Chemotherapy’s Role In Treating Advanced Prostate Cancer

Advanced prostate cancer is usually treated with a combination of different approaches, which may include hormone therapy, chemotherapy, immunotherapy, or radiation. Some patients, even with advanced disease, may be offered surgery to remove the prostate if their cancer’s spread is still limited to the lymph nodes, and there is no evidence of spread to other parts of the body.

Metastatic prostate cancer is not considered curable, but treatment can often control the disease for prolonged periods of time.

When To Use Chemotherapy

Some men are diagnosed with advanced prostate cancer from the beginning, while others develop advanced disease after they were originally diagnosed and treated for cancer that was local, or restricted to the prostate.  While chemotherapy can play a key role in managing advanced prostate cancer, the best time to use the approach can vary a great deal from patient to patient.

Treatment often starts with medications to lower testosterone, also known as androgen deprivation therapy (ADT) or hormone therapy, as soon as advanced disease is diagnosed. The aim is to slow cancer growth and, in some cases, extend life. Chemotherapy may be used in combination with hormone therapy or other approaches.

Because each person’s cancer, health, and priorities are unique, the best approach is the one that fits your goals and risk tolerance, which is why it’s critical to discuss the potential benefits, side effects, and monitoring plan with your care team so you can decide together when to begin.

Managing Chemotherapy Side Effects

Many people facing cancer are wary of going on chemotherapy due to its reputation for causing difficult side effects, like nausea, hair loss, and more.

As opposed to many other chemotherapies widely known for the treatment of diseases like breast or lung cancer, the chemotherapy used for prostate cancer tends to be more tolerable, Dr. Narayan says.

“We certainly have patients even in the older ages, seventies and even eighties, who we successfully give chemotherapy to with prostate cancer,’’ explains Dr. Narayan.

“Even though these chemotherapies can be better tolerated than some others, they do come with potential side effects that need to be very carefully thought about,” he adds.

Side effects of chemotherapy might include:

• Fatigue
• Hair Loss
• Loss of appetite
• Nausea and vomiting
• Diarrhea
• Increased risk of infections

“There has to be a fair degree of motivation or acceptance of that trade off understanding that yes, this is something that may help, but at the same time may come with these potentially bothersome side effects,” Dr. Narayan explains. “And that calculus or that decision-making can vary quite considerably from person to person.”

Questions To Ask Your Doctor

• What are the potential benefits of adding chemotherapy to my treatment plan?
• What are the risks?
• What measures can we take to help with side effects?
• What if we need to change my treatment plan?
• If the disease still progresses, what are the next steps?

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