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Getting Chemo boost as part of my treatment!!

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Posted 1/19/2017 9:20 PM (GMT 0)
I just got done talking at length to my MO and our discussion about adding Docetaxel boost to my treatment almost went out the door until I showed him the NCCN guidelines for initial treatment options that included adding docetaxel to IMRT +HT. He had been saying that there have been incomplete studies showing promise but that there wasn't enough data ,blah blah blah.
He said if we were sitting here talking high risk breast cancer that it would be a 2 minute talk. I said yes but I have High risk prostate cancer and I don't think I have given this the most that I can give. (BRACHY was pulled from my treatment plan) Without the BRACHY I lost out on the amount gys I could have received.
So basically the only thing he was going by was the fact that there hasn't "enough" proof because of numbers ,length of time and the fact that a study ( there have been more studies done will larger numbers) was conducted improperly or something so they can't recommend it, although the studies showed promise. So I said I guess than I can throw this out (I had printed out a copy of the NCCN guidelines ) and he said wait, can I see that. At that point the conversation turned dramatically around.

Long story short he is going to prescribe me 3 maybe 4 docetaxel treatments as a boost to my IMRT+ADT. Of course we will have to see if the insurance will cover it.

I feel better and also a little apprehensive but I am convinced this is giving it all I can give it for now.


Battle on brothers



The Artistic One - Mark
Posted 1/19/2017 9:32 PM (GMT 0)
It really is amazing how much everyone owns their own health care these days... I would hate to consider what happens to those folks who have no advocates and are too ill to advocate for themselves. Anyways, congratulations on doing your research and pursuing what you decided is the best treatment!
Posted 1/19/2017 10:20 PM (GMT 0)
Way good for you Mark!! Awesome ownership of the problem.

And I love your enthusiasm for chemo- it will do you well in the trenches-

here's to fightin'!

rf
Posted 1/19/2017 10:27 PM (GMT 0)
I thought having chemo as a neo adjuvant therapy to RT was where the true benefit was. It will shrink the tumor and make radiation more effective. After RT it's a salvage treatment for those not responding well to treatment.

Not trying to be judgmental but why would you want chemo (it sucks) if your PSA is undetectable from your current treatment? The guildeline states treatment is working for radiation unless you have 3 consecutive rises in a certain time period or a 2.0 rise above Nadir before anyone will approve or need further treatment. So with a psa of 0.02 it's not castrate resistant at this point and responded well to RT.
Posted 1/19/2017 10:42 PM (GMT 0)
Mark ,
I applaud you for being your own best care advocate. Our cases are different, but I faced similar deferrals of treatment. I know that I should have been offered Taxotere first, prior to Zytiga. Even though Zytiga has been and continues to be an awesome drug for me. Perhaps I'll print that study NCCN guideline,even if it don't quite fit my situation.
Keep keepin on, and raging against the "machine".
Wings
Posted 1/19/2017 10:54 PM (GMT 0)
Good Luck Mark !! I hope the insurance will cover it ....I know you want to slam this and I understand .......David
Posted 1/19/2017 11:08 PM (GMT 0)
Congratulations on advocating for yourself so successfully! I always find it is a better idea to email them the study you would like to discuss in advance of the meeting. That way they have a chance to review and think about it, without being put on the spot for a snap judgment.

Hilander64 - The docetaxel was given for six 3-week cycles beginning 4 weeks after the completion of radiotherapy in RTOG 0521, which is the best randomized clinical trial we have on this to date.

www.ascopost.com/issues/june-25-2015/adjuvant-chemotherapy-proves-effective-in-localized-high-risk-prostate-cancer/
Posted 1/20/2017 12:56 AM (GMT 0)
Highlander64.

There are new studies coming out stating that adjuvant therapy for certain high risk PC. More and more if you look you can see that there is promise in this area. Why wouldn't there be. Women with high risk breast cancer are given chemo right out the gate. One reason for this is the many studies that have been done on breast cancer.(were as fewer studies have been done on PC.)
I know the studies are small but they "do" show a significant positive out come.

If it doesn't work or I can't get through it oh well. I'm giving it a shot so that the greater than 50% chance of BCR by 5 years that I'm looking at can be pushed back or that my cancer will be cured.

It isn't an unknown treatment. Look up the NCCN guidelines for treatment of high risk aggressive PC cancer. You will see it there.

Best regards - Mark
Posted 1/20/2017 1:14 AM (GMT 0)
TA i didn't see your post before I wrote my response, but that is the exact study I found. I was trying to post that last night but can't figure out how to make it show up so all's you have to do is click on it. Not real computer savy!

Thanks to all for your support!

The Artistic One - Mark
Posted 1/20/2017 1:15 AM (GMT 0)
Way to go, Mark! I also applaud your MO for stopping and reading the guidelines when you offered it. His stock would go up a lot in my book for that.

I have a similar situation with my uro. I expected him to veto a med I've been taking for some years, so I went to another specialist to get input, and forwarded copies of the report to the uro. Unbeknownst to me, my uro then went out and read a lot of the work published by the specialist, and when I saw him a couple of days ago, he's on the same page that I'm on.

I'll agree, too, with tutor_paul in that I feel truly sorry for the patients who are of the old "do what the doctor tells you" generation. Many of them will be missing out on potential benefits.
Posted 1/21/2017 9:24 AM (GMT 0)
So this is only for Adjuvant Chemotherapy Proves Effective in Localized, High-Risk Prostate Cancer?

As our specialist hasnt not introduced chemo for my dad, he is on Xtandi after becoming resistant to HT, the pill are keep it at 65-80 PSA and not letting it go higher. He is on clinical trial, the only way to get Zytiga if Xtandi fails else we gotta pay from pocket in Canada
I kept asking about chemo but they say no, as they will feel it might make him weak, and he is pretty fit for 27 and works 5 days a week /8 hrs outdoor in a gas station
He gets ct scan and bone scan done every 2 months- nothing worse since it started I guess xgeva is helping
Posted 1/21/2017 6:26 PM (GMT 0)
ron82,

That's correct that this doesn't apply to your father who has a completely different diagnosis (mCRPC). For men in your father's situation, chemo should be started as soon as multiple mets are detected. There may be reasons like low blood counts or poor liver function for not starting chemo. Xgeva together with Celebrex may be helpful. Xtandi is somewhat better than Zytiga. There are clinical trials he may qualify for - he should discuss that with his oncologist if interested.
Posted 1/22/2017 7:06 AM (GMT 0)
Hi Mark, I know we talked by email a few times and I am glad you are adding the chemo for the boost... and that you convinced your doctor for that treatment plan. I believe young and G9 cases should throw everything at it so we lessen our chances of recurrence. If a boost will give me 5% more benefit, I would take it... and of course I did. You can have some bad days on chemo but you just get through it like everything else we go through. I wish you luck buddy. Keep us posted. Take care. -JR
Posted 1/22/2017 7:12 PM (GMT 0)

Hello Artist Mark, a.k.a. "The Artistic One" ~

I always follow your posts, and want to wish you well on the new chapter you are writing in your treatment history, so to speak.

You've got the fighting spirit that is needed to get started on a few rounds of chemotherapy ...

There are quite a few of us right here who are members of what we call "The Chemo Club" ... so, plenty of support surrounding you, if you need advice or moral support, once you start digging into your treatments.

For some tips and strategies for navigating through a few chemo treatments, be sure to use your SEARCH BAR at the top right-hand corner of your screen and check out the thread entitled "TAXOTERE SIDE EFFECTS" ... there's a wide range of first-hand experiences collected there ... and definitely some strategies that may help mitigate some of the chemo side effects, along the way.

We're right here for you, Artist Mark ... I will be thinking about you, and wishing you the best !

Handshake from "one brother to another brother" ~
"Cyclone Team Fan" ~ Iowa State University
Posted 1/23/2017 8:07 AM (GMT 0)
Way to go Mark!! yeah
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