HealingWell
Search Close Search
☰

MedOnc recommends Frank add docetaxel to ADT2

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/5/2014 7:35 PM (GMT -5)
Hello all,

Frank and I had an appointment with his medonc this afternoon. He is recommending that Frank follow the new protocol of adding docetaxel to his current regimen of leuprolide acetate/bicalutamide. Our medonc was at ASOS conference recently and sat in on the presentation of the "practice changing" study about this chemotherapy in hormone-sensitive, chemotherapy-naive metastatic prostate cancer patients. Any thoughts/opinions on this new recommendation from his doctor? I have read all the literature that has been posted this past week.

Thanks so much,
Lisa
Posted 6/5/2014 8:31 PM (GMT -5)
Lisa,
Given the available evidence, it seems like a great plan for Frank. He is hitting it at a perfect time because he so recently started on hormone therapy. We still have so much left to learn about optimal sequencing and combinations, but for men just starting on hormone therapy with extensive bone mets, it is clearly a winner.

- Allen
Posted 6/5/2014 8:40 PM (GMT -5)
Lisa

I am in a similar place to Frank. Meeting with my Dr's in 10 days to discuss the docetaxel treatment. Currently on Lupron/bicalutamide regime. I will be interested in hearing Frank's experience and once I speak with my oncologist's I will keep you updated. I wish you both well.

Mike
Posted 6/6/2014 9:37 AM (GMT -5)
This methodolgy appears to be gaining traction for high risk guys. Myers has discussed it and Scholz & Lam appear to be bullish on introducing chemo early. My med-onc has also discussed it with me.

One of our members, Southern Comfort, pursued this protocol and appears to be doing well.
Posted 6/6/2014 6:13 PM (GMT -5)
When Paul goes to MD next week to discuss whats next, treatments, etc. I am pretty sure we are asking for this.
Posted 6/8/2014 8:58 PM (GMT -5)
The more I read about this treatment protocol, the more I like it, if chemo can be "liked". On the other hand, Frank needs time to let the idea of chemotherapy sink in...though, he is slowly jumping on board. We are starting to make the question list for our medonc, but, he's used to me by now.

Lisa

Post Edited (redheadskier) : 6/8/2014 8:10:15 PM (GMT-6)

Posted 6/8/2014 10:12 PM (GMT -5)
My oncologist wants me to do this as well, but my (big national) insurance company won't budge until HT stops working. Supposedly experimental. We fought for a year to a standoff. My oncologist is of the opinion that I will go refractory during the next 6-month Lupron session, so the question will be resolved soon enough.

I was / am all for it, as I am in good enough health otherwise to support the treatment. I think that "saving" chemo for the time that you are least able to support it seems incorrect.
Posted 6/8/2014 11:18 PM (GMT -5)
142,
I don't know what carrier you have but I can say it's time to re-apply and appeal. Here are the reasons that should make the a "no brainer".

1. Until this past week there was no published paper proving it was effective. But the CHAARTED trial now not only proves it effective in early settings, it also is now a liability to your carrier to deny it. You are however off protocol of CHAARTED as docetaxel was proven in that trial to be effective on initial application for HT in metastatic men with more extensive mets. But reason two is a good one:

2. Docetaxel is now a generic. It's not that big monster cost it used to be. And reason three is even better:

3. Should you become resistant to ADT, you are still not considered hormone refractory. There is always Xtandi and Zytiga. And they cost a hellofa lot more than 6 rounds of docetaxel. These options are still seeking when sequencing should take place but if docetaxel can delay them then the carriers stands to possibly pay less over time by approving chemotherapy in an earlier setting.

They listen to paying less. But whatever the plan, if your physician prescribes docetaxel and your carrier resists, then drafting them a letter that they are denying you access to prescribed cancer treatment can in fact be a liability under law and the threat of being reported to a state commission can soften their stance. Remember Todd's story. Kaiser denied his claims for Provenge in Washington and they lost on appeal.

Just a few thoughts here.
Posted 6/8/2014 11:35 PM (GMT -5)
Tony,

I'll be having the quarterly meet with uro/onco on the 18th. The discussion will come up.

Problem is that my insurance is a "self-insured" situation managed through one of the biggest companies, so the rules have two levels. One to reduce costs, the second to avoid costs.

I'll make the points you mentioned.

I may qualify under the mets category, 4 vertebrae and 5 ribs involved. I am getting shorter by the day as the vertebrae collapse.

BTW - if you can come to GFMPH Sept, I got that bottle of batch 45 Aberlour last night after stopping at a half-dozen stores. It will be on the list.
Posted 6/8/2014 11:57 PM (GMT -5)
You absolutely qualify right now if you have identified mets. Docetaxel is still standard of case in that situation. Denying it would be silly in lieu of Zytiga what costs much higher. Xtandi has yet to be approved pre-chemo but that will change. They best save money nor rather than after those other two.

I wish you the best on that.

I already know I'm dead for NY GFMPH as I run our Las Vegas race on the last Saturday in September ~ the same weekend Jeff has his event. But I will try to keep my calendar open for March. In fact I'd love to host one here and then I can enjoy the batch without car keys.

:-)
✚ New Topic ✚ Reply