Docetaxel vs. Abiraterone

Hi Robbo (Jackie?).

We have had some interaction on here before on a different thread, on which I explained the parallels between your Dad's situation and proposed treatment schedule and my own. I recall from that that your Dad is a fair bit senior to me in age however. I have been on HT since January and have just had my 5th dose of docetaxel. Although they were fairly debilitating, I would not have had any worries about an older man sharing my experience of the first 4 doses provided the expectation of them was that they were achieving something. My 5th cycle however has been a much more challenging experience. Having said that, chemo dosages can easily be modified by your Dad's oncologist should he run into trouble himself. We are so different in terms of our personal biochemistries anyway that it is very difficult for oncologists to know what our optimal individual chemo dosages might be. So I guess that one needs to be aware that a discussion around such issues with our oncologists might be an extremely worthwhile step and that one should have no concerns about initiating one.Things AREN'T set in stone, and worthwhile modifications to treatment regimes CAN be made on the hoof during the treatment process. Like yourselves I am scheduled for a 6 week break from treatment following my chemo before my RT begins. This worried me at the beginning of my treatment, as it was tempting to feel that this period might be too long and that my cancer might regain a foothold during it. With less than 5 weeks of chemo left to run now however I can't wait for the break, as my body really feels as though it needs it. Regarding abiraterone, I have no personal experience. HOWEVER, I do know that all the currently available HT drugs generally exhibit a drop-off in efficacy over time (I had just been invited to contribute to the funding of research at Southampton University to try to determine why this might be the case). This seems to explain to me why it might be considered foolhardy to abandon one HT drug for another before this begins to happen, as one my in the process run out of effective treatment options earlier than otherwise. Generally speaking, from what I have read, abiraterone seems to function most of the time as a secondary back-up HT drug that people have recourse to only once their primary HT drug ceases to combat the suppression of the cancer effectively. I hope that some of this information proves of some use to you.

Very best wishes,

Jonathan x

Hi Jonathan

Yes Jackie :-)! 

Thank you it's good to hear it's at least bearable :-(

We have spoken before regarding the similarities in treatment.  Dad was going to have radiotherapy contained and chemo if in bones so lightly different as his diagnosis was either basic which in affect could have been cured (docs words) with bone involvement it had to be chemo.  However now dad's had confirmation of bone mets but classed as low met burden they are throwing everything at it chemo, rt and ht.  But i had read that the docetaxel had been switched to abirateone  not the original ht - that stays the same.  I may be confused aswith read so mychmuch :-(

Jackie

Jonathan

Now you've said that about changing one ht for another I wonder if it is just abirateone and rt and the abirateone does the job of both chemo and ht?? Need to see if I can find the report again !!  Or someone may be able to make sense of what I've thinking !

J

i'm on abiraterone now , i finnished chemo in may and despite a psa of 0.4 it had spread even further !! 

abiraterone is another but stronger hormone treatment , when other treatments dont work well enough ur put on this .

the side effects of this can be quite nasty for some i have to see an apodi nurse every 2 weeks and have blood tests too .

the standard treatment for metastatic pc is ht either prostap or zoladex injections , 6 sessions of docetaxel chemo followed by 20 sessions of radiotherapy .

so i dont think u will be offered abiraterone instead of chemo but no harm in asking 

for me the chemo was no where near as bad as i thought it would be , never had a day off work right through it and i'm a self employed gardener , metallic mouth was the worst thing for me !!

Thanks anubis

It's not that he necessarily wants abirateone I just wondered why chemo was offered over it if 1 was kinder than the other.  

That's interesting that you say its standard treatment as dad was given 2 choices depending on his results if it was T3a n0 m0 he was told rt if it was with mets then chemo only no mention of rt with it.  The rt was added to be aimed at the prostate due to low metastatic burden and he was told this wasn't available this time last year.

Sorry to hear the chemo not worked.  Is the Abi working? 

Dad quite a lot older and has other health issues on top of this.  He's feeling really down at the moment and suffering with lots of minor stuff too.  He's got oral thrush again which is making him feel pretty grotty :-( 

Fingers  crossed with the Abi.

hi robbo 

abi seems to be a bit of a life extender for a lot of people,  read some people have been on it yrs ! .

both oncs i saw did say the ht + chemo plus rt is quite a new thing for anybody with incurable p.c .

they found that combination right at the start of treatment was giving people 20-24mnths more life expectancy .

every one's cancer is different and people deal with it and the treatment differently . 

but i do know a positive mental attitude will work wonders for u all 

hope ur dad will respond to whatever treatment they decide on , and hopefully its not to debillitating for him 

Thanks Anubis

Fingers crossed for the Abi for you and everyone needing it.

Yes hope dad has a good response.  Trying to stay.positive but suppose there's good and bad days even then.

I try not to take too much notice of the statistics or prognosis cos as you say everyone is different and each response is different.  Reading lots and some is really positive but then you read something else and it knocks that positivity away :-( anyway we have a holiday to look forward to before the treatment starts.

I just started June 16 2020 and have 5 more infusions every 3 weeks. I got thru the first infusion and really just noticed nauseous and dizziness and tired. I have been in Lupron-2012, casodex, enzalutamide, Xgeva and originally radiation in 2010. PSA was 2.8 with a Gleason 3/4= 7. Long road and still waiting for cure. I still have albiterone left after chemo.