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Chemotherapy or no chemotherapy?

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User
Posted 30 Apr 2026 at 15:04

Hello

I am due to start 6 cycles of chemotherapy in 2 weeks time (Darolutamide and Docetaxel with androgen deprivation therapy). I was diagnosed with stage 3 advanced metastatic cancer October 2025(Gleason 9) (with some spread to pelvis and spine) and have been on Zoladex hormone therapy for just over 5 months now. My question is this - is it better to feel fit and well, potentially for the next couple of years, or go through all the risks and side effects associated with chemotherapy, for the next 5 months, which potentially could add a further 1-2 years to my life? Lots of people I've spoken to (including my wife) say no don't do it, quality of life is more important, even if it's shorter. What do others think?

Thanks

Jovan

User
Posted 30 Apr 2026 at 16:05

Hi Jovan,

I'm in a similar boat and went for chemo with the view I'd rather take the risk whilst spread is low burden and to hopefully do away with any micromets that might not have been picked up on the scans, and also whilst I felt fit enough to handle it.

The side effects were minimal for me, I don't feel any different than before I had it, just very dry skin now and nails have grooves in them but they are growing out, otherwise I feel fine.

My dilemma was not doing it now and maybe having to do it later if things get worse, and the chemo might be harder on the body, and at least in my head I tried the best I could at the earliest opportunity.

ATB with what you decide to do, or don't do!

hawkz

 

Edited by member 30 Apr 2026 at 16:30  | Reason: Not specified

User
Posted 30 Apr 2026 at 16:16
Hi , my husband had similar stats to you 4+5 spread to lymph nodes . He was offered chemo as soon as he was diagnosed. His thoughts were take it while he was in good health rather than later when his body wasn’t as good shape . He sailed through it ,working all the way throughout. His PSA came down to undetectable after about 4 sessions . He kept all the hair on his head (no cold cap) but lost all his body hair including eye brows . He was 55 when diagnosed, he’s due to have his 66th birthday soon . He has been on other medication since to keep him ticking along ,but he still works full time and his PSA is still undetectable.

Hope this helps

Debby

User
Posted 01 May 2026 at 11:52

Hi, sorry to hear that you are facing this dilemma. I have literally just had the same conversation with my husband - his situation is a little different but the same dilemma. He has liver, lung and bone mets, so supposed to be starting chemo on the 11th, however, he's not in good shape despite being only 55, so the decision is - enjoy the summer without the risk of severe side effects and delay, or completely opt out of it and manage QOL as best as possible. So many here have had the treatment and done well, so it's a very difficult choice. Best wishes to you and fingers crossed that you have the best outcomes whatever you choose. 

Rach

User
Posted 01 May 2026 at 13:21

I have no expertise or experience of chemotherapy but I have (like others on this forum) found the videos posted by Dr Scholz (an American prostate cancer expert) to be a very useful source of information on a wide range of postate cancer issues. Here is is a link to one that I have watched on chemotherapy and you may find it to be of interest:

https://www.youtube.com/watch?v=KZ9yy-Msbu0

Two points which I found particularly interesting were:

a. chemotherapy for prostate cancer, while it does have side effects, is generally tolerated much better than chemotherapy for other cancers, so it is possible that some of the opinions that you are receiving are based on a more general impression of what chemotherapy entails

b. chemotherapy does not work for everybody but it seems to be beneficial for more than half of the men who undergo it.

Best wishes to you whatever you decide to do

Kevin

User
Posted 01 May 2026 at 15:18
As you are young you have most to gain from a long remission, up front chemo + The 2 androgen deprivation therapies are proven to increase the length of remission and we have an excellent example on this thread.

It's not a guarantee but it's definitely your best shot.

User
Posted 01 May 2026 at 15:24

I had chemotherapy and looked a real

mess with half my hair gone and a face like a football but I didn’t feel ill at all. In fact, I went straight onto my home gym after I got home from the third session.

I would go for it if I were you.

User
Posted 01 May 2026 at 17:09

Just to add an alternative perspective. I decided to postpone chemotherapy and start with zoladex and Enzalutamide hormone therapies.  That has kept the PSA undetectable for 3+years now.  I expect I will have chemotherapy at some point in the future.

 

User
Posted 01 May 2026 at 21:48
Hi Jovan, your diagnosis sounds similar to mine December 24/January 25. Mine is stage 3 advanced, Gleason 9, spread to lymph node, spine and possibly pubic bones. I was 70, and in good health otherwise. I was offered Enzalutamide or chemotherapy, plus ADT and radiotherapy. I chose to have chemotherapy while well enough to cope, and save Enzo for later. Chemotherapy wasn’t without its side effects, body hair loss and thinning beard and head hair, but I didn’t have a lot anyway. Taste was affected, as well as finger and toe nails. Some other affects but all manageable. I did avoid mixing with people, but as long as family and close friends didn’t have anything contagious, I spent time with them as normal. But once through it and the radiotherapy my PSA is down to 0.04 and staying there, and the lymph node was shown on the CT scan to be significantly reduced. So I’m happy enough with my choice.

Although that’s my experience so far, I realise the side effects can be different from one person to another.

All the best with making the choice best for you, and hope whatever treatment you choose works out well.

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User
Posted 30 Apr 2026 at 16:05

Hi Jovan,

I'm in a similar boat and went for chemo with the view I'd rather take the risk whilst spread is low burden and to hopefully do away with any micromets that might not have been picked up on the scans, and also whilst I felt fit enough to handle it.

The side effects were minimal for me, I don't feel any different than before I had it, just very dry skin now and nails have grooves in them but they are growing out, otherwise I feel fine.

My dilemma was not doing it now and maybe having to do it later if things get worse, and the chemo might be harder on the body, and at least in my head I tried the best I could at the earliest opportunity.

ATB with what you decide to do, or don't do!

hawkz

 

Edited by member 30 Apr 2026 at 16:30  | Reason: Not specified

User
Posted 30 Apr 2026 at 16:16
Hi , my husband had similar stats to you 4+5 spread to lymph nodes . He was offered chemo as soon as he was diagnosed. His thoughts were take it while he was in good health rather than later when his body wasn’t as good shape . He sailed through it ,working all the way throughout. His PSA came down to undetectable after about 4 sessions . He kept all the hair on his head (no cold cap) but lost all his body hair including eye brows . He was 55 when diagnosed, he’s due to have his 66th birthday soon . He has been on other medication since to keep him ticking along ,but he still works full time and his PSA is still undetectable.

Hope this helps

Debby

User
Posted 01 May 2026 at 03:11

Hi, Jovan.

Welcome to the forum, mate. I have no personal experience of chemotherapy. However, this conversation may be some use to you. 👍

https://community.prostatecanceruk.org/posts/t30347-Starting-docetaxel-chemotherapy

 

Edited by member 01 May 2026 at 03:13  | Reason: Add link

User
Posted 01 May 2026 at 11:52

Hi, sorry to hear that you are facing this dilemma. I have literally just had the same conversation with my husband - his situation is a little different but the same dilemma. He has liver, lung and bone mets, so supposed to be starting chemo on the 11th, however, he's not in good shape despite being only 55, so the decision is - enjoy the summer without the risk of severe side effects and delay, or completely opt out of it and manage QOL as best as possible. So many here have had the treatment and done well, so it's a very difficult choice. Best wishes to you and fingers crossed that you have the best outcomes whatever you choose. 

Rach

User
Posted 01 May 2026 at 13:21

I have no expertise or experience of chemotherapy but I have (like others on this forum) found the videos posted by Dr Scholz (an American prostate cancer expert) to be a very useful source of information on a wide range of postate cancer issues. Here is is a link to one that I have watched on chemotherapy and you may find it to be of interest:

https://www.youtube.com/watch?v=KZ9yy-Msbu0

Two points which I found particularly interesting were:

a. chemotherapy for prostate cancer, while it does have side effects, is generally tolerated much better than chemotherapy for other cancers, so it is possible that some of the opinions that you are receiving are based on a more general impression of what chemotherapy entails

b. chemotherapy does not work for everybody but it seems to be beneficial for more than half of the men who undergo it.

Best wishes to you whatever you decide to do

Kevin

User
Posted 01 May 2026 at 15:18
As you are young you have most to gain from a long remission, up front chemo + The 2 androgen deprivation therapies are proven to increase the length of remission and we have an excellent example on this thread.

It's not a guarantee but it's definitely your best shot.

User
Posted 01 May 2026 at 15:24

I had chemotherapy and looked a real

mess with half my hair gone and a face like a football but I didn’t feel ill at all. In fact, I went straight onto my home gym after I got home from the third session.

I would go for it if I were you.

User
Posted 01 May 2026 at 17:09

Just to add an alternative perspective. I decided to postpone chemotherapy and start with zoladex and Enzalutamide hormone therapies.  That has kept the PSA undetectable for 3+years now.  I expect I will have chemotherapy at some point in the future.

 

User
Posted 01 May 2026 at 21:48
Hi Jovan, your diagnosis sounds similar to mine December 24/January 25. Mine is stage 3 advanced, Gleason 9, spread to lymph node, spine and possibly pubic bones. I was 70, and in good health otherwise. I was offered Enzalutamide or chemotherapy, plus ADT and radiotherapy. I chose to have chemotherapy while well enough to cope, and save Enzo for later. Chemotherapy wasn’t without its side effects, body hair loss and thinning beard and head hair, but I didn’t have a lot anyway. Taste was affected, as well as finger and toe nails. Some other affects but all manageable. I did avoid mixing with people, but as long as family and close friends didn’t have anything contagious, I spent time with them as normal. But once through it and the radiotherapy my PSA is down to 0.04 and staying there, and the lymph node was shown on the CT scan to be significantly reduced. So I’m happy enough with my choice.

Although that’s my experience so far, I realise the side effects can be different from one person to another.

All the best with making the choice best for you, and hope whatever treatment you choose works out well.

User
Posted 02 May 2026 at 02:59

Hello Jovan,

                     Deciding on your own treatment pathway based on the experience of others is folly in my view. The reason? Each of us react in distinctly individual patterns to carcinogenic antagonist's. Rationale? We are not clones of each other. You have no guarantees whatsoever that the experience of others will be aligned with your own. The expert medical opinion that you are receiving is given in good faith and shaped by your medical circumstance. Options are the norm. Why? Disease complexity and responsiveness. So essentially the decision is your's to make. What opinions you give credence to, in that process, is a matter for you. Having read a few, I suspect your good wife know's you best. Quality v Quantity. If only that choice was infinite.

 
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