Chemotherapy is another treatment choice for men with metastatic CRPC (mCRPC).
What is chemotherapy?
Chemotherapy drugs slow the growth of cancer and reduce symptoms. Most of the drugs are given into the vein (intravenous, IV). Chemotherapy does not cure mCRPC. It can ease the pain from prostate cancer, shrink tumors and lower levels of PSA. Studies show that many chemotherapy drugs can affect prostate cancer.
Some, such as Docetaxel (Taxotere®, DocefrezTM) and Cabazitaxel (Jevtana®) have been shown to help men live longer. Scientists are studying other new chemotherapy drugs and mixtures of drugs.
Drugs circulate in the blood during chemotherapy. They kill any rapidly growing cells, both cancer and non-cancer cells. Often, chemotherapy is not the main therapy for prostate cancer. But it is a useful treatment for men whose cancer has spread and are still repsonding to hormone therapy (hormone sensitive).
Chemotherapy is standard for prostate cancer that has spread and is progressing despite low levels of testosterone. New data suggest that when combined with hormone therapy, it may also improve survival for men whose cancer has spread.
In 2004, two studies showed that chemotherapy could extend survival. This was in men whose mCRPC no longer responded to hormone therapy. The FDA approved Docetaxel for use with Prednisone. It is the first registered treatment for patients with mCRPC. The combination therapy has extended survival by several months.
A drug called Cabazitaxel is also approved for the treatment of mCRPC. When men who have received Docetaxel have progression of their cancer, Cabazitaxel may slow the cancer growth.
What are the benefits, risks and side effects of chemotherapy?
The decision to start chemotherapy is a difficult and personal one. It is based on:
- What other treatments or clinical trials are available.
- How well chemotherapy is likely to be tolerated.
- What other therapies have been tried.
- Whether radiation is needed to relieve pain quickly.
Often chemotherapy is given before pain starts. The goal is to prevent pain as cancer spreads to bones and other sites.
Chemotherapy may improve survival. It may prevent pain. Side effects include fatigue, nausea, vomiting and hair loss. There can be changes in your sense of taste. There may also be a decrease in blood cells. This may lead to a risk of infections. Chemotherapy drugs are monitored closely. There are medicines to lessen side effects. Most side effects stop once chemotherapy ends.
Who are good candidates for chemotherapy?
Chemotherapy is useful for men whose cancer is widespread. It can relieve symptoms. It can even prolong life for some men with advanced prostate cancer.