Chemotherapy involves taking drugs that kill cancer cells or prevent them from multiplying. It is usually administered via intravenous lines and/or orally and is reserved for men who have stage III or IV cancers, cancer that reappears despite surgery, cancer that has spread beyond the prostate, or for men who no longer respond to hormone therapy. This latter type of cancer is often referred to as hormone resistant or hormone refractory prostate cancer. If any of these situations describe you, it is time for you and your doctor and a medical oncologist to talk about chemotherapy.
Different types of chemotherapy drugs can be effective at different times during the growth cycle of cancer cells, which is why physicians often prescribe a combination of drugs and/or try a variety of doses to find the treatment that is most effective and least toxic. The hope when taking chemotherapy drugs is that they will shrink the cancer and make it disappear, or at the very least, relieve symptoms.
Because chemotherapy rapidly kills dividing cancer cells, it also kills other rapidly dividing healthy cells, such as the membranes that line the mouth, the lining of the gastrointestinal tract, bone marrow, and hair follicles. Therefore the side effects associated with chemotherapy can be nasty, although they are mostly temporary and can vary, depending on which drug is used.
Drugs to Treat Prostate Cancer
A number of drugs are available to treat prostate cancer. Some are more effective at relieving symptoms and decreasing the PSA level than others, but thus far none have demonstrated the ability to destroy all the prostate cancer cells in a man’s body. Chemotherapy is often used to treat hormone resistant prostate cancer. Here are the more common chemotherapy drugs for prostate cancer. They are often combined with other cancer drugs, such as 5-fluorouacil or corticosteroids.
- Doxetaxel (Taxotere) is given intravenously and is often used along with other drugs. It is one of the main drugs used to treat prostate cancer, including hormone-refractory cancer.
- Cabazitaxel (Jevtana) is an injectable drug used along with prednisone for hormone resistant prostate cancer and cancer that has not responded to docetaxel.
- Mitoxantrone (Novantrone) is used along with corticosteroids for men with pain related to advanced hormone-refractory prostate cancer
- Estramustine (Emcyt), taken orally and may be taken with other cancer drugs
- Paclitaxel (Taxol), given intravenously
- Etoposide (Vepsid, V-16), given intravenously and orally and used in combination with other cancer drugs
- Doxorubicin (Adriamycin) is an antibiotic that is taken intravenously. It has been linked with heart damage.
- Vinblastine (Velban), taken intravenously and often with other cancer drugs
Side Effects of Chemotherapy
The most common side effects associated with chemotherapy for prostate cancer are:
- Erectile Dysfunction
- Black, tarry stools
- Bleeding gums
- Chest pain
- Hair loss
- Nausea and vomiting
- Painful or difficult urination
- Shortness of breath
- Sore throat
- Sores, ulcers on the lips or in the mouth
- Swollen glands
- Unusual bleeding or bruising
- Unusual weakness or tiredness
Less common or rare side effects include:
- Blurry vision
- Difficulty swallowing
- Difficulty walking (rare)
- Dizziness or lightheadedness
- Loss of consciousness (rare)
- Numbness or tingling in the fingers or toes
- Pain in the lower back or side accompanied by fever or chills
- Rapid or slow heartbeat
- Swelling of the eyelids
- Swelling of the tongue or face (rare)
- Tightness in the chest