Should I Add Docetaxel to Lupron and ... - Advanced Prostate...

Advanced Prostate Cancer

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Should I Add Docetaxel to Lupron and Zytiga?

jfoesq profile image
21 Replies

I have been on Lupron and Abiraterone for most of my almost 12 years of treatment. Triplet therapy was not SOC when I was first dx'd. I am just wondering why, Docetaxel isn't routinely added to those of us who started on doublet therapy before we become resistant to the doublet therapy. My guess is that there aren't any studies dealing with this question, but it would seem to make sense to me, a non-scientist...., that if those recently dx'd do better on triplet therapy, then those on doublet therapy should add it sooner rather than later. Perhaps, the reasoning is that if doublet therapy is effective at keeping one's PSA below .05, then the docetaxel wouldn't be effective. On the other hand, if Docetaxel can shrink bone mets, wouldn't it be helpful even though PSA is below .05?

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jfoesq
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21 Replies
Balylone profile image
Balylone

Hi Jfoesq

With ADT and Zytiga, prostate cells fall asleep (senescence). They stop dividing and Chemo is not effective anymore. This is why you can use it only at the start… or when Zytiga fails…

jfoesq profile image
jfoesq in reply toBalylone

Thank you

Balylone profile image
Balylone in reply tojfoesq

I forgot to congratulate you for your 12 years ! So much hope in this figure for all of us !

jfoesq profile image
jfoesq in reply toBalylone

Thx. I hope everyone does well in treatment and even better than me.

Tall_Allen profile image
Tall_Allen

Docetaxel only kills rapidly growing cells. It has no effect on cells that are dormant. 2nd gen hormonals kill off a lot of cancer cells at first, but eventually the remaining cancer cells enter a cell cycle called "senescence" in which they are impervious to attack by medicines. It is only when those cells emerge from their dormancy that docetaxel can have any effect.

jfoesq profile image
jfoesq in reply toTall_Allen

Thank you

jackwfrench profile image
jackwfrench in reply toTall_Allen

Hi TA - in the senescence or drug failure, how do they identify (in my case Lupron and abi) which drug is failing or are both assumed? And previously its been said "continue ADT thru castration", so would abi be continued as well as I eventually add chemo? I know you're not a doctor.

Tall_Allen profile image
Tall_Allen in reply tojackwfrench

If you are on Lupron+abi and your PSA gets high, you are both castration-resistant and resistant to abi. Only abi is discontinued because the cancer has figured out a workaround. However, the PRESIDE trial suggests that you can get extended use from switching to enzalutamide and adding docetaxel to it:

prostatecancer.news/2022/10...

Proflac profile image
Proflac

Thank you for asking this. I'm sure it's something a lot of folk have wondered including myself at one point. We have the answer for everyone in the replies. At least chemo is still in the arsenal for if and when things move on. Good luck.

jeetu_g27 profile image
jeetu_g27

congratulations for your 12 years of fight . Hope you live a healthy and fit life

jfoesq profile image
jfoesq in reply tojeetu_g27

Thx. You too.

I started on a triplet therapy right out of the gate... Lupron and Taxotere first.... Started at PSA 0.29... Three Lupron shots and Six Taxotere treatments later PSA < 0.1...

Three PSA tests over the course of 18 weeks of said treatment revealed PSA < 0.1...

Post Taxotere treatments

Abiraterone Acetate and prednisone daily were added, and will continue as such.

As well as Lupron every three months.

Next PSA test, next week... 🤞

PSA post RP surgery... <0.1 rose to 0.29 within one year...

PSMA scan revealed lower lymph nodes affected...

Oncologist diagnosis:

Prostate Cancer Ductal Variant Stage IV.

I was advised that triplet therapy was my best option for longevity...

Congratulations on twelve years....

Ron

jfoesq profile image
jfoesq in reply to

Thx. Good luck to you.

jfoesq profile image
jfoesq in reply to

THX

Bangkok profile image
Bangkok

I am an unusual case J. I did not go through the usual preamble of pills, cocktails or normal radiation. I was diagnosed with stage 4 prostate cancer after a routine bloodwork turned up a PSA of over 900. I had no idea I had the big C or a host of mets. I only noticed my hip hurt on long hikes or mt. biking for over 3 hr. . I was going to Vietnam for an 8 day cycle tour when I got the news so my daughter arranged a PSMA pet scan at Sameitivj hospital in Bangkok. I was lit up like a Christmas tree. After our bike trip in Vietnam, my wife and I took up an apartment in Bangkok and we stayed 5 months and had 3 Lute - 177 treatments ( one month intervals). Then a final scan and sent home with no mets visible with a PSA of 0.14. Nine months later it was starting to double again so I went back and had another Lute-177 then 20 rounds of IMRT and sent home with an 18 month supply of Lupron ( their brand was called Luprein). Since that was completed I have enjoyed a year and a half holiday but now it has started to creep again ever so slowly. My wife has done the math and at this rate I should be back on hormones again by next January. We leave in 3 weeks for a two month cycle trip from Paris to Barcelona and the only drugs I'm packing are Tylonal and Cialis! I don't know any of the acronyms spoken of here on this site. I basically walked in off the street and started with a treatment that most countries call a 'Hail Mary'. I'm 77, still running 5k a day, playing old timer hockey, and having relations with my wife - no cocktails but I have spent $150,000 in the last 4 years to enjoy this return to what I have always taken for granted. I hope all this and more an be your story. Good Luck J.

Tommyj2 profile image
Tommyj2 in reply toBangkok

Glad you have the money to do this……best of luck to you.

jfoesq profile image
jfoesq in reply toBangkok

“Keep I. Truckin” 5ks and 2 week bike rides. Impressive! Enjoy and good luck

Bangkok profile image
Bangkok in reply tojfoesq

J: This is the only time we can count on so we're going for it. I realize that we have a small window before my 'Hormone Holiday" is over so I've warned the adult kids that their inheritance will be greatly diminished. My oldest son quoted Neil Young: "It's better to burn out than fade away".

j-o-h-n profile image
j-o-h-n

Bangkok and Cialis in the same post???............... Sorry I couldn't help myself. (Roger Rabbit.... HELP ME!!!)

Good Luck, Good Health and Good Humor.

j-o-h-n

Mbnm profile image
Mbnm

In Canada on lupron pred and abiraterone for 9 months so far results as hoped…..wow congrats on 12 years…thats my dream !

jfoesq profile image
jfoesq in reply toMbnm

I hope you get there and beyond.

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