what comes after chemo ?

User

Posted 12 Apr 2025 at 16:00

A few stats : Age : 70 , fit and active. Diagnosed 2020 : Gleason 9 (5+4). Radical prost. March 21.: metastatic. On various HT : zoladex , arbit., enza .,. HT failing to keep PSA down (doubling each month) . Cancer now in left leg , pelvic area , 2 lymph glands and ureter of right kidney.

Doc recommends course of chemo. at 3 week cycles until PSA drops.

Has anyone experience of this ? How successful has it been in extending active life (Im a keen cyclist) ? What follow up is required in terms of RT /HT.

I have had 4 good years , feel pretty well. I do not want post chemo to be a round of blood tests , scans ....... I rather enjoy what is left if little time with QoL so reduced.

User

Posted 13 Apr 2025 at 01:00

I don't have any experience of being in your position. From the posts I have read on here over the last five years, I get the impression that the most common chemo for prostate cancer, which I think is docetaxel is not too brutal.

I think with a doubling time of a month, you have a short life ahead of you, and the side effects of the cancer may be worse than the side effects of the chemo. If I were in your position I would at least start on the chemo.

A friend of mine had a different cancer and I'm not to sure what treatment he had. He put up with the treatment and lived about 7 years disease free. His cancer then returned and he opted for no treatment, resulting in his death. On the recurrence, his decision was perfectly informed, he knew exactly what the treatment would be like and exactly what the outcome would be if he refused it.

That is the reason I would suggest start chemo, it may not be too bad, it may give you a reasonable quality of life. If you decide it is too unpleasant it will be an informed choice.

Dave

User

Posted 13 Apr 2025 at 09:56

Hi and welcome,

my treatment pathway is a little different to yours (see my profile), but I recently had 6 rounds of Docetaxel chemo starting in August '24 and finishing in December. This was my second bout of Docetaxel, after my initial treatment back in 2019. My consultant suggested the second bout to try and slow the progress of some mets in my liver, bones and lymph nodes.

The chemo did keep my PSA suppressed during the 6 cycles of treatment, and scans showed it shrank the tumours on my liver and elsewhere, which is good. While I found the first 4 cycles were fine and relatively easy to tolerate, the final 2 cycles of chemo were really brutal, I was bedbound for days after both. At that point I stopped treatment (my consultant suggested up to 10 cycles were possible, if I was tolerating it OK).

My PSA is now rising rapidly like yours, but I'm very much focusing on QoL. I have been offered further chemo using a different drug (Cabazitaxel) but I'd have to be convinced it would offer a real longevity / survival benefit. I'd rather be reasonably well and doing what I enjoy, than spending days either in bed or draped over the sick bucket.

Having said all the above, you could start the chemo and see how you go on for 2 or 3 rounds. It will have some effect in slowing disease progression. If you're managing it OK, carry on; if it's making you ill, you can always stop.

Don't hesitate to ask if you've questions about the chemo, and best of luck with whatever you decide to do.

Cheers, Craig

User

Posted 13 Apr 2025 at 12:22

I am no expert on these matters. And whilst I also have spread in the bones I am hoping the current triplet treatment I am undergoing means it will be a few years (I hope) before I have to go through chemo again. But I have just finished 6 cycles of chemo (docetaxal) and it was not too bad. Everyone is different. I did my best to maintain my walking and cycling throughout and I think that really assisted. If you are fit as it sounds I would give it a go. What do you have to lose?

User

Posted 13 Apr 2025 at 19:14

Thanks to you all for your responses. My consultant is of the opinion that I should give it a go and I can stop if it gets too bad. I have had a few weeks to think about it . I felt that I was on a train which didn't stop to let me off . Now I have had time to read up on the forum and listen to your responses I will discuss it further with my wife. Tony 58 has given me some hope that I'll be able to stay active. I am being recommended a 3 week cycle . How soon after the 'dose' were you able to be up and about ? Do you need follow up RT ?

User

Posted 13 Apr 2025 at 21:48

I’m sorry I can’t offer you any advice on this, but I can wish you all the best whatever you decide.

Derek

User

Posted 14 Apr 2025 at 07:12

I had six rounds of chemotherapy and was able to carry on as normal throughout. It made me tired, gave me a moon face and half my hair dropped out but I continued to work out on a multi gym once a week and go out on my vintage motorcycle, which required kick starting.I wasn’t sick and didn’t feel ill in any way.

After the chemotherapy, I had 37 rounds of radiotherapy.

User

Posted 14 Apr 2025 at 09:18

I found that the chemo after-effects followed a (relatively) predictable cycle. It affects everyone differently, but each cycle was usually like this for me:

- I had the infusion on Thursday

- Friday I felt fine and would be out & about as normal

- Saturday afternoon, I started to feel a bit tired & drained

- Sunday a bit more tired, and like I was coming down with a cold. I usually slept / rested most of the day

- Monday onwards: start to pick up again, by Wednesday I felt fully back to normal

You'll likely be given a course of steroids alongside the chemo which help with energy levels and recovery from the chemo. You may also be given a course of injections which you self-administer to boost your white blood cell count (this is usual with the Docetaxel chemo drug).

User

Posted 15 Apr 2025 at 21:46

Thanks Craig, Your experience of chemo sems in line with most I have read but not all, different for everyone. I am 70 and have had RP , HT - 3 different sorts the las - enza - only kept ALF(the aggresive little f....) down for a few months. Its in my leg, pubic bone , 2 lymph ... The chemo will knock it back. I wonder whether the time , discomfort , raised hopes ... are worth it. Perhaps better sooner than later.

User

Posted 16 Apr 2025 at 08:20

Defo worth it for me started docetaxel January 24 with 10 rounds,started cabazitaxel Feb 25 at 10 rounds booked in have my 3rd infusion tomorrow with MRI,Scsn and full body x-ray booked in for today Will update my profile and thread then.

All the best with your journey.

User

Posted 16 Apr 2025 at 09:45

Originally Posted by: Online Community Member

I wonder whether the time , discomfort , raised hopes ... are worth it. Perhaps better sooner than later.

It is a tricky decision, QoL versus the hassle of treatment and risks of side-effects. My 10p worth would be, have a chat with your consultant and perhaps give the chemo a try.

You can always stop the treatment at any point if you're experiencing bad side-effects, you certainly do not have to carry on regardless.

All the best,

Craig

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