If it doesn't make you feel bad, is it working?

[MiaAmia]

Background:

My husband recently received his fourth docetaxel treatment. He has mets to bones and lymph nodes and has had two SBRT sessions to bone and prostate which significantly reduced both pain and node size. He has "failed" both apalutamide and abiraterone and is officially castrate resistant. Initial diagnosis was such that he was not offered triple therapy (he was low volume in Feb 2022).

After the second treatment, his PSA had gone down to 22 from 41. After the third, it had increased to 25. Bone and CT scans have been ordered but there is a backlog. We expect the bone scan in the next week or so, but the CT might be quite a while. PSMA will be ordered after that. Unless Pluvicto is approved for funding by Cancer Care Ontario, even if it's indicated, the cost will be prohibitive - still, we'd know if it might be worth using up his savings.

The Question: In the meantime, he had a fourth docetaxel infusion on Thursday. Our concern? He feels great! I mean, no side effects whatsoever, not even fatigue. Is this a prime indicator that it's not working at all, or is this just coincidental? Is this normal? We've read that each session generally gets worse.

[TMcgee]

I completed 6 cycles of Docetaxel in July. I had significant issues after the 3rd cycle; but no side-effects for 4th thru 6th. Based on my readings, age, comobilities, diet and exercise have a significant impact on side-effects. I imagine luck and genes also play a role.

I have read a lot about Docetaxel and haven’t read where there is a correlation between the severity of side effects and effectiveness of treatment.

Best to you and your family

[john4803 in reply to TMcgee]

Did he exercise, eat right, get enough sleep, etc.?

[MiaAmia in reply to john4803]

He's a rule follower. Everything by the book.

[Tall_Allen]

"Don't look a gift horse in the mouth."

[JohnInTheMiddle]

I'm also in Ontario diagnosed a year and a half ago with metastatic high-volume PCa.You didn't mention which ADT your husband is on? Lupron or Firmagon? I did six Docetaxel - and didn't have a lot of symptoms that I remember. Seemed to work though. We had found some not-crazy research that indicated that fasting for 2 days around the chemo for PCa was a good idea for multiple reasons. (The hardest thing about chemo was the stupid bags of ice cubes intended to possibly reduce the risk of neuropathy on hands and feet.)

[MiaAmia in reply to JohnInTheMiddle]

He is still taking Firmagon but no longer Abiraterone or apalutamide as neither worked. London Regional Cancer Centre provides ice mitts and booties (which they'll switch at least once during treatment) and all the ice chips you can handle, so that has not been an issue.

[JohnInTheMiddle in reply to MiaAmia]

OK "cool" regarding mitts and booties - we just had bags of ice. As for the ice chips - what are they for? 🧊

Oh another recollection - the stronger-than-prednisone steroid dexamethasone, during the Docetaxel, I felt was what did make me feel great! I'd forgotten.

[MiaAmia in reply to JohnInTheMiddle]

Ice chips are to keep from developing mouth sores. He chews them throughout the chemo session. And yes, we feel the dexamethasone gives him a real boost.

[j-o-h-n]

I don't care what they say........... First I look women in their mouth.......

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 09/02/2023 4:53 PM DST

[spencoid2]

I also had highly variable side effects. at first I thought it was not working. By the time of the 10th infusion the SEs were really awful. Don't worry it might get worse

[32Percenter]

Has he been taking vitamin C or other antioxidant supplements during his treatment? These can neutralize Docetaxel's effects.

[MiaAmia in reply to 32Percenter]

No. We are strictly by the books for treatment and do not use supplements except as prescribed. Thanks.

[tsim]

Of course, everyone has different reactions . The human body is a complicated organism of which we have only a little undestanding