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Docetaxel and Tumor Size

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Prostate Cancer
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Posted 11/12/2024 6:19 PM (GMT -5)
Has anyone had chemo and symptoms (pain) goes away but the tumor stays the same size or varies a little larger (different scanning sites) and maybe due to shifting? Oncologist thinks the chemo is working because the symptoms have improved but said the tumor could be dead/dying but stay “stable” on scans. I can’t find much good info on this so wanted to check here. Lung nodules have decreased in size and disappeared but this pelvic sidewall mass is just “stable”. Feel free to read my other posts for additional information.
Posted 11/16/2024 3:30 PM (GMT -5)
Anyone with input here?
Posted 11/16/2024 5:05 PM (GMT -5)
No substantive input from me, but I want to emphasize that your medical status has improved and that imaging methods aren't necessarily 100% reliable.
Posted 11/16/2024 5:44 PM (GMT -5)
Great, thank you! I’m a big worrier so it all just makes me nervous.
Posted 1/2/2025 12:03 PM (GMT -5)
Well, scan from Dec 30 shows that the pelvic mass has increased .5 cm. Two lung nodules have gotten smaller while others have gotten larger. I’m so frustrated and worried. I have seen, and read, that when docetaxel stops working, or fails, that Cabazitaxel is the next step. Again, my Dad is 78 and has been using a walker since August because of losing so much strength. Started Docetaxel in August, has had 5 rounds, and October scans showed lung nodules decreased in size and pelvic mass was stable. He’s also on Eliquis for afib but we’ve had to stop that due to blood in the urine. We hope to start it up again at some point. If he does take Cabazitaxel next, how long does he have to wait to start? Suggestions in treatment?
Posted 1/3/2025 9:09 AM (GMT -5)
My concern is are there more options after growth with Docetaxel? He’s had 5 rounds and just now experienced some growth. He did have to go 6 weeks between the 4th and 5th round. Not sure if that could make a difference?
Posted 1/3/2025 11:54 AM (GMT -5)
nmckinley,

None of us are oncologists, so it's hard to give a specific answer. So much depends on what his history has been, and his responses to the therapies and, importantly, the side effects. I'm sure there are plenty of ongoing conversations, an important one to have with him is to ask what he wants?

I hate to raise the question, but my life experience says that having that honest, caring conversation with him is critically important.
Posted 1/3/2025 12:02 PM (GMT -5)
A lot of the info should be in the signature. Dad does want to continue treatment and working with PT and OT, as of now. That’s why I’m inquiring about other treatments. We have discussed him not wanting to be bed bound, etc.
It’s so hard because we lost my sister in April 2024 to stage 4 melanoma.
Posted 1/3/2025 2:31 PM (GMT -5)
nmckinley,
I thought I recognized your user name from a few years ago. As I recall, you’re his daughter who has been looking after him. He has been very fortunate to have you around.

I looked at some of your old posts and I guess your Dad is still on Erleada and Lupron? I didn’t notice where you may have posted his current PSA? Is he still having bone pain? In any case, it seems that his situation is not good at all. I don’t know if you’ve looked into Pluvicto or Bipolar Androgen therapy. I do not know if he would qualify for those treatments.

I also have ask, and this is said with best of intentions. are you certain that your Dad really wants more treatments? Is there a chance he’s agreeing to more treatments more because he wants them, or because he doesn’t want to “let down” his child who is understandably scared? I apologize if I’m probing an area where I have no business. I hope your Dad is full on board with never giving up, and having you beside him all the way!
Posted 1/3/2025 2:59 PM (GMT -5)
Yes, that’s us. He isn’t on erleada and Lupron anymore. He is only on the Docetaxel now. He doesn’t have any bone pain at this time. His PSA is still undetectable. He does have pain from the mass in the pelvic area. That has stopped after the first 2 rounds of Docetaxel. It has gotten larger by .5 cm. Are you saying that you don’t think trying cabazitaxel would be worth it, or effective? I have looked into Pluvicto. I haven’t looked into bipolar androgen therapy.
Here are the impressions
Abdominal/Pelvic Area
IMPRESSION:
1. Interval notable progression of most of the pulmonary metastatic disease. There are one or 2 nodules that are
decreased.
2. Interval decrease in size of right paratracheal lymph node.
3. Interval development of bilateral pleural effusions, small on the right, trace on the left.
4. Interval increase in size of right pelvic sidewall mass.
5. Interval development of moderate right hydronephrosis. Correlate clinically for ureteral stent occlusion.
6. Interval placement of left double-J ureteral stent.
7. Mural thickening of the urinary bladder, likely unchanged.
8. Stable sclerotic lesions within the pelvis.
9. Cholelithiasis.
10. Diverticulosis.

Chest
IMPRESSION:
1. Interval notable progression of most of the pulmonary metastatic disease. There are one or 2 nodules that are
decreased.
2. Interval decrease in size of right paratracheal lymph node.
3. Interval development of bilateral pleural effusions, small on the right, trace on the left.
4. Interval increase in size of right pelvic sidewall mass.
5. Interval development of moderate right hydronephrosis. Correlate clinically for ureteral stent occlusion.
6. Interval placement of left double-J ureteral stent.
7. Mural thickening of the urinary bladder, likely unchanged.
8. Stable sclerotic lesions within the pelvis.
9. Cholelithiasis.
10. Diverticulosis.
11. Body wall edema.
Posted 1/3/2025 10:04 PM (GMT -5)
No I’m not at all saying that I think cabazitaxel is not worth trying. It’s a treatment that is left to try, and it sounds like your Dad is good for giving it a shot, so why not.

When I read Members’ stories I often think about it from my perspective and what I would do. Reading all that your Dad has been through my head was spinning and I was thinking that guy has a lot more guts than I do. Of course, we never know until we find ourselves in a similar position.

Here’s to the courage of your Dad, and to yours as well.
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