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A Quandry between two medical recommendations for mPCa to lung only

Posted by dpfbanks @dpfbanks, Apr 21 8:13pm

History is in profile and I have asked a few questions here already. The gist is we went to a large research center and got a recommendation for a pretty aggressive ‘quad’ therapy, I call it because it’s triple therapy adding carboplatin to the Docetaxil for the chemo portion. This is in conjunction with ADT (just received Firmagon belly shots) and Abiraterone (+prednisone). This is recommended due to the odd presentation of 3 lung nodules on PET and current PSA of 0.34, and low mutational burden from liquid biopsy. It’s seems it’s the odd unknown that is screaming for this non- traditional therapy (only found one other here with that tx…so far).

We met today with our local MO who is not embracing that ‘quad’ therapy as he states there are no clinical trials supporting it. He prefers the triple therapy..BUT, he is willing to start with the Docetaxil+Carboplatin and then do the ARPI (Abiraterone) when chemois finished in 4.5-5 mos.

So which do we choose? Triple or Quad with delayed ARPI?
Is delaying the ARPI to add carboplatin a detriment seeing how the trials with ARPIs are so beneficial? Is adding carboplatin really a benefit or where can I find info about adding it for PCa? That’s too many questions!Yet, I hope some of you in this wise & experienced group can shed some light. 🙏🏼

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

heavyphil | @heavyphil | 2 days ago
In reply to @dpfbanks "Update: Day 7 post Chemo #1/6. Doxetaxel + Carboplatin. He feels pretty good today and has..." + (show)
@dpfbanks

Update: Day 7 post Chemo #1/6. Doxetaxel + Carboplatin.
He feels pretty good today and has been able to stay active, which we are told is key - slow walks, short bike rides, and some wood splitting! His worn out hip joint appreciated the steroid in the cocktail on day 2, even though it was a temporary reprieve. Yesterday was first day without deep long naps, yet sleep at night turned less deep. Appetite has been good, although he needed encouragement the first 5 days. I recommend the book, ‘Cancer Fighting Kitchen’ highly - good info on how to nourish for side effects. We don’t know what to expect but it seems the side effects and impact will be cumulative. We will see - so far, the plan is kicking it to the curb asap!

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The ADT can cause sleep issues - from insomnia to restlessness. My sleep was terrible while on Orgovyx but since I knew it was a SE I just took it for what it was and napped during the day.
It seems that he is doing pretty well, all things considered, so hang in there. It will be over before you know it.
Best,
Phil

REPLY
dailyeffort | @dailyeffort | 1 day ago
In reply to @dpfbanks "Update: Day 7 post Chemo #1/6. Doxetaxel + Carboplatin. He feels pretty good today and has..." + (show)
@dpfbanks

Update: Day 7 post Chemo #1/6. Doxetaxel + Carboplatin.
He feels pretty good today and has been able to stay active, which we are told is key - slow walks, short bike rides, and some wood splitting! His worn out hip joint appreciated the steroid in the cocktail on day 2, even though it was a temporary reprieve. Yesterday was first day without deep long naps, yet sleep at night turned less deep. Appetite has been good, although he needed encouragement the first 5 days. I recommend the book, ‘Cancer Fighting Kitchen’ highly - good info on how to nourish for side effects. We don’t know what to expect but it seems the side effects and impact will be cumulative. We will see - so far, the plan is kicking it to the curb asap!

Jump to this post

So happy to hear that your husband is doing so well with round 1 of the chemo! You have certainly put your heart and soul into researching the very best treatment options for him. I admire your perseverance and the level of understanding you aquired of potential therapies, sequences and side effects.

Thanks for sharing your recommendation of 'The Cancer Fighting Kitchen' for suggestions on mitigating side effects through nourishment. It looks like there is a 2017 Kindle version which I will add to my bookshelf.

It brightened my day to read of your husband's walks, bike rides and wood splitting! Way to go!! Your collective cancer journey continues to be an inspiration to all of us. We are sending you positive thoughts for your continued success in "kicking it to the curb asap" (I love that!).
Bill

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