Chemotherapy for prostate cancer is a type of treatment that uses medications that are either injected or swallowed in pill form to kill prostate cancer. Chemotherapy is effective against advanced cancers, which have spread to distant parts of the body, because the drugs travel in the bloodstream and move throughout the body.
Chemotherapy drugs interfere with a cells process of growth, division and repair. Doctors will administer chemotherapy of the prostate in cycles so that the drugs can act on cells at different stages of their growth and division, thereby slowing down and controlling the growth of the prostate cancer. Chemotherapy affects both normal and cancerous cells; so many men are strongly affected by prostate cancer chemotherapy drugs. The main issue becomes whether chemotherapy’s possible benefits truly outweigh its side effects, which can be severe, and sometimes, fatal. Chemotherapy for prostate cancer may add only a few months to a man’s life span, and he may spend that time weak and nauseated.
There are about 10 different drugs that can be used for prostate cancer, but chemotherapy is generally a combination of 1 to 2 drugs at a time. Oncologists may prescribe pills along with intravenous injection for chemotherapy, and prostate cancer patients are sometimes able to participate in clinical trials of drugs that are still in the testing stage. Sometimes these experimental drugs have no effect at all on prostate cancer, but occasionally, they provide good results.
Advantages of Chemotherapy for Prostate Cancer
Chemotherapy alone is not a viable treatment for prostate cancer, although for other types of cancer is it routinely used as a main treatment. However, there is abundant evidence that several classes of chemotherapy can kill prostate cancer cells and provide a reasonable chance of decreasing cancer-related effects for men with prostate cancer. Chemotherapy may offer the following advantages:
- Reduced PSA
- Decreased bone pain
- Reduced soft tissue masses
- Shrinkage of tumors which have metastasized to other areas in the body
- Shrinkage of tumors that are no longer responding to hormonal therapy
- Longer survival – prolongs life by several months for those with metastatic disease
Good Candidates for Prostate Cancer Chemotherapy
Since prostate cancer does not respond to chemotherapy in the same way that other cancers do, it is generally not considered an appropriate treatment for men with low grade cancer or cancer that is still contained within in the prostate. Although chemotherapy cannot cure prostate cancer, chemotherapy can prolong life for a few months and alleviate bone pain, and is usually reserved for men with metastasized or advanced cancer or high-risk cancer which failed to respond positively to treatments intended to cure, such as radiation and hormone therapies.
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Likely Candidates for Chemotherapy |
Unlikely Candidates for Chemotherapy |
Men with:
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Men with:
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The side effects of chemotherapy for prostate cancer
The potential complications or side effects of chemotherapy for prostate cancer can vary, depending upon the drug and the person. Chemotherapy drugs vary widely in their characteristics and makeup, how they are given, their effectiveness in treating specific forms of cancer and in their side effects, and at the same time, reactions to prostate cancer chemotherapy can range from minimal to severe to fatal.
Prostate cancer chemotherapy drugs destroy fast dividing cells, which are characteristic of cancerous cells, but other normal cells in the body divide rapidly too, such as bone marrow cells, and cells in the digestive tract, the reproductive system, and in hair follicles. These normal, fast diving cells are sometimes be affected by chemotherapy, and prostate cancer patients experience side effects such as nausea, diarrhea and vomiting.
However, many men are able to go through their treatment cycle without experiencing severe side effects from the chemotherapy, and prostate cancer patients often find that their side effects stop when their treatment stops. Doctors usually can provide remedies to many of the temporary side effects from chemotherapy, and prostate cancer patients are given drugs that can prevent or reduce nausea and vomiting, or drugs that boost blood cell counts.
Prostate Cancer Chemotherapy Drugs and their Potential Side Effects
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Drug Name |
Dosage/Frequency |
Potential Side Effects |
| carboplatin (Paraplatin) |
Intravenously alone or in combination with VP-16 | Decrease in white blood cells(which fight infection), nausea, vomiting, diarrhea or constipation, loss of appetite, numbness or tingling in hands or feet, tiredness |
| cyclophosphamide (Cytoxan) |
Taken orally for 21 out of 28 days | Nausea, vomiting, decrease in white blood cells |
| docetaxel (Taxotere) |
Intravenously every week or every 3 weeks, in combination with either estramustine taken by the mouth twice a day | Decrease in white blood cells, fatigue, nausea, diarrhea, numbness or tingling in hands or feet, nail changes, fluid retention, constipation, hair loss |
| doxorubicin (Adriamcin) |
Intravenously on days 1 and 8 | Heart muscle damage, decrease in white blood cells, fevers |
| epirubicin (Ellence) |
Intravenously for 3 weeks | Decrease in white blood cells, heart muscle damage, inflammation of mucus membrane in the mouth and throat |
| etoposide, VP-16 (VePesid) |
Intravenously in combination with either estramustine or carboplatin | Fatigue, decrease in white blood cells, fevers |
| estramustine (Emcyt) |
3 oral doses a day | Nausea, vomiting, blood clots in the legs |
| miloxantrone (Novantrone) |
Intravenously in combination with prednisone (Deltasone), which is given twice a day | Decrease in white blood cells, hair loss, heart muscle damage, constipation, nausea, vomiting, diarrhea |
| paclitaxel (Taxol) |
Intravenously weekly either alone or with estramustine | Weakness, pain, numbness or tingling in hands or feet, , nausea, vomiting, diarrhea, hair loss |
| vinblastine (Velban) |
Intravenously weekly either alone or with daily etramustine | Weakness, pain, numbness or tingling in hands or feet, decrease in white blood cells, nausea, diarrhea |
| vinorelbino (velban) |
Intravenously once a week either alone or with daily estramustine | Decrease in white blood cells, , nausea, vomiting, diarrhea or constipation, loss of appetite, mouth sores |
Doctors often turn to chemotherapy for prostate cancer to try to slow and control its growth, especially after other treatments have been attempted with no success, however most doctors agree that chemotherapy is not a long-term option. How long and how well the drugs will slow the growth prostate cancer is unpredictable. At best, chemotherapy can help for about 20% to 40% of the men who receive it. But for men with metastatic prostate cancer, chemotherapy can provide them with relief from the effects of the disease, and prolong their lives for several months.
If you are considering chemotherapy for your prostate cancer, you should discuss with your oncologist how often and how long you will need to receive treatments, its side effects, and how will your doctor assess how well the treatment are working. Also if you have to travel or have other plans that would conflict with your treatment schedule, ask your doctor if the prostate cancer chemotherapy can be interrupted temporarily.
