Chemotherapy for advanced prostate cancer

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. The aim of chemotherapy for advanced prostate cancer is to control the cancer. This will help to relieve symptoms and improve quality of life.

Chemotherapy is given to men when they are first diagnosed with advanced prostate cancer, together with hormonal therapy. It may also be used to treat cancer that is no longer being controlled by hormonal therapy.

Chemotherapy drugs are given into a vein (intravenously). The drugs get into the blood and can reach cancer cells all over the body.

You usually have several sessions of treatment and each session is followed by a rest period. Chemotherapy and the rest period make up a cycle of treatment. Your cancer doctor will explain how many cycles you need to treat the cancer.

Chemotherapy can cause side effects, the main ones are risk of infection, bruising and bleeding, or feeling sick. Most side effects stop or gradually get better when chemotherapy is over. Your doctor, nurse, or pharmacist may prescribe drugs to help control side effects.

Chemotherapy explained

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It is given to men when they are first diagnosed with advanced prostate cancer, together with hormonal therapy. It may also be used to treat cancer that is no longer being controlled by hormonal therapy.

The aim of chemotherapy for advanced prostate cancer is to control the cancer. This will help to relieve symptoms and improve quality of life.

The most commonly used chemotherapy drug to treat prostate cancer is docetaxel (Taxotere®). Other drugs that may be used are:


How chemotherapy is given

The chemotherapy drugs are given into a vein (intravenously). The drugs circulate in the bloodstream and reach cancer cells all over the body.

You will have the chemotherapy given through one of the following:

  • a short thin tube (cannula) that the nurse puts into a vein in your arm or hand
  • a fine tube that is put into a vein in your arm and goes up into a vein in your chest (PICC line)
  • a fine tube that goes under the skin of your chest and into a vein close by (central line).

We have more information about PICC and central lines.

Chemotherapy is usually given as several sessions of treatment. Each session is followed by a rest period of a few weeks. The rest period allows your body to recover from the side effects.

Some people are given drugs to take a day or two before treatment to reduce the risk of an allergic reaction or sickness. This depends on the type of chemotherapy you have and your nurse will go over this with you.

Chemotherapy and the rest period, together, make up a cycle of your treatment. Your cancer doctor will explain the number of cycles you need to treat the cancer. After your first cycle, you’ll have a better idea of what you can plan for and how much you may or may not be able to do.

It may take several months to complete all the cycles of your chemotherapy.

I've had the works treatment-wise - surgery, radiotherapy hormone therapy and my last one was chemo. That was after being on the hormones for 18 months. I knew it wouldn't be a cure but, so far, it's had the best effect on my PSA of all the treatments I've had.

Jim


Side effects


Risk of infection

This treatment can reduce the number of white blood cells in your blood. These cells fight infection. If the number of white blood cells is low, you are more likely to get an infection. A low white blood cell count is called neutropenia.

If you have an infection, it is important to treat it as soon as possible. Contact the hospital straight away on the 24-hour contact number you have if:

  • your temperature goes over 37.5°C (99.5°F)
  • you suddenly feel unwell, even with a normal temperature
  • you have symptoms of an infection.

Symptoms of an infection include:

  • feeling shivery
  • a sore throat
  • a cough
  • diarrhoea
  • needing to pass urine often.

It is important to follow any specific advice your cancer treatment team gives you.

The number of white blood cells will usually return to normal before your next treatment. You will have a blood test before having more treatment. If your white blood cell count is low, your doctor may delay your treatment for a short time.


Bruising and bleeding

This treatment can reduce the number of platelets in your blood. Platelets are cells that help the blood to clot. Tell your doctor if you have any bruising or bleeding that you cannot explain. This includes:

  • nosebleeds
  • bleeding gums
  • tiny red or purple spots on the skin that may look like a rash.

Some people may need a drip to give them extra platelets. This is called a platelet transfusion.


Anaemia (low number of red blood cells)

This treatment can reduce the number of red blood cells in your blood. These cells carry oxygen around the body. If the number of red blood cells is low, you may be tired and breathless. Tell your doctor or nurse if you feel like this. If you are very anaemic, you may need a drip to give you extra red blood cells. This is called a blood transfusion.


Feeling sick

You may feel sick in the first few days after this treatment. Your doctor will give you anti-sickness drugs to help prevent or control sickness. Take the drugs exactly as your nurse or pharmacist tells you. It is easier to prevent sickness than to treat it after it has started.

If you feel sick, take small sips of fluids and eat small amounts often. If you continue to feel sick, or if you vomit more than once in 24 hours, contact the hospital as soon as possible. They will give you advice and may change the anti-sickness drug to one that works better for you.


Loss of appetite

This treatment can affect your appetite. Do not worry if you do not eat much for a day or two. But if your appetite does not come back after a few days, tell your nurse or dietitian. They will give you advice. They may give you food or drink supplements.


Sore mouth

You may get a sore mouth or mouth ulcers. This can make you more likely to get a mouth infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth is sore:

  • tell your nurse or doctor – they can give you a mouthwash or medicines to help
  • try to drink plenty of fluids
  • avoid alcohol, tobacco, and foods that irritate your mouth.


Hair loss

Your hair will get thinner or you may lose all the hair from your head. You may also lose your eyelashes, eyebrows or other body hair. Hair loss usually starts after your first or second treatment.

Your nurse can talk to you about ways to cope with hair loss. There are ways to cover up hair loss if you want to. It is important to cover your head to protect your scalp when you are out in the sun.

Hair loss is almost always temporary and your hair will usually grow back after treatment ends.


Feeling tired

Feeling tired is a common side effect. It is often worse towards the end of treatment and for some weeks after it has finished. Try to pace yourself and plan your day so you have time to rest. Gentle exercise, like short walks, can give you more energy. If you feel sleepy, do not drive or operate machinery.


Diarrhoea

If you have diarrhoea, contact the hospital for advice. Try to drink at least 2 litres (3½ pints) of fluids every day. It can help to avoid alcohol, caffeine, milk products, high-fat foods and high-fibre foods.

Back to Chemotherapy explained

When is chemotherapy used?

Chemotherapy is used to kill cancer cells in the body. Your doctor will explain if chemotherapy is advised for you.

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.