But chemotherapy (chemo) has changed a lot over the years and doesn’t affect everyone the same way, so it’s important not to jump too far ahead. Your doctor, nurse or care team will best be able to prepare you for your exact treatment plan.
Below, we’ll provide some basic information to help you understand chemo better and how to manage side effects. This can be a stressful and uncertain time, so it’s important that you get all the information you need to make the best decisions for you.
Chemo works by using anti-cancer drugs to kill cancer cells or stop them from growing and dividing. Chemo can slow down the growth of prostate cancer or delay symptoms, but it cannot cure cancer.
While chemo may be given in different ways for different forms of cancer, in prostate cancer treatment it is given through an intravenous (IV) tube placed into a vein using a needle.
Before deciding to have chemo, carefully consider your options and talk to your doctor, nurse, care team and your family.
If you have advanced (or metastatic) prostate cancer, you might have chemo as your first phase of treatment. It can also be given at the same time as hormone therapy or after your hormone therapy stops working (for castration-resistant prostate cancer).
If you decide to have chemo, you'll likely be referred to a medical oncologist (although you may already have one). Sometimes, your urologist can also supervise your chemotherapy.
The chemo is given in sessions (also called ‘cycles’) that are usually 3 weeks long. You’ll receive the treatment on the first day of the session and then there will be a rest period to allow your body to recover from the effects of the drug. Each session includes time for treatment and time for rest. The exact number of sessions you’ll have will really depend on a number of factors, including how well the chemo is working and the side effects.
Your doctor or nurse will discuss your treatment plan with you and explain what to expect in your sessions.
the type of chemo you’ll have
what the treatment will involve
the usual number of treatment sessions (cycles)
the length of each session (cycle)
side effects you might experience
the tests you’ll need before, during and after treatment
This is all to make sure you understand your customised plan, what to expect, and how to manage any side effects.
Your doctor will monitor you after each cycle. You may also be given steroid tablets to take alongside chemotherapy, which can cause additional side effects. Your doctor will give you more information about these tablets.
Each chemo infusion usually takes about an hour but the visit to the chemotherapy treatment area will be longer as the nurses will ensure they do a full assessment and make sure that everything is okay before you leave. It does not require an overnight stay. You can probably head straight back home, depending on how your body reacts to treatment and what your care team advises.
There are different chemo drugs used to treat prostate cancer.
Click on the drug names below to learn more.
Docetaxel is a very commonly used chemotherapy drug for advanced prostate cancer. It can be combined with hormone therapy for men who have just been diagnosed with advanced prostate cancer that is hormone sensitive, and sometimes for locally advanced prostate cancer. It can also be used for men who have cancer that has stopped responding to hormone therapy, also known as castrate-resistant prostate cancer. It is usually given as an injection into your veins every 3 weeks and is typically well-tolerated. Some men see an improvement in symptoms while on treatment. It has also been shown to make some men live longer.
While on docetaxel, it’s very important to closely monitor for signs of infection as your white blood cell count may go low. Some men experience a lowered count during treatment, which may need medical attention.
You might be offered cabazitaxel if you have advanced prostate cancer that has stopped responding to hormone therapy and you've already had docetaxel.
Cabazitaxel is typically used as a second defence after docetaxel has been tried but cancer has continued to progress. As with docetaxel, cabazitaxel cannot cure prostate cancer but can help prolong life and reduce symptoms. It's also usually given as an injection in your veins, every 3 weeks.
Mitoxantrone is a chemotherapy drug to treat advanced prostate cancer that has stopped responding to hormone therapy. It’s rarely used now. However, it may be offered if your doctor thinks you may not tolerate the side effects of docetaxel well. Your doctor will make that judgement based on your level of fitness and any other health issues you may have.