My OH has just had his second cycle of Docetaxel which started about 8 weeks after initial diagnosis with advanced PCa.
Mostly he has been feeling OK. Not had to take the anti emetic tablets. A bit tired but hip pain has improved since treatment began, so been busy gardening. Some funny taste in the mouth but appetite fine. Occasionally seems to have a little difficulty swallowing so just eats a little slower than before. The strong steroids on the day of the treatment and preceding day seem to bring on a bit of flushing but nothing bothersome.
Here comes the but...
on day 8 after the first cycle he woke up v early and retched over the toilet bowl but no vomit. Had some crampy pain in his legs so took one antiemetic, some paracetamol had a cup of tea and went back to sleep. Temperature when he woke up was normal, so we thought he was ok. Seemed a bit tired but not unwell for the rest of the day. But late afternoon he emerged from the study shivering and shaking. His temperature at first seemed low. By the time I’d checked the guidance and spotted that a low temperature could be a reason to ring in he’d taken it again and it was OK. Lit the fire, made a cuppa , he seemed better. I had to persuade him to ring anyhow...on account of the shivering. Temperature still not above 37.5. But during the call he was asked to take it again and keep the thermometer under tongue for what seemed like ages. 38.5. So advised to come straight in and bring an overnight bag. By the time we got there he was unsteady on his feet and temperature was 39.8.
He was in hospital for 4 days with neutrophenic sepsis. Neutrophils had gone down to zero, which was clearly quite a surprise to the nursing staff. But IV antibiotics and paracetamol worked wonders. Kept in till neutrophils crept up to 1.2. A week later they had recovered to 7.5.
So my advice would be..go for the Docetaxel. The side effects may well be quite bearable. But at the nadir phase for your immune system..about a week to 10 days after treatment I believe..DO NOT mess about if you feel unwell. You could have an infection and that could be life threatening. Ring for advice, don’t hesitate and don’t rely too heavily on your temperature readings.
We will be staying away from people around the mid cycle stage if we can manage that. Going out for a meal can wait for a few days.
The idea for us was to combine the early chemo with hormone therapy but it now appears the Prostap isn’t doing what we hoped. PSA having fallen from 645 to 400 to 196 has climbed back up to 600. Bugger.