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(A-Z listing includes diseases, conditions, tests and procedures)

Prostate Cancer: Chemotherapy

What is chemotherapy?

Chemotherapy refers to any type of therapy that uses chemicals to kill or halt the growth of cancer cells. The drugs work in various ways but are all based on the same simple principle: stop the cells from dividing and you stop the growth and spread of the tumor.

Until recently, chemotherapy was used only to relieve symptoms associated with very advanced or metastatic disease. But studies now show that docetaxel (Taxotere) can prolong the lives of men with prostate cancer that no longer responds to hormone therapy. Consequently, doctors are increasingly recognizing the potential benefits of chemotherapy for their patients with prostate cancer.

Dozens of clinical trials are underway to identify chemotherapy regimens that are more tolerable and more effective at different stages of the disease. Some trials seek to improve upon the results with docetaxel by adding it to other novel agents and testing the combination.

How is chemotherapy given for prostate cancer?

Most people have chemotherapy as outpatients at hospitals or clinics. You will likely not need to stay overnight. Chemotherapy is given in cycles that last a few weeks. You will be given the medicines with rest periods in between. This is to help let your body recover.

There are many different kinds of chemotherapy medicines. You will likely only be given one medicine for your treatment. Each medicine works in a different way. Some are given by mouth as pills. Other types of medicines are given in a vein through an IV.

What types of medicines are used to treat prostate cancer?

The most common medicine used is docetaxel. It is usually given with prednisone. This is a steroid medicine.

What are common side effects of chemotherapy?

All chemotherapy drugs work in slightly different ways, so it’s hard to predict the side effects. There are a few rules of thumb to consider:

  • Ignore what others have said about their reactions to the different drugs. Dosage, drug combinations and the response to the drugs might be completely different. No two people will react to drugs the same way, especially for different types of cancers.

  • Pay close attention to expected and unexpected reactions to the drugs. Your medical team will describe what to look out for in general, but you could always experience something they didn’t anticipate, and it’s good to be extra cautious.

  • Don’t be “macho.” There are plenty of drugs to help ward off or treat different side effects, including nausea/vomiting, sleep problems and general exhaustion. All treatments work best when the body is at its strongest.

  • Relax. Chemotherapy drugs are powerful and can take a toll on the body. Focus on getting well by finding ways to alleviate stress: listening to music, doing yoga or stretching exercises, taking walks or watching TV.

Talk with your healthcare providers about any side effects you have. They may be able to help lessen them. 

About Docetaxel (Taxotere)

Docetaxel, the most common chemotherapy drug, is actually very well tolerated. Many men are pleasantly surprised at the improvements in many disease-related symptoms — pain, fatigue, loss of energy — after starting this therapy.

Docetaxel does have some side effects. About 3 percent of men experience a fever with a low white blood cell count that requires medical attention. This can be prevented by using white blood cell growth factors (Neulasta), although infection remains a slight but serious risk.

About 50 percent of men will experience significant fatigue at some point in their therapy, usually for the first week of each cycle. About one third of men will experience numbness or weakness in their toes or fingers that interferes with function (neuropathy). This is best handled by prevention, so you must tell your doctor if you are experiencing these symptoms.

Other docetaxel side effects include:

  • Low platelets that can result in bleeding (1%)

  • Anemia (5%)

  • Reduced heart function (10%)

  • Hair loss (65%)

  • Diarrhea (32%)

  • Nail changes (30%)

  • Loss of appetite (20%)

  • Shortness of breath (15%)

  • Fluid retention (10% to 20%)

Many of these effects are mild and reversible or treatable.

Working with your healthcare provider

It's important to know which medicines you're taking. Write your medicines down, and ask your healthcare team how they work and what side effects they might have.

Talk with your healthcare providers about what signs to look for and when to call them. For example, chemotherapy can make you more likely to get infections.  Make sure you know what number to call with questions. Is there a different number for evenings and weekends?

 It may be helpful to keep a diary of your side effects. Write down physical, thinking, and emotional changes. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your healthcare team to make a plan to manage your side effects.

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