I started triple therapy over a month ago with Eligard and Nubeqa, Zometa for bones, and Docetaxel chemo (with daily prednisone). Gleason 10, RP with 12 lymph nodes all negative, but then quickly went metastatic to multiple bones - too many for radiation to be effective. PSA peaked 3 months after RP at 156. Was all the way down to 2.9 day of second Docetaxel infusion. 64 years old and good health except for the MPC.

My question is about the Docetaxel side effects. After infusion #1, I took nausea medicine for a couple days as a precaution but never felt sick. Days 5 thru 10 I had dry mouth. Also had some slight skin peeling at a few fingers. Some slight hair loss but I got a shorter haircut and it isn’t hardly noticeable (and temporary hair loss for me isn’t a big concern anyway). Some modest fatigue but who knows from which of the medications I’m on. Now it is day # 11 after second infusion. Side effects are even less than after first infusion.

I hear of people that really struggle with chemo or even avoid it even if warranted. Am I just lucky so far? And if I didn’t struggle much with first two infusions, am I likely to be ok for the next four?

[MarkBC]

I was 55 when diagnosed and did chemo shortly thereafter. It wasn't fun but it wasn't nearly as bad as I expected. Docetaxel, and the ADT, knocked my cancer back tremendously. My PSA went from 103.0 to 0.17 a year later.

The side effects intensified after each infusion. I never had nausea and never took the pills prescribed for it. Extreme fatigue on days 3, 4, and 5 after each infusion had me in bed most of the time. Hair loss happened after the second round. I shaved my head when it started. I wore ice mittens to prevent neuropathy in my fingers. It did happen in my toes and I gradually lost all feeling there. Taste bud changes after round 5 made finding good food difficult. Milk and apples tasted great. The side effects disappeared within 3 months of completion. The only permanent changes were the loss of about half my body hair, my eyelashes, and my eyebrows.

Best of luck to you. I hope you get great results like I did. It's been 5 years now. My PSA is currently undectable. My bone mets have not been visible on scans for the last three years. I'm living a great life and enjoying every day.

[dhccpa in reply to MarkBC]

You got your toes back eventually? I've wondered about that.

[MarkBC in reply to dhccpa]

Yes. The neuropathy started on my little toes after the second infusion. It spread to all my toes by the sixth. The neuropathy left my toes in reverse order and finally disappeared about three months after I was finished.

[dhccpa in reply to MarkBC]

I've debated doing the ice thing. Not ready for chemo just yet, but it's coming.

[MarkBC in reply to dhccpa]

You definitely need ice mittens for your fingers. Neuropathy there would make life difficult. In Canada, the ice gloves are provided as part of the treatment. We can pay extra to have our toes and hair protected.

The ice mittens were the worst part of the infusion. They are very cold. After about 30 minutes the inside would warm up just enough to make them bearable. At that moment, the nurse would appear with a new set fresh from the freezer. I used to hate that moment! 😀😃

[dhccpa in reply to MarkBC]

Thanks. I'll inquire about it whenever I start.

[Bret5 in reply to MarkBC]

I brought up the concept of ice caps, ice mittons, etc. with my oncologist just prior to my most recent chemo treatments infusion. He told me that some people do these things and some don’t, but with half life of Docetaxel at 72 hours, it was unclear to him how applying cold for a few hours at time of infusion would make a difference. Just relating what I was told.

[MarkBC in reply to Bret5]

He makes an interesting point. I don't know why it works but it does. Here in British Columbia, ice mittens are provided to everyone receiving docetaxel and I would advise everyone to ice their fingers. I had neuropathy in my toes for a few months. I wouldn't risk getting it in my fingers. Everyday life would be difficult with the loss of sensation in our fingers. In some patients, the neuropathy can be permanent.

I would be curious to know if anyone went through docetaxel without icing their fingers.

[Oblivious1 in reply to MarkBC]

I have had five of six docetaxel treatments, and I have wore the ice cap, mittens, and socks. I am type two diabetic and had a bit of neuropathy prior to the treatment, and it worsened a bit in my feet even with wearing the socks, but overall it is not been significantly worse. I think if I had not worn the socks and mittens. It would’ve been much worse, I have heard that from others as well. I do think it’s helpful. I have not had hair loss as well. Neuropathy has been a bit worse of my feet and fingers with some of the early recycles but now after the fifth, I have not noticed really much of an increase in it at all. I purchased my own and have two sets so I can replace them when they warm up. I like to have them on a few minutes before the infusion starts, during the infusion and for a few minutes after.

[OzzieJ]

I did 6 sessions of chemo earlier this year. I found the first 5 days afterwards tiring but then recovered pretty well. Also my taste was “funny” for about 7 days. But there was also a cumulative effect so by the end of the 6 sessions I was more tired and really glad to finish. I did manage to work (from home) during chemo and also went skiing a couple of times so while it was not a walk in the park it was doable. I used the cold cap system so had no hair loss. I also used Neulasta after each infusion. But 3 weeks after I finished chemo I caught a fever which I couldn’t shake off and ended up back in hospital for a week on IV Antibiotics. So just be aware that you might feel reasonably OK but your immune system is going to be compromised so it’s a good idea to take things easy. Also in the week before my next infusion I would try to do something nice like visit a good restaurant before getting hit with the next round.

Wishing you all the best and really hope this treatment works for you.

[EdBar]

I had 6 rounds back in 2015 per CHAARTED. For me the SE’s got progressively worse especially after rounds 3-4. Hair loss, brittle nails, lining of the mouth peeling, sores on my tongue, fatigue and a general sickly, flu like feeling 2-3 days after infusion that lasted about a week. I had neuropathy in my feet that lasted several years and would flare up when walking or hiking. You just have to embrace the suck. As I look back it’s likely one of the reasons I’m still here today. That was my experience perhaps yours will be better.

Ed

[SteveTheJ]

Not speaking from experience, take nothing for granted but be encouraged. IMHO, unless you know your bones are weak stop with Zometa. It causes side effects also and will be of little benefit unless you know you have osteopenia (sp?) or osteoporosis.

[Bret5 in reply to SteveTheJ]

yes, bones are weak with numerous lesions. Most concerning are upper legs and pelvis due to weight bearing. Did bone scans, met with radiation oncologist, had X-rays, met with orthopedist. All at City of Hope. Consensus right now is that I don’t need surgical pins or spot radiation but do need to address the bone strength. Received dental clearance, as jaw issues can occur in some cases. Also looked at Xgeva as the preferred medication but current insurance approved Zometra. I believe that addressing the bones in this way is a standard part of triple therapy for metastatic prostate cancer reaching multiple bones.

[CAMPSOUPS in reply to SteveTheJ]

Zometa is of benefit for those with bone mets. Its not strictly for osteo problems. Zometa will prolong the time it will take for my extensive bone mets to crumble and break my bones.

[Hidden]

My husband had 9 infusions of Docetaxal in 20/21 and next week is getting his last of 10 Cabazitaxal infusion. Has done fairly well with all, some neuropathy, hair loss, tiredness. I wish they had worked better for him though. PSA still remains high, will consult with MO next week to find out next course of treatment

[Texasjack1957]

Every individual is completely different and will have different side affects.