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.

When is chemotherapy used?

Chemo is sometimes used if prostate cancer has spread outside the prostate gland andhormone therapy isn’t working. Recent research has also shown that chemo might be helpful if given along with hormone therapy.

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.

Chemo drugs used to treat prostate cancer

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)

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), 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 longer, on average, than older chemo drugs. They may slow the cancer’s growth and also reduce symptoms, resulting in a better quality of life. Still, chemo is very unlikely to cure prostate cancer.

Doctors give chemo 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.

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 (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can also be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and how long they are taken. Some common side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Increased chance of infections (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

These side effects usually 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.

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

• Docetaxel and cabazitaxel sometimes cause severe allergic reactions. Medicines are given before each treatment to help prevent this. These drugs can also damage nerves (known as peripheral neuropathy), which can cause numbness, tingling, or burning sensations in the hands or feet.
• Mitoxantrone can, very rarely, cause leukemia several years later.
• Estramustine carries an increased risk of blood clots.

If you notice any side effects while getting chemo report them to your medical team so that they can be treated promptly. In some cases, the doses of the chemo drugs may need to be reduced or treatment may need to be delayed or stopped to prevent the effects from getting worse.

To learn more about chemo, see the Chemotherapy section on our website.