Chemotherapy for Locally advanced PC

Sorry Shaun, I perhaps didn't express myself very well.

The public perception is that chemo cures cancer - many of the members here will have been in situations where, when first diagnosed, they had visions of having chemo or have had well meaning friends / family asking why they aren't having it. In fact, there is only a small group of cancers that chemo can cure on its own .... lymphoma, leukemia, some brain tumours, etc. There are many more cancers where chemo is used alongside other treatments, either before radiation starts or before surgery (some breast or lung cancers, for example) to weaken the cells and help the other treatments to work. In the case of prostate cancer, for many years it has been known that chemo does not make surgery or RT more successful so there was no point giving it. Like quite a lot of other cancers, chemo was only used when other treatments had failed.

The world of PCa is changing rapidly - every bit of new research or trial changes the landscape a little. Plus of course they keep devising new chemo drugs. My guess is that you are not being offered chemo because the MDT is confident that your cancer is contained - it is being offered (boldly and radically) because they have a sneaking suspicion that the RT / HT cannot do the job on their own. If your MDT is correct, how exciting that you are being offered a combination of three treatments that together could be curative. Much better than a shrug of the shoulders, the offer of only RT/HT and then 'cross your fingers and hope' mentality that some men would have to bear.

When I think of all the men that have come through here, have had the RT and then never made it to full remission - instead faced with permanent HT to control the cancer - I could weep. If this possibility - RT/HT/chemo - had been available perhaps we would still have some very dear friends with us.

Grasp it with both hands Shaun and I don't think I will be the only one cheering you on from the sidelines

Thanks Lyn
That's all starting to make sense now and info like that is very very valuable to the far less informed of us. It sounds a plan Shaun. An ordeal , but one that could save your life and lead the way for others.
Very best wishes
Chris

Perhaps I can help based on my experience. Advanced PCa just depends upon high PSA and Gleason scores. With those comes the likelihood based on experience across the world, that spread will have occurred outside the capsule. Not certainty, just likelihood. That is why chemo is a good early option, now approved by NICE and surely now standard treatment in selected cases nationwide. It may well.pick up any micromets that don't show on scans. I was Gleason 9 and PSA 62.3 over eight years ago. No scan ever showed spread. The evidence is that there has been no spread, but who knows? I had RT (of the prostate and seminal vesicles) and ADT, still on ADT.

I had bladder cancer four years or so ago and after other treatments including chemo, opted for bladder removal and with it the prostate and several lymph nodes. In the bits that were removed there was no sign of bladder cancer, thankfully, but interestingly no sign of PCa either, save in the bladder neck (which would not have been irradiated). The urethra left behind showed clear at the time but unfortunately must have contained some cells because subsequently the PCa has shown up there (again, a site that was not irradiated) and I have crumbly bits in my pipe! Now that met or local spread, whichever you may prefer, never showed on scans.

The likely next stage in my treatment after abiraterone is docetaxel. I think anyone who has it offered at an early stage in treatment of local advanced PCa (which perhaps mine was) should take it. Would that it had been available to me years ago!

AC in Northants