Anyone above 80 years -on triple therapy ?

[Tinkudi]

Anyone over 80 years who has taken triple therapy - first and second generation ADT as well as chemo ?

Could you please share how your experience of it was.

[Tinkudi]

anyone ?

[Pinkyboy in reply to Tinkudi]

Good afternoon Tinkudi,

I was 83 when diagnosed with metastatic prostate cancer (April 2023). I have metastases to bone (only). They are widespread through pelvic region, ribs, and sternum. No organ or soft tissue mets.

My oncologist immediately put me on Triplet therapy (docetaxal chemotherapy, Lupron, and Nubeqa). The chemotherapy sent me to bed for several days after each infusion, I lost all appetite, and was very lethargic. After the chemotherapy ended, I returned nearly to normal, but I still have chronic fatigue, usually later in the day, but I can live with that just fine.

[Tinkudi in reply to Pinkyboy]

Hello pinkyboy. The chemo sent you to bed due to fatigue or were there any serious side effects also ? My dads MO seems adamant that chemo is not to be thought of at this age !

[Pinkyboy in reply to Tinkudi]

Yes, it was just severe fatigue. Please remember this was only my experience. Everybody is different, and my experience may or may not be similar to what your dad may experience. My oncologist thought my overall physical condition was good enough that I could tolerate chemotherapy well. Looking back, he was right. If your dad’s doctor believes he will not tolerate chemotherapy well, consider that he may be right.

Best wishes to you and your dad.

[Tinkudi in reply to Pinkyboy]

My best wishes and prayers for you too 😊

Dad is in good physical condition. Will take another opinion too and see. I am in Indian so protocols may differ

[Tinkudi in reply to Pinkyboy]

how many cycles of chemo did you have. Was it at the regular dose or lesser dose due to age ? Are you still continuing with ADT ?

[Pinkyboy]

Good morning Tinkudi …

I was originally scheduled for six rounds of docetaxal but my oncologist felt I had responded so well that my chemo was “paused” after four rounds. My 3rd and 4th chemotherapy infusions were a reduced dose; 60% as I recall.

I did find that the side effects of my chemotherapy worsened slightly with each additional infusion (fatigue, weakness, lethargy). The doctor told me that would likely happen. It did.

It has been just over a year since my diagnosis and I have to say “so far, so good.” My PSA has dropped from 24.4 to 0.05 and there has been no increase in mets… decrease in some.

Keep asking ; I know you are a good advocate for your dad.

[Tinkudi in reply to Pinkyboy]

good morning 😊. What was your Gleason score ? Also , can you tell me which ADT did you take. I am conflicted whether to get dad antagonist like Firmagon or agonist like lupron as I read antagonists may be safer from the heart point of view. Though dad has no known cardiac issues yet , we do have a strong family history of cardiac problems.

[Pinkyboy]

My Gleason score was a solid 10 ! But, as I understand it, the number is essentially useless since the cancer had already metastasized. I was too old to even consider prostate remival surgery, so Triplet therapy was put in place immediately.

It consisted of: (1) Lupron injection, (2) Docetaxal chemotherapy… 4 infusions, and (3) Nubeqa capsules twice a day.

I can’t comment on the comparative cardiac safety of Firmagon and Lupron.

[Tinkudi in reply to Pinkyboy]

Thank you 😊