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Now for Docetaxel


Kezza2

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18 hours ago, Kezza2 said:

and my PSa has stalled at 16. 

Hi Kezza, what was your Psa before you began Docetaxel?

I had Psa of only 12 before chemo last July, and after 4 injects and 3 months it went to 45, and a PsMa scan showed more mets, and bigger existing bone mets, so I called it a failure, and a GP had called it a failure after 3 shots, and my onco agreed. He had told me it would not work. He referred me to Theranostics Australia for Lu177, and after a 5th docet inject things did not improve and a month after No 5 I had my first Lu177. But by then Psa had fallen to 25, and nobody knew why.

A month after No 1 Lu177 Psa was still 25, then 2 weeks later it was 21 before No 2 Lu177. 

Now its about 15. But all my many soft tissue mets cannot be seen on PsMa scans. After No 2 Lu177, I had bone pain on 5 areas see to be active on scans. But now, 6 weeks later, all my bone pains have gone except for a right hip. 

During last 4 weeks I have replaced a 40M long dilapidated brush fence with a colour bond fence around my pool area. I am now on finishing work to re-lay about 20 square meters of paving bricks so if any doctor was watching me he'd say I wasn't real crook.

I have tried to cycle a few times but I got hip pain and maybe my cycling has to cease. 

 

Now exactly 2 years ago I had both knees replaced, Psa < 1 while on Zytiga, so mets were small, but mainly asleep, so docs gave me the new knees. It was like being re-born. Before my new knees, I could hardly walk or stand for long but could cycle OK. But now, its the other way around, I can do Hard Labour but cycling is painful so I'll be having an MRI soon to tell me more about my hip which could have coincidently decided to fail because it is not uncommon that anyone who has knees fail can then have hips fail, or vice versa, and none of us know what kind of life out hips or knees will give. I know men who have done harder work and sports for longer than me and their skeleton gives no trouble. Others have needed hips and knees sooner than me. 

But its likely that the soreness while cycling is due to different load bearing area during cycling and that area happens to be cancer affected.

So I am having No 3 Lu177 on 28 Feb in Sydney, in 2 weeks, and doc thinks that bone mets probably will be reduced but that I may need No 4 Lu177. He said that a man in Germany had 10 Lu177 shots.

 

But it seems damage has been done by Pca in bones even where met size was small and Psa was relatively low to begin with, not what I expected, and radiated tissue does not regenerate easily, but there's a chance that if Psa goes low enough and scans indicate very low Pca activity, I might get a hip joint. But that would mean surgically excising the cancer affected area, and it involves bone and tissues having to heal up where there was previous entry pathway of X-rays used for EBRT in 2010. So a courageous surgeon and courageous patient would be involved, and its doubtful that it would be sensible for me to continue cycling afterwards. So this is one reason I am trying to get the hard work done on my house, as well as clean out and prepare 2 spare bedrooms for a live-in carer for if and when the Pca grows up again and there is little point in continuing treatment. 

 

I would guess that most of us have the Long Fight that follows where an RP was not fully successful, or where RP was not possible even though Psa was low, like mine, Psa was 6 at diagnosis in 2009 but I had Gleason 9, and in-operable, cancer was outside the capsule, blocking any attempt to do RP after they opened me up.

 

So I am thinking ahead about what happens after Lu177.

I have no idea if Zytiga might be effective again. Chemo and Lu177 are said to make the cancer sensitive to hormonal manipulation. But I know men who were put back onto Xtandi after failed chemo and the Xtandi had very little effect if any. I have to think about Ra223, and whatever happens to be available. My immune system has been under attack from chemo, and Lu177. But so far, no dry mouth of dry eyes, although I did have dryish eyes for a week after No 2 Lu177, and I expect a longer time after No 3, and its a case of Suck It Up Bro.

I have a friend who has had a dry mouth for 10 years after IMRT to a neck cancer before he got Pca which finally seems to have been defeated with RP and a full course of EBRT to PG some 7 years later. He as lucky he had no spread to distant sites. He didn't even need to have ADT, which I am continuing with. 

 

But I'll make it to a concert here next Tuesday night with Vivaldi, Bach, and Saint-Saens, so there remains to be wonderments to enjoy while alive.

Patrick Turner. 

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Hi Patrick,

PSA when Abiraterone failed was 48 before we started chemo.  PSA at diagnosis in 2000 was 28 and doubling every 6 weeks, so initial treatment was EBRT.  As my Med Onc explained to me yesterday, there are a mix of cells within each met that I have - some are still being controlled by the Lucrin ADT, some have been controlled by the Docetaxel, and there are some others that have mutated to resist the Docetaxel, probably during the chemo.  The challenge is now to find them with the PSMA PET scan and to identify which therapy to hit them with depending on where they are.  If they are only a few bone mets, radiation my be an option, but I am pushing for inclusion in the TheraP trial, and hoping for Lutetium rather than Carbazitaxel.  There is also the possibility that some of the tumor cells currently not showing up as they are being controlled by the docetaxel may "re-emerge" - only time will tell.  PSMA PET in 4 weeks, then bloods, and Med Onc in 6 weeks, so all will be revealed then I hope.  In the meantime, after I get over the side effects of this latest dose, I hope to get back on my bike and re-start going to the gym to see if I can reverse some of the muscle wastage of the last 6 months.

Cheers, and keep smiling.

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That so challenging Kerry. In my case why would I go onto Docetaxel + Lucrin for my supposed mets in my hip and liver when yesterdays psa is 0.3 ( down from 0.82 a month ago) which is a continuation of reducing for the last 18 months. 

You've got to smile, Cheers

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Yes Colin, I know what you mean.. This reinforces my previously made point about taking charge of your own treatment, and not just blindly accepting what you are told.  While I have the greatest respect and admiration for the members of the medical profession, especially some of our leading specialists, they are not infallable.  I sacked my first urologist because I did not have absolute faith in what he was telling me, but that's another story.  You must question and seek second and third opinions if you have any doubts at all.  I can't understand anyone having chemo on a falling PSa at your levels.

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They are a bit perplexed as well. However their theory is that the prostate cells have mutated in the mets ( some evidence from my turps samples ) and no longer contain pca psa. Well my response is why should Docetaxel work well?

Hope your continuing to mend, Colin

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