Anyone had chemo for high risk locally advanced?

Hi Caron,
Things are moving very quickly in terms of chemo and prostate cancer. Until maybe 4 years ago, it was only given to men in the final stages of the disease when all other treatments had failed and the hope was that it would reduce some of the symptoms for a short time. Chemo cannot cure hormone based cancers in the same way as it can cure leukemia, etc. The big breakthrough was realising that chemo given earlier to a man with advanced PCa could make the hormone treatments work better and for longer, and we have seen some stunning results even just among members here. However, the new thinking was all about men with advanced cancer with mets ie who are incurable.

I have recently read a couple of papers by oncologists who think that introducing chemo early to men who have locally advanced cancer may improve the likelihood of RT/HT being curative but there is no specific trial running and no data at the minute. I can think of only two or three members on here that are on curative chemo / RT / HT which gives you an idea of how new it is as a concept.

I suppose the issue for you is who suggested it? Was it the onco or a well-meaning lay person? If it was the onco, I would ask them why they are suggesting what is still an unusual route, whether it is part of a trial or they have seen or read something that suggests it would be a good approach, and why they think it is right for your OH. Keep in mind that chemo is quite a dangerous treatment with its own risks but that some men tolerate docetaxel extremely well.

Edited by member 06 Aug 2018 at 23:40  | Reason: typo

Hi Caron, my OH was told by the urologist, that they were going to throw the kitchen sink at the cancer, he had a starting psa of 135, 3tb N0 M0, Dec 15. He is on 12 weekly prostrap, had chemo and radiotherapy, When we first saw the oncologist, he thought it was likely he had micro mets. The last few his psa has started to rise again, had PET scan last week, MDT meeting tomorrow to discuss results.

Good luck

Sheila

Edited by member 06 Aug 2018 at 23:40  | Reason: Not specified

Thank you all. It's really helpful to hear different opinions/journeys. Apologies for slow reply: teenagers and summer holidays plus more uncertainty! For context the chemo route was initially told to us at a follow up appointment with the urologist, confirmed in writing, and then we were told actually it was to be radiotherapy following an MDT meeting. A (much later) appointment with the oncologist was found to be just about the radiotherapy (at the time of my posting I thought it was a general treatment discussion) which will start in January. We were told that if we were interested in chemo then we would need to make another appointment with the right oncologist but that the MDT decision was that radiotherapy was the way to go. I think it might have been decided now anyway because following that appointment my husband doesn't want to follow it up as he's happy with the oncologist that we saw and feels that any gains would be 'marginal' anyway. I'm stuck inbetween and would like to have an appointment to discuss it but at least at the moment I think there isn't space in his head to complicate things.....thanks again and any further thoughts welcome.

Gary continued to work all the way through in a manual job ( constructing marinas!) but towards the end was very fatigued .

He is currently on the stampede trial arm j and still working full time but with more holidays slotted in .

Good luck in your journey

Debby

- PSA should be less than 10

- G7 or below

- T1 / T2a

- no urinary problems or hesitancy

When John was diagnosed brachy was his first choice but at that time they didn’t offer it to younger men due to the slightly higher risk of second cancers later down the line. I understand some hospitals have relaxed this rule more recently.

Apart from a couple of very unusual members here, chemo is not offered to men on curative treatment plans. Chemo doesn’t kill prostate cancer; it can weaken it to make Abiraterone or Enzalutimide more effective for longer but unless your OH goes onto the Stampede trial this won’t be relevant to him.

Not sure how helpful it is to assume everything you read is relevant to your case; I can see why the medical team want you to wait for the allocated appointment. Most outpatients departments will be closing down in the next few days until the new year, or at least existing on a skeleton staff so I am not sure you could get anything much earlier than 22nd January anyway?

Why are you worried about him being on HT for 3 months? The longer he is on it before RT, the better the outcome tends to be and 3 months would be the absolute minimum.

Chemo with curative RT is not approved by NICE and there is currently no trial for you to request referral to so you are not going to get it through any normal route. You may be lucky and find that when you do see the specialist, s/he is an adventurer and knows a way to do it but really, they are the experts and know better than any lay person.

'Early' in relation to chemo for prostate cancer does not mean 'early after diagnosis' ... it means 'not palliative' or 'not at end of life stage'

Personally, I am struggling with why you are not happy with the treatment plan. With locally advanced PCa, he is fortunate to be offered radiotherapy with curative intentions and I would be grabbing that with both hands.

Edited by member 12 Dec 2018 at 20:25  | Reason: Not specified