Chemotherapy

Chemotherapy is a common treatment for advanced prostate cancer. In particular, it is a standard of care option for men with mCRPC. It is often given in combination with hormone therapy or after hormone therapy stops working. Chemotherapy is sometimes used along with hormone therapy in patients with early stage prostate cancer who are at very high risk for spread or recurrence.

Taxane chemotherapy is the approved chemotherapy agent to treat prostate cancer. It may be given in two ways. The most common form is as an infusion, given intravenously (IV) through a vein. This may be done in a doctor’s office, chemotherapy or infusion clinic, or in a hospital setting. The types of infusion chemotherapy include:

• Docetaxel (Taxotere^®)
• Cabazitaxel (Jevtana^®)
• Mitoxantrone (Novantrone^®)

There are also oral chemotherapies, given as a pill. This includes:

• Estramustine (Emcyt^®)

Chemotherapy is given in cycles, with each treatment period followed by time to allow you to recover from the effects of the drugs. Most treatment cycles are two or three weeks long, but schedules vary depending on the type of drug. 

The first chemotherapy drug given is often docetaxel, combined with the steroid prednisone. If this doesn't work or stops working, cabazitaxel is often the next chemotherapy tried. There may be other treatment options as well.

Docetaxel and cabazitaxel have been shown to help men live longer than older chemotherapy drugs. They may slow the cancer’s growth and reduce symptoms.

Platinum chemotherapy drugs are being studied for use in prostate cancer, including carboplatin, oxaliplatin, and cisplatin. While these drugs aren't FDA approved for the treatment of prostate cancer, they are sometimes used in very advanced prostate cancer patients who have exhausted all other treatment options.

Chemotherapy attacks cells that are dividing quickly, which is why it is effective at attacking cancer cells. But there are other healthy cells in the body that also divide quickly. Chemotherapy can affect these cells, too, which can cause side effects.

Side effects vary based on medication type and amount, and the overall health of the patient. Significant fatigue is one of the most common side effects, usually experienced during the first week of each cycle. Other side effects include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Numbness or weakness in finger and/or toes (neuropathy)
• Increased chance of infections
• Easy bruising or bleeding

Talk to your doctor about ways to manage any side effects you're experiencing. Most of these side effects go away after chemotherapy is completed.

Chemotherapy can reduce your white blood cell count and put you at higher risk for infection. Therefore, it's important to report a fever to your doctor right away. Other serious side effects, such as not being able to keep food or drinks down, should also be reported to doctors so they can be addressed immediately.