Xtandi no longer working for my dad. PSA went to double in 3 months (from 54.00 to 109.00) and new lymph nodes and bone mets showed up, so MO recommends 8-10 cycles of docetaxel.
Questions:
1.) MO said that my dad would not take daily prednisone because it could feed the cancer. Is that true? Wouldn’t the side effects of docetaxel be worse without prednisone?
2.) Do cold socks + mittens work as a profylaxis against peripheral neuropathy or is it only a myth?
3.) Does chewing ice works as a profylaxis against mouth ulcers?
4.) Does fasting before docetaxel make fatigue more tolerable? If so, how long the fasting should last? Should it be only before the infusion of docetaxel or even some hours after the infusion?
5.) Do you have any other tips?
Thank you.
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WisdomSeeking
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I think docetaxel will be harder without prednisone for your father. As for prednisone feeding cancer, I also discovered this fact recently and was very surprised, because I know of patients with even aggressive diseases who managed to keep the disease under control for several years with zytiga and 10 mg of prednisone, so this fact seems to go against the theory that prednisone feeds cancer. It must also be said that some patients after the failure of zytiga and prednisone managed to make zytiga work again by changing the prednisone with dexamethasone, so this may lead to the belief that prednisone after an uncertain period of time can actually feed cancer. Some time ago I had a conversation with a member of this forum who claimed to have had a discussion with his oncologist who in turn claimed that prednisone after a certain period of time can interact with the intestinal microbiome and produce testosterone which can fuel cancer.
1) Prednisone (and other glucocorticoids) slow the cancer at first. It is only with sustained use that they may feed the cancer. There is no reason to suffer the chemo side effects that they prevent. But the downside is fatigue.
5) Neulasta (or similar), anthistamine, antiemetic, ½ -1 liter water (N saline) infusion the next day, electric blanket to keep core warm if using ice. Cold cap can prevent hair loss.
I agree 5 or 10 mg of prednisone for a few months is not a problem, in fact at the beginning it could have antitumor effects. While used for a long time it could actually feed the cancer but this unfortunately happens with several drugs such as casodex.
In Italy they give you 50 mg of Prednisone twice a day the day before Docetaxel, idem the same day and for other 2 days after. Before you get your Docetaxel infusion they give you another prednisone infusion, then 75 mgr. Docetaxel and after that a liquid N-Saline infusion. 72 hours after Docetaxel you get Filgrastim injection for 3 days to boost your white blood cells.
I wore icecaps for feet, hands and head. Until now I have no neuropathic pain. I still have my hair, but some losses are beginning to show.
I did no fastening, and until now no nausea.
Biggest problem is fatigue. Before Docetaxel I could run the 3 staircases to my flat many times, now I can barely make it. At least I did not lose my appetite.
Hope it's worth all the pain. In some countries in Europe they are leaving Docetaxel behind and go directly with Radium-223 if you have become mcRPC. Better tolerated and better success rate. Docetaxel is still the protocol in Italy however. Radium-223 is very hard to get as there are still very few places available.
Another thing. I also take CBD which helps to keep nausea under control.
I meant Xofigo (Radium- 223) which is normally chosen for metastasis in the only bones, no other organs involved. Pluvicto is Lutetium (177Lu) vipivotide tetraxetan used for PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC). Very few hospitals apply the last in Italy covered by the national health system. Out of reach as each infusion is about €30.000 and you must have at least 3 of them.
In Italy there are many hospitals that administer xofigo also because it has been available for more than 10 years. While the hospitals that administer lutetium (pluvicto) can be counted on the fingers of one hand that's why I thought you were confused in writing.
Right, but to get Xofigo you must be eligible, and times at least here where I live are very long. My Oncologist could start the procedure, but she said only in the case that Docetaxel does not work.
I only had a Prendisone pill the day before, a bag prior to the chemo bag, and another pill the day after. Only hands were in ice and WB shot was 24 hours after chemo.
I cannot say enough about Docetaxel! It was great for my Dad. He did 6 rounds in his early 70s and it killed a TON of his prostate cancer. His tumors shrunk to nothing and he had undectable PSA for two years. Now he is on a generic Zytiga. He also recently underwent spot radiation on his prostate.
Anyway I think it would be great for your Dad. My Dad tolerated it pretty well. The first rounds did not bother him. The last rounds were not fun for him, but he got through it. I think kinda like a flu or hangover feel for a couple of days. It is worth it though.
Thank you so much for your encouaccount of your Dad experience of Docetaxyl. My husband is to start it and we are so wortied we are making the roght decision. He has T4 & distant bone mets only. Your post has helped a lot !Thank you
not a doctor but navigating a similar terrain with my dad. You can discuss Pluvicto as well as an alternative with your doc if concerned about chemotherapy.
I can speak to the ice gloves and boots that a friend doing double chemo was frustrated as she was given those as a recommendation and when she asked the cancer center they actually had them but never offered them! She said they made all the difference (unclear what it was for, maybe nueroposy)?
No one here can predict how your dad will react to Chemo. I didn’t do half the stuff, or for as long, mentioned in some of these replies. But yet, Chemo worked great for me even with being G9 with a couple of mets in my right lung. He will have to give it a shot and see how it goes for him. Don’t rely on what I say or anyone else in here says. It very well might be different fir him.
1) Decadron is commonly used with Docetaxel. Usually an oral dose the night before, that morning as well as an IV dose during the chemo infusion. You get a "steroid high" for about 24 hours, then crash.
2-3)The cold socks, mittens, cool cap do work. The cool cap is an all day affair. Some say ice chips work, it didn't help me much. At the first sign of mouth sores, I began sucking on deglycerized licorice tablets. They work very well for canker sores and seemed to help with sores from the chemo.
4) It makes no difference
5) Hydrate well before during and after. Exercise is important, even if you have to push yourself to do it. The effects are cumulative, so after the first 2-3 infusions, I noted no major issue except for joint pain for the first few days. the next 3 infusions, you note increasing fatigue, loss of taste, loss of ambition. Things revert to normal about 4-6 weeks later. The ADT will cause fatigue. Again, you have to fight through that and exercise!
How about updating your dear Dads bio?......All info is voluntary but tell us more background, location in Europe, Medical facility, meds, treatments and etc. It will help him/you and us, Thank you and keep posting!!!
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