Chemotherapy or chemo is an option for patients whose prostate cancer has spread outside of the prostate gland and for whom hormone therapy is no longer working. It is not expected to destroy all of the cancer cells, but it may shrink the cancer or slow its growth and reduce pain.

Chemotherapy uses anti-cancer drugs that are injected into a vein, injected into a muscle, or taken by mouth. These drugs kill cancer cells, but they also damage some normal cells. The doctor must maintain a delicate balance of chemo doses, making them high enough to kill the cancer cells but not high enough to destroy too many healthy cells.

Docetaxel is a chemo drug that is used to treat prostate cancer that has returned or continued to grow and spread after treatment with hormone therapy. The National Comprehensive Cancer Network (NCCN) experts state that the first chemo regimen a patient receives should be docetaxel. Docetaxel may be combined with other drugs to reduce the chances of the cancer cells becoming resistant to chemo.

Small cell prostate carcinoma or neuroendocrine cancer is a rare type of prostate cancer that is more likely to respond to chemotherapy than to hormone therapy. Small cell carcinoma develops most often in the lungs. Because small cell lung cancer often responds to chemotherapy with cisplatin and etoposide, these drugs are recommended for treating small cell cancers that develop in the prostate.

Side Effects

The side effects of chemotherapy depend on the type of drugs, the amount taken, and the length of treatment. Temporary side effects might include nausea and vomiting, loss of appetite, hair loss, and mouth sores. Because chemo can damage the blood-producing cells of the bone marrow, patients may have low blood cell counts. This can result in an increased chance of infection (due to a shortage of white blood cells), excessive bleeding or bruising after minor cuts or injuries (due to a shortage of blood platelets), and fatigue (due to low red blood cell counts).

Most side effects disappear once treatment is stopped. There are treatments for many of the short-term chemo side effects. For example, anti-nausea drugs can be given to prevent or reduce nausea and vomiting. Other drugs can be given to boost blood cell counts.