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What is chemotherapy?

Chemotherapy involves a variety of anti-cancer medications that destroy cancer cells to shrink or slow the growth of your cancer.

Chemotherapy can help extend your life expectancy, improve your quality of life and prevent or reduce the pain from your cancer, but how well chemotherapy controls the cancer is different from one person to another. It depends on how aggressive your cancer is and how far the cancer has spread when you start chemotherapy.

Don’t be alarmed – modern chemotherapy comes with less severe side effects, is less toxic and is more efficient than chemotherapy of the past

In the past, side effects were a big concern for men having chemotherapy. With modern chemotherapy these effects are less severe, and the medications are less toxic and more effective. Also, supportive medications, such as ones to relieve nausea have also improved.

However, the decision to have chemotherapy needs to be discussed between yourself, your medical oncologist and your healthcare team. The decision will be based on the benefits versus the potential side effects and whether it is the best option for you.

The aim of this section of your toolkit is to explain what chemotherapy is, who it is for and what is involved.

Who can have chemotherapy?

Chemotherapy may be recommended to you if:

  • You have been on hormone therapy, but your cancer has become resistant to the hormones and has continued to spread and cause symptoms
  • You have advanced prostate cancer, and the cancer had already spread (metastasised) when you were first diagnosed – in this situation, chemotherapy will usually be given with hormone therapy injections

It is important to remember that although chemotherapy can be a good treatment for advanced prostate cancer, it is not suitable for everyone. Ask your medical oncologist plenty of questions so you can understand chemotherapy and whether it is appropriate for you.

What does having chemotherapy involve?

You’ll usually have chemotherapy as an outpatient in a hospital or cancer centre, which means you don’t have to stay overnight. You will visit the hospital or centre regularly for safety checks and to have treatment.

How often will I need to have treatment?

It’s likely that you’ll need to attend the hospital or cancer centre every 3 weeks for each cycle of treatment, although this may change depending on how well you are managing with your treatments.

The number of chemotherapy cycles varies from person to person, and it’s hard to predict how many you will need. Most men receive between 4 and 10 cycles of chemotherapy but may have more if required. If you are newly diagnosed, fit and in good health you may be given fewer cycles of chemotherapy in combination with hormone therapy.

Usually, chemotherapy is continued if you are managing the side effects, and if the treatment is having the desired effect of controlling your cancer and keeping you well.

Sometimes the treatment is stopped because you have already achieved as much benefit as can be expected. In that situation, your cancer might be observed to see if it changes or spreads. In many cases your cancer might not grow again for some time. Your medical oncologist will discuss all of this with you before and during your treatment.

What to expect before each treatment

Before you have each chemotherapy treatment, you will need to have a blood test to check your levels of different types of blood cells (such as red and white blood cells and platelets) called a blood cell count. This is important because chemotherapy can cause the levels of these blood cells to drop, increasing your risk of anaemia and infections. If your blood cell count is low, you may not be able to have your treatment as planned.

You will also have blood tests to check how well your liver and kidneys are working.

Your treating centre will provide you with a pathology request form and further instructions on where to go for your blood tests.

What happens during each treatment?

Chemotherapy is given slowly by an intravenous drip into a vein in your arm. This allows the chemotherapy medications to go into your bloodstream and to move through your body to attack any cancer cells wherever they are. You will sit on a comfortable chair while the medication is being administered.

Your doctor or nurse will check on you regularly to see how you are feeling. The nurse may provide cooling for your scalp, feet and hands to slow the circulation of the chemotherapy drug and minimise side effects in these areas.

Your healthcare team will help you manage any side effects during treatment.

What chemotherapy medications will you be given?

Your chemotherapy treatment will be managed by your medical oncologist and an oncology nurse. They will talk to you about the different chemotherapy drugs that are available, which medication is best for you, your treatment plan, and how to manage any side effects.

There are two types of chemotherapy drugs commonly used:

  • Docetaxel – this is the first-line chemotherapy medication
  • Cabazitaxel – this may be used if Docetaxel and hormone therapy have stopped working

You may also be given corticosteroid medications (anti-inflammatories) to help reduce the side effects of chemotherapy.

More information on medications used in chemotherapy can be found on the eviQ website.

How will your specialist know if the chemotherapy is working?

During your treatment cycle, your medical oncologist can find out how your cancer is responding to the chemotherapy medications in different ways:

  • If a cancer is visible or can be palpated (felt under touch) – your doctor will be able to tell if it’s responding to chemotherapy by doing a physical examination
  • If the cancer can be seen on a scan (imaging test) – you may have a scan periodically to see if your cancer is getting smaller

What are the side effects with chemotherapy?

All treatments for prostate cancer have side effects. Chemotherapy is well-known for having severe side effects because it can damage some of the healthy cells in your body. Healthy cells in certain parts of the body, such as your bone marrow (which makes blood cells) and your digestive system, are especially sensitive to chemotherapy medications. This is why certain side effects, such as the risk of infection or feeling sick, are more common.

The side effects have lessened with better chemotherapy medications and can often be well managed. Also, most will go away when treatment is completed.

Chemotherapy affects different people differently, so it’s difficult to know what side effects you will get or how serious they might be. Follow the link to side effects to learn more.

Looking after yourself before, during and after chemotherapy

You can download a copy of My Wellbeing Plan to keep track of your appointments, test results and ongoing care information

It is important to look after yourself before, during and after chemotherapy.

Follow the links for more information:

Health & Wellbeing provides general tips and information on keeping yourself healthy.

Recovery & Rehabilitation for general recovery after diagnosis, testing and treatment.

Pre- & Rehabilitation will give you specific advice for before and after treatment.

If you are feeling distressed call a PCFA Nurse on 1800 22 00 99 or if you need urgent help, call Lifeline on 13 11 44 or Beyond Blue on 1300 22 46 36

Also, reach out to your partner, friends and family or talk to your doctor or a PCFA nurse for more support. They can connect you with support groups, other health professionals and/or resources for you and your family and friends.

Key points

  • Chemotherapy involves anti-cancer medications that shrink or slow cancer growth
  • Newer chemotherapy medications have less severe side effects, are more effective and less toxic than older chemotherapy medications
  • Chemotherapy may be recommended if hormone therapy has failed or if you have advanced cancer and your cancer had already spread when you were diagnosed
  • Chemotherapy may be given with hormone therapy and/or corticosteroids
  • You will usually have multiple cycles of treatments as an outpatient, depending on your personal circumstances and health
  • The medications used in your chemotherapy will be prescribed by your medical oncologist
  • Scans or physical examinations may be done to check the progress of your chemotherapy
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