Cabazitaxil

Hello CMF and welcome. My husband also has advanced prostate cancer, diagnosed in 2020, and he had 6 sessions of Docetaxel after the Enzalutamide stopped working for him. Cabazitaxel is a similar chemotherapy treatment and from what I understand it has similar side effects. My husband was dreading chemotherapy but at the end said it was not as bad as he feared. From others on the forum the one thing we have learnt is that the degree to which people get side effects can vary. Yes there are treatments beyond cabazitaxel but some of them might depend on certain genes so it is a good idea to have a genetic screening. I can give a fuller description once we get home from the oncologist today.

Thank you so much for your reply this is his second round of chemo and as you said the first lot wasn’t too bad but he only had 6 this time it’s 10 over 30 weeks!

Hello again. We have just had a productive meeting with the oncologist discussing 'What next'. My husband has had 3 recurrences in 4 years so we are also working through the options but one thing that was stressed today is that every persons cancer is different and can react well to some treatments but not so well to others. In his case the cancer appears to be particularly sensitive to radiotherapy but not so sensitive to chemotherapy so any further chemo will be left until other therapies have been exhausted. We discussed challenging with a different form of ARPI such as Abiraterone and steroids as well as rechallenging with Enzalutamide. Then there were the options of radioligands such as Lutetium 177 (this is his preferred next step if and when a recurrence occurs). Another radioligand Radium 223 is not suitable as my husband doesn't have bone mets. My husband originally had EBRT to the whole pelvic area in 2020 which remains successful. In April 2024 he had SBRT to distant mets and adrenal glands mets which have now either disappeared or reduced significantly. More targeted SBRT may be possible provided the area has not reached the maximum dose. The results from his genetic testing should be through in the next few days so the oncologist will let us know whether treatments like PARP inhibitors might be suitable. He is also leaning towards immunotherapy. In the meantime we are to keep monitoring PSA, Testosterone and bloods every 3 months and then a 3rd PSMA PET CT scan in April to check on progress and that no new mets have appeared (but this will be brought forward if the PSA starts to go up). I did ask whether Cabazitaxel would generate worse side effects compared to Docetaxel and was assured that this does not normally happen provided the appropriate supportive drugs are administered - he did say that he has one patient who had 10 cycles and he had decided to visit 10 different places or islands whilst having treatment. We had a brief discussion about Bipolar Androgen Therapy BAT but he would prefer to continue with therapies to kill the cancer at the moment rather than those which just put it into hibernation, although there may be some merit to using combined therapies which are showing a longer time before progression. The only qualifying statement I would make is that we live in Greece so may have easier access to therapies compared to the UK.

I do hope your husband copes as well with the Cabazitaxel as he did with the Docetxel, and that it does it's job.

Seems i registered twice once as Freda1 and the CMF.  Thank you for all your information, have to say it’s mind boggling atm.  As my husband has bone mets 24 areas to be exact they are trying to hold it back rather than cure. We have been told there is no cure.  We hoping the canazitaxil reduces his PSA which seems to be increasing rapidly!  Thanks again 

This is my go to video for advanced prostate cancer if you want to see what the options are. It is about an hour long.

https://youtu.be/-RVVq0uDAEE?si=edxGBmHe25iR5lVX