Chemotherapy for prostate cancer: what makes it so effective?

In the below article, Dr Aspasia Soultati, an esteemed consultant medical oncologist, talks about various cancer treatment developments that have been made in recent years, and explains in expert detail why chemotherapy is the most effective treatment option for patients who have been diagnosed with prostate cancer.

Can you detail what developments have been made in relation to cancer treatment, and how this has influenced patient cancer care?

Recent developments in the field of cancer care have enabled a more personalised approach when it comes to the delivery of cancer treatment. The use of early second-generation hormones and/or chemotherapy, the use of PARP inhibitors or Lutetium PSMA-targeted treatments has had an immensely positive impact on cancer patients’ survival, with the majority of our patients having the possibility to enjoy years of good quality of life with minimal symptoms.

Is chemotherapy used for all stages of prostate cancer?

Despite years of research on prostate cancer, chemotherapy still remains one of the most effective tried and tested treatment options for the most common cancer amongst men. In recent years, the role of chemotherapy has expanded to include not only patients in the late stage of their cancer when the cancer has become refractory to the hormonal treatment, but also as upfront treatment for all newly diagnosed metastatic patients.

What makes chemotherapy the best treatment for a patient with prostate cancer?

Multiple studies have demonstrated the benefit of chemotherapy for metastatic patients who are still hormone sensitive, increasing the patient’s survival. Chemotherapy has the unique ability to kill cancerous cells, thus stopping the growth of cancer either in the prostate gland, in the bone, or lymph node metastasis.

As a result of the tumour shrinkage, the numerous cancer-related symptoms are greatly reduced, and overall quality of life is improved. Not only that, but the survival of the patient is also prolonged.

What are the most effective alternative treatments?

Chemotherapy is used sequentially with multiple other treatments for prostate cancer. The main alternative treatments include second-generation hormones, various bone-targeted treatments, as well as radiotherapy.

How many sessions of chemotherapy are needed to treat prostate cancer?

Chemotherapy is delivered in the hospital where the patient needs to attend every few weeks for a few hours. These sessions do not require the patient to stay in the hospital overnight. We usually recommend between six to 10 chemotherapy sessions, depending, of course, on the stage of the disease. We monitor the patients’ prostate-specific antigen to assess for response and also organise scans every three months to verify the shrinkage of the tumours.

What are the two most commonly used types of chemotherapy?

The two most commonly used types of chemotherapy are docetaxel and cabazitaxel. They are both given alongside daily steroid tablets.

What are the main side effects of chemotherapy for prostate cancer?

Chemotherapy can have side effects that can adversely affect the patients’ quality of life. The most commonly reported side effects include fatigue, nausea, numbness in hands and feet, nail changes, joint aches, hair loss, painful mouth, diarrhoea, as well as lung inflammation (pneumonitis). It can also cause a severe infection called neutropenic sepsis, which can be life threatening.

Dr Aspasia Soultati is an exceptionally well-regarded and highly experienced Brighton-based consultant medical oncologist who specialises in numerous kinds of cancer. Book a consultation with her today by visiting her Top Doctors profile.