Should I have chemo?

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User

Posted 07 Jun 2023 at 01:17

A recent PET scan has shown my cancer has now spread to my liver. At the moment it's 14mm. My PSA is approaching 1.0. I have already had radiotherapy when the cancer was diagnosed in 2014 and have been on Abiraterone and Enzaluthamide since then

My doctor is now saying that the drugs are failing and I need chemo. He says that my prognosis is 9-12 months without chemo and 12-18 months with chemo.

I really don't know what to do. I've read so much about the bad side effects of chemo it makes me wonder if it is worth it. I need to make a decision quickly before I get too weak to tolerate the chemo.

Can anyone offer me real world advice in my situation having already tried the ADT drugs?

User

Posted 07 Jun 2023 at 09:07

Really feel for you but it’s a difficult question to answer. I’m on ADT with spread to bones and lymph nodes. Currently the meds are still working. My whole mantra since surgery in 2015 has been quality of life. I’ve rejected or delayed a fair few treatments. Given that I detest hospital visits and generally feeling ill I’ve wondered myself whether chemo would be worth it when the time comes , just for the sake of maybe 6 months. Sometimes the chemo can accelerate the process also. I just wish you luck and strength 🙏

User

Posted 07 Jun 2023 at 09:12

Not all chemotherapies are the same. Generally speaking, docetaxel (the main one used for prostate cancer) is tolerated very well and doesn't cause the horrendous side effects that we all read about for leukaemia, lymphoma, etc.

Even if you start the chemo and then stop because you find you don't like the side effects, you will still have gained some benefit.

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

User

Posted 07 Jun 2023 at 12:53

Hi Tim. I have just had my 4th 3 weekly cycle of Docetaxel having become resistant to Enzalutamide and I would not say that it is anything to be too afraid of. I have used a cold cap and have not lost any hair so far and 3 hours in the hospital every 3 weeks is not too much hassle. The side effects are significant but loss of taste and fatigue seem to be the worst. The effects on my gut are quite manageable. The fatigue seems to be pretty severe between day 3 and 9 and this was made much worse by having a dose of Covid. I am on day 9 after my 4th dose now and I am out in the garden planting roses etc.

As Lyn says it is easy to stop the chemo if you don't tolerate or don't like it but having 3 to 4 cycles is likely to give you quite a benefit. They have put me down for 10 but I don't know if I will make it that far without blood parameters getting too abnormal. Docetaxel could also lead onto other treatments being made available to you in the future once you have had it.

Also, I just wondered if SABR to the liver met might be an option to discuss.

Let me know if there is anything else specific that you might like to know.

All best.....Mike.

User

Posted 07 Jun 2023 at 18:30

Everyone is different, I had a particularly rough time after my first dose of docetaxel in 2018 and my Onco put me on a three quarter dose for the final five sessions. I didn't feel great through the 18 week journey but recovered pretty quickly once the course of treatment ended and I stopped taking steroids.

Guess it's just a decision you can make, good luck with whatever you decide.

User

Posted 07 Jun 2023 at 18:41

Thanks Mike. That's a very helpful reply.

I just worry that my remaining time is going to be spent feeling rubbish and being restricted by the 3-weekly proceedure. I know the cancer will get me in the end but I had really hoped that I'd see 2 or 3 more birthdays.

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