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78 year old man on Docetaxel

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Posted 9/29/2024 10:34 PM (GMT -5)
I have read many posts from men who have taken Docetaxel for their PC. The ones I read about seemed to be a bit younger. My Dad is 78 and has lost about 10 pounds. He looks super frail. (If you search my posts you can see my last one that details all he’s been through this year.). He’s had two rounds of chemo so far. He’s still using a walker since he was in the hospital almost 3 weeks in August. He’s doing PT at home and recently they added OT for upper body. He seems so down. Not sure he’ll beat this. He ate ice chips while getting chemo (as I read on a post that helps taste buds) but nothing tastes good to him still. We are trying to get him to eat small portions throughout the day. Sometimes even that is a chore. His pain that was in his right leg is a lot better since having the iliac stint placed and having chemo. Now it’s just mainly being tired and weak and frustrated because he isn’t active yet like he was earlier this year. Any advice would be great!
Posted 9/30/2024 8:05 AM (GMT -5)
nmckinley, I wish I had advice for you, unfortunately, I just don't have the knowledge to make suggestions, so all I can say is your dad is lucky to have you staying on top of this for him. He's been through a lot, so it's not surprising that he seems frail. Hopefully the OT helps him regain some strength, and his taste buds reactivate, if he can enjoy his food again, perhaps he puts some weight on, and builds some muscle. Make sure he is getting his protein.
Hopefully someone with more expertise in the latest treatments for advanced disease will chime in at some point today
Posted 10/30/2024 1:10 PM (GMT -5)
Dad has had 3 rounds of chemo so far. Below are results from his scans. Is this normal or should we see better results? The lungs we don’t have a fully accurate picture of because when the lung nodules were found in August, only an abdominal scan was done. They didn’t do a chest scan to check upper lungs. I knew that I would kick myself for not insisting that be done. Dad is feeling so much better, pain wise, so I’m just baffled that the spot on pelvic sidewall is only stable.

IMPRESSION:
Overall stable examination when compared prior exam from 8/13/2024
Stable right pelvic sidewall/retroperitoneal mass with encasement of the traversing ureter, vasculature, with invasion of the
adjacent musculature and heterogeneous stranding along the presacral space
Decompressed urinary bladder demonstrates circumferential wall thickening. Previously demonstrated right lateral
posterior bladder wall mass demonstrated on the prior scan
Additional nonacute findings as above

Radiology Report
When compared prior CT of the chest from 2/12/2024, there is interval development of multiple bilateral pulmonary and
pleural nodules, concerning for metastatic disease
Slightly increase in size of prominent right upper paratracheal lymph node
Scattered sclerotic lesions present throughout the ribs
Additional nonacute findings as above
Posted 10/30/2024 1:19 PM (GMT -5)
Below full chest report. Not sure how the hilar lymph node showed slight increase when I didn’t see note about that on February scan

COMPARISON: Multiple priors most recent 2/12/2024 CT chest
Technique: Routine noncontrasted CT of the chest. One or more of these dose optimization techniques were utilized:
Automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched
to clinical indication); or iterative reconstruction.
FINDINGS:
Lungs/pleura: When compared with CT chest from 2/12/2024, interval development of multiple pulmonary and pleural
nodules bilaterally. Additional scattered groundglass opacities are present within the right lung apex.
Airways: Patent.
Mediastinal/hilar lymph nodes: Slight interval increase in size of a 1.2 cm right upper paratracheal lymph node (series 2
image 17, previously 0.7 cm. Additional scattered subcentimeter mediastinal lymph nodes are present. Hilar
lymphadenopathy not well-visualized without intravenous contrast. No axillary lymphadenopathy.
Aorta: Prominent calcified atherosclerotic disease present within the thoracic aorta and branch vessels.
Cardiac: Postoperative changes as post CABG. Left-sided pacemaker leads.
Pulmonary arteries: Normal caliber and morphology.
Bones: Scattered sclerotic lesions are present throughout the ribs. Chronic appearing compression deformity of lower
thoracic vertebral bodies.
Axilla: No lymphadenopathy.
Thyroid: Any visualized thyroid tissue is unremarkable.
Soft tissue: Unremarkable.
Abdomen (visible): Please refer to the concurrent CT of the abdomen and pelvis for additional evaluation
Posted 10/31/2024 6:02 AM (GMT -5)
nmckinley, I don't have any wisdom for you either. The question, perhaps, to ask him is what does he want?

Treatment of advanced PC in the elderly is a serious challenge. Treatments that a younger man can get through without a lot of misery are totally different as we age. Treatments aren't as effective, recovery takes longer, suffering increases.

Whatever is next on his path, know that we are standing with you.
Posted 10/31/2024 8:31 AM (GMT -5)
Well the good thing is that his symptoms have greatly improved. I’m just trying to figure out if this is a good report or not after 3 rounds of chemo. Again, we didn’t have a full picture of the lungs before chemo started in August. Lungs were clear in February.
Posted 10/31/2024 10:28 AM (GMT -5)
I do not think of 78 as elderly anymore as it is possible to appear healthy or not healthy depending on a myriad of life factors. I do not see anything in the report(s) good or bad for someone with metastatic cancer but am far from an expert with radiology reports.

When was the chest CT in your post above taken as it references previous scan on 2/12/24?

He should be tired while taking chemo, not unusual. The scan mentions spine compression issues which can be related to age and bone loss also.

I suspect there will be no obvious signs of improvement with tiredness and scans until after treatment is over. The tough part is healing and recovery slows with age and it gets more difficult with each additional issue along the way. I think you just need to do what your are doing which is kindness, care, and assistance without overdoing it.
Posted 10/31/2024 5:55 PM (GMT -5)
Hello
These scans were done on October 29. I’m just wondering if these are ok or good scans after 3 rounds of chemo? This is my first close encounter with chemo. I’ve tried researching and found some mixed info.
Thanks.
Posted 10/31/2024 7:09 PM (GMT -5)
Search for AI Chat (https://deepai.org/chat) and copy his CT report text into it and it will translate the report for you. The fact that treatment is ongoing makes it hard to draw conclusions.
Posted 10/31/2024 9:51 PM (GMT -5)
So you’re saying since we are only 3 treatments in we have a ways to go yet to see what’s going to happen? I’ll check the AI chat out tomorrow.
Thanks
Posted 11/12/2024 6:20 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”.
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