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Worried about Chemo

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User
Posted 29 Apr 2019 at 22:58

A short recap: my husband was diagnosed with advanced stage 4 prostate cancer spread to the bones on 24 January 2019. He has a Gleason score of 8 (4+4). A PSA of 121 at diagnoses rising to 161. He was started on Hormone tablets for 3 weeks and then injection (Decapeptyl 11.25 mg) every 3 months which started on 5 February. His PSA has dropped to 1.7 and the second injection is due on 7 May. He saw the oncologist on 25 March thinking he was going to get chemo but because of a dizzy episode she postponed the treatment. After an MRI scan to rule out any sign of a TIA (mini stroke) which it did, he saw the oncologist today. However years ago when he was a child he had a mastoid operation and attends regularly 3 to 6monthly for check ups on his ear. A couple of weeks ago he had an infection in his ear and has had treatment which is due to finish tomorrow. He also has an appointment at the Ear clinic on Friday. The oncologist has booked him in for chemo (Docetaxel) on the understanding that he gets assurance on Friday that the infection is COMPLETELY cleared. She said that if it is not completely cleared there are other treatments that can be used. I’m now wondering if he would be better not to have Chemo? Can anyone let me know if the had hormone treatment and no chemo or what are the thoughts. Sorry for this long saga. Thanks in advance for you help. LizP

User
Posted 30 Apr 2019 at 08:30

These infections can be very difficult to clear, hope it’s gone and chemo can go ahead.

Also hope others will respond soon.

Best wishes to you both.

Ido4

User
Posted 30 Apr 2019 at 09:04

I would have thought that once on HT, the downside of delaying chemo for a few months is negligible, versus ensuring infection is completely cleared. Indeed, it wouldn't surprise me if chemo becomes more effective as PSA drops lower, for same reasons radiotherapy gets more effective the lower the PSA (where getting down to 0.1 is ideal if you can), but I'm guessing here with regards to chemo. If so, the important thing would be to monitor PSA, and have the chemo before it starts rising. Ask the onco.

Or is the problem that this is a frequent or continuously running infection, and it's likely to be difficult getting a clear duration long enough for the chemo?

User
Posted 02 May 2019 at 10:28

You definitely don’t want to start chemo with any infection markers, it would be a disaster. Delaying is definitely the right move here, no oncologist would authorise it in these circumstances. There are other treatments that could be used, other hormone treatments, including some of the older ones. My own husband has diethylstillbestrill (sp) for nearly three years and it worked really well at keeping his cancer at bay. He’s now on Enzalutimide and that’s been good too.

good luck on whatever is decided.

love Devonmaid  

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User
Posted 30 Apr 2019 at 08:30

These infections can be very difficult to clear, hope it’s gone and chemo can go ahead.

Also hope others will respond soon.

Best wishes to you both.

Ido4

User
Posted 30 Apr 2019 at 09:04

I would have thought that once on HT, the downside of delaying chemo for a few months is negligible, versus ensuring infection is completely cleared. Indeed, it wouldn't surprise me if chemo becomes more effective as PSA drops lower, for same reasons radiotherapy gets more effective the lower the PSA (where getting down to 0.1 is ideal if you can), but I'm guessing here with regards to chemo. If so, the important thing would be to monitor PSA, and have the chemo before it starts rising. Ask the onco.

Or is the problem that this is a frequent or continuously running infection, and it's likely to be difficult getting a clear duration long enough for the chemo?

User
Posted 02 May 2019 at 10:28

You definitely don’t want to start chemo with any infection markers, it would be a disaster. Delaying is definitely the right move here, no oncologist would authorise it in these circumstances. There are other treatments that could be used, other hormone treatments, including some of the older ones. My own husband has diethylstillbestrill (sp) for nearly three years and it worked really well at keeping his cancer at bay. He’s now on Enzalutimide and that’s been good too.

good luck on whatever is decided.

love Devonmaid  

 
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