Should one consider repeating a cycle of docetaxel?

Posted by wauserfriendly @wauserfriendly, 5 days ago

I have metastatic, hormone sensitive PC, that has spread to my spine, shoulder and hips. I started with Lupron and Abiraterone 2.5 years ago. I went through a cycle of docytaxel as well. I've continued with Lupron and Abiraterone, but have replaced Lupron with Estradiol Patches about two months ago. My PSA has been close to zero. I do have the Braca2 gene defect.

I've not read anything about repeating the docytaxel treatment. Is it a consideration to repeat it after a few years? Or has the body had enough damage with one cycle?

My doctors think that if the current treatment stops working the next step for me would be a Parp inhibitor.

My chief side effects have been loss of lean muscle mass, weakness, fatigue and osteopenia. From what I've read, the osteopenia will probably be reversed with Estradiol.

Should the chemotherapy be repeated? How often?

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melcanada | @melcanada | 4 days ago

My lungs filled with fluid on second chemo Now on Abiraterone and prednisone PSA still flared at 208 Previous Xtandi and Radium 223
Approved for LU 177 in April Mets in T 11 L 4 and hip and one rib
What is your PSA on Abi

heavyphil | @heavyphil | 4 days ago

Jeffmarc is THE man to know the answer to this! I’m Sure he’ll weigh in on this one as he also has BRCA gene.
Phil

jeffMar | @jeffmarc | 4 days ago

I know someone with an advanced case of prostate cancer who stays on chemo, almost constantly. One of my neighbor’s father is in that situation. You’ll find that people who have neuroendocrine PC will get chemo with platinum, Even if previously they had standard chemo treatment.

The first treatment for PC is usually docetaxel If the cancer advances, then they use cabazitaxel and if it is real bad they add carboplatin. After fully recovering from a previous chemo, they can do it again.

thmssllvn | @thmssllvn | 4 days ago

Pluvicto has just been approved by the FDA for hormone resistant disease without having to go through chemotherapy first. This may not apply as you commented that yours is still sensitive.

round5 | @round5 | 3 days ago

In reply to @jeffmarc "I know someone with an advanced case of prostate cancer who stays on chemo, almost constantly...." + (show)

I received the Carboplatin with the Docetaxel

jeffMar | @jeffmarc | 3 days ago

In reply to @round5 "I received the Carboplatin with the Docetaxel" + (show)

How are you doing? Was this your first Chemo treatment? What was the reason carboplatin was used. Do you have small cell (neuroendocrine) PC?

round5 | @round5 | 3 days ago

In reply to @jeffmarc "How are you doing? Was this your first Chemo treatment? What was the reason carboplatin was..." + (show)

I am doing ok. I completed all 6 cycles immediately followed by 6 cycles of Pluvicto. I completed the Pluvicto 11 months ago,continued on Lupron and Nubeqa since. Getting my hemoglobin back up has been very slow. Was 10.3 last draw and had bottomed out at 9.1 at my last treatment. Documentation prior to starting treatment stated something about suspicion of “neuroendocrine differentiation”

jeffMar | @jeffmarc | 3 days ago

In reply to @round5 "I am doing ok. I completed all 6 cycles immediately followed by 6 cycles of Pluvicto...." + (show)

You really want to speak to the doctor about the neuroendocrine comment. Frequently carboplatin is used when Neuroendocrine is found.

Neuroendocrine refers to a much more lethal form of PC. You need to know what’s going on. The PSMA Pet scan can’t see neuroendocrine cancer and Pluvicto also doesn’t see it so it doesn't remove it.

You want to either have a C11-Choline (at Mayo) or FDG scan to find Neuroendocrine cancer.

Get more information .

round5 | @round5 | 3 days ago

In reply to @jeffmarc "You really want to speak to the doctor about the neuroendocrine comment. Frequently carboplatin is used..." + (show)

I’m getting my treatment at Mayo and I have had multiple choline scans and the last one was clear. I am getting scanned every 3 months rotating between the choline and PSMA. I was given 3-5 years when I did just what you are talking about. One of the reasons I chose to do the Pluvicto as quick as I could after the chemotherapy. I haven’t heard of the FDG scan so I’ll have to check that out too. Thank You for the info and your concern's.

melcanada | @melcanada | 3 days ago

In reply to @round5 "I am doing ok. I completed all 6 cycles immediately followed by 6 cycles of Pluvicto...." + (show)

I did Xtandi, Radium 223 and 2 chemo's till my lungs got fluid After months on Oxygen oncologist put me on Abiraterone and more prednisone
I did PSMA PET scan and qualify for LU 177 Pluvicto My PSA is 208

What is yours after Pluvicto Did it kill caner What is your prognosis and OS Overall Survival

I have C in bones only T 11 L 4 hip and Rib, 80 and feel great and positive Had radiation in 2017 so 8 years now Precious Blood of JESUS please heal me.