Chemotherapy Drugs and Delivery

Prostate cancer chemotherapy are most often given one at a time. The most common drugs are:

• Docetaxel (Taxotere)
• Cabazitaxel (Jevtana)
• Mixtoxantrone (Novantrone)
• Estramustine (Emcyt)

Docetaxel is most often given first. If this drug does not work (or stops working), cabazitaxel is often next. Other treatments may be tried as well. Both of these drugs have been shown to help men live longer than older chemo drugs. Chemo is unlikely to cure prostate cancer. They may:

• Slow the cancer’s growth
• Reduce symptoms
• Lead to better quality of life

Doctors give chemo in cycles. Each cycle of treatment is followed by a rest period. This will give the body time to recover. Each cycle lasts for a few weeks.

Side Effects and Management

Chemo drugs attack cells that are dividing quickly. This targets cancer cells but can also affect healthy cells in the body as well. Cells in the bone marrow that make blood cells, the lining of the mouth and intestines, and the hair follicles are most affected. This will lead to side effects. Some common side effects can include:

• Hair loss
• Mouth sores
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Increased chance of infections (from having too few white blood cells)
• Easy bruising or bleeding (from having too few blood platelets)
• Fatigue (from having too few red blood cells)

These side effects often go away once treatment is finished. There is treatment for many of these side effects.

Some other side effects with the following chemo drugs include:

• Docetaxel and cabazitaxel sometimes cause severe allergic reactions. Medicines are given before each treatment to help prevent this. These drugs can also damage nerves. It can cause numbness, tingling, or burning sensations in the hands or feet.
• Mitoxantrone can, very rarely, cause leukemia years later.
• Estramustine carries an increased risk of blood clots.

The doses of the chemo drugs may need to be changed or treatment may need to be delayed or stopped to stop worsening.