PROSTATE CANCER - Chemotherapy for prostate cancer

Chemotherapy for prostate cancer

Chemotherapy (chemo) uses anti-cancer drugs injected into a vein or given by mouth. These drugs enter the bloodstream and go throughout the body, making this treatment potentially useful for cancers that have spread (metastasized) to distant organs.

Chemotherapy is sometimes used if prostate cancer has spread outside the prostate gland and hormone therapy isn't working. Chemo is not a standard treatment for early prostate cancer, but some studies are looking to see if it could be helpful if given for a short time after surgery.

Doctors give chemotherapy in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks.

For prostate cancer, chemo drugs are typically used one at a time. Some of the chemo drugs used to treat prostate cancer include:

• Docetaxel (Taxotere®)
• Cabazitaxel (Jevtana®)
• Mitoxantrone (Novantrone®)
• Estramustine (Emcyt®)
• Doxorubicin (Adriamycin®)
• Etoposide (VP-16)
• Vinblastine (Velban®)
• Paclitaxel (Taxol®)
• Carboplatin (Paraplatin®)
• Vinorelbine (Navelbine®)

In most cases, the first chemo drug given is docetaxel, combined with the steroid drug prednisone. If this drug does not work (or stops working), a newer drug called cabazitaxel is often the next chemo drug tried (although there may be other treatment options as well).

Both of these drugs have been shown to help men live several months longer, on average, than older chemotherapy drugs. They may slow the cancer's growth and also reduce symptoms, resulting in a better quality of life. Still, chemotherapy for prostate cancer is very unlikely to result in a cure.

Possible side effects of chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow, the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemotherapy, which can lead to side effects.

The side effects of chemotherapy depend on the type and dose of drugs given and the length of time they are taken. These side effects may include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Lowered resistance to infection (due to low white blood cell counts)
• Easy bruising or bleeding (due to low blood platelets)
• Fatigue (due to low red blood cells)

Most of these side effects are usually short-term and go away once treatment is finished. There is help for many of these side effects. For example, drugs can be given to help prevent or reduce nausea and vomiting. Other drugs can be given to boost blood cell counts, if needed.

Along with the risks above, some side effects are seen more often with certain chemo drugs. For example:

• Docetaxel and cabazitaxel can sometimes cause severe allergic reactions. Medicines are given before each treatment to help prevent this problem. These drugs can also cause numbness, tingling, or burning sensations in the hands or feet, which is known as peripheral neuropathy.
• Mitoxantrone can rarely cause leukemia several years later.
• Estramustine carries an increased risk of blood clots.
• Doxorubicin can weaken the heart muscle over time, so doctors must limit the amount of this drug that is used.

To learn more about chemotherapy, see the “Chemotherapy” section on our website, or our document Understanding Chemotherapy: A Guide for Patients and Families.