Should I do chemotherapy?

[Simpson80]

New here. I am 81 and was diagnosed last month with PCa metastatic to a few bones. Gleason 9. PSA 21 at diagnosis.

Have been put on orgovyx and xtandi.

Chemo was not mentioned.

Reading some posts here I wonder if chemo would be an important option for me ?

I will turn 82 In a few months. I Do 45 minutes of walking and some light exercises daily. I would not call myself strong but well kept enough to function independently. I take medicines for hypertension.

Would welcome views and experiences of those who have done chemotherapy along with adt plus ARPI. Was it very tough on the body ? Was the chemo started after the arpi was added or before it?

What is the determining factor to decide if chemotherapy has to be added ?

Thank you

[Tall_Allen]

Men originally diagnosed with metastases do better with triplet therapy. They are started at about the same time.

prostatecancer.news/2021/05...

[Simpson80 in reply to Tall_Allen]

Thank you. This is very useful albeit complex with so many comparisons and permutations.

[Simpson80 in reply to Tall_Allen]

If I understand it correctly , it says latitude and stampede trials for ADT +abiraterone give an avg survival of 50 -56 months whereas adding the doxy increases it to 61 months? ( as per the chart drawing on the link you shared )

[Tall_Allen in reply to Simpson80]

Yes, about a year extra it seems, although there's never been a randomized trial.

[Simpson80]

Was hoping some more geriatrics could share their experiences

[Hidden]

Take a few moments to look at several of my responses about my chemo experiences...

They contain how I arrived at chemo...

Briefly, I elected Triplet therapy right out of the gate... Lupron, Taxotere, and then Abiraterone and prednisone.

Six Taxotere treatments given in three week increments.

Though side effects can be numerous, mine were minimal... Hair loss... and a few days of tiredness that did not resolve with rest between doses. I refered to those as chemo dips.

They provide medication to handle any nausea post treatment, which I never had.

You can try it and stop it if it gives you too many side effects.

I refer to Taxotere as ROUNDUP for the body. It circulates through your system killing those little bastards wherever they are hiding...

The trick is to be stronger than the treatment. It was extremely effective in my case... I consider it a longevity enhancer.

Triplet therapy has me running at a PSA of <0.1 (undetectable). 4 tests running...

Death to the active cancer... Nuke it!

I would do it again... Without reservation.

Best wishes

Ron

I was on the tail end of 68 during chemo.

I am now 69.

[Simpson80]

awesome results for you.

My age is the concerning factor

[Springsunshi]

Hello,

My dad is currently half way through his 6 chemo treatments. He is 76 years old and we live in the UK.

He was diagnosed in February with Gleason 9 and a few bone mets.

After his first round of chemo he developed neutropenic sepsis and was in hospital for a week. He now self injects for 5 days after chemo to keep his white blood cells up.

He seems to be tolerating it quite well. His main symptom is extreme tiredness more so in the mornings and then he feels better as the day progresses.

He has always been fit and healthy with no other health issues which is why his oncologist recommended the triplet therapy for him.

Best wishes.

[Simpson80 in reply to Springsunshi]

Thank you. What does he self inject ? Is he on ADT ?

[Springsunshi]

I think it’s called Filgrastim.

Yes he’s on daralutamide and then 3 monthly hormone injections too.

[RWRB]

Hi why are they discussing chemo? Your Gleason 9 score is high mine was 7. PSA is also high mine was 4.9 when treatment started it went to 13.39. Your much higher scores but has radiation been discussed. Try to stay away from Lupron it's bad too many side effects. Your quality of life may not be what it is now. Wishing you all the best.