Chemo: Here I Go Again ?

Hello !

After being diagnosed with prostate cancer that had spread to both lungs in the fall of 2013, my initial PSA value was over 100. I have been on Lupron shots for over a year, which resolved the mets in both of my lungs within a few months. My prostate cancer was classified as metastatic, so I was not eligible for surgery.

My PSA dropped to .12 while on Lupron, which seemed like a big drop when it started at over 100 upon diagnosis. Some cancer must have remained, however ? After bottoming out at .12, then the PSA began creeping up a bit.

Last summer, based on the CHAARTED study, I did six rounds of chemo (Taxotere), over the course of eighteen weeks. I finished the last round of chemo in November of 2014. The lowest the PSA got on chemo was .04, which seemed encouraging.

After chemo was finished, then the PSA started creeping up, bit by bit. This past week, it crept up to 0.15.

The past few months, I have also tried Firmagon hormone shots, as an alternative to Lupron shots.  Then this past month, I just received my first Zolodex hormone shot.  The idea was that maybe other kinds of hormone shots might help manage the PSA better than the Lupron shots.  If we don't see a significant difference, then I suppose I will just return to the Lupron shots, as before.  I feel a little bit like a "guinea pig" right now trying these 3 different kinds of hormone shots.

This past week, I felt a shortness of breath and a bit light-headed. Yesterday, a new lung scan found evidence of lung nodules returning in both lungs. I was hoping to keep the "wolves at bay" for a while longer, I have to admit.

Needless to say, this was disheartening, especially after completing chemo treatments in November of 2014. Just when my hair was starting to grow back, too ! I used a comb the other morning for the first time in months !

My oncologist now wants me to undergo ANOTHER series of chemo treatments, starting next month. He said we might go 10 rounds of Taxotere this time, instead of the 6 rounds like we did last time. That means I would be undergoing chemo treatments over the course of 30 weeks, from June to December.

I wonder if any of you have undergone two series of chemotherapy treatments in such quick succession ? I feel like I just got done with chemo, and now 6 months later, it is being suggested again to combat the prostate cancer that has spread to both my lungs.

I also wonder if a second series of chemo treatments can do something more that the first series of chemo treatments couldn't quite do?   Or ... are we just trying to buy some more time ?

By some miracle, I have gone to work every single day since being diagnosed two years ago.

Stay strong in the battle, everyone !
Cyclone

Post Edited (ISU-CycloneFan) : 5/9/2015 10:39:08 AM (GMT-6)

ISU:

I'll second what Tall Allen said; it might be worth seeing if other chemos might help. As it was explained to me, some cancer variations might not respond as well to just Taxotere. In my case, we did a mix of Taxotere and Carboplatin (even though I couldn't get a biopsy, we just went for it)

... i know that Gunner34 was at Mayo and they used some different combinations on him. (Mayo might be worth a second opinion too; they seem to have an open mind and a big toolbox of things to try.)

In my case i also got quite a bit of relief from a second line hormone therapy (Zytiga in my case). It kept things at bay while i worked through radiation and chemo.

Glad to see your great attitude it matters ... btw I just had to get a haircut (just the sides, not the top yet); i was so happy.

Peace,
Ray

Hi ISU. Sorry to hear of your progression already. I follow your posts as I have a similar treatment path as you but behind by a couple months. This past Friday I completed my chemo, am on Eligard and Casodex. PSA test in a couple weeks. December was 179, March was 13 so hoping for another good drop.
I have bone Mets and possible 9mm lung spot but no biopsy on lung to confirm. Will see in July scans if it has shrunk or disappeared.
I was wondering if you had consideration to have Circulating Tumor Blood Test done? Or perhaps you have done it? I am looking into that lately to consider having that done.
My urologist said that when I show signs of Hormone Resistance I would go on Zytiga next. But perhaps your doc thinks the lung Mets will react better to chemo. Wondering about that since I also was able to continue work and life near normal throughout the chemo and was wondering how often we can have Docetaxel.? Take care buddy! I wish you well and keep kicking this cancer"

Hello To All ---

I follow each one of you on your posts and thankful to hear from each one of you. We all have our story, yet we are all united as "cancer comrades" in all of this.

Yes, I have just had the "Circulating Tumor Cells" blood test that "Travling Guy" mentioned above. This blood test was taken and then sent away to Mayo Clinic, where a doctor has to read and analyze the results. Surprisingly, it stated that there were ZERO circulating tumor cells, which is a bit of good news. This is another type of blood test that can be given, if you need further diagnostic tests done in addition to PSA levels, testosterone levels, and so forth.

Ironically, I am ALSO allergic to TAXOTERE chemotherapy, just like Casper described in his post above. Last fall, on my second infusion of Taxotere, I went into a severe allergic reaction just like Casper described from his experience --- I also turned beet red and it was an emergency situation. They now have to inject me first with a strong "cocktail" to counteract allergic reactions to the Taxotere infusions.

Despite the allergic reactions, my side effects from Taxotere were relatively mild, and I realize I am fortunate in that. My appetite stayed intact, I was able to keep working, and I didn't have any nausea. My hair did fall out shortly after the first chemo treatment. To counteract the possibility of neuropathy, they kept my fingers and toes on ice bags during all the chemotherapy infusions, which seemed to work in preventing neuropathy.

The Taxotere helped knock the PSA down to an all-time low of 0.04, but shortly after the chemotherapy sessions were over, then the PSA started creeping up, bit by bit. The PSA is now at just 0.15, but there is already evidence that there are small nodules re-appearing in both my lungs, based on the lung scan from last week. One step forward, two steps back, it often seems ... I guess the re-appearance of lung nodules helps to explain why the PSA was starting to creep up again ...

The plan seems to be to give me Taxotere again for 10 rounds this time, instead of just 6 rounds like last fall. Each round is given every 3 weeks. If we go 10 rounds, that will be 30 weeks. It sounds daunting right now, getting started with chemo treatments all over again. Following that, my oncologist mentioned the next step would likely be Zytiga.

I am also given twice-a-year injections of PROLIA to promote bone strength, since I am on continuous ADT, which leeches calcium away from our bones.

Thanks for all your responses --- I follow each one of you on the website --- we are truly a "Band of Brothers" and we also have caring sisters out there, too !

Your Brother In The Battle,
Cyclone

Cyclone,

Like Allen and other have said on the thread, it might make a lot of sense to also add Xtandi or Zytiga together with your chemo. Since both are approved for the pre-chemo setting, combining one of them with chemo might increase the cancer-killing power of your next round of treatments.

Here's to continued success with Taxotere and continuing low PSA scores!

Arthur

GCB-
While I understand what you want to know, the way you are asking this is unanswerable. You are asking if someone's life and quality of life was lengthened by chemo. How can anyone know what would have happened had he not had chemo?

This is where studies are useful for decision making. They can tell you that for the average guy in that situation what would happen if he takes chemo and what would happen if he doesn't. I can summarize it for you -- docetaxel extends both life and quality of life more, the earlier it is used. It is both palliative (it relieves pain and other quality-of-life robbing symptoms of metastases) and it extends life while doing so. Most guys find the symptoms while taking it manageable and tolerable. Afterwards, one is likely to feel better than one did before taking it.

I don't know what your particular situation is, but for a man who is still hormone-responsive and has multiple mets, a cycle of docetaxel is likely to add a median of a year and a half of life, much of it, symptom free. If, on the other hand, one waits until he is castrate-resistant and needs it to relieve the constant pain of mets, its benefit is much reduced - about 4 extra months.

- Allen