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First chemo this week

kidclutch
Posts: 41
Joined: Oct 2017

Dad’s first docetaxel (of 6) is on Wednesday! For you Taxotere veterans— do you have any tips or advice?

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

Kid,

I hope someone comes forward to help you with their experience in chemotherapy. Your initial thread with your dad's story is lost/deleted by the IT administrators. Many here may want to know details as these may influence their responses. I recall reading that his case is advanced with metastases in bone. I wonder the age of your dad.

Your last entries on the subject are here;

https://csn.cancer.org/node/318471

https://csn.cancer.org/node/318655

Can you share the results of the genomic test? Did they find any particulars on the type of the cancerous cells of your dad?

Chemotherapy in some patients was not successful due to a response by the immune system working against the chemo. There are successful stories of guys that had the new types of immunotherapy involving monoclonals which principle is to knock down those survivors switches in the cells so that the chemo can do the work freely killing the cancer. The same principle is also used to influence our immune system in fighting the bandit (Pembrolizumab as shown in your link below). You may want to discuss this with his oncologist, once you get the full spectrum on the type of cancer from the "foundation test" commented by you in your other thread. Here are links about the matter;

https://www.ncbi.nlm.nih.gov/pubmed/29231062

https://www.ncbi.nlm.nih.gov/pubmed/30348069

https://clinicaltrials.gov/ct2/show/NCT00005857

https://www.icr.ac.uk/news-archive/asco-2018-major-trial-is-first-to-show-benefits-of-immunotherapy-in-some-men-with-prostate-cancer

https://www.cancer.gov/about-cancer/treatment/clinical-trials/intervention/pembrolizumab

The survivor SantaZia commented about it and you also shared this link;

https://www.google.com/amp/s/www.bostonglobe.com/business/2018/12/03/test-turns-out-lifesaver/dH8F5QcbPGEOpl3LaqVcaN/amp.html

Chemotherapy in prostate cancer has not many successful stories and most of the patients have report nasty side effects. Some even got worse conditions on other health issues. You need to be vigilant with constant blood tests and monitor for any interaction between drugs. Anemia condition is sometimes fatal.

Best wishes for improvement.

VGama

kidclutch
Posts: 41
Joined: Oct 2017

My dad is 60 years old! Overall quite healthy except for the cancer / bone metastases and the side effects of that and treatments (currently, just Lupron quarterly with docetaxel beginning in two days). No serious issues with Zytiga, it just was unfortunately no longer working, so it was discontinued. Potassium was a bit low, nothing worrisome.

We don't have the results from the Foundation One testing yet. Hoping there is something to look at this week. Could alter the treatment course, depending on what it says, but the oncologist wanted to go ahead and do six rounds of docetaxel following (seemingly successful!) prostate gland radiation. Genome sequencing results may offer a better plan, but I don't have that information just yet. Will certainly share when I know more! I am of course hopeful that it will offer up a suggestion down the immunotherapy route, but as always, we will take the speed bumps as they come. It has been stressful learning the hormonal therapies were not working, but I am trying my best to look forward onto what could work instead of what has not worked.

Diagnosed October 2017 after the L3 vertebrae fractured, "gleason 8-10," two prior biopsies had come back negative so it was difficult to grade at the time. Lupron and Casodex, then Lupron and Zytiga. Now onto Taxotere. Spine radiation, hip radiation, shoulder blade and ribs also all since then. Recently prostate radiation after an actual visible tumor popped up on a scan.

The cancer center has been excellent throughout all of this, taking away some of the stress and anxiety. They are on top of bloodwork and going over side effects and things to watch for.

kidclutch
Posts: 41
Joined: Oct 2017

The Foundation Medicine results are supposed to arrive with suggestions for treatment + clinical trials that may be useful to the patient. Fingers crossed!!

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3252
Joined: May 2012

kid,

I have had two friends 'run the course' on Taxotere; one I was in-effect a volunteer nurse for...

Taxotere is a somewhat older, and "conventional," chemo drug, a 'taxane' and 'cytotoxic' in action, which just means that it kills rapidly-dividing cells, both cancerous and others, such as hair and stomach-lining cells (hence, hair loss and nausea).  It is relatively harsh, and cumulative in side-effects, meaning that it gets worse the more it is used.  One or two infusions may not cause too severe a response in your father, and he might not even lose any hair until around the third or so application.  It likely will cause profound weakness.  Prednisone is almost always given via pills followning Taxotere, and it has a slew of nasty side-effects itself, although Prednisone is not technically a chemotherapy agent.  It assist the workings of the chemo, and gives energy, appetite, and reduces inflammation.  But it also commonly causes agitation, insomnia, and other problems.  Taxotere is also one of the most common drugs against breast cancer.

Some chemos will 'cure' some forms of cancer, at some stages, but PCa is not regarded as one of these. That is, it is not perscribed by the oncologist for 'curative effect, but rather for 'palliative effect.'  It is used to reduce symptoms and beat back the disease. At times it does this with remarkable success, at other times, not.  Almost always it will achieve tumor size reductions and a drop in PSA.  Some men get this benefit for a time, but few stay on chemo against PCa for over a year or thereabout (this is a huge generalization).

Taxotere is a frequent adjuvant therapy, utilized simulatneously with radiation or HT, and in combination, sometimes the effictiveness is very good.  

People on chemo need to be closely monitored for fever, which can be a sign of neutropenia -- a plunge in white blood cell counts.  This is dangerous, but can be treated with the colony-modifer/ bone marrow stimulant drug Neulasta. Nausea is well-controlled today with EMEND or similiar drugs. Verify with the oncologist that he is to be given EMEND beforhand. If not, I would request it.

I wish  him well,

http://chemocare.com/chemotherapy/drug-info/Taxotere.aspx

max

kidclutch
Posts: 41
Joined: Oct 2017

He went today for pre-chemo labwork, where he was told chemo has been CANCELLED! His Foundation One genome testing returned and has revealed a mutation for which they will be ordering targeted immunotherapy to begin in two weeks. He will be receiving a bit of radiation on a painful shoulder in the meantime, and also received his first infusion of Xgeva.

What a rollercoaster! I don't have specifics on the mutation or immunotherapy course just yet, but will be happy to update when I do in case it could help anyone on this forum.

It certainly is a relief to have at least a delay on the chemotherapy--I think the whole family was dreading it.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3252
Joined: May 2012

Interesting, kid.  It could be that he becomes part of a revolutionalry new PCa treatment.  Please keep us informed,

max

kidclutch
Posts: 41
Joined: Oct 2017

Genome sequencing is fascinating stuff. I hope to see it become standard for all newly diagnosed patients in the future. I will update as soon as I know more. Thanks so much for your chemo tips, will save them just in case. 

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