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Finished chemo - radiation next??

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User
Posted 16 Aug 2024 at 23:00

Dear all,


I have not been keeping up with this forum because I have been too depressed trying to cope with my father's illness and the repercussions... so have tried to avoid thinking about PCa for many months.


Anyway, a recap. The history is in my profile. In March this year my dad's PSA went flying up to 29. The apalutamide and 3 monthly injections were no longer working for him, and the next treatment they had in mind was chemotherapy - 6 cycles. My dad is nearly 83 and balked at it, but in the end, agreed to go through with it, and seems to have, by and large, tolerated it rather well, suffering mostly only bad fatigue as a side-effect as well as losing chunks of his hair. From what I can tell, he has escaped quite lightly, despite being elderly and very weak because of kidney issues. His PSA was shooting up aggressively, after the first chemo cycle, the PSA was over 70! But after the 4th cycle, his PSA had dropped only to 40.


Now he has finished his 6 cycles. Does not know his PSA yet. The doc wants him to undergo a scan in 3 weeks to assess the situation and decide what to do next. He has suggested possible radiotherapy to target any 'hot spots'. I worry that this means that treatment has failed - I have not heard of doing RT after chemo. He had never been offered radiation in the first place because of his extensive mets and stage 4 cancer.


Can anyone throw some light on this? Utterly devastated by the news, but I don't really know what I was expecting from the chemo.


Ru (aka Worried Daughter)


 


 


 

User
Posted 16 Aug 2024 at 23:00

Dear all,


I have not been keeping up with this forum because I have been too depressed trying to cope with my father's illness and the repercussions... so have tried to avoid thinking about PCa for many months.


Anyway, a recap. The history is in my profile. In March this year my dad's PSA went flying up to 29. The apalutamide and 3 monthly injections were no longer working for him, and the next treatment they had in mind was chemotherapy - 6 cycles. My dad is nearly 83 and balked at it, but in the end, agreed to go through with it, and seems to have, by and large, tolerated it rather well, suffering mostly only bad fatigue as a side-effect as well as losing chunks of his hair. From what I can tell, he has escaped quite lightly, despite being elderly and very weak because of kidney issues. His PSA was shooting up aggressively, after the first chemo cycle, the PSA was over 70! But after the 4th cycle, his PSA had dropped only to 40.


Now he has finished his 6 cycles. Does not know his PSA yet. The doc wants him to undergo a scan in 3 weeks to assess the situation and decide what to do next. He has suggested possible radiotherapy to target any 'hot spots'. I worry that this means that treatment has failed - I have not heard of doing RT after chemo. He had never been offered radiation in the first place because of his extensive mets and stage 4 cancer.


Can anyone throw some light on this? Utterly devastated by the news, but I don't really know what I was expecting from the chemo.


Ru (aka Worried Daughter)


 


 


 

User
Posted 19 Aug 2024 at 09:07

Hi Ru,


I am replying, as some of my treatment echoes that of your father's. I am slightly younger than he is - but only by a handful of years.


I underwent chemo in 2022 and that was followed up with RT later the same year. The chemo shrank my locally advanced PC 'significantly' but the RT failed to mop up the remainder. I was on three-monthly HT (Zoladex) the whole time, and I am now also on Apalutamide as my PSA was rising rapidly, doubling every couple of months. Of the three treatments - HT, chemo, and RT - I found the RT the easiest, even if it was ultimately unsuccessful. Although similar, my treatments seem to have been in a different order to your father's.


I am off to the hospital this morning for my first monthly Apalutamide review. Whenever I visit this site, I am always reminded that everyone's treatment journey is different. This probably doesn't answer your question fully, but I hope you might find some of it useful.


Best wishes to you and your father, and I hope you receive some good news once you get the chemo results.

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User
Posted 17 Aug 2024 at 08:29

Hi Womble


If you can,phone your specialist nurse (living with and beyond cancer)if there like mine they'll talk you through your dad's blood test results,options you have and what happens next.


Hope this helps and best wishes to you and your dad


Phil 

User
Posted 17 Aug 2024 at 11:33

PSA during chemo is not very indicative - indeed it often increases over the first few cycles.


What they might do is to look and see if any of the mets are at risk of causing serious problems soon due to their closeness to other organs or structures, and zap those. This would potentially give a longer time before the cancer starts to cause problems.

User
Posted 17 Aug 2024 at 12:12

Hi Ru, if this is any help I reacted to chemo so it was taken off the table , but I did get radio therapy I think was in 2020 to local hotspots on my lower ribs to ease pains, got to admit it worked wonders for me, more or less not having to take painkillers till recently. It was only a single dose taking a couple of minutes with no side effects other than a lot less pain


Cheers

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

User
Posted 19 Aug 2024 at 09:07

Hi Ru,


I am replying, as some of my treatment echoes that of your father's. I am slightly younger than he is - but only by a handful of years.


I underwent chemo in 2022 and that was followed up with RT later the same year. The chemo shrank my locally advanced PC 'significantly' but the RT failed to mop up the remainder. I was on three-monthly HT (Zoladex) the whole time, and I am now also on Apalutamide as my PSA was rising rapidly, doubling every couple of months. Of the three treatments - HT, chemo, and RT - I found the RT the easiest, even if it was ultimately unsuccessful. Although similar, my treatments seem to have been in a different order to your father's.


I am off to the hospital this morning for my first monthly Apalutamide review. Whenever I visit this site, I am always reminded that everyone's treatment journey is different. This probably doesn't answer your question fully, but I hope you might find some of it useful.


Best wishes to you and your father, and I hope you receive some good news once you get the chemo results.

User
Posted 09 Sep 2024 at 22:41

Thank you so much for all your replies. I know I haven't posted much, it has been such a harrowing journey for me watching my father go through all of this. Last month he celebrated his 83rd birthday, so I should really consider myself fortunate that I have had him around for this long. But he has changed dramatically since PCa treatment started.... aged a decade at least, and the last 6 rounds of chemo have taken their toll. He barely walks unless he has to, and complains of fatigue all the time. However, his appetite is still pretty decent.


His (private) urologist has just viewed his scans, and suggested trying Lutetium 177. Which I understand, is horrendously expensive. My dad has not told me what the latest scans have shown, but he is seeing the oncologist tomorrow and so that should throw some light on the situation. I am trying to support my dad from afar, as he doesn't live in the UK - and has had to pay for all his treatment privately and it has been a considerable financial drain, but the emotional toll has been worse. :(


I wish you all the best. I'm just so anxious waiting for news from his onco appointment tomorrow. The uncertainty is just awful!


Ru aka womble


 


 

 
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