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Our father is a patient with prostate cancer and I have questions

ellenlong13
Posts: 3
Joined: May 2016

Our father is a patient with prostate cancer. He is currently deciding if he should undergo the chemotherapy treatment option that is offered to patients (6 cycles, 3 weeks apart). I Would like to know if anyone else has been in a similar situation. The chemo protocol Dad would go through Docetetaxel is the chemo, given six times, every 3 weeks, over 18 weeks, started within four months of Lupron injections. I have a few questions that would help my dad decide whether or not to go though it.

What side effects did you have from chemo?

How long did they last?

Did you feel them after the first round of chemo? Second? Etc?

Did you feel good the second or third weeks?

Did you have a port? If yes, would you recommend? Was it easy?

Family Members? What was your experience?

 

Swingshiftworker
Posts: 1013
Joined: Mar 2010

You don't say but I must assume that your father's cancer is very serious if the protocool suggested is Lupron (for adrogen deprivation therapy - ADT) followed by Docetetaxel (for chemotherapy).  These are both very powerful drugs that have their individual side effects which will be compounded by them being taken together.  You can easily research the effects of these drugs on the Net.  Their combined effects probably cannot be predicted but, whatever the result, it's not likely to be good.  I would expect the worst and hope for the best.

I'm not sure if anyone here has had the experience of taking both of these drugs in combination but I'm sure anyone who has will respond.  I just don't know how useful their response will be to your father's decision.     He might be able to skip taking the Lupron (because all it does is reduce testosterone production by means of chemical castration on the theory that that will reduce the growth of prostate cancer) but do you actually believe that he can beat the cancer w/o chemotherapy if it has already spread through out his body?   Doesn't seem like he has much choice to me.

 

Old Salt
Posts: 720
Joined: Aug 2014

Swingshiftworker and I infer that your Dad has metastatic prostate cancer (the cancer has spread outside of the prostate), but for us to give advice it would be good to have details. I agree that metastatic prostate cander is quite serious, but several therapies are available that are likely to extend his life span significantly. Please provide details regarding

Age and general health status

PSA and scan results

Prior treatments, if any

How important are Quality of Life (QOL) issues to him?

I do want to extend my support and best wishes and will try to offer non-professional (!) advice once you provide us with additional information.

 

ellenlong13
Posts: 3
Joined: May 2016

 

His cancer has spread to his lungs but has been treated with radiation and chemotherapy. His last PET scan showed virtually no signs of cancer. He is currently on hormone therapy  which is working.

 

 

 

Age and general health status

 

He is an active 76 year old.

 

PSA and scan results

 

As of 5/6 his PSA was 0.72

 

Prior treatments, if any

 

He has gone through one round of Radiation and Chemotherapy so far with good results

 

How important are Quality of Life (QOL) issues to him?

 

He is very active and although his treatment has slowed him down a little he refuses to stop. He takes great care of himself.

The doctor said that the added chemotherapy would extend his life another 6 months.

Old Salt
Posts: 720
Joined: Aug 2014

The doctor's statement (actually, understatement) likely is based on the results of the CHAARTED trial.

http://www.nejm.org/doi/full/10.1056/NEJMoa1503747

Basically, patients with hormone-sensitive prostate cancer that had metastasized were treated with hormone therapy (standard of care) or with hormone therapy + docetaxel (six cycles) The latter group survived more than a year longer (average). 

As you and your Dad undoubtedly know, hormone therapy (ADT) is no walk in the park and adding chemotherapy with taxotere/docetaxel makes it even harder. Whether the benefit is worth it, is for your Dad to decide.

The side effects of the taxotere vary person to person. Your Dad went through one cycle, so he has experience. I have read about people who manage to keep on working and of people who really do have serious side effects. It's very important that the medical staff has extensive (!) experience with this kind of chemo so that they can provide the proper care when needed.

 

PS: I scanned the above mentioned paper and this is what the authors wrote about the side effects:

Among the patients who received combination therapy, approximately 2% had a treatment-related grade 3 or 4 allergic reaction; grade 3 fatigue occurred in 4% of the patients, and grade 3 diarrhea, stomatitis, motor neuropathy, and sensory neuropathy each occurred at a rate of 1% or less Approximately 1% of the patients in the combination group had a thromboembolic event. One patient died suddenly at home of an unknown cause during the course of docetaxel therapy; the death was considered to be possibly related to docetaxel according to the Adverse Event Expedited Reporting System. Approximately 6% of the patients in the combination group had neutropenic fever, and approximately 2% had grade 3 or 4 infection with neutropenia.

VascodaGama's picture
VascodaGama
Posts: 2968
Joined: Nov 2010

I think your dad has been recommended chemotherapy because he is confronting an advanced PCa case or he is confronting recurrence from failed therapies. The former option is nowadays used by oncologists as the prime and initial treatment in patients whose advanced status would not benefit totally from a radical treatment. The hormonal portion (Lupron) in combination with chemo has sown better outcomes in terms of improved survival (longer life spans). These patients will still have surgery and/or radiation added to the protocol if any benefit is judged to happen after considerations to the initial therapy outcome.

If chemo has been recommended to a recurrence case, then the treatment is highly palliative. Many guys avoid that sequential because of the side effects. The hormonal treatment (Lupron, Casodex, Zytiga, etc) taken alone may be enough to control the advancement of the cancer. It is palliative but it has lower risks and lesser side effects than chemo.

You can get all answers to your queries (side effects and benefits, etc) in this link;

http://www.cancer.gov/about-cancer/treatment/drugs/docetaxel

You can read the stories of survivors who confronted the same situation of that of your father in this link;

http://www.yananow.org/query_stories.php

Welcome to the board.

Best wishes for luck in your dad’s journey.

VGama

 

ellenlong13
Posts: 3
Joined: May 2016

Thank you for the links they are very helpful.

As for my dad's treatment everything he has done so far has worked to reduce his cancer and his PSA is down to 0.75 so I am just trying to understand the true

benefit of added chemotherapy.

 

tspoon
Posts: 24
Joined: Aug 2011

My husband did 6 treatments without Lupron, took a month off did another 6 with Lupron. It was not easy but until number 10 it was predictable.  Chemo on Thursday felt great all weekend Monday begin to feel week. Lasted a week got strong and was okay until next treatment. By number 10 he was weaker and weaker,  he never regretted his choices.  Two years later he went back and did 3 more at which point he opted out and went on hospice for a year. 

Good luck in the fight. 

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