Chemothgerapy

User

Posted 11 Mar 2016 at 22:06

Well it is about. Three months now since my last post and the ADT hormone therapy is going quite well with PSA down to .5 now. The doctors etc are all satisfied with my progress and I had my third 3 monthly injection today. Side effects are few. Some tiredness, some slight hot flushes mainly at night but nothing to sweat about. I have no symptoms from the metastases sites.

I saw the oncologist last Friday the 4th and have now been offered chemotherapy. This is in line with the latest trial results which seem to show that chemotherapy early in ADT increases life expectancy for us with advanced prostate cancer. The treatment would be with docetaxel.

I am still trying to decide whether to go ahead. If you have read my previous posts you will know I am looking after my wife who has advanced Alzheimer's disease and that is a full time job. That is one consideration. Another is would I benefit. I am reasonably fit and exercise and go running twice a week and current treatment seems to be working and not causing too much problem for me. We have all heard the horror stories about chemotherapy and side effects. Though one of my doctors says that in general men cope well with docetaxel. Would I be one. Also ADT can last for longer than the average and if that was the case with me why should I worry about taking chemotherapy. Presumably any extension of lifespan on this regime is based on averages so if I had longer than average on ADT would I see any benefit anyway.

For me quality of life is more important than quantity.

I have about a month before my next oncology appointment so shall ponder further and ask more questions. If anyone has experience of docetaxel I would be interested to hear your thoughts. Thanks for listening and good luck to all in your own battles.

User

Posted 12 Mar 2016 at 08:53

My OH had 10 doses of Docetaxel after the ADT stopped working for him. He was feeling unwell when he started it and improved dramatically once he was on it. His quality of life was much better to the extent that we went on holidays that we wouldn't have been able to without it. He had very few side effects apart from a day or two of feeling less well each cycle. Tiredness did increase towards the end of the course.

I appreciate that your circumstances are different but I can definitely say that he benefited from it. Good luck in your decision making.

Rosy

User

Posted 12 Mar 2016 at 13:21

I have advanced PCa with widespread bone mets. I was treated with ADT and quickly with chemo (docetaxal).
As you say, there are a number of trails which show real benefit eg (STAMPEDE)
I am 58, reasonably fit.
The chemo has not been a breeze, but the side effects are minimal if you think there might be say another 2 years life. Its a 3 week cycle and over those 21 days there are about 4/5 crappy ones, but not too bad. I lost some hair in cycle 1, have had quite a bit of annoying fatigue on those bad days, but no nausea. I would recommend it...given our situation.
I can honestly say quality of life has not suffered too much.
You can of course always wait and opt for chemo later, however for me the trails showed such real benefirt, I said lets do it.

Best wishes with your decision.

Martin

"And Rocky said, doc it's only a scratch. And I'll be better, I'll be better doc as soon as I am able"

User

Posted 12 Mar 2016 at 13:52

My view is that you shouldn't consider early chemo until you have had a discussion with the local authority or a review of your carer's assessment and know whether any additional support will be available for your wife while you are on the 'off' weeks. It would be very important that you avoid infection which is difficult if you are providing personal care for someone that can't tell you when they feel unwell.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 12 Mar 2016 at 16:47

Thanks for replies and your experiences etc. Though my cancer has spread it is not in a great number of areas. As I had no outward signs or symptoms of advanced cancer I am hoping I may be able to carry on for years!! as I am since the hormone treatment is working well, causes few problems and I am able to keep fit and carry on as normal. That is the ideal. I realise this may not be the reality and am still seeking information on the chemotherapy option and lots here to think about as usual. I also see my MacMillan nurse Monday and my cancer specialist nurse next Monday so will keep an open mind. I then have oncology appointment on 15 April.

My wife, though with advanced Alzheimer's, is still physically fit but her mind has gone. I take her for walks twice a day, go for coffee sometimes and go shopping together so some normality. I have not been prone to infection and never get colds etc but realise chemo can change that. I have some care available so I can go out for a few hours but I suppose hope that side effects of chemotherapy are minimal as they are for me on ADT. Maybe I have to think again as though OK physically my couldn't even make me a cup of tea let alone a sandwich.

I know at the end of the day the decision is mine and there are no set answers. We are all different, react differently to treatments and cannot foresee the outcomes. I will stay positive, keep fit, and I don't appear to be worrying about the cancer. Maybe I should!

User

Posted 12 Mar 2016 at 23:52

You present a difficult dilemma. Had you been diagnosed four years ago as I was you would not have been offered chemotherapy if you responded to HT as I have. I still await the delights of chemotherapy. However though I have been on HT, fatigue has increased over that time and I will be retiring shortly. Although symptom free at the start I now have pain in increasing amounts and different sites. I had RT last year to relieve the pain. All I am saying is that you could survive as I have over the next four/five years (if you are lucky) but you will eventually have increasing side effects. So you may be ok for a while.

Since I was diagnosed the evidence is clear that early chemo works best at extending time and a close friend of mine has just been diagnosed and he is getting chemo straightaway. If I was starting now I would not object to chemo as a first strategy.

I am where I am and relative to many others I am doing ok. But I am on a journey that current knowledge indicates will not only be incurable but will reach an end point. I have worked with the medics to maximise my chances of living as long as I can and am very focused on a positive approach as you appear to be. But I wonder if it is really the right path to miss out on the best treatment.

Lyn is right you need to make arrangements to get support but the better you are feeling the longer you can give the care you obviously do.

Just my thoughts. Good luck on your journey whatever you decide,

User

Posted 13 Mar 2016 at 13:07

Elares,

You make a valid point about being prone to infection DURING the chemo, but that is not a lasting condition. Once your white blood cells have recovered, you'll be fine. I haven't had docetaxel but three years ago or so I had a course of chemo for bladder cancer and the oncology nurse told me that compared with that docetaxel is a "pussy cat". Most people have few side effects and the only real problem is the risk of infection during the treatment. That should not interfere with your walks or even shopping trips (if you take care). Of course you have to think of your carer role, but you need to get over your own problems to be of maximum help to your wife.

I have a comparable situation (though her problem is not Alzheimers) and I shall have no hesitation in having the docetaxel treatment, which may be offered quite soon now.

Good Luck with whatever you decide and do eat well, look after your weight and remain fit for both your sakes.

AC in Northants

User

Posted 13 Mar 2016 at 19:59

Thanks for your experience and I am grateful for your interest and take what you say onboard. It is great getting real life experiences which add useful info for me to use and make decision making easier. If anything can be called easy with advance prostate cancer.

User

Posted 13 Mar 2016 at 21:07

I am finding this one tricky to answer since my hubby, 61 at diagnosis, PSA 25' Gleason 10' spread to five areas and lymph has not yet had chemotherapy, is on an old Hormone drug and is still OK after more than five years. A bit like Paul, I'm sure we would have said yes to chemo if it had been offered early, but with hindsight I am rather glad we still have it in the Arsenal to use.

We have been told it would still not be offered over enzalutimide when the time comes (as it surely will), the medics seeming to prefer enza. As my hubby gets older and more "damaged" by the side effects of treatment I do wonder about chemo and whether he will ever want to have it. I'll find out one day I suppose.

I am younger by 8 years and still working and we would manage ok. Please be sure about one thing, one of our friends here on the forum (Martini) died from an infection during chemo. It's not to be sniffed at.

A hard decision in your circumstances, I wish you well whatever you decide.

Devonmaid

User

Posted 14 Mar 2016 at 01:08

One other thing to consider is that you can; at least here in NZ; opt out of chemo during the treatment. So if the side effects were bad you would not have to continue on with the whole program. Probably worth raising with the Oncologist.

"And Rocky said, doc it's only a scratch. And I'll be better, I'll be better doc as soon as I am able"

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