Chemotherapy for prostate cancer

Chemotherapy is a common treatment for metastatic prostate cancer. Chemotherapy uses anti cancer drugs to destroy prostate cancer cells. The drugs circulate throughout the body in the bloodstream. The most common type of chemotherapy for prostate cancer is docetaxel. 

Metastatic prostate cancer is a cancer that began in the prostate and has spread to other parts of the body such as the bones. It is also called advanced prostate cancer.

Chemotherapy isn't a common treatment for prostate cancer that hasn't spread. But if you have a high risk of your cancer spreading, your doctor might suggest chemotherapy alongside other treatments. 

When you might have chemotherapy for prostate cancer

Chemotherapy for metastatic prostate cancer can help relieve symptoms. It can also help to control the cancer and improve your quality of life. But it can’t cure metastatic prostate cancer.

You need to be quite fit to have chemotherapy. This is because the side effects can be worse if you have other health problems. 

Chemotherapy as part of your first treatment

You might have chemotherapy alongside hormone therapy for newly diagnosed metastatic prostate cancer.  

Chemotherapy if your cancer starts to grow again

You might have chemotherapy later on for metastatic cancer. For example if your cancer no longer responds to hormone therapy. 

Chemotherapy for cancer that hasn't spread

You don't usually have chemotherapy for localised and locally advanced prostate cancer. These cancers haven't spread to other parts of your body. 

But your doctor might suggest chemotherapy if there's a high chance your cancer could spread. You have it along with other treatments.

Chemotherapy for rare types of prostate cancer

There are some rare types of prostate cancer, such as small cell prostate cancer. This is different to the most common type of prostate cancer. It can grow quickly and you often have chemotherapy as part of your treatment. You usually have chemotherapy drugs that doctors use for other small cell cancers.

Types of chemotherapy for prostate cancer

The most common types of chemotherapy treatment for prostate cancer are:

• docetaxel (Taxotere)

• cabazitaxel (Jevtana)

You usually have docetaxel first. You may have this with hormone therapy and steroids. 

And then you might have cabazitaxel if your cancer continues to grow after you've had treatment with docetaxel.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test. 

You may need:

• a blood transfusion if your red blood cells are very low
• some injections to help raise your white blood cells

Your doctors and pharmacists work out your chemotherapy dose based on your blood cell levels, and your weight, height and general health.

How you have chemotherapy

You have docetaxel and cabazitaxel directly into your bloodstream through a drip (intravenously).

Into your bloodstream

You have the treatment through a drip into your arm or hand. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

You might need a central line. This is a long plastic tube that gives the drugs into a large vein, either in your chest or through a vein in your arm. It stays in while you’re having treatment, which may be for a few months.

You usually have chemotherapy as cycles of treatment. Each cycle is usually a 3 week period. This means that you have a docetaxel or cabazitaxel drip once every 3 weeks.

You might also take a steroid tablet called prednisolone. 

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Side effects

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

Side effects depend on:

• which drugs you have

• how much of each drug you have

• how you react

Tell your treatment team about any side effects that you have.

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements
• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.