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Coming to the end of planned Docetaxel Chemo, what happens next?

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User
Posted 16 May 2024 at 22:12

Question: as I start to approach the end of the 6 cycle docetaxel regime, what are other people's experience of "what happens next".

I have bone mestasteses so I am expecting to have a further scan (MRI /CT /PET) to compare a before and after chemo treatment; I've been told 2 weeks after the last chemo treatment for a scan, what are other people's experience? Is there a typical PSA blood test regime / interval, post treatment  to monitor for changes? How soon after treatment ends do people then see their consultant? 
{I'm on darolutamide and decapeptyl both indefinitely; no talk of radiation at this time}

[Big thanks to those who replied to this question in my other thread, but I thought a dedicated thread would get a bigger response]

User
Posted 17 May 2024 at 17:09
If the Docetaxel doesn't knock your PSA right down, they may put you on Enzalutamide (Xanti) which is like chemo-lite. I went down that route, and while the enza was effective to start with, it couldn't do anything in the face of the bone mets.

Only because I had had both Docetaxel and Enzalutamide without success, I was eligible to be referred for Radium223 therapy.

My PSA had gone up to 92, and after one infusion of radium it shot up to 300 in five weeks! Apparently in the world of nuclear medicine this is not a problem. It's only a marker. According to my Nuclear Medicine Consultant it seems that over time PSA is absorbed and stored in the bones themselves, so as the radium tries to repair the bones by removing the "bad stuff", it releases PSA into the bloodstream. It's a sign that the radium is working. Four weeks later it had dropped to 271. They don't seem bothered about PSA, they are more interested in the ALP (alkaline phosphatase) level for white blood cells.

User
Posted 17 May 2024 at 09:14

Hi

I'd also be interested to see what people answer to your comments.

But as I mentioned in your other thread,if your coping well with treatment don't be surprised if they up your cycles to 10,they did with me.

Regards Phil 

User
Posted 17 May 2024 at 12:37

Hi Mike, you can see my story from my profile, but briefly I was diagnosed with inoperable Stage 4 back in Jan 2019 (aged 54), with mets in my pelvis, spine and ribs.  My consultant at The Christie in Manchester put me on Zoladex implants, I had 6 cycles of Docetaxel followed by 18 sessions of radiotherapy targeting the primary tumour in the prostate. 

From memory, the radiotherapy was always on the cards because of the number & size of mets, and I'm pretty sure that I had MRI & CT scans inbetween finishing the chemo and starting the radiotherapy so that the oncology team had a benchmark.  

After the above treatment ended, I've been on 3-monthly follow-ups with my consultant, with full bloodwork done each time to assess PSA levels, bone damage etc. 

I hope this helps, let me know if you've any questions and I'll do my best to answer.

Cheers, Craig 

 

Edited by member 17 May 2024 at 12:38  | Reason: Not specified

User
Posted 17 May 2024 at 14:53

I had my last 6th cycle on the 30/04/24.  I had a PSMA PET scan last week and have a meeting with Oncology team to discuss the scan and next steps next week.  Fingers and everything else crossed, could do with some good news tbh.

 

 

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User
Posted 17 May 2024 at 09:14

Hi

I'd also be interested to see what people answer to your comments.

But as I mentioned in your other thread,if your coping well with treatment don't be surprised if they up your cycles to 10,they did with me.

Regards Phil 

User
Posted 17 May 2024 at 12:37

Hi Mike, you can see my story from my profile, but briefly I was diagnosed with inoperable Stage 4 back in Jan 2019 (aged 54), with mets in my pelvis, spine and ribs.  My consultant at The Christie in Manchester put me on Zoladex implants, I had 6 cycles of Docetaxel followed by 18 sessions of radiotherapy targeting the primary tumour in the prostate. 

From memory, the radiotherapy was always on the cards because of the number & size of mets, and I'm pretty sure that I had MRI & CT scans inbetween finishing the chemo and starting the radiotherapy so that the oncology team had a benchmark.  

After the above treatment ended, I've been on 3-monthly follow-ups with my consultant, with full bloodwork done each time to assess PSA levels, bone damage etc. 

I hope this helps, let me know if you've any questions and I'll do my best to answer.

Cheers, Craig 

 

Edited by member 17 May 2024 at 12:38  | Reason: Not specified

User
Posted 17 May 2024 at 14:53

I had my last 6th cycle on the 30/04/24.  I had a PSMA PET scan last week and have a meeting with Oncology team to discuss the scan and next steps next week.  Fingers and everything else crossed, could do with some good news tbh.

 

 

User
Posted 17 May 2024 at 17:09
If the Docetaxel doesn't knock your PSA right down, they may put you on Enzalutamide (Xanti) which is like chemo-lite. I went down that route, and while the enza was effective to start with, it couldn't do anything in the face of the bone mets.

Only because I had had both Docetaxel and Enzalutamide without success, I was eligible to be referred for Radium223 therapy.

My PSA had gone up to 92, and after one infusion of radium it shot up to 300 in five weeks! Apparently in the world of nuclear medicine this is not a problem. It's only a marker. According to my Nuclear Medicine Consultant it seems that over time PSA is absorbed and stored in the bones themselves, so as the radium tries to repair the bones by removing the "bad stuff", it releases PSA into the bloodstream. It's a sign that the radium is working. Four weeks later it had dropped to 271. They don't seem bothered about PSA, they are more interested in the ALP (alkaline phosphatase) level for white blood cells.

 
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