I am sorry you are facing the beast- I offer comments based a lot on my experience of two years (so far) after diagnosis of de novo metastatic PCa-
(1) you will go on ADT of course ASAP- this usually has a big impact on tumor burden initially- your PSA should drop dramatically and many of the tumor sites will shrink substantially-
(2) I am not sure what your doc means by "aggressive" chemo, but if it is docetaxel alone, many guys get through it without truly debilitating side effects- some continue working while on regimen; I am glad I did not have to, but I only had 4 rounds (not 6) because of skin reaction-
(3) between the ADT and the chemo, if you respond to both, you could get your PSA really low, which is then the floor for the return of the beast; some guys will have an extended period of low PSA before castration-resistance, you could be one; my PSA started climbing shortly after my last chemo treatment, but my nadir was 0.05 PSA about
6 mos into treatment (chemo + ADT), and after two years my last PSA is 3.03 and I am still relatively symptom free from the disease itself; it is a good year so far.
(4) for me the first year was the hardest emotionally- the combo of coping with the diagnosis and the onset of ADT side effects was draining- things seemed to change going into 2nd year- I am still fighting (on my seventh form of PCa therapy now) and as long as major symptoms are held at bay, I feel pretty normal most of the time- all that bad stuff that will happen, well it will happen to a guy I do not know now (me of course) and off in the future.
(5) any time you buy now may gain you access to treatments, proven or on trial, that can give you more time later- things are developing real fast in PCa these days
(6) chemo can be very rough on some people- part of that depends on your current health status I guess- but you will never get better benefit from it than now- later, after castrate resistance, chemo is also used, but to less benefit with regard to time-
I make no recommendation, of course. But there is a thread on this forum called "Taxotere side effects" where many have detailed their experiences with the drug- and Cyclone Fan has placed an excellent write up on preparation for and managing the chemotherapy. It may help you in making your decisions.
I wish you great luck -
3/16 PSA 19.4
Status G10 M1a
5/9 ADT PSA 29.5
NIH trial PROSTVAC ADT chemo (x4)
NADIR .05 10/4
10/25 PSA .06 Scans- nodes shrunk
5/1 EBRT 37.5 Gy prostate
PSA 6/27 1.65 off trial -> Provenge
PSA 8/28 1.79 9/19 1.73 -> Xtandi -> 0.85; 12/12 1.24 fail, local but nodes biggerwww.healingwell.com/community/default.aspx?f=35&m=3634829