Prostate cancer treatment -Chemotherapy

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Chemotherapy for prostate cancer

Chemotherapy consists of a class of cytotoxic (cell killing) drugs that can act on cancer cells wherever they are in the body. Unlike other cancers, chemotherapy drugs used for prostate cancer may slow down the growth of the cancer, or even shrink tumours for a while, but will not eliminate prostate cancer.

It is never used for localised prostate cancer for which there are far better alternatives. It is occasionally used as an adjuvant treatment in combination with radiotherapy and hormone therapy for locally advanced prostate cancer that has spread outside the prostate gland, but its main use is in the treatment of advanced prostate cancer that has spread throughout the body. In this case it is a palliative treatment that helps to slow down cancer growth and relieve symptoms including pain. It is not a cure.

Chemotherapy is usually used in conjunction with hormone therapy for advanced disease or where hormone therapy has ceased to be effective. Its other use is to treat rare types of prostate cancer, such as small cell cancers.

Typically cancer cells divide and multiply faster than normal cells. Cytotoxic drugs attack and destroy cells that are dividing quickly, which is why they are used for the treatment of cancers.

However, there are several types of normal cell which also divide quickly, namely in the bone marrow, where new red blood cells and white blood cells used to fight infection, are made, as well as the lining of the mouth and intestines, and hair follicles. 

For this reason, chemotherapy can have unpleasant side effects, such as tiredness and extreme fatigue. Also common are hair loss, anemia, mouth sores, and nausea and vomiting. It can also leave patients vunerable to infection.

For these reasons, patients need to be relatively strong and healthy to cope with the treatment.

Patients are given antiemetic (anti sick drugs) and steroids (premisolone) to reduce the inflammatory reaction, but these drugs themselves can have unpleasant side effects.

Cytotoxic drugs used to treat advanced prostate cancer

There are two main chemotherapy drugs that are used to treat prostate cancer, docetaxel and cabazitaxel.

Docetaxel is the most commonly used drug used in the UK. It is often used in conjunction with hormone therapy, or as an alternative if hormone therapy has stopped being effective.

Cabazitaxel is used as a second line chemotherapy, for those who have had (finished a course of ?) docetaxel, or when hormone therapy has stopped being effective.

NEEDS WORK ON NEWER DRUGS INCLUDING OLAPARIB and enzalutamide, developed by Astellas under the commercial name Xtandi, without having to go through chemotherapy first. The drug, which the Institute of Cancer Research in the UK and The Royal Marsden helped to develop, has proven benefits for extending life and improving quality of life.

However, NICE rejected a push from Johnson & Johnson to extend patient access to abiraterone, which treats prostate cancer, because it was not deemed to be cost effective to use in patients who have not yet undergone chemotherapy.

Where to access Chemotherapy

If you are already undergoing treatment for prostate cancer, which will certainly be the case if Chemotherapy is an option, then you will know Just about all NHS Trusts throughout the country are  equiped to provide Chemotherapy .

It is certain your Consultant Oncologist at the hospital where you are being treated will have a Chemotherapy service capability.

Private treatment

Chemotherapy is available from the private wings some large NHS teaching hospitals and a few large private hospitals.

Further, there are private cancer centres run by Genesis Care (formerly Cancer UK) in conjunction with regional private hospitals who provide private cancer treatment.

The website page Where to access private non surgical Prostate cancer treatments provides information on these centres and the Consultant Oncologists who practice at them who use chemotherapy for prostate cancer.

You can click the button below to access the page.