Unlike other types of cancer, for prostate cancer chemotherapy is generally not used as a first attempt for a cure, especially when the cancer is in the early stages.
Chemotherapy is sometimes used when cancer has spread beyond the prostate gland and hormone therapies have failed to control it. Prostate cancer chemotherapy may also be used to treat pain caused by cancer that has spread to the bone.
How it works
This type of treatment involves the use of powerful and toxic drugs that kill both cancer cells and normal cells throughout the body. The reason for this is that these drugs target cells that divide quickly, like cancer cells. But there are also normal cells in the body that divide quickly.
There are several different kinds of chemotherapy drugs that are currently being used for prostate cancer. These drugs can be:
- Taken orally (pills)
- Administered into the vein (called intravenously)
- Injected into a muscle (called intramuscular)
It is not uncommon for more than one chemotherapy drug to be used in combination with others in treating prostate cancer.
More research is needed
Researchers are now conducting studies to determine if giving a man chemotherapy after radical prostatectomy will provide any benefit.
Other studies are looking at whether using chemotherapy with other prostate cancer treatments will provide additional benefits. What is needed (in our opinion), but is currently missing, is studies about whether chemotherapy could be effective earlier on in men with prostate cancer that has returned, but is believed to still be localized (such as before hormone therapy is used).
Two fairly large studies have shown that docetaxel helped extend survival in men with advanced prostate cancer.
In the first study of 770 men with metastatic, androgen-independent prostate cancer, the use of prostate cancer chemotherapy drugs docetaxel and estramustine together improved median survival in men by nearly two months, compared to men who received prednisone and the chemotherapy drug mitoxantrone.
In the second study of 1,006 men with metastatic hormone refractory prostate cancer, those men who received docetaxel plus prednisone every three weeks had superior survival compared to men who received mitoxantrone plus prednisone (18.9 months vs 16.5 months).
If docetaxel does not work, cabazitaxel is often the next choice. Cabazitaxel (brand name Jevtana) was approved in 2010 for second-line treatment of metastatic castration-resistant prostate cancer in men who were previously treated with the chemotherapy drug docetaxel (brand name Taxotere).
When used in combination with prednisone, cabazitaxel reduced the risk of death by 30% in men with metastatic castration-resistant prostate cancer. The combination of drugs also extended the median overall survival rate from 12.7 months to 15.1 months.
Just recently, researchers demonstrated that cabazitaxel was more effective against hormone-resistant, human prostate cancer cell lines in laboratory studies than docetaxel.
Potential side effects
The side effects of prostate cancer chemotherapy depend upon the drugs that are being used. And each man may react differently to chemotherapy.
If your loved one will undergo prostate cancer chemotherapy, ask his doctor about the potential side effects of the drugs that will be used.
The American Cancer Society. Prostate Cancer. http://www.cancer.org. Accessed March 17, 2015.
Bostwick DG, Crawford DE, Higano CS, Roach M, eds. American Cancer Society’s Complete Guide to Prostate Cancer. Atlanta, GA: American Cancer Society Health Promotions; 2005.
Petrylak DP, Tangen C et al. Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. NEJM. 2004;351(15):1513-1520.
Tannock IF, De Wit R et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. NEJM. 2004;351(15):1502-1512.