Rising psa during chemotherapy - help!

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Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 6/24/2011 8:06 AM (GMT -6)   
Hi all,
 
Long time since I posted on here - hope everyone's keeping well.
 
I wanted to ask those who have been battling advanced pc if they have any advice for my husband.
 
Due to recent psa increase (up to 56 a couple of months ago) he has been given chemotherapy (taxotere) at 3 weekly intervals. Initial results were good. His psa dropped to 26, then 21, then 19. The most recent result, however, has shown a rise up to 23 - not the direction we want it to go!
 
His oncologist says not to panic, it may just be a blip, but of course we are very concerned. He says if the psa continues to rise the chemo will be abandoned. But, is there anything else that can be done?
 
We were given the impression that the chemo was the final shot at battling this horrible disease. If the chemo isn't working, is there anything else out there?
 
Sorry to ramble on, but we are a bit devestated today and just looking for a glimmer of hope (by the way, my husband is in very good health - apart from having advanced cancer! He is working full time in a physical job, eating well, coping fine with the chemo)
 
Thanks in advance

medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 6/24/2011 8:52 AM (GMT -6)   
Suggest you ask your husband's oncologist about second line chemotherapies. There are others that have worked after taxotere ceased workiing well. And ask about other options, such as provenge, Zytiga, keto, DES, thalidomide. You need an oncologist who is very knowledgeable about advanced prostate cancer. Best wishes, Medved

Post Edited (medved) : 6/24/2011 7:57:22 AM (GMT-6)


RobertC
Veteran Member


Date Joined May 2011
Total Posts : 1313
   Posted 6/24/2011 8:55 AM (GMT -6)   
The new medicine Zytiga is out and someone posted a program that allows for a low copay for this med.
There is Provenge immunotherapy / vaccine that Medicare might pay for.

In trials: MDV3100 , cabozantinib (XL184) , Prostvac vaccine , tasquinimod all of which have some promise

Good luck to you both.

Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 6/24/2011 9:37 AM (GMT -6)   

Great, thanks for that information - good to know there are alternatives available. Just hope they are licensed in the UK too.

Interesting about the second line chemotherapy - will do some research ready for our next appointment

I'm guessing Zytiga is the same as Abiraterone? The doctor did say it hasn't been licensed yet over here but will be as of September.

Thanks again :)


medved
Veteran Member


Date Joined Nov 2009
Total Posts : 1100
   Posted 6/24/2011 10:57 AM (GMT -6)   
Yes, Zytiga is the trade name for abiraterone.  You might be interested to have a look at www.hrpca.org    It has some information about so-called second line treatments -- chemotherapies and others.  Best wishes.

ralfinaz
Veteran Member


Date Joined Jan 2011
Total Posts : 735
   Posted 6/24/2011 11:30 AM (GMT -6)   
Hi Missyj,
There are several options. Some include adding other chemicals to Taxotere.
Carboplatin, Gemcitabine, Avastin, etc could be added.

Another option is to switch to another taxane such as Taxol or Abraxane.
There are other oral combinations of chemotherape available. Read a paper by Dr. Lam at tinyurl.com/5r4qqx9 for more detailed options.

Remain positive! Your husband is in otherwise good health and not weaken by the disease. That is important. Like mentioned by others there are clinical trial options also. Keep in touch and keep us informed of your progress.

RalphV
Phoenix, Arizona
Disclaimer: I am a long-term prostate cancer survivor. My comments are not intended as medical advice. The intent is to provide information. Seek direct recommendations from your medical team.
Surviving prostate cancer since 1992 at age 58. RP; Orchiectomy; GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall; Stage T4; Last PSA September, 2010: <0.1 ng/m

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 6/24/2011 12:35 PM (GMT -6)   
Missyj is located in Great Britain so the options we see on trial here may not be available to them.

Julia, also look into JEVTANA (cabazitaxel) as it has shown response when Taxotere stopped working. I am pretty sure that Sanofi-Aventis has this one approved in Europe now. Also look into the other suggestions as well as these drugs, while working in small time intervals, combined can be quite effective.

Stay well Missyj...thinking of you both always...

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3888
   Posted 6/24/2011 12:51 PM (GMT -6)   
Also consider Emcyt. It has been beneficial to many. Dr Lee in Michigan, a pioneer in prostate cancer detection, has been going for nearly 30 years after bone mets were found. One of his main treatments has been Emcyt.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

Willie B
Regular Member


Date Joined Jul 2010
Total Posts : 155
   Posted 6/24/2011 8:45 PM (GMT -6)   
Hi MissyJ,

Mary here,

My husband is also fighting advanced PC and he's had to stop chemo due to a lung complication.

According to our family doctor, who has a SIL who is head of the hospital pharmacy, there are many other drugs left to try.

I don't have details, no needing the info. at the time but as others have posted, we're not done yet.

It's excellent news that your husband is still active and healthy in every other way, should help immensely.

Hoping for the best for you both.

Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 6/25/2011 2:10 AM (GMT -6)   
Thank you all so much. This has been a great help, to know that there are other options to investigate.
 
Will be researching all treatments mentioned to present to the oncologist at our next meeting in 3 weeks (I'm sure his heart sinks when I walk in shaking a bunch of paper at him from Dr Google :D )
 
he has made an appointment for my hubby to have a ct scan in two weeks, and he will have had a further chemo treatment, so the appointment will be nerve wracking to say the least!
 
Great to hear from you Tony - looks like you're doing fine, I'm really pleased :)
 
Thanks again for your help everyone

Arno
Regular Member


Date Joined Apr 2010
Total Posts : 54
   Posted 6/25/2011 4:42 AM (GMT -6)   
Missyj said...


Due to recent psa increase (up to 56 a couple of months ago) he has been given chemotherapy (taxotere) at 3 weekly intervals. Initial results were good. His psa dropped to 26, then 21, then 19. The most recent result, however, has shown a rise up to 23 - not the direction we want it to go!


A reduction by 66% with Taxotere is actually a quite good response for this chemo. DES (diethylstilbestrol) is known to be effective after this chemo (David E., for example, got about 85% reduction using it after this chemo).
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