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Chemotherapy - when to use it

Updated: 4 hours ago

Taxotere (Docetaxel), Jevtana (Cabazitaxel), Paraplatin (carboplatin)


My summary of the YouTube interview of Dr Evan Yu by Dr Mark Moyad from PCRI (below).


(Ask your doctor about this. I am not a doctor. Many of my simple statements should have 'may' or 'might' or 'possibly' or 'probably' of 'perhaps' and so on in them. The reason you go to a specialist doctor is that they have years of study to fully understand the complexity of this disease.)


mHSPC

Metastatic hormone sensitive prostate cancer

(Usually metastases found on initial diagnosis)

Metastases

• New prostate cancer growth (metastases) found away from the prostate.

• If you have metastases, your cancer is said to be metastatic.

• Avoid these toungue-twisters by calling them 'mets'.

Hormone sensitive

• Hormone therapy can keep PSA under control.


Dr Yu

Taxotere (Docetaxel) plus ordinary hormone therapy.

Earlier the better.

If Taxotere (Docetaxel) has run its course, use Jevtana (Cabazitaxel).


mCRPC

Metastatic castrate resistant prostate cancer

(Man already on hormone therapy, perhaps for a long time)

Metastases

• New prostate cancer growth (metastases) found away from the prostate.

• If you have metastases, your cancer is said to be metastatic.

• Avoid these toungue-twisters by calling them 'mets'.

Castrate resistant

• Testosterone low (at the same level as a man who has been castrated), but PSA rising.


Dr Yu

Ordinary hormone therapy, then Taxotere (Docetaxel) when pain becomes a problem, because Taxotere (Docetaxel) both extends life and eases pain.

If Taxotere (Docetaxel) has run its course, use Jevtana (Cabazitaxel).

DNA repair mutations

• DNA: The instruction set in every cell of your body.

• Repair: Your DNA has bits at the end that can repair the damage your DNA gets in ordinary everyday use.

• Mutation: Damage to a bit of your DNA

• If a bit that does the repairs is damaged, we call that bit a DNA repair mutation.


Dr Yu

If you have a DNA repair mutation, Paraplatin (carboplatin) may be used.


PSA: (Jim only. Not Dr Yu)

PSA: Found by a blood test.

• Ordinary prostate cells make PSA.

• The PSA made by ordinary prostate cells will change slowly higher as your prostate grows larger as you age and if you gain weight.

• Between tests the PSA made by ordinary prostate cells will be pretty much the same.

• Prostate cancer cells also make PSA.

• Prostate cancer growing - PSA rises between tests.

• Prostate cancer coming under control - PSA falls between tests.

• Prostate cancer under control - PSA steady between tests.

So:

A higher PSA result than the man next door may be because you have a bigger prostate, or your prostate hasn't aged as well as his.

Single test not usually interesting to your doctor, unless very high. (Jim's guess: first time measured over 10).

Your doctor will be most interested in how PSA changes between tests. (Jim's impression: at least 3 tests, unless PSA is rising very rapidly.)


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