Metastatic prostate cancer due to have chemotherapy

[Panthava]

Hi everyone,

My father is due to have chemotherapy for advanced metastatic prostate cancer . He is 73 and been fighting prostate 10years and also had aml Leaukeamia 5 years ago. He has had a lot of chemotherapy in the past and i am concerned that this may reduce his life rather than help. They have said 10 sessions once every 3 weeks.

Has anybody had chemo for metastatic prostate cancer and how long was you in remission for.

My father has it in the lymph nodes and bones.

Thank you for your support

[NPfisherman]

Hi Panthava,

I take it they are looking at giving him Jevtana (Cabazitaxel) with Carboplatin to treat your father--improved efficacy---see article. I have never had this drug but described in this article from "The Lancet" as generally well tolerated--see below:

thelancet.com/journals/lano...

As for efficacy and duration, that always varies from patient to patient. Has he had genetic testing?? That may reveal a treatable genetic mutation. If possible, I would advise to have it done....

Don Pescado

[Panthava in reply to NPfisherman]

Hi it’s docetaxel I will be having once every 3 weeks for a course of up to 10.

I don’t recall any genetic testing being done?

How would they do a genetic testing if it’s moved from the prostate to bones and lymphs? What part do they do genetic test?

Thanks

[NPfisherman in reply to Panthava]

Blood testing for DNA....As for the docetaxel, Jevtana is used after failing 2nd generation AR drugs like abiraterone or Xtandi...see below:

ascopost.com/issues/novembe...

Improved progression free survival....

Don Pescado

[Panthava in reply to NPfisherman]

Thanks for the info.

I think the plan is to try docetaxel first and if no response they said there’s stronger chemo to try .

[NPfisherman in reply to Panthava]

From the article:

Until now, the optimal sequencing of new agents available for metastatic castration-resistant prostate cancer has been unknown. This study provides level 1 evidence that after patients with the disease experience treatment failure on docetaxel and one of the newer androgen signaling–targeted inhibitors (ie, abiraterone or enzalutamide), cabazitaxel can extend their lives. I guess he can try the docetaxel first, but monitor his labs...His PSA may rise dramatically initially if docetaxel works well as lots of prostate cancer cells are killed but a slow consistent rise may mean that he should be on Jevtana and carboplatin. Monitor monthly and see....

Best of luck....

Don Pescado

[Panthava in reply to NPfisherman]

Thank you

[NPfisherman in reply to Panthava]

You are most welcome...

Fish

[Panthava in reply to NPfisherman]

Hi Further to your previous reply ,

I have had my first course and my psa has not come down yet also having nose bleeds. Does the psa normally come down from the first if it’s working ?

Many thanks

[NPfisherman in reply to Panthava]

I would expect the PSA to come down after a few treatments....the bleeding is likely due to a drop in platelet count, you should get a CBC and monitor bleeding...I believe Cabazitaxel with Carboplatin has been proven to be beneficial and if your disease is progressing, then insist on a change...Another option would be Lu-177 or AC-225 or a combo of the two...perhaps with Provenge...or a clinical trial...Best of luck...

Fish

[Panthava in reply to NPfisherman]

Thank you. 🙏I asked about my platelets and they said it was fine.

[NPfisherman in reply to Panthava]

You're welcome...best of luck to you...

[P-b49wgolf]

I am 71 and was diagnosed with metastatic PC 1 year ago. My original treatment plan included hormone injections, chemotherapy and radiotherapy, however in April this year my plan was changed to avoid me having to go to hospital during the coronavirus epidemic. I was prescribed Enzalutamide (4 tablets 40 mg per tablet) per day. My radiotherapy was brought forward and only had to attend hospital once per week for six weeks.

I now have a monthly check up with a nurse who is trained to monitor any side effects and evaluate my PSA blood test (at point of diagnosis 33.0 which is now 0.01). So my treatment is working and at this stage I don’t have to go through chemotherapy.

I hope this helps

[Panthava in reply to P-b49wgolf]

Thanks for your response.

I was on enzulatime for 6 months but didn’t work for me.

Keep strong.