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Posted 6/22/2017 8:29 PM (GMT 0)
Hubby's psa has gone down now that he is back on HT ... he does have the BRCA2 gene (not good); Dr. Sartor is talking about starting him on chemo now as well. ASked the side effects ... and there are many. Is there really any study that shows if the HT is keeping psa down, that starting chemo before you really become castrate resistant helps in the long run???????

That is really my question. He is going to do scans in July and we will decide where to go from there, just trying to get y'all's take on this. Thanks, Lynn
Posted 6/23/2017 12:30 AM (GMT 0)
Sartor is one of the best anywhere.

Yes, there have been two major randomized clinical trials called CHAARTED and STAMPEDE the proved that early use of chemo gives a large survival advantage over waiting. For men with multiple mets, the survival advantage was 17 months. When they waited to use it, the survival advantage dwindled down to 4 months.

New learning this month is a similar advantage with Zytiga - not yet FDA-approved for that though. Maybe it will be approved by the time the chemo cycle is done.

Is there a trial for a PARP-inhibitor that Dr Sartor can get him into?
Posted 6/23/2017 11:26 AM (GMT 0)
Allen,

Not to hi-jack this thread, but can you elaborate on your remark regarding Zytiga?

Thanks, Donna
Posted 6/23/2017 1:27 PM (GMT 0)
Tall Allen - Thank you very much for that information. I just finished reading about those two studies and it does look like it maybe the thing to do. Guess we will decide for sure after the scans. We kindof said no to the chemo route right now if the scans don't show anything new - but may want to rethink that. Again, thank you so much, very helpful.
Posted 6/23/2017 1:52 PM (GMT 0)
The Latitude study is probably what you are referring to on Zytiga. That really does look promising and a whole lot easier on the body than Docetaxel, that's for sure.
Posted 6/23/2017 4:34 PM (GMT 0)
Donna-

Here's the info on early use of Zytiga, as well as a rundown of other options for newly diagnosed metastatic hormone-sensitive men:

/pcnrv.blogspot.com/2017/06/newly-diagnosed-metastatic-m1-but-still.html

DebbieMH-

One of the surprising findings was that was not true:

"One might expect that the increase in toxic events would have been worse with docetaxel, but while they were different in kind, the incidence of all events requiring medical attention was similar for both treatments. All medicines seem to have lower incidence of side effects when they are used earlier, while patients are healthier."

Chemo has a bad rep based on what we've all heard about the experience of patients, often with other cancers using different, more toxic kinds of chemo for end-stage cancer. Unfortunately, what people think they know often gets in the way of extending survival and quality of life. Tragic.
Posted 6/23/2017 5:36 PM (GMT 0)
Tall Allen - yes thank you. And you are correct, our thought of chemo is what we have heard from people in the past and not necessarily PCa patients. I will start talking to my husband about the advantages I'm finding from this forum and from your assistance. We have a trip scheduled for the end of July and part of August ... so, maybe when we return, he might want to reconsider doing the chemo. Going to see what the test results are of the scans in July.
Posted 6/24/2017 4:15 PM (GMT 0)
DebbieMH,

My husband was diagnosed a year ago, and he'd already progressed to bone mets. The oncologist recommended that he start chemo right away (Docetaxel). Everyone reacts differently, of course, but in Steve's case chemo was not fun but it was manageable. The first two infusions went pretty easy, but the side effects started in earnest after that. He lost most of his hair but it has grown back nicely (actually, his hair is thicker now than it has been in 20 years... we credit the ADT for that.. but his mustache is gone forever, sadly). He started feeling better about a month after the last infusion, and was pretty well recovered after two months.

Controlling nausea is super important so that your husband can eat and keep his strength up. If you are in a medical cannabis state you may consider it--it doesn't always work for nausea, but we found that it helped with GI cramping when nothing else would.

Hope this helps.
Posted 6/24/2017 5:03 PM (GMT 0)
Adrienne, Thank you so much! I really appreciate all the insights! Take care, Lynn
Posted 6/24/2017 5:17 PM (GMT 0)
Lynn,

Glad I could be of help. Best to you and your husband... we are all stronger than we think we are!

Adrienne
Posted 6/24/2017 7:29 PM (GMT 0)
Lynn,

Forgot to add, about food and cooking... our friend, who is a breast cancer survivor and nutritionist, highly recommended the book "The Cancer-Fighting Kitchen" by Rebecca Katz. There are excellent tips and recipes for cooking for a chemo patient.

One difficult part of chemo is that nothing tastes right! Food is often either flavorless or has a metallic taste (yuk). Steve found that the flavor could change from one bite to the next, so often something that didn't taste good one bite would be ok the next and vice versa. Our friend told us that the one thing that always tasted right no matter what was maple syrup (the real kind). Steve found this to be true, and a liberal splash of maple syrup could make his yogurt or oatmeal edible.

Steve likes to cook and continued to make most of our meals while he was on chemo. We had lots of soups & stews, good hearty broths with lots of vegetables. Bone broth is very good overall, both chicken and beef... take it like medicine... use good quality organic bones and lots of fresh organic vegetables.

Steve would eat whenever and whatever he could, sometimes it was only a few bites but sometimes more. He ate ice cream, butter, peanut butter, and similar calorie-dense foods whenever he could. He lost about 8 pounds (he's a little guy so it was noticeable), but gained it back within about 6 weeks.

Best,
Adrienne
Posted 6/25/2017 1:24 AM (GMT 0)

Hello Debbie,

Many of us here have successfully navigated through chemo treatments --- many of us kept working full-time, exercised often, and stayed active.

I just wanted you and your husband to keep an "open mind" in terms of chemo treatments --- stay in close consultation with your husband's doctors. You've already explored the clinical trial data which showed the impact that a series of chemo treatments can have, depending on your particular case.

For some first-hand experiences from our members here --- I invite you to go to the search box at the top of your screen. Type in this thread title, as follows: "TAXOTERE SIDE EFFECTS" ---

You will immediately find the thread --- it is a collection of our first-hand experiences with chemotherapy --- you might be surprised to find that many of the old misconceptions about chemotherapy treatments are no longer true --- for example, I was NEVER nauseated --- my appetite stayed intact --- I was able to keep working full-time --- I pursued my usual hobbies and activities --- and I attended many social events during my chemo treatments.

First-hand testimonial --- I'm an elementary school teacher and there were 800 elementary youngsters in my school building the year I underwent chemo treatments --- I went to school, each and every day --- did recess duty each day, went on field trips, and kept up a normal schedule. I'm thankful for that --- other friends of mine have stayed active while undergoing chemotherapy treatments for prostate cancer --- each case is unique, but it is possible.

This is why I say, "Keep an open mind."

Don't assume that you will be bedridden for days or weeks at a time after each chemo infusion --- I rested on those weekends after each infusion, but I taught school every single day during those months. It's just good to keep a balanced perspective when considering all medical options and treatments.

It sounds like you are facing forward and doing your research. That's important ! That way, you can continue to make informed decisions, as your husband's treatments continue.

Stay strong --- keep checking in with us here --- stay determined --- keep living life to the fullest, each and every day!

Sent with my best,
Iowa State University "Cyclone"
Posted 7/13/2017 3:24 AM (GMT 0)
My husbands scans came back today and an email from Dr. Sartor, "CT scan really quite good". His PSA is responding to the HT again and so guess we will wait until his next appointment in October to start the chemo discussion again. Thanks for all your insights ... it's not quite a scary as it was because of y'all! Lynn
Posted 7/13/2017 10:45 PM (GMT 0)


Thankful to hear this good news, Debbie!

Great scans --- that's the best news, isn't it ?

Keep forging ahead --- stay determined !

"Cyclone" ~ Iowa State University
Posted 8/21/2017 10:05 PM (GMT 0)
Another PSA test and it came back at .35 ... not bad, but not the best either. Dr. Sartor is talking about putting him on Abiraterone (Zytiga) at his next appointment in October. Gives us time to prepare and research. Anyway ... wanted to give an update.
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