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What is Chemotherapy for Prostate Cancer?

 

Chemotherapy is a treatment in which drugs circulate through the body to kill rapidly growing cancer cells. Unfortunately, it can also kill healthy cells, so it is known to cause some unpleasant side effects. The amount of drug used and how often are carefully controlled to limit discomfort. These drugs tend to be given once per month for several months. Many chemotherapy drugs are given intravenously (through a vein). A few may be taken as a pill. There is no need to stay in the hospital for chemotherapy.

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Chemotherapy drugs slow the growth of cancer and reduce symptoms. Most of the drugs are given into the vein (intravenous, IV).

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Chemotherapy does not cure prostate cancer. It can ease the pain from prostate cancer, shrink tumors and lower levels of PSA. Studies show that many chemotherapy drugs can affect prostate cancer.

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Some, such as Docetaxel (Taxotere®, DocefrezTM) and Cabazitaxel (Jevtana®) have been shown to help men live longer. Scientists are studying other new chemotherapy drugs and mixtures of drugs.

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Drugs circulate in the blood during chemotherapy. They kill any rapidly growing cells, both cancer and non-cancer cells. Often, chemotherapy is not the main therapy for prostate cancer. But it is a useful treatment for men whose cancer has spread and are still responding to hormone therapy (hormone sensitive).

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Chemotherapy is standard for prostate cancer that has spread and is progressing despite low levels of testosterone. New data suggest that when combined with hormone therapy, it may also improve survival for men whose cancer has spread.

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In 2004, two studies showed that chemotherapy could extend survival. This was in men whose mCRPC no longer responded to hormone therapy. The FDA approved Docetaxel for use with Prednisone. It is the first registered treatment for patients with mCRPC. The combination therapy has extended survival by several months.

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A drug called Cabazitaxel is also approved for the treatment of mCRPC. When men who have received Docetaxel have progression of their cancer, Cabazitaxel may slow the cancer growth. 

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Who is a Good Candidate?

 

Chemotherapy is not the primary treatment for most prostate cancer patients. Still, it can help:

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• Men with advanced stages of prostate cancer

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• Men whose cancer has spread from the prostate gland to other parts of the body

 

• Men with advanced prostate cancer that no longer responds to hormone therapy

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What are the benefits, risks and side effects of chemotherapy?

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The decision to start chemotherapy is a difficult and personal one. It is based on:

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• What other treatments or clinical trials are available.

• How well chemotherapy is likely to be tolerated.

• What other therapies have been tried.

• Whether radiation is needed to relieve pain quickly.

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Often chemotherapy is given before pain starts. The goal is to prevent pain as cancer spreads to bones and other sites.

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Chemotherapy may improve survival. It may prevent pain. Side effects include fatigue, nausea, vomiting and hair loss. There can be changes in your sense of taste. There may also be a decrease in blood cells. This may lead to a risk of infections. Chemotherapy drugs are monitored closely. There are medicines to lessen side effects. Most side effects stop once chemotherapy ends.

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The main benefit of chemotherapy is killing rapidly growing prostate cancer cells. Side effects of chemotherapy will depend on your health, the drug, the dose, and how long treatment lasts. The most common side effects are fatigue (feeling very tired), nausea, vomiting, diarrhea and possibly hair loss. A change in your sense of taste and touch (feeling numb) are also possible. There is an increased risk of infections and anemia because of lower blood cell counts. Some people become more forgetful. Most of these side effects can be managed. After the treatment ends, many will go away. Some side effects may linger for a long time.

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Should I Consider Chemotherapy?

 

Choosing the right treatment and when to begin is an individual choice that men should make with their doctor. No one treatment is perfect for every man. Chemotherapy has been found to help patients when it is given at the same time as hormone therapy. Chemotherapy is not recommended for men with non-metastatic castration resistant prostate cancer (nmCPRC). It may help patients with metastatic castration resistant prostate cancer (mCRPC) who have not had certain other treatments.

 

It’s important to know that chemotherapy only works for a limited time. Not all prostate cancers require active treatment. Not everyone will benefit from chemotherapy. The decision to move forward with a powerful treatment like this should be carefully considered. Learn the benefits, risks and side effects of chemotherapy before starting.

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Other Considerations

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With follow-up care, your healthcare team can help you with long-term side effects. Your follow-up care will include regular visits with your doctor. Choosing the right treatment for prostate cancer is an individual decision. Rather than aggressive treatment, surveillance alone may be a fine option for you. Talk to your doctor about which treatment is right for you

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