Now what? Second go-around of docetaxel not responding.

[westjl2]

I am 65 years old and was Diagnosed 8 years ago with stage 4 PC. Metastasis to hips, pelvis, ribs and many lymph nodes. Took 6 rounds of docetaxel followed by ongoing Lupron injections and then 3 years of Zytiga. PSA was driven down to 2.0 from 76 with 1st 6 rounds of docetaxel. Zytiga drove PSA down again to 3.0 from 14.

PSA began rising early this year from 7.5 in January to 36 in June. Started Docetaxel in July but PSA has not budged.

Most recent CT shows large tumor off of prostate pushing against bladder and blocking urine flow. Also shows new mets. along with a couple of pathological fractures of left inferior pubic ramus and left fifth rib.

Just had stints put in to ease pressure on both kidneys and relieve pain from Hydronephrosis.

What would be the anticipated next steps?

[Tall_Allen]

Cabazitaxel

[westjl2]

I just wondered because of the fact that 5 rounds of docetaxel had failed this time, and my system is pretty beat up, if it would be more effective to go back to an Antiandrogen now?

Additional Information:

1. System still knocked down from 5 rounds of Docetaxel (suffered through 2 different infections). Jumping right into Cabazitaxel seems questionable.

2. Will need to attack the large prostate mass that's blocking the bladder from emptying. Would radiation be an option here? Surgery?

Meeting with my MO today