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After Cabazitaxel ???

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User
Posted 07 Dec 2020 at 14:24

Hello & best wishes everyone.

Been reading the forum for a while now & this is my first post.

I was diagnosed with prostate cancer in April 2019 at the age of 53yrs.

The original disease was diagnosed as T4N1M1b Grade5 which was quite a shock to both my mrs & myself,

Original PSA was a low 5.56 & Gleeson score a high 4+5 +9

Biopsy showed 43% tumors on right & 69% on left lobe of prostate, with disease in the left lymph nodes & left hip.

Started LH-RH Prostap 3 monthly hormone injection, then in June 2019 started 6 cycles of Docetaxel, All seemed to be going well as after my chemo my PSA was 0.14.

Had a TURP procedure Dec 2019.

Fast forward to May2020 :-

Onc team were pleased with previous results but decided to give me radiotherapy on my prostate as a precaution so a CT scan was arranged .... then another bone scan . We were shocked at the results to say the least.

The cancer had spread to my other(right) hip,sternum,rib,shoulder & 3 places up my spine.(this would explain the pain i had in my hip & chest)  PSA 0.027ug/l

Onc Diagnosed 'castrate resistant metastatic prostate cancer'  & promptly got me in for radiotherapy with a view to start Cabazitaxel asap. So, the pain in my sternum has subsided to almost nothing. I do get a little pain in both my hips but take pain killers to control this.

I have now had my 5th cycle of cab which I'm tolerating well with no major side effects.

My question(or 2) now is, what happens when i've had the 10 cycles of cab as i believe this is the max you can have? How long after the final dosage does it remain effective as i've read that 80% will have left the body after 2 weeks?

Has anyone else been in this situation with cabazitaxel ? what treatment was offered after your last cycle?

sorry for the long post

my best wishes to everyone

Kev.

 

 

 

 

User
Posted 13 Dec 2020 at 11:34

Kev,

You will see from Lyn's post above there are also other meds available before the tool box is empty.Then there may be trials of new drugs in development that you may be eligible to join.

Stay strong

Regards

Norm

User
Posted 15 Feb 2021 at 16:36
The average for abi or enza is about 18 months but some men do far, far better than that so hopefully, you won't need to think yet what is after those. Repeating the cabz is a realistic option if you have responded well to it this time round.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Feb 2021 at 22:16
My husband has just been taken off Cabazitaxel after 6 sessions (out of 10) but his PSA had climbed to over a thousand although it had brought his pain levels right down (no longer taking Morphine) and increased his mobility. He is now looking at trials which is something you could ask about after Abi or Enza. My husband had them both as Abi was part of a trial and the trial affected his liver function. He was then able to have Enza for almost a year. Minimal side effects on Enza but unfortunately PSA just continued to increase. Hopefully with such a low PSA this will be years down the road for you.
User
Posted 15 Feb 2021 at 23:02
Good luck with the treatment Kev.
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User
Posted 07 Dec 2020 at 17:17

The last session isn't the end of the cabz story - if it turns out to have been effective, you can have it again in the future. We have one member who has had 10 rounds of chemo (docetaxel in the early years and cabz more recently)

I assume that the onco has also added a new hormone treatment to the Prostap - either bicalutimide, abiraterone or enzalutimide?

What happens next - hopefully the abi or enza will dampen down the cancer activity for a while. Radium 223 might be offered at some point. If the Cabz is successful you could have it again.

Do you still have your diagnosis paperwork? Worth checking that you were diagnosed with an adenocarcinoma rather than one of the more rare prostate cancers that does not respond to HT and / or produces no PSA. If it was diagnosed as adenocarcinoma, it may be worth asking the onco whether the samples could be looked at again, just to check that there is no small cell, large cell or mucinous carcinoma present.


"How long after the final dosage does it remain effective as i've read that 80% will have left the body after 2 weeks?"

It is important to understand that chemo does not kill prostate cancer - it damages the DNA of the cells so that they can't replicate and / or when they do, they are weakened. It seems that in your case, the docetaxel didn't damage the DNA of the cancer cells in the way that had been anticipated. So while the chemo doesn't stay in your body for very long (if it did, it would kill you) the damage continues through the generations of cancer cells while your healthy cells repair and regenerate. That is why hair grows back and taste buds recover, etc.

 

 

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

User
Posted 12 Dec 2020 at 11:20

Hi again.

Thank you Lyn for your reply,it was most helpful.

Looking back through my paperwork i was diagnosed with an adenocarcinoma & not small cell or other,

The onco didn't offer any other hormone therapy & suggested cabz as i have become resistant to the HT(CRPD).

I will be having another CT scan in about 8 weeks time to check on how things are going with the chemo so will be asking him then what other HT is available to try. After cycle 3 of cabazitaxel the bone mets had stabilised but what worries me is,what will happen after cycle 10 ? Will the cancer start to progress? I asked the onco this but he was reluctant to commit to an answer.... 

Has anyone else been at this point after having cabz? what were you offered?

Best wishes

Kev

User
Posted 12 Dec 2020 at 14:12

Hi Kev.

From your posting you do not seem to have been offered Enzalutamide or the alternative yet .This should in most cases keep you going for months or years depending on your individual response after chemo fails (Lyn's comments above refer).

Regards

Norm

Edited by member 12 Dec 2020 at 14:18  | Reason: Typo

User
Posted 13 Dec 2020 at 09:07

Thanks for your reply Norm,

No,I haven't been offered any other HT yet,maybe the oncologist is waiting to see how I respond to the chemo before making a decision on what to offer me next.

Good luck with your treatment

best wishes

Kev

 

User
Posted 13 Dec 2020 at 11:34

Kev,

You will see from Lyn's post above there are also other meds available before the tool box is empty.Then there may be trials of new drugs in development that you may be eligible to join.

Stay strong

Regards

Norm

User
Posted 15 Feb 2021 at 12:08

Hello again,

Hope everyone is keeping safe & well.

So, following on from my previous post, had a phone conversation with my Oncologist last week.

Due to increasing lower back pain, weakness in my legs & vomiting after my chemo(cabazitaxel) we agreed to stop the chemo. I've tolerated 8 cycles out of 10 scheduled. My PSA has been quite steady at 0.017ng/ml.

I'm due to have a scan in the next 2 weeks to check for any progression & also to use the scan as a baseline before starting Enzalutamide or Abiraterone. Hopefully i'll tolerate whichever one he puts me on.

Having already been on docetaxel & cabz as well as having targeted radiotherapy I wonder if there will be much left to try in the future.

Any information from anyone who has been in the same situation will be greatly appreciated.

Thanks

Kev

User
Posted 15 Feb 2021 at 16:36
The average for abi or enza is about 18 months but some men do far, far better than that so hopefully, you won't need to think yet what is after those. Repeating the cabz is a realistic option if you have responded well to it this time round.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 15 Feb 2021 at 22:16
My husband has just been taken off Cabazitaxel after 6 sessions (out of 10) but his PSA had climbed to over a thousand although it had brought his pain levels right down (no longer taking Morphine) and increased his mobility. He is now looking at trials which is something you could ask about after Abi or Enza. My husband had them both as Abi was part of a trial and the trial affected his liver function. He was then able to have Enza for almost a year. Minimal side effects on Enza but unfortunately PSA just continued to increase. Hopefully with such a low PSA this will be years down the road for you.
User
Posted 15 Feb 2021 at 23:02
Good luck with the treatment Kev.
User
Posted 16 Feb 2021 at 08:45

Thank you for the encouraging replies,

Hope your husband is feeling well & coping with his treatment hiitsme,

My Onco was quite baffled as my PSA is so low yet the disease had spread significantly which is why we are not relying on PSA levels any more, so will now be having a scan on a regular basis.

Good luck to everyone & keep up the battle.

Kev

Edited by member 16 Feb 2021 at 08:47  | Reason: Not specified

 
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