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Dad’s chemo stopped - what happens next?

User
Posted 25 Oct 2018 at 21:50

My beloved dad has made the decision to stop chemo (cabazitaxel) after 3 sessions. 


He’s got spread to bone but no pain. He’s got other health issues, which have deteriorated his quality of life lately and these were not helped by chemo.


Anyway after being in and out of hospital for over a month, he’s finally feeling a bit better in himself and has decided to stop chemo, in case it sets him back again and the consultant said it would only give him 2 more months anyway.


I wondered if anyone had experienced the journey from this point?


I lost my mum from bowel cancer in 2016 but we didn’t realise how close she was to leaving us, so I don’t think we made the most of her last few months. 


I don’t want the same to happen with dad. I’d like to help him do things he wants like go on holiday but I don’t know if he’ll deteriorate straight away or whether planning a holiday for Feb half term is feasible.


Any advice would be great to hear.


 

User
Posted 28 Oct 2018 at 00:35

Hard to say without knowing how rapidly the PSA is rising. Men don’t die of bone mets though - it is usually either organ failure, serious infection or that they need so much pain relief for the bone mets that they eventually slip into a morphine induced end. Not everyone is in a lot of pain with end stage PCa though.


So in dad’s case, radium would definitely be worth a try if they offer it. I think if I was in your situation, I would risk planning a February holiday but perhaps not anywhere where the travel insurance would be very expensive. 

Edited by member 28 Oct 2018 at 00:38  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 25 Oct 2018 at 23:20
Hi, we need a lot more information from you like:
- was the chemo being given because all other treatments had failed OR
- was he offered chemo as part of a new early intervention approach to improve the effectiveness of his hormone treatment?
- what hormones is he on and what has he had in the past
- if he has mets (spread to bones or other organs) where are they?
- is his PSA rising rapidly or holding reasonably steady?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 26 Oct 2018 at 06:34

Hi sorry yes here’s a potted history:


Prostate removed 11 years ago


Radiotherapy (this has been seen as the cause of radiation cystitis that he’s suffering from now)


Hormone treatment (not sure which)


Zoladex (still on)


Enzalutamide


Doxetaxel - 10 doses but with a two month break due to chemo burn and then pneumonia


 Cabazataxel - 3 doses stopped because of problems with radilation cystitis causing blood in urine and subsequent infection, eating, sodium and potassium level problems.


New steroid prescribed now to control PSA more (not sure of name).


His PSA decreased when on chemo but as soon as stopped it increased. At the last blood test I think it was 236.


He also has heart failure and a pacemaker.


We understand the only other treatment he can have is radium to control pain, if/when that occurs.


Thanks


 

User
Posted 26 Oct 2018 at 20:48
Okay so he had a recurrence after surgery which was treated with radiotherapy and hormone therapy? The Zoladex is probably the hormone he has been on all the way through. Radium 223 doesn’t kill the cancer everywhere but has a good effect in controlling bone metastases that are causing pain; not much help if dad isn’t in pain though.

Have they actually told dad where the metastases (spread) are? If radium is a possibility for the future that suggests that there are bone mets but it doesn’t seem certain? If he has mets in the liver, brain, lungs, etc then he could worsen quickly or suddenly but with bone mets and no pain, the steroids could keep him well for quite a long time.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 27 Oct 2018 at 23:16

Hi


Thanks for your time in replying :-).


He’s basically at the end of treatment offered, with bone mets that had grown when last scanned but not causing any pain at the moment. The scan was before the 3 x Cabazataxel.


At this point i don’t think he has any other spread.


So when you say quite a long time, (I won’t hold you to this) but what, over 6 months is likely?


Oh and do you know if the bone mets definitely end with pain or is there a chance they won’t?


Thanks for reading, once again x

User
Posted 28 Oct 2018 at 00:35

Hard to say without knowing how rapidly the PSA is rising. Men don’t die of bone mets though - it is usually either organ failure, serious infection or that they need so much pain relief for the bone mets that they eventually slip into a morphine induced end. Not everyone is in a lot of pain with end stage PCa though.


So in dad’s case, radium would definitely be worth a try if they offer it. I think if I was in your situation, I would risk planning a February holiday but perhaps not anywhere where the travel insurance would be very expensive. 

Edited by member 28 Oct 2018 at 00:38  | Reason: Not specified

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