Chemotherapy uses anti-cancer medicines to destroy cancer cells. It can be used for some people with prostate cancer, particularly when the cancer has spread beyond the prostate or when there is a higher risk of the cancer progressing.
Chemotherapy is usually given alongside other prostate cancer treatments rather than being considered in isolation. Whether it is suitable depends on the stage and characteristics of your cancer, your general health and treatments you have already received.
Read NHS information about prostate cancer treatment.
Docetaxel chemotherapy
Docetaxel is the chemotherapy medicine most commonly used for prostate cancer. It is given into a vein as an intravenous infusion, usually in treatment cycles with rest periods between them.
Medicines such as steroids may also be given alongside docetaxel. Your oncology team will explain the treatment schedule that applies to you.
When may chemotherapy be offered?
Newly diagnosed metastatic prostate cancer
For some people whose prostate cancer has already spread to other parts of the body when they are diagnosed, docetaxel may be offered early in treatment alongside androgen deprivation therapy (hormone therapy). Other medicines may also form part of the treatment plan depending on individual circumstances and current guidance.
High-risk non-metastatic prostate cancer
NICE recommends discussing docetaxel with some people who have newly diagnosed high-risk prostate cancer that has not spread to distant parts of the body, when they are starting long-term hormone therapy and are well enough for chemotherapy. The potential benefits and harms should be considered together with the specialist team.
Cancer that progresses despite hormone therapy
Chemotherapy can also be used when prostate cancer begins to grow despite testosterone being kept at a very low level. This is known as castration-resistant prostate cancer. The most appropriate treatment depends on what treatments you have already had and the characteristics of your cancer.
Read NICE recommendations on prostate cancer treatment.
Possible side effects
Chemotherapy affects healthy cells as well as cancer cells, so it can cause side effects. These vary from person to person and your oncology team will monitor you during treatment.
Possible side effects of docetaxel include:
- tiredness and weakness
- an increased risk of infection because of a reduced number of white blood cells
- bruising or bleeding more easily
- feeling or being sick
- diarrhoea
- hair loss
- numbness or tingling in the hands or feet
- changes to the nails
Your team can provide medicines and advice to help prevent or manage many of these effects.
Infection during chemotherapy
Chemotherapy can temporarily reduce your ability to fight infection. Your treatment team will tell you which symptoms require urgent attention and provide a 24-hour contact number. Follow their instructions immediately if you develop a fever, feel suddenly unwell or have other signs of infection during treatment.
Monitoring treatment
You will have blood tests before and during chemotherapy to check that it is safe to continue treatment. Your specialist team will also monitor how the cancer is responding, which may include PSA tests, scans and assessment of your symptoms.
Questions to ask your specialist
- Why are you recommending chemotherapy for me?
- What benefits might it provide in my situation?
- How many treatment cycles am I likely to have?
- What side effects should I look out for?
- Who should I contact if I feel unwell between treatments?
- What other treatments will I have alongside chemotherapy?
This information provides a general introduction to chemotherapy for prostate cancer and does not replace advice from your oncologist or specialist cancer team.