Options to Chemo?
New here, so to introduce myself/ourselves, I'm Tanya and my husband is Roger.--he's 63, in great shape, active and feels great so far.
He was Dx'd PCa in July 2017, (G-7, 2 cores of 12 positive) RP on Aug 31, 2017, PSA went up from 5.3 pre-op to 14.1 3 and Dxd Mets to bones and Stage IV on Oct 13, 3 weeks post op. Initially, it appeared an easy course of one and done--meaning operate, and move on--but we all know how the beast doesn't follow the rules. The results of the scans he's had all say he has suspicious spots, but nothing says definitively that the spots are mets, just that they are 'hot'. He's had CT, Bone and PET, but not a C-11 PET.
Roger has now had a shot of Fermigon (a month ago) and is facing Chemo, with Taxotere being the chosen drug, apparently. We met with the Rocky Mountain Cancer Center, and found the place and the doc to be unacceptabe (felt like a Take a Number and Wait to Die place--the "care" may be good, but, um, no....), so are now going to UC Denver to get a second opinion as to course of action. We will meet with a new doc there on Nov 7.
My questions: What would you all recommend that we focus on asking her? Are there any other viable options to Chemo that we should or could persue?
I have researched and learned quite a lot, but I just don't have time to get a medical degree in oncology by Nov 7. I appreciate you all and value your input. This forum and these threads are helping a lot. Thank you.
Comments
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Conventional path
Tanya,
Chemo is usually begun only after many years of Hormonal Therapy (HT). There are some exceptions, but this is the general sequence. Hormonal Therapy begun after surgical or radiation failure can keep a guy in good health a long time, commonly 10-12 years or more, before beginning chemo. And chemo is the harshest treatment in an oncologist's goody bag.
My first question would be how certain they are of bone involvement. If there were only metastais to the groin/ prostate bed, radiation (RT) can often be curative -- completely eradicate the disease. Metastasis to bone does yield radiation of less utility, usually just for "spot welding" tumors in various bones, pallative in intent, to reduce pain and extend life somewhat.
My second question would be why begin chemo now, rather than long term hormonal ? Chemo can beat PCa way back, but is never curative of PCa (unlike many other forms of cancer). And while chemo can yield powerful results, these always eventually fail, as the disease acclimates to the drug and morphs into cells that become in-effect immune to Taxanes.
A set of second opinions is absolutely necessary in your husband's case, given what you've been told and experienced thus far.
max
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Early taxotere is becoming more common
Ask the Denver doc(s) about the results of the STAMPEDE trial and whether adding taxotere early on might be beneficial for your husband
Here is a link
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(15)01037-5.pdf
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