Docetaxel - was it worth it?
We will look at the costs and the benefits. The only way I've got of measuring the benefits is to use PSA as an indicator of whether treatment is working or not. Now we know it is an imperfect measure, PSA can drop but the PCa can still be spreading in the background. However, it's all we've got, if we don't use it then all decisions regarding all treatments are being taken in the dark in the hope that they work but with no way of knowing whether they do until expensive scans are taken. So PSA is what we've got and it is that I will use in defining the benefits.
Costs
1. Hair loss. Not something that bothered me so I consider this a zero cost item.
2. A few crappy days , usually 3, each 21 day cycle. All bearable and thus a low cost item.
3. Peripheral neuropathy, minor in fingers but more marked in toes and feet. Not a pleasant thing but not painful so no pain killers needed. It doesn't affect my ability to walk so it doesn't have a negative impact on my quality of life.
4. Skanky nails, hands and feet. Again not pleasant but not painful so no pain killers needed.
5. Oedema in ankles and feet. Not pleasant but not painful so no pain killers needed.
6. Pneumonia. This has been a substantial cost. Two weeks of feeling pretty bad and quality of life significantly impaired. There will probably be a couple more weeks before I am fully restored.
Benefits
1. My PSA at the start of docetaxel was 26.28. It is reasonable to assume that without docetaxel it would of continued to rise. I can't estimate how far it would have risen but in the 27 weeks I've been on docetaxel it would have been far higher, maybe in the region of 70 to 100. My PSA now is 4.85. During the time on docetaxel, with the exception of the last two weeks, I've maintained a pretty good quality of life.
Conclusion
The benefits outweigh the costs and if I were to be faced with the same choice again I would opt for docetaxel, although I might stop after infusion 8. http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-wink.gif