Hi everyone! We're currently trying to convince my Father to have chemotherapy as per advised from his oncologist but hes resisting. Is chemotherapy that bad? He is currently still working and doesn't want to anything to impede on this. What are everyone's experiences with it? Many thanks!
Chemotherapy: Hi everyone! We're... - Advanced Prostate...
Chemotherapy
He can do a nomagram formulated from many years of experience from Sloan Kettering to see what will happen if he does nothing. As long as he understands that the last couple of years of that won’t be pleasant.
webcore.mskcc.org/survey/su...
There are several other interesting ones.
He could start a course of Melatonin at the rate of 4x60mgs per day .it has the effect of mitigating the effects of chemo .it did for me and I worked thru chemo and didn't lose my hair Good luck
Thank you 🙏
Thank for your response 🙏
I did chemo early on in my treatment. (nearly 3 years ago). I got fantastic results in terms of obliterating the tumors both in bone and soft tissue.
But, yes, it is unlikely he will continue to work to the same level he is used to during the treatment (6 doses at 3 weeks apart.)
There is a low spot about 3 days after chemo and lasts for about 3-4 days. Outside of that he should be able to function at half pace or more while on the treatment. It was not long before I was fully functional again - at least that was my experience.
I was able to work during chemo, just not quite full time. I needed to take a sick day or two during each round. Fortunately, my boss had been through the same thing and was fully supportive of my working when I could.
An alternative to a chemo would be a Lutetium 177 therapy. Very expensive in the UK.
Chemotherapy for prostate cancer is quite tolerable for most. I felt crappy for most of the first week, but it wasn't that bad for me.
I think it depends on what kind of work he does as far as being able to work. A desk job should be possible, but something more physical would be tough for the first week after the infusion. I was fairly active in the second two weeks after infusion when I did 6 cycles of Docetaxel. A lot of people who work get their infusion on Thursday to take the brunt of the worst part on the weekend.
The important thing to remember is doing chemotherapy is a commitment to do one cycle only. Afer each cycle he can evaluate and decide if he wants to keep going. It's a small commitment for a treatment that can be very effective. I'm glad I did it and would do it again.
Wishing him the best.
Thank you. He's currently experiencing a lot of nerve pain in his legs so he won't entertain the thought at the moment. His PSA has gradually risen to 19 from 1 over the course of a few tests but he's recently had prostate radiotherapy and he's hoping it's that. But I fear he's sensitive now
If the side effects get too bad he can always stop.
Info about chemo from an expert:
grandroundsinurology.com/dr...
She is an expert. But unless she has had chemotherapy for PCa she cannot address the question that the member has posed. Every individual will respond differently to chemo and none of us can predict how another will experience it.
Anecdotical information by members of this forum , is just a group of anecdotes. Dr. Dorff's opinions and information about chemo based in her personal clinical experience treating hundreds of patients and scientific published studies may be a more robust information. I do agree, nobody can determine with precision the negative side effects and efficacy of chemo in a particular patient.
Thank you very much. The take home I got from that article was about the neuropathy from Docetaxel. He currently has a lot of nerve pain in his legs so I'm thinking it would be worth him lobbying for taxotere
If he has pain in his legs and it is contemplating chemo, you could consider to consult with a neurologist, to determine is he has a peripheral neuropathy. He may not have peripheral neuropathy and he could be a candidate for chemotherapy.
If I recall correctly, Docetaxel and Taxotere are the same thing, derived from the less rare European yew tree, some time after the earlier Paclitaxel (Taxol) became scarce for a while after it was originally extracted from the much rarer Pacific yew tree.
Anecdotally, I've been on Carboplatin plus Taxol for a few months now as treatment for a different type of advanced cancer. My experience with neuropathy and fatigue and general weakness seems to be worse than several of my fellow prostate cancer guys who took their Docetaxel "up front" in the earlier part of their advanced prostate cancer treatment(s).
There is lots of information on this site about how to manage chemo side effects, and most of that will be a pleasant surprise, because chemo has a reputation of being more debilitating than it actually is. The normal course of treatment is six infusions, spaced three weeks apart. I was working full time in an office job and had my infusions on Thursday mornings, felt somewhat crappy on the weekend and managed to deal with some lingering unpleasantness the following week, mostly fatigue and some flu like soreness. I never had nausea, and believe that most guys don’t.
I would suggest he get a port installed (usually in a large vein in the upper right chest), because the infusions can be tough on the veins in his arms. The process is a 30 minute out-patient procedure.
The reason for chemo is that it KILLS cancer cells. My PSA dropped to undetectable while I was having chemo, and the follow-up bone scan showed my bone Mets as just scar tissue. Do it!
Did it in 2018 with hardly any side effects and worked part time, I followed the diet protocol, limit red meat, lots of protein, fruits, vegetables and do not eat fried food. I used one anti nausea pill that was my fault. If necessary I would do it again without reservations.
Despite having had PCa for 14 years, I have still not received chemo, for the same reasons as your father. The side effects from chemo can be very tough. I have gone another route instead: lots of PSA tests, PSMA PET scans to stage the disease, then RapidArc radiation for local leasions. And above all: eleven cycles of PSMA Lutetium spread over the last five years. That has kept my disease in very good control, almost without side effects. And I am still working, even in my own company since three years ago. It’s very important to stay active, both physically and mentally - and working is an excellent way of doing exactly that.
I certainly couldn’t work during chemo. To be honest I haven’t worked since! But as Gregg57 said, you can always start then stop again if it’s too hard. Take it one cycle at a time.The point of chemo is life extension, so it really comes down to whether he prefers to work, or live longer !
Had 6 rounds of taxotere, my only thought is that do it while he is strong , chemo kicked the heck out of me. If he doesn’t have to work for the finances it can extend his life a while depending on how bad his cancer is 🙏. Keep up the fight warrior
Chemo was pretty rough for me, rounds 4-6 were the worst. I did work during it but at half pace at best and I had an understanding employer who let me take time off as needed.Other considerations depend on the type of job he has, I wouldn’t recommend travel or being in crowds etc. since it really does a number on your immune system. Other considerations are things like hair loss etc. and being the “guy with cancer” which will become pretty obvious after the first couple of rounds. Just some things to consider.
Ed
I just completed dose 5 yesterday of 6. I still work full time. I did have to take a day off after my last treatment for fatigue. But it seems it's dose to dose how I feel, but mostly just earlier to bed. I still road bike or mountain bike, but throughout the course those have gotten shorter, but not gone away. You didn't say how old or active your father is, but I'm 60 and although I exercise steadily, not nearly like some of the guys here that really powered through.
Thank you. He is 69 now and was fit until very recently. He's having a lot of nerve pain in his legs so that and the treatment he's been given for it (that doesn't seem to work) has slowed him down a lot. Having said that, he still puts in a good 4 to 5 mile walk on a Sunday, he just needs to dose himself up and use a walking aid
Chemotherapy with docetaxel was not nearly as bad as I feared when I started. The side effects do build up over time, though. I had six infusions, each three weeks apart. Here are the notes I have from when I went through it:
1) neuropathy - tingling or even pain in feet and hands
What you can do to mitigate it: chill the feet and hands during treatment
Some go so far as to use ice in booties or mittens
2) mouth and tongue - sores, sensations, and changes in taste perception
What you can do about it: suck on ice cubes during treatment
I didn't get any sores, but my tongue would feel "scalded" for about a week
Changes to how things tasted were very noticeable, and thankfully temporary
3) nausea - gradual build-up as treatments progressed
What you can do about it: ginger for mild cases. I tried ginger ale, ginger tea, candied ginger, and ginger candies. All helped.
Bland foods were easier.
Later in the treatment, when the nausea was worse, I took a prescription medication "Zofran" (generic is ondansetron), and that worked very well at relieving the nausea. I probably should have taken it more often instead of trying to "tough it out."
4) fatigue - gradual build-up as treatments progressed
What you can do about it: move, exercise, get into a routine, push against limits, keep morale up, rest when needed, stay hydrated, keep up nutrition.
5) hair loss - lots of variation
I lost body hair first, then scalp hair.
Later lost nose hair, which felt odd, had to blow my nose a lot more
Later lost half my eyebrows, and most of my eyelashes
The good news is, although it took some time, much of the above was temporary for me. It took about a month after my last docetaxel treatment for me to feel normal again, and the hair did come back. I still have some lingering tingles in my feet, but it's not bad.
One other thing. Each night before a docetaxel infusion I had to take an oral prescription steroid, dexamethasone. Then again the morning of the treatment. And then more dexamethasone by IV infusion before the docetaxel infusion. The result was that I was wired the rest of the day, had insomnia that night, was wired the next day, and then energy and mood crashed the day after that. Every one is different, but be prepared for similar effects.
That's really concise, thanks for that. I'll be sure to recommend this should he decide to go ahead 🙏
Just my opinion, but don't try to kill a dead horse. If PSA remains low, it means the cancer is not growing. Chemo might reduce immune system.
It's a bit of a tricky one that. Over his last few tests, he's gone up to 19 from 1. He's hoping it's the fact he's recently had prostate radiotherapy but my opinion is that it seems to be an upward trend as opposed to the bounce he's hoping for. I fear his deniability could be taking considerable time off his life
I feared Chemo based on heresay But I found it tolerable and I have had a good result
I am glad I made that choice
The met pain is totally gone
Back to work and training 4 days per week
Diagnosed 2019 Gleason 9 with bone mets PSA 13 .3 PRIOR TO Docataxal Hormone suppressants and radiotherapy
PSA now 0.16
Many others have had amazing results and many years after are still here with us with a reasonably good quality of life
Have a heart to heart with him
When I developed metastatic lesions, I immediately entered into six month chemotherapy with ADT (Lupron/Eligard). That was in 2004. Any side effects experienced can be managed. As far as ice, I sucked on some chips during my first infusion, then stopped the ice thing. I just didn’t need it.
My chemotherapy was different than 99% of the men in this group. In fact it has been the go to treatment for breast cancer at some facilities. Essentially 9 infusions of docetaxel alternated with 9 infusions of doxorubicin. Both cause cancer cells to die - cytotoxic; or, causing cellular apoptosis on cells that rapidly divide. I took several orals as well. However, my point is, fo not fear chemotherapy. Best of luck and guidance with the decision.
GD
Thank you very much for sharing your experience 🙏