I don't think penny pinching is the right phrase but cost probably comes into it. Docetaxel costs about £600 per infusion and most men will have 6 infusions (although some will have 10). If it is unsuccessful, they may have docetaxel again maybe a couple of years later but not all get that chance if they are in the 50% for whom docetaxel did nothing. So for an average man, doce will cost £3600.
Abi and Enza cost around £2500 per month and are not limited to 6 or 10 doses. Generally, when you start Enza or Abi, you are on it for life. As far as I can see, there is no information about the impact of giving a man Abi / Enza now because of COVID and then withdrawing it in 4 months. If the reality is that those men will then be on Abi / Enza permanently I would be concerned about a) what treatment they turn to next when the A/E inevitably fails b) whether it will fail quicker than it would have done otherwise and c) if he lives for 3 years, how the NHS is going to find the £86,400 difference in cost.
To be honest, I wonder just as much about whether lots of treatments will be withdrawn in future years. If our country is bankrupt and difficult decisions have to be made, I can see all the hard won arguments about cost v benefit of extending life by a few weeks or months turning to dust, not just for prostate cancer but lots of life limiting diseases.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi Lyn,
Grateful to mine your knowledge of Docetaxel please having recently finished 6 cycles with side effects not too awful and psa down to 1.You say it is unsuccessful with 50 per cent of men.Do you mean that the effect only lasts very short term before cancer gets active again?Also you mention men having 10 cycles 2 years later.Would this be on basis that other than continuing on HT injections as in my case no other meds. options such as Albi or Ena would be likely to be used before being possibly offered 10 cycles of Doc. further down the road if your health was up to it?
Tried to get an indication from doc. at my recent check up how long on average the chemo. was effective for and was told everybody different and just get on with life!
Regards
User
Hi Lyn,
Grateful to mine your knowledge of Docetaxel please having recently finished 6 cycles with side effects not too awful and psa down to 1.You say it is unsuccessful with 50 per cent of men.Do you mean that the effect only lasts very short term before cancer gets active again?Also you mention men having 10 cycles 2 years later.Would this be on basis that other than continuing on HT injections as in my case no other meds. options such as Albi or Ena would be likely to be used before being possibly offered 10 cycles of Doc. further down the road if your health was up to it?
Tried to get an indication from doc. at my recent check up how long on average the chemo. was effective for and was told everybody different and just get on with life!
Regards
User
I think that the concept of it being unsuccessful for 50% of men is based on those whose PSA continues to rise and the tumours continue to spread while having the 6 or 10 rounds - we see men on here sometimes having their chemo stopped after 3 or 4 sessions because it clearly isn't having any benefit. If your PSA went down to 1 due to the chemo, it sounds like you were in the other half.
The main benefit of chemo is that it can make the HT much more effective and for longer. If a man has a good response to chemo the first time, it can be used again in the future to give the HT another boost - there are members here that have been in that situation and will perhaps come along to give you their perspective. I don't think it is always 10 sessions though - or even always 6 sessions - it probably depends on the patient and the oncologist.
Some men are offered cabazitaxel if docetaxel hasn't worked.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi Lyn,
Ref above,many thanks for your swift response.I would indeeed be interested in hearing the perspective of any other members who have had a second cycle of chemo. to give HT another boost later in their treatment.
Kind Regards
Norm