chemotherapy to treat prostate cancer

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torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 4/11/2008 4:36 AM (GMT -6)   
Hi
   I'm new to this site, I had my prostate removed in late Jan this year by Da Vinci and have yet to have my 3 month psa test. However I had a test three weeks after the operation which showed a level of .5.
 My pre op biopsy showed cancer on both sides of the prostate with a gleason of 7 (3+4), my post op pathology report was gleason 7(4+3), no involvment to the seminal vessels or lymph nodes, but with a small 1mm break through the prostate wall. I have had no incontinence problems, but I'm not able to achieve an erection, but apart from that I feel very well.
 I received a call at the beginning of the week from the hospital where I had the operation to ask if I was prepared to enter a trial lasting 18 weeks, the trial will involve six injections of taxotere every three weeks, this will start at the end of this month.
 Apparently the trial will not affect my other treatment options if my psa should rise above .5. I'm somewhat surprised and confused by this as I understood that chemotherapy is only used on ps after all else has failed. The trial will take place in Oslo where I live and is in conjunction with other  Scandinavian countries.

aus
Regular Member


Date Joined Sep 2006
Total Posts : 211
   Posted 4/11/2008 5:45 AM (GMT -6)   

It can take some time for pre surgery PSA to wash out of the system, so PSA testing within a few weeks of surgery might not be meaningful.

To enter a trial could also confuse the issue.


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 4/11/2008 7:52 AM (GMT -6)   
What I forgot to say was there are two arms to this trial, one arm will be treated, the other will be monitored. The participants (who have fairly aggressive cancer) will have three monthly psa checks and the results will be analysed in five years to see if the treated group had less reoccurrence of prostate cancer.

War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 4/11/2008 8:46 AM (GMT -6)   

Torgeir,

Welcome to the site. All here will offer support and insight into treatment options, but most off all we will offer love and prayers.

As you can see from my signature, I am taking chemo now. My PCa is advanced and I have already been through the whole nine yards of treatment options. We did a lot of research before staring the chemo and had long discussions with our oncologist. He explained that the use of chemo after surgery may become a more common treatment option based upon the good results that they are seeing in the same treatment with women that have breast cancer. The common treatment after surgery is chemo. The common drug of choice is Taxetre in conjunction with Predisone. They have seen survival rates increase and reoccurances of the cancer drop. So this may be where your doctors are coming from with this trial.

Personally I would not have entered into any trial that offered more than one option. I don't like the idea of one patient getting the drug and another take a placibo or "watchful waiting". This is my opinion. All treatment option are a personal choice and you must be comfortable with your choices. If you have any other questions, you can post them here or send me an e-mail. I here for you brother.

Be blessed and War Eagle,

Walt 


Age: 55 ( still alive at 55)
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
PSA 8.23 2/2008 - Starting prednisone for 30 days
PSA 14 2-29-2008 - start chemo on 3/12
PSA 12.82 3/1/2008 round one chemo
PSA 12.24 4/2/2008 round two chemo 
 
"I will persist without exception - I will find a way where there is no way"


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/11/2008 9:18 AM (GMT -6)   
torgeir,
This is a good trial I've been reading about. My USTOO meetings and my cancer center are talking about it. There is a strong question if Taxotere immediately after failed surgery is better than Taxotere after failed HT. This is a second attempt at this study. The first by sanofi-Aventis was dropped and I was going to go with that one. I toiled with it because it did not allow radiation therapy until a sure return of the cancer. Ican't recall if this trial will have that option, perhaps you can elaborate if you can have radiation as well. Likely not but new members at stage III or stage IV may wish to know more about this study.

Good Luck into your future, and if you go on study, please keep us updated.


Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 4/11/2008 11:40 AM (GMT -6)   
Tony
I was assured that participating in the trial would not invalidate any other treatment such as radiation therapy.
Could you point me in the direction where you read about this trial.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/11/2008 6:38 PM (GMT -6)   

All new stage III patients should be made aware of this study after they have reached undetectable after surgery.

Here is what I understand from my center.  The cannot be any radiotherapy post-operitively.  This is why I balked at the first study.  But I am not so sure I was right in that logic.  There were 4 control arms in th efirst study.  sanofi-Aventis is trying hard to get this study completed.  If I could back up, I might reconsider my position and have taken chemotherapy and awaited the radiation.  There is promising information that needs to be confirmed that high risk patients undergo chemotherapy at stage III instead at the back end of stage IV.

http://www.nevadacancerinstitute.org/pdf/clinical-trials/NVCI0625.pdf

Tony

 


Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator


bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 4/11/2008 6:45 PM (GMT -6)   

tongue  Hi ~ Torgeir and Loved Ones,

 

Welcome   to…   ~ HealingWell ~

 

and

 

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bluebird
Veteran Member


Date Joined May 2006
Total Posts : 2542
   Posted 4/11/2008 6:50 PM (GMT -6)   

tongue  Hey ~ Torgeir,

Thanks for reaching out to all of us!!!  You will find helping hands here reaching back.  Please ~ as you research and as you move forward with your decision… keep us in mind.  HealingWell is a forum that becomes stronger and stronger because of the sharing of journeys…  Knowing we have options and learning about these give us Knowledge.  This knowledge gives us the power to move forward in the direction that we feel is best for our own personal journey.  Thank you ~ and know we care.

In New Friendship ~ Lee & Buddy


mama bluebird - Lee & Buddy… from North Carolina

 

v          We invite you to visit our personal thread:  Click Here:  “Our Journey” ~ Sharing is Caring 

April 3, 2006  53 on surgery day

RRP / Radical Retropubic Prostatectomy

PSA 4.6   Gleason  3+3=6    T2a   Confined to Prostate

4th PSA 2-13-2008 (23 months) Less than 0.1 Non-Detectable :)


livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 4/11/2008 6:55 PM (GMT -6)   
i would encourage you to do your research, as it sounds like you have done. From my vantage point I think the use of chemo post-op will probably be the treatment of choice in the future. If time is on your side get a 2nd opinion to confirm your doctors decision. I believe in being armed with knowledge to combat the enemy. We all have to make choices that we think are best for our lives. Which ever choice you make, give it all you have and never look back. Stay hopeful, and remember we chose to live with cancer, not die from it.
Welcome to the forum
My PSA at diagnosis was 16.3
age 46 (current)
My gleason score from prostate was 4+5=9 and from the lymph nodes was 4+4=8
I had 44 IMRT's
Casodex
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 4/16/2008 8:07 AM (GMT -6)   
Well I have entered the trial and I will have my first chemo session this Friday, I must say I'm dreading the side effects more than the operation. The treatment will consist of six sessions of chemo every three weeks so the treatment will go on to August. I received the results of my 3-monthly psa test yesterday which was .3 so I guess I still have cancer cells floating around somewhere in my body, not a very reassuring thought. Thanks for your replies and I will keep this board updated with my progress.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/16/2008 9:30 AM (GMT -6)   

torgeir,
I wish you many prayers and well wishes.  As a prostate cancer patient, I sincerely thank you for being willing to take part in a study.  These studies are done to give us a better understanding of how effective treatments are.  Those that participate in these studies are the most corageous, and in my opinion, the best patients out there.  I wanted to enter the first sanofi-Aventis study, so I am very much interested in your progress.  But the best I can say now is, thank you, thank you, thank you.  yeah yeah yeah

Tony



Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (1/08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
 
STAY POSITIVE!
 
Prostate Cancer Forum Moderator

Post Edited (TC-LasVegas) : 4/16/2008 10:08:50 AM (GMT-6)


landcrab
Regular Member


Date Joined Feb 2008
Total Posts : 25
   Posted 4/16/2008 9:50 AM (GMT -6)   
torgeir,
All the very best I hope all goes well and the side affects are not too severe, please keep us informed.

War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 4/16/2008 12:28 PM (GMT -6)   

torgeir,

Hang in there buddy. I had my second round of chemo April 2nd. So far the side effects are not bad. They run some good drugs through you first to stop the nausa and I got some pills to take the next day, one every 12 hours. Be careful, those pills are expensive without insurance. 12 pills without insurance would have been $700.00. Ouch! Other than that the only side effect that I have seen has been an increase in fatigue. My hair did start to fall out on day 13 so I had it cut. My luck, it stopped, so now I'm bald (peach fuss) and I didn't need to be. You will do fine.

We will be praying for you and waiting to hear the great results.

War Eagle, baby

Walt


Age: 55 ( still alive at 55)
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
PSA 8.23 2/2008 - Starting prednisone for 30 days
PSA 14 2-29-2008 - start chemo on 3/12
PSA 12.82 3/1/2008 round one chemo
PSA 12.24 4/2/2008 round two chemo 
 
"I will persist without exception - I will find a way where there is no way"


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 4/17/2008 11:48 AM (GMT -6)   
Tony,
Thanks for the encouragement I must say I really appreciate the positive comments and the goodwill that generates from this board. I will keep the board informed of my progress, all the best.

smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 4/17/2008 12:02 PM (GMT -6)   

torgeir

Welcome and hope all goes well with your treatment.

I am waiting to start treatment so have limited experience in this area but my doctor at U of Florida Proton Institue did mention a protocol of chemo along with proton.  It is not something I have actually gotten into but will post more as my treatments become reality.

Keep the faith and good luck with this trial.

Richard

 


Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Neg Bios 1997 & 2000 PSA within considered normal range
11/06 PSA 1.9 PSA 11/07 was 4.9 PSA 12/07 was 7.7 MDA 2/12/08 3.3 On Proscar so shud be doubled
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Bone scan 1/17/08 hot spot on ribs, CT shows rib enjury CT CHest 1/30/08 Clear
M.D. Anderson 2/12/08 Gleason 9 - CT Abdomin & Pelvis Clear Recommended Hormone&Radiation
2/19/08 Dr Fagin, Austin, TX did not recommend surgery based on medical history
2/22/08 Contacted U of Florida Proton Therapy Institute - Appt 3/13/08 
3/24/08 PET Scan await results - 4/1/08 Prostascint Scan await results
Appointment UFPTI for 3 day workup April 29th and 30th and May 1st.
Radiation to start 4-5 weeks later
Turn Stumbling Blocks into Steping Stones and Keep Smiling


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 5/14/2008 1:35 PM (GMT -6)   
I feel its time for an update, my first chemo (taxotere) session on the 18/04, did not turn out to be very pleasant. For the first three days after I could feel no effects whatsoever, this could be due to the steroids that I was taking which stopped on day three. For the remainder of the week I felt very tired with flue like symptoms and exactly one week after the chemo session my temperature had risen to 38.5c
I was admitted in to hospital where it was found I had an infection and my white blood cell count was .01 which 24 hours later fell to zero. My stay in hospital was seven days where I was on an antibiotic iv every six hours.
My doctor has recommended a 20% decrease in the amount of taxotere for the next session which took place last Friday 09/05 also I was prescribed Neulasta which hopefully will boost my white blood count.
All these problems have made me question whether to continue with the trial, if I come through this current session unscathed I guess I will continue. Searching on the internet there appears to be a mixed reaction to chemo following surgery, some opinion feels that as prostate cancer is so slow to grow chemo is not the best treatment.
Has anybody any experience of chemo to treat prostate cancer immediatly after rp I would appreciate to hear your story.

smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 5/14/2008 1:52 PM (GMT -6)   
Tangier

I am kinda new to PCa but Dr. Nichols, my doctor at UFPTI indicated in our first meeting about a protocol of doing chemo at the same time as radiation as it showed some promise. He initially considered that for me before my protocol was changed to Hormone, IMRT, and then Proton.

As others have said, please keep us informed of you situation and we will keep you in our thoughts and prayers.

Richard
Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
U of Florida Proton Therapy Institute
5/2/2008 LUPRON & Casodex
IMRT to start 5/15/2008 for approx 4 weeks with Proton to follow for approx 4 weeks
Turn Stumbling Blocks into Steping Stones and Keep Smiling
Our Journey is on WWW.GLEASON10.COM
 


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 5/14/2008 5:04 PM (GMT -6)   
Torgeir-
Sorry to hear that your first round didn't go very well. I hope you are feeling a bit better. Unfortunately, I don't know anyone else that has gone directly to chemo post- op. I'm sure that is probably why they are doing the clinical trial. I wish I had more answers for you, but hopefully my post will bump your thread to the top and others can reply. Hang in there and hoping this trial produces excellent results for you and those to follow! Thanks for being a pioneer, but take care of yourself first! Thinking of you!

Doting
DX July 15, 2007
Age 62 (now 63)
PSA 5.5
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7, T3a N1 M0
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node
Bone Scan/CT Negative (Sept. 10, 2007)
Post Surgery Gleason- 4+3=7
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07
Lupron beg. Dec 03, 2007 2 yr
Radiation March 03-April 22, 2008- 8 weeks 5x a week
Praying for a cured dad. First PSA 3 months!


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 5/14/2008 5:45 PM (GMT -6)   
Torgier--
Sorry to hear of your first reaction to the chemo but hopefully if you persevere with it , it will become more tolerable. As it is with all members here, your words are invaluable------treatment for PCA is evolving all the time with different techniques being tried. I can't help with any information on chemo at this stage but I sincerely wish for it to be a great success for you in the battle---
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable


landcrab
Regular Member


Date Joined Feb 2008
Total Posts : 25
   Posted 5/14/2008 11:49 PM (GMT -6)   
Torgeir
I do not wish to be negative regarding your treatment but I have asked myself the question several times is how well does chemotherapy work in completely eradicating cancer. My brother was dx with throat cancer 18 months ago and went through 2 chemotherapy (not Taxotere) sessions he was unable to complete the third. The idea was he was to have the chemo to shrink the tumour and then operate. The chemo did give him some relief but did not work as well as the doctors had hoped, and he died four weeks ago. From what I have learned through his experience is that the chemo stays in the body approx 3-4 days during that time it will attack all fast growing cells. However cancer cells that are resting will be missed so in reality if you have a three week cycle you have only 3-4 days during that period that the chemo works on the cancer cells. The hope is that during say a 6 course treatment cycle all active cancer cells will be destroyed.
As I say I do not wish to be negative and the doctors treating you know more than I do and perhaps in cases where there is very few cancer cells chemo works better, obviously your treatment is to elliminate the cancer at a very early stage.
All the best in your treatment

FLHW(David E)
Regular Member


Date Joined Nov 2007
Total Posts : 201
   Posted 5/15/2008 8:58 PM (GMT -6)   
War-eagle said...
Torgeir,

Welcome to the site. All here will offer support and insight into treatment options, but most off all we will offer love and prayers.

As you can see from my signature, I am taking chemo now. My PCa is advanced and I have already been through the whole nine yards of treatment options. We did a lot of research before staring the chemo and had long discussions with our oncologist. He explained that the use of chemo after surgery may become a more common treatment option based upon the good results that they are seeing in the same treatment with women that have breast cancer. The common treatment after surgery is chemo. The common drug of choice is Taxetre in conjunction with Predisone. They have seen survival rates increase and reoccurances of the cancer drop. So this may be where your doctors are coming from with this trial.

Personally I would not have entered into any trial that offered more than one option. I don't like the idea of one patient getting the drug and another take a placibo or "watchful waiting". This is my opinion. All treatment option are a personal choice and you must be comfortable with your choices. If you have any other questions, you can post them here or send me an e-mail. I here for you brother.

Be blessed and War Eagle,

Walt


Walt - lloks like your treatments are 4 weeks apart? I was under the impression that Tax was given every 21 days?
Dx'd 2/18/05
PSA 219, bone mets, lymph node involvement
Gleason Score: 7
Current (4-21-08)
PSA: 38
Lupron only as I await a Chemo trial on June 9
Personal Blog:
prostatecancerat42.blogspot.com


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 5/16/2008 10:15 AM (GMT -6)   

David and Torgeir,

They are every three weeks. The next is June 5th. I posted today about the last results. Check it out, buddy.

Torgei, Can you give me any idea of what dosage you started with? I am on 165/250 Ng2, but we are increasing the dosage next month. I am running on the same time line you are. Side effects kick in on week 2 after chemo, but nothing like you have seen. Just fatigue. I am getting a steroid, Decadron, with the chemo. It can and does cause major heartburn, but Zantec takes care of that.

Take care my brother,

Walt


Age: 55 ( still alive at 55)
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
PSA 8.23 2/2008 - Starting prednisone for 30 days
PSA 14 2-29-2008 - start chemo on 3/12
PSA 12.82 3/1/2008 round one chemo
PSA 12.24 4/2/2008 round two chemo 
PSA 10.86 4/24/2008 round three chemo
PSA 10.4 5/15/2008 round four chemo - increase dosage next month
 
"I will persist without exception - I will find a way where there is no way"


torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 35
   Posted 5/16/2008 12:10 PM (GMT -6)   
Walt,
I replied to you on the other thread regarding dosage, I too take steriods (Medrol methylprednisolon) 2 the day before the chemo 2 the morning of chemo 2 the evening of chemo and 2 on the following two days. On the first session I felt so bad I continued them for a further day. I told my chemo nurse and she explained that the body does produce is own steriods but once you take the steriod tablets it ceases. So there is a bit of withdrawal until your body catches up and starts to produce its own steriods.
Because of the bad reaction to the first session I also self inject Neulasta (very expensive) 24 hours after the chemo session this ensures white blood cells still produce.

All the best
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