Completed 6rounds chemo Taxotere/Carboplatin. good results. Next Chapter?

It's been a while since I've posted here regarding my husband. I have been staying in touch with reading post to glean lots of good information. We are getting ready for a New Chapter in my husbands PC journey. Tried to fit as much stats in signature.
He was told in February that he has the type of PC that does not respond to hormone treatment. His T-level came down to <20, right away with Degerilex yet PSA continued to rise. Tried Casodex then Zytiga. Scans in 2/14 showed Mets through lymph system from neck, chest, abdomen and pelvis. He began six rounds of Taxotere/Carboplatin. Stopped Zytiga 5/14 Completed chemo end of June. Scans in beginning of June showed great reduction in mets and prostate area looking "normal"
Now, this is where we need some input.. Onc. Called this morning to say he has consulted with expert team and would recommend "radiation", I assume Prostate. Labs have showed his PSA is now at 0.72, they tested NSE and slightly elevated @19, Drs. feel he has Nueroendocrine Disease. The question would be if cancer has metastasized through his lymph system with Nueroendocrine disease, what benefit would radiation have at this point? Has anyone had similar stats? He has been off all meds. Now for almost a month. We don't want to let our guard down. Everything I've read on this site is to "stay ahead of this disease" , we have been in constant "attack mode" since diagnosed a year ago. Seems so strange to be letting so much time pass with out actively doing something to fight this disease. What should we do how? Should we have scans done? I don't want this to get out of control again? Any suggestions? Tall allen? Anybody?

Barb,

I wish I had some definitive data to offer you. This horrible disease is so rare that doctors just try what makes sense. I'm so glad he responded to Taxotere/Carboplatin.

All I can tell you is that a man in my PC support group has small cell PC, and had the radiation treatment, which seems to have at least slowed it down. He was treated by Dr. King at UCLA as his RO, and Dr. Rettig is his oncologist.

There is little on neuroendocrine PC specifically, but for high risk cases w LN involvement there is some evidence (below) that radiation to the prostate and whole pelvis acts like a kind of de-bulking even after it has spread to the LNs. The theory is that the original source (the prostate) is the cause of most of the clonal spread of the disease. Cut off the source, and you slow down the spread. The downside is that neuroendocrine disease is somewhat impervious to radiation. What might help kill those cancer cells better is pre-treatment with ADT and chemo. The radiation must be very high dose to kill of the radioresistant cells - either via a brachy boost to the prostate or with SBRT monotherapy.

Does Local Treatment of the Prostate in Advanced and/or Lymph Node Metastatic Disease Improve Efficacy of Androgen-Deprivation Therapy? A Systematic Review

I have the full text article as a pdf if you write to me.

I believe that Provenge pre-treatment may help too.

- Allen

Thank you Michael60 for your encouragement also.

I'm just now getting back on this thread. We met with the Radiation Onco. In July. After reviewing new scans. They have declined radiation treatment. His pelvic mets responded pretty good to the chemo. There are some mediastinal Mets. That have had mixed response. They felt that these should be of special attention. That radiation of the pelvis would just add too much stress on the body. They would like to do biopsies of tumors located in the abdomen/ chest area. To see if their is a "secondary " Cancer and may need a different type of chemo. Husband has declined biopsy after some consultation. Due to risks affiliated with location, etc.
We now have an apt. Scheduled with Dr. Lam tomorrow. Hoping he will have a plan that will be effective. Just had new labs and scans done Day before yesterday. Prostate area still looks good. There are some stuff showing up in the rectal area again. And chest and necks mets seem to be"progressing" per reports. PSA had gone down to lowest # .05 in August. Then 1.7 Sept. And Monday 3.9. Onc. Recommending try Xtandi. Husband is going to wait and see what Dr. Lam has to say. Can't let the"guard" down. Thanks for any suggestions that we can ask Dr. Lam about. He has been on Degarilix, Casodex, Zytiga then chemo combo Taxotere/carboplatin.

Barb,
Dr. Lam - he has the reputation and credentials to hopefully come up with an acceptable plan for your husband. I admire the way you have attacked this together. It's a tough battle - seems the best you can do is throw everything at it you can!

I'll be watching to see what decision is made and hoping for the best of outcomes,
Susan

Hi Barb,

We were just told today my husband needs the taxotere/carboplatin combo. How were the side effects for your hubby? My hubby is pretty stressed out over the whole thing and I haven't seen this combo used before. Being only 46, of course he is wanting to throw everything we can at this monster, just trying to figure out what we are in for.

Thanks for your help!
Barb