Treatment

Chemotherapy

Chemotherapy uses anti-cancer drugs to kill the prostate cancer cells, wherever they are in the body. Chemotherapy won’t get rid of your prostate cancer, but aims to shrink it and slow down its growth. This helps some men to live longer, and can help to control or delay symptoms such as pain.

You might be offered chemotherapy if:
• your cancer has spread from your prostate to other parts of your body (known as advanced or metastatic prostate cancer), and
• it’s not responding as well as it was to hormone therapy.

Prostate cancer is not usually treated with chemotherapy at an early stage, although some men might be offered it at an earlier stage as part of a clinical trial.

You need to be fairly fit to have chemotherapy because the side effects are sometimes hard to deal with. If your doctor thinks you might benefit from chemotherapy, they will do some tests, such as blood tests, to make sure it’s suitable for you.

There are several chemotherapy drugs that are used to treat prostate cancer, including docetaxel (Taxotere®), cabazitaxel (Jevtana®) and mitoxantrone (Novantrone®). You will also take other medicines with your chemotherapy, such as steroids to help make it more effective and lower the risk of side effects.

If you’re having hormone therapy with LHRH agonists (luteinizing hormone-releasing hormone agonists), you’ll usually keep taking it during chemotherapy, as it might still help to control your cancer. You may also have other treatments to manage any symptoms you may have, such as radiotherapy, bisphosphonates and pain-relieving drugs.

What other treatments are available?

 

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What are the advantages and disadvantages?

An advantage for one person might not be for someone else. Speak to your doctor or nurse before deciding whether to have chemotherapy – they’ll be able to help you weigh up the pros and cons.

Advantages

  • Chemotherapy might shrink the cancer or slow down its growth. This may help some men live longer.
  • It can help to control or delay symptoms such as pain, which can improve how you feel in your day-to-day life.
  • Most men are able to leave hospital on the day of their treatment – there’s usually no need to stay overnight.
  • You may have more regular check-ups, tests and support from your medical team than usual, which some men find reassuring.

Disadvantages

  • You will have hospital appointments every few weeks. This can go on for a few months.
  • Chemotherapy affects each man differently, and it may not work so well for everyone.
  • It can cause side effects which can be difficult to deal with.
  • You may also get side effects from the steroids you take with the chemotherapy.

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What does treatment involve?

Most types of chemotherapy are given as a course of up to 10 sessions (also called cycles) of treatment. There’s usually a break of three weeks between each session.

Before each treatment session begins, your doctor or nurse will check how you’re feeling and how you’re dealing with any side effects. You will also have blood tests to check:

  • that the levels of different blood cells (your blood count) are in the normal range - chemotherapy can lower your blood count which can cause side effects
  • how well your liver and kidneys are working – they are involved in how your body handles chemotherapy drugs.  

At each treatment session, the chemotherapy will be given through a drip (intravenous infusion). This usually involves running the medicine through a thin tube into a vein. Treatment usually takes about one hour and the tube will be removed before you go home.

You will have regular check-ups to check your PSA (prostate specific antigen) level, and discuss any symptoms or side effects you may have. If your PSA level falls or your symptoms improve, for example you have less pain, this usually suggests that the chemotherapy is working.

You can read more about what treatment involves in our chemotherapy fact sheet.

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What are the side effects?

As well as damaging cancer cells, chemotherapy can affect some healthy cells, and this can cause side effects. The side effects will affect each man differently, and you may not get all of them. Most of them are temporary and will gradually go away after you finish treatment.

The most common side effects are listed below. Each type of chemotherapy can cause its own particular side effects – so ask your doctor or nurse about the possible side effects of the type you’re having.

  • A higher risk of infection
  • Feeling breathless, tired or weak
  • Bleeding and bruising more easily
  • Extreme tiredness (fatigue)
  • Feeling and being sick (nausea and vomiting)
  • Loss of appetite
  • Sore mouth
  • Bowel problems, such as loose and watery stools (diarrhoea), or difficulty emptying your bowels (constipation)
  • Hair loss
  • Fluid retention, which can cause your ankles or legs to swell, or make you feel a bit bloated
  • Numbness or tingling in the hands and feet (peripheral neuropathy)
  • Nail changes  – your finger nails and toe nails grow more slowly, or become hard, brittle or flaky
  • Watery eyes
  • Changes to your mood – some people say they feel down at certain times during their chemotherapy

It’s important to tell your doctor or nurse if you get any of these side effects. You can read more about side effects and ways to manage them in our chemotherapy fact sheet.

Signs of infection
Contact the hospital immediately if you get any signs of infection. These include a fever (high temperature), sweating, chills and shivering, or a sore throat.

In general it’s safe to be around other people when you’re having chemotherapy, including children and pregnant women. But you should try to avoid crowded places and contact with people who have an infection, to keep the chances of getting an infection down.

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Questions to ask your doctor or nurse

  • How can chemotherapy help?
  • Which chemotherapy would be most suitable for me?
  • How long will the treatment last? How many sessions will I need?
  • Are there any activities I should avoid between sessions, such as driving or swimming?
  • What are the possible side effects of chemotherapy, and how long will they last?
  • Can I stop the treatment if I find the side effects difficult to deal with?
  • Who should I contact if I have any questions at any point during my treatment? How do I contact them?
  • Who will I see after my treatment finishes, and how often will I have check-ups?
  • Will having chemotherapy affect my treatment options later on?
  • What happens if chemotherapy doesn’t work? Are there other treatments I can have?
  • Are there any other treatments available to me?
  • Are there any clinical trials I can take part in?

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References

You can find a list of references used to produce this page in our online fact sheet.

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