Chemo before RP? Anyone?

Hello,

My husband has been invited to be in a phase 2 clinical trial for chemo before RP. It's called the ACDC trial and it uses cabazitaxel. https://clinicaltrials.gov/ct2/show/NCT02543255

Has anyone had chemo before RP? If so, what did you take and how have you done?

My husband- PSA 28, GS 4+5, N0, M0. He also has extension of PCa into the bladder neck. Presently, he's taking Firmagon.

Thank you!

Annie

I did several rounds of chemo between June and December in the year I was diagnosed before my open RP in January of the next calendar year. This first half was taxotere and last rounds were etoposide & cisplatin.

My RP was very nontraditional since I was stage IV and had mets. You could say my RP was a debulking. But, it provided me with over 2 years of zero PSA.

I have reported issues here about chronic pain and other side effects but I would say I am doing very well considering the shape I was in when diagnosed. You can see my stats in my signature below.

Good luck to your husband.

Gunnar,

Thank you for your response and for sharing your experience. It is encouraging that the chemo has helped you and it seems there would be no harm to trying it. I think there is an assumption that people with "very high risk" PCa like my husband likely have micrometastisis.

What great news on your recent PSA!! Cheering you on for continued declines.

Mr URO works at the Universty Medical Center Speciality Center Hospital and offered me to be a part of a clinical trial using chemo before surgery. Since my scans were clears and PSA of 6.75 (had been normal 3 or 4 years prior) I opt'd out.

If I had thought I had mets prior to suregery I would have considered it.

Deciding how to treat is one of the hardest parts of this

Final Path:
All 17 lymph nodes were negative.

Prostate size: 4.1 x 3.7 x 4.9 cm

Prostate weight: 53 grams

Total GS 9 (4+5=9)

40% of the prostate involved

Seminal vesicles invasion: Identified

Margins: Minute focus of left posterior margin involved by the tumor. In the right and left apex there is focus approaching the edge, but due to the absence of ink in the portion, it cannot be definitively said that it is a true margin

Perineural invasion: Present, extensive

Path staging: pT3bNO

I was diagnosed with PC at the end of August last year just after turning 57 and had open surgery. Even with the G10 – (second opinion - G9), the doctors could not “feel” anything with the DRE and said there was a 50/50 chance that surgery could cure me. But if the surgery did not cure me, then likely I would need adjuvant RT afterwards and that came to pass.

EBRT was used and I did 40 rounds completed in May of this year and my PSA keeps dropping since surgery and radiation.

We talked about HT during radiation with the URO, before and after surgery. We also talked to the medical oncologist and radiation oncologist as well about HT. My surgeon said he wanted to know if the radiation worked or not up front and that HT would keep the PSA down and then we would not know what my real situation was. My medical oncologist understood the reasoning and went along with it, even though I think he really wanted to sell the shots.

So all said and done, I had the surgery going in for the following reasons

1. Chance for a cure
2. Very accurate pathology report to know my staging
3. Remove every LN that was visible to a very experienced surgeon
4. Nerve sparing was ruled out by the surgeon upfront but both the surgeon and my regular URO said they could “fix” the ED and as of yesterday the surgeon proved it with injections

Cancer is a scary word, and when the doctor “calls you in to talk” it is a life changing moment. The final path after surgery with no LN involvement was one of the best things I have ever heard in my life. The road we choose to battle PC is hard and deciding how to treat is the hardest part.

Good luck and I wish you peace with the treatment choice y’all make