Chemo (Taxotere/docetaxel) experience and lessons learned

This is an old write-up but with all the chemo talk lately on the board, I thought I would resurrect it.
SC
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Protocol (March 2012 through July 2012):
• Infusion Drug: Taxotere (docetaxel)
• Other drugs: Prednisone, twice a day; Dexamethasone, the day before, day of, and day after infusion
• Frequency: Six 3-week cycles
• Dose: 60 mg/m2; for my body mass, that translated to 117 mg
• Administration method: IV infusion

Reflections and Lessons Learned

Port versus IV: Get a port. If I had it to do over again, I would get a port instead using an IV. I am a hard IV stick. I probably had 15 IV stick attempts over those 6 sessions. My poor arms were a pin cushion.

Neulasta: Get a Neulasta injection every time. I skipped the last cycle, and wound up in the hospital with neutropenic fever.

Prednisone and Dexamethasone: Be prepared for the initial start of Prednisone and Dexamethasone. My appetite blew through roof and I was wired for the first 2-3 days each cycle. These side effects (SEs) eased up as I went through the later cycles.

Icing: I sucked on ice chips and held freezer cold packs in my hands during infusion. I don’t know if they helped or not.

Hair loss: I lost about half my hair on my head, two weeks after the first cycle. After that, it was a slow, gradual loss. By the 5th cycle, I was looking fairly mangy. So, buzzed it very short. My eyebrows thinned but I never lost all of the eyebrow hair. I lost all the hair on my legs and most of the hair on my arms. My wife was jealous of my smooth, hairless legs. After chemo, my hair grew back thick and wavy – a temporary situation, sigh!

Taste: my taste would go “off” for a week after each infusion. I still ate and enjoyed eating, but certain foods just tasted odd. I would adjust the menu to have foods that seemed appetizing to me. Spicy and savory seemed best. Sweet items did not taste very good to me.

Nausea: At first, I had virtually no nausea. They gave me Aloxi the day of infusion. In the early cycles, I would take a few of the anti-nausea pills I was prescribed. I eventually stop taking those. However, in the later cycles, I started getting some low-grade nausea for a few days. It was not bad and I kept eating. It was a nagging, slight nauseous feeling that seemed to hang around for several days after the infusion.

Neuropathy: I had very little neuropathy. Some of my left toes would feel a little numb after infusion. In the later cycles, my fingers, maybe, had some strange sensations. It took over a year for the slight sensation of numbness in left toes to go away.

Nails: My fingernails were fine. Some of my toenails started to discolor and became sore with the last cycle or two. That has seemed to clear up.

Tear duct scarring: At times I had weird sensations in my right eye area. After the last cycle, my right eye was watering and dripping all the time. This cleared up right away.

Fatigue: The fatigue got worse as the cycles wore on. Days 3 and 4 after the infusion were the worst. The best analogy I can think of: it is like catching the flu every 3 weeks.

Incontinence: I was prone to drip for the first couple of days after the infusion. It was as if my sphincter muscle and bladder were completely relaxed. I would even drip a bit at night when I was sleeping. I never found an explanation or solution to this issue. Again, this eventually resolved after I was finished.

Constipation: Eat plenty of fiber! I was caught off guard for the first cycle and I had a tough time. I wound up drinking some magnesium citrate (yuck!). After that, I was on top of things.

Exercise: I tried to keep exercising and mostly succeeded. I would have to back off on the worst days.

Work: I kept working. My boss and co-workers were great. Also, I had the flexibility to work from home. I definitely took advantage of that at times. I also took a fold-up cot into work and would occasionally unfold it and nap in my office. Fortunately, I have a walled office with a door. Getting a quick nap at work was nice!

Typical SE profile the week of infusion:

Monday: infusion
Sunday – Tuesday; high energy; wired; hard to sleep
Wednesday: energy crash; fatigue sets in
Thursday and Friday: The worst days: lots of fatigue; food tasted weird; aches and pains. The best analogy: It is like catching the flu every 3 weeks. I took lots of naps.
Saturday: things start easing up on Saturday. By Saturday evening I would feel a little more normal.
Monday – Tuesday: Energy level was mostly back to normal. Taste was back to normal. The time to get to full energy level seemed to be greater as I went through each cycle. For the last cycle, it was 3 weeks before I felt my energy level really hit 100%.

Thanks Southern Comfort,

Very timely, as you know, with last week's ASCO presentation.

Frank is leaning more and more towards the docetaxel, so, had him read this thread.

Lisa

I just completed 6 cycles, as well. bicaludimide then one week later lupron, then a week later docetaxle, no prednisone.

I would echo Southern Comfort's lessons learned except:

Port: I chose non-port, yes they don't always get the vein the first time

Neulasta: Every time, dangerous not to take

bicaludimide: no known reaction

Icing: no reaction to infusion

Hair: lost most, then bought a hair shaver and cut off hair leaving ~1/2 inch

Food: hard to eat anything, most food tasted terrible had to think up new food item taste still not 100%

Nausea: very little, had meds but didn't take any

Constipation: watch food intake at day before through after injection to avoid constipation, drink LOTS of water!

Exercise: Try as much as possible, I didn't have much success, due initially to gout

Complications: recurring gout left foot due to increased uric acid from dead cells (treated with Allopurinol), cellulitis left eye and cheek area, left eye tearing, and diverticulitis potentially a result of taking docetaxel as I never had diverticulitis before that I am aware of.