Prostate cancer: chemotherapy

Chemotherapy is the use of cancer-killing drugs, either alone or in combination. It is prescribed in cases of recurrent or advanced prostate cancer that has not responded to hormone treatment. Chemotherapy is not used to treat early-stage disease.

The drugs are given in cycles of treatment followed by a recovery period. The full treatment generally lasts three to six months, depending on the type of chemotherapy medications used.

How is chemotherapy given?

Chemotherapy drugs are usually given intravenously (directly into the vein), although there is a growing trend towards oral treatments. Once the drugs enter the bloodstream, they travel to all parts of the body to reach cancer cells that may have spread beyond the prostate.

When is chemotherapy given?

Chemotherapy may be prescribed for advanced prostate cancer that has not responded to hormone treatment. It may also be used for metastatic disease (disease that has spread). Metastatic disease may be present at diagnosis, or in some cases the cancer can return far from its original location months or years after initial treatment.

The aim of chemotherapy is that the cancer should shrink and, hopefully, disappear. Even if the cancer does not disappear, symptoms may be relieved.

What are the side effects?

Because chemotherapy works by eliminating rapidly dividing cancer cells, it also kills other rapidly dividing healthy cells in the body such as the membranes lining the mouth, the lining of the gastrointestinal tract, hair follicles and bone marrow. As a result the side effects of chemotherapy relate to these areas of damaged cells. The good news is that the damaged non-cancerous cells will be replaced with healthy cells, so the side effects are only temporary.

The specific side effects depend on the type and amount of medicines you are given, and how long you are taking them. The most common, temporary side effects of chemotherapy include:

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Diarrhoea
• Infertility (a potential permanent side effect of chemotherapy)

Other side effects associated with chemotherapy's impact on bone marrow include increased risk of infection (due to low white blood-cell counts), bleeding or bruising from minor injuries (due to low blood platelet counts) and anaemia-related fatigue (due to low red blood-cell counts).

Some medications help to control certain side effects such as nausea and vomiting or diarrhoea. Although it may take some time, side effects related to chemotherapy will go away once the treatments are over.

Ask your doctor for advice about specific side effects you can expect from your chemotherapy medicines. Also discuss any troubling or unmanageable side effects with your doctor.