My husband has just finished his rechallenge of Docetaxel on 2/29x
He did 6 rounds and while things are shrinking it didn’t have the significant change I think they wanted. So his MO at Mayo now wants him to do more chemo until he can no longer tolerate. It’s the standard 75g and my wrestle is why put him through if it’s going to affect his QoL. Why not wait a bit longer to see what happens.
And what is the study to support continuing use of chemo past 6 rounds,
how many Mets ? May be radiation is good options if it’s less than 5 METs
he has several throughout bones. But all responded to chemo. PSA went down a little as well just not as much as we would like,
I am not doctor. Usually larger spot are tougher. Maybe larger spot can be targeted using radiation SBRT.
Some MOs will do up to 10 rounds if the patient tolerates it well. It may prevent pain later. Another option is to switch to cabazitaxel±carboplatin.
How about having more docetaxel not immediately the 6th round but when PSa starts rising again, say in a year or two? I know the standard of thinking is that at that point the cancer has mutated and will not respond to chemo. Is there a clinical trial to support this?
Many clinical trials support the fact that chemo has more effect and less side effects if done sooner rather than later:
prostatecancer.news/2019/02...
Sorry, I wasn't clear. My question was about Docetaxel at diagnosis (6 rounds) plus several rounds after it progresses.
It can be repeated until it stops working. At that point, cabazitaxel might work. It will never work as well or have as few side effects as it has now.
Tall Allen definitely has a better handle on protocols for treatment than I do. All I will say is I believe that it's very important to balance the treatment benefits and side effects, especially when the disease is advanced to a point where treatment options are running out. What is a realistic expectation for an outcome from extending the chemo? How long does it take to recover from treatment, versus the range of time that may be gained in PFS and OS?
I want to enjoy life as much as possible, not spend it in infusion rooms, in clinical trials or recovering from the side effects of treatment. I wish you and your husband all the best in deciding what to do. I hope you find the path that is right for what you want.
Take care.
this is my exact thought.
We have alot of life things happening this month and having chemo does not fit in our things we’re trying to do. I am scheduled for a second opinion next Monday. Seeing that we had to harass Mayo for this post chemo appointment vs then calling us and it’s been 4 weeks already let’s me know that perhaps we don’t have to make a decision this minute- I am meeting with the Oncologist who just left the Mayo and is at a different hospital
Pca world, dilemma after dilemma.......My Good wishes to you both.....
Good Luck, Good Health and Good Humor.
j-o-h-n
Nubeqa or docetaxel and Liver Enzymes 
Docetaxel rechallenge
Docetaxel and Circulating tumor cells
