Docetaxel Side Effects Prostate Cancer

What Happens Afterwards

After you finish your chemotherapy, you will have regular follow-up appointments to check how well your treatment is working and monitor any side effects. Your doctor or nurse will let you know how often youll have appointments.

You will have regular blood tests to measure your level of PSA . Your doctor will also ask you about any side effects from your treatment and any symptoms you might have. If your PSA level falls, you may find that your symptoms start to get better.

Sometimes PSA levels can rise after having chemotherapy, then come back down again. So a rise in PSA doesnt necessarily mean that your chemotherapy isnt working.

Are there further treatments available after chemotherapy?

If your cancer starts to grow again after you finish chemotherapy, you may be able to have other treatments. The aim of further treatment is to control your cancer and delay or manage any symptoms you might have, such as pain.

You might have more than one of the treatments we describe here. Which treatments you are offered will depend on how well you are, any symptoms you have, which treatments youve already had, and any other health problems you have. Talk to your doctor or nurse about which treatments are available to you.

• More chemotherapy. If youve already had docetaxel and not had any serious problems with it, you might be offered more docetaxel or cabazitaxel.

Sore Mouth And Throat

This treatment may cause a sore mouth and throat. You may also get mouth ulcers. This can make you more likely to get a mouth or throat infection. Use a soft toothbrush to clean your teeth or dentures in the morning, at night and after meals.

If your mouth or throat is sore:

• tell your nurse or doctor they can give you a mouthwash or medicines to help
• try to drink plenty of fluids
• avoid alcohol, tobacco, and foods that irritate your mouth and throat.

Sucking ice chips may sometimes help relieve mouth or throat pain. But if you are having radiotherapy to the head or neck, do not suck on ice. It can cause damage.

How To Take Docetaxel

Use Docetaxel exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Docetaxel is given as an infusion into a vein. A healthcare provider will give you this injection.

Docetaxel can be harmful if it gets on your skin during an IV infusion. If this happens, wash right away with soap and water. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when docetaxel is injected.

You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results. Your vision may also need to be checked.

You will be given steroid medication to help prevent fluid retention. Keep using the steroid for as long as your doctor has prescribed.

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Sore And Red Palms Of Hands And Soles Of Feet

You may get sore and red palms of hands and soles of feet. The skin may also begin to peel. This is called palmar-plantar or hand-foot syndrome. It usually gets better after treatment ends.

Tell your doctor or nurse about any changes to your hands or feet. They can give you advice and prescribe creams to improve any symptoms you have. It can help to:

• keep your hands and feet cool
• moisturise your hands and feet regularly
• avoid tight-fitting socks, shoes and gloves.

• dizziness
• changes to your heartbeat.

Other conditions can cause these symptoms, but it is important to get them checked by a doctor. If you cannot get through to your doctor, call the NHS urgent advice number on 111.

Numb Or Tingling Hands Or Feet

This treatment affects the nerves, which can cause numb, tingling or painful hands or feet. You may find it hard to fasten buttons or do other fiddly tasks.

Tell your doctor if you have these symptoms. They sometimes need to lower the dose of the drug. The symptoms usually improve slowly after treatment finishes, but for some people they may never go away. Talk to your doctor if you are worried about this.

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Endocrine Drugs For Prostate Cancer

Drugs work as well as prostate cancer surgery to reduce the level of hormones in the body. Most men opt for drug therapy rather than surgery. The three types of hormone-related drugs approved to treat advanced prostate cancer include luteinizing hormone-releasing hormone analogs, luteinizing hormone-releasing hormone antagonists, and antiandrogens.

Chemo Drugs Used To Treat Prostate Cancer

For prostate cancer, chemo drugs are typically used one at a time. Some of the chemo drugs used to treat prostate cancer include:

• Docetaxel
• Mitoxantrone
• Estramustine

In most cases, the first chemo drug given is docetaxel, combined with the steroid drug prednisone. If this does not work , cabazitaxel is often the next chemo drug tried .

Docetaxel and cabazitaxel have been shown to help men live longer, on average, than older chemo drugs. They may slow the cancers growth and also reduce symptoms, resulting in a better quality of life. Still, chemo is very unlikely to cure prostate cancer.

Other chemo drugs being studied for use in prostate cancer include carboplatin, oxaliplatin, and cisplatin.

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Questions To Ask Your Doctor Or Nurse

• How can chemotherapy help?
• How long will the treatment last, and how many sessions will I need?
• What are the possible side effects of chemotherapy, and how long will they last?
• Can I stop the treatment if I find the side effects difficult to deal with?
• Are there any other treatments available to me?
• Who should I contact if I have any questions during my treatment and how do I contact them?
• What happens if chemotherapy doesnt work? Are there other treatments I can have later on?
• Are there any clinical trials I can take part in?

What Are The Side Effects Of Docetaxel

You may have a life-threatening allergic reaction or a severe skin reaction. Get emergency medical help if you have signs of an allergic reaction: hives, burning eyes, skin pain, red or purple skin rash with blistering and peeling fever, sore throat, wheezing, chest tightness, trouble breathing feeling like you might pass out swelling of your face, lips, tongue, or throat.

You may have swelling in your intestines, which could cause death quickly. Call your doctor right away if you have stomach pain or tenderness, diarrhea, or fever.

Some side effects may occur during the injection. Tell your caregiver if you feel light-headed, or if you have trouble breathing or fast or irregular heartbeats.

Also call your doctor at once if you have:

Side effects may be more likely in older adults.

Your cancer treatments may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

• allergic reactions
• hair loss or
• fingernail or toenail changes.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

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Dealing With Taxotere Side Effects

Marina del Rey, CA | Edited from PCRI Insights May, 2007 vol. 10, no.2

Overall, Taxotere® is well tolerated. However, successful administration of this powerful medicine requires diligent surveillance so that potential complications can be detected and corrected before they become severe.

Introduction

Taxotere® is the most active chemotherapy for prostate cancer. In 2004, two randomized prospective studies1,2 comparing Taxotere and mitoxantrone, an older chemotherapy agent, clearly demonstrated that Taxotere was superior in three important criteria: overall survival duration, pain control, and quality of life. As a result, the FDA promptly approved Taxotere for the treatment of metastatic hormone refractory prostate cancer.

Taxotere in Early Disease

Besides its proven activity in metastatic disease, Taxotere is also being studied3 in the preventative, or adjuvant, setting. Effective treatment against advanced cancer works even better against earlier stages of the same type of cancer. Patients with high-grade prostate cancer may already harbor microscopic metastases. Intuitively, if one wants to improve the cure rate, one must also treat the microscopic disease outside the prostate. To date, the main adjuvant therapy for prostate cancer is hormone blockade.

Methods of Administration

Managing Taxoteres Effect on the Blood

Managing Taxoteres Effects on the Alimentary Tract

Managing Other Side Effects

References

4.) Taxotere. Physicians Desk Reference 2007 61:2932-2943.

What Are The Important Side Effects Of Taxotere

Following are some of the common side effects associated with docetaxel. Patients who have these or other side effects should tell their doctor or nurse.

The most common side effects of docetaxel include:

• changes in your sense of taste
• feeling short of breath

• myalgia.

Incidence varies depending on the indication.

Adverse reactions are described according to indication. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.

Responding patients may not experience an improvement in performance status on therapy and may experience worsening. The relationship between changes in performance status, response to therapy, and treatment-related side effects has not been established.

Clinical Trials Experience

Monotherapy with Taxotere for Locally Advanced Or Metastatic Breast Cancer After Failure Of Prior Chemotherapy

Taxotere 100 mg/m2

Adverse drug reactions occurring in at least 5% of patients are compared for three populations who received Taxotere administered at 100 mg/m2 as a 1-hour infusion every 3 weeks:

Table 3: Summary of Adverse Reactions in Patients Receiving Taxotere at 100 mg/m2

Hematologic Reactions

Hypersensitivity Reactions

Fluid Retention

• Fluid retention can occur with the use of Taxotere.

Cutaneous Reactions

Neurologic Reactions

Gastrointestinal Reactions

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Surgery For Prostate Cancer

In some cases of advanced or recurrent prostate cancer, surgeons may remove the entire prostate gland in a surgery known as “salvage” prostatectomy. They usually do not perform the nerve-sparing form of prostatectomy. Often, surgeons will remove the pelvic lymph nodes at the same time.

Cyrosurgery may be used in cases of recurrent prostate cancer if the cancer has not spread beyond the prostate. Cryosurgery is the use of extreme cold to destroy cancer cells.

To reduce testosterone levels in the body, doctors may sometimes recommend removing the testicles, a surgery called orchiectomy. After this surgery, some men choose to get prosthetics that resemble the shape of testicles.

Doctors may also remove part of the prostate gland with one of two procedures, either a transurethral resection of the prostate or a transurethral incision of the prostate . This relieves blockage caused by the prostate tumor, so urine can flow normally. This is a palliative measure, which means it is done to increase the patient’s comfort level, not to treat the prostate cancer itself.

How Docetaxel Is Given

You will be given docetaxel in the chemotherapy day unit or during a stay in hospital. A chemotherapy nurse will give it to you. Docetaxel can be given in combination with other cancer drugs.

During treatment you usually see a cancer doctor, a chemotherapy nurse or a specialist nurse, and a specialist pharmacist. This is who we mean when we mention doctor, nurse or pharmacist in this information.

Before or on the day of treatment, a nurse or person trained to take blood will take a blood sample from you. This is to check that your blood cells are at a safe level to have chemotherapy.

You will see a doctor or nurse before you have chemotherapy. They will ask you how you have been feeling. If your blood results are okay, the pharmacist will prepare your chemotherapy. Your nurse will tell you when your treatment is likely to be ready.

Your nurse usually gives you anti-sickness drugs before the chemotherapy. The chemotherapy drugs can be given through a:

• short, thin tube the nurse puts into a vein in your arm or hand
• fine tube that goes under the skin of your chest and into a vein close by
• fine tube that is put into a vein in your arm and goes up into a vein in your chest .

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How Is Taxotere Given

Taxotere is given as an infusion into a vein. A healthcare provider will give you this injection. ou may receive other cancer medicines at the same time.

Taxotere can be harmful if it gets on your skin during an IV infusion. If this happens, wash right away with soap and water. Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when docetaxel is injected.

You may need frequent medical tests to be sure this medicine is not causing harmful effects. Your cancer treatments may be delayed based on the results. Your vision may also need to be checked.

You may be given steroid medication to help prevent fluid retention. Keep using the steroid for as long as your doctor has prescribed.

Taxotere And Hair Loss

Hair loss is an unfortunate side effect of many chemotherapy drugs and cancer treatment. In most cases, hair that is lost during treatment for cancer will grow back within 3 to 6 months after the treatment is discontinued.

Patients who took Taxotere for treatment of breast cancer or other cancers were warned of temporary hair loss. Contrary to warnings however, between six and nine percent of patients who experienced hair loss during Taxotere treatment did not have hair growth return. These patients have permanent alopecia and may have experienced negative consequences due to that hair loss.

Patients who lose hair during chemotherapy often face psychological challenges, even when that hair loss is temporary. When hair loss has become permanent, patients may experience:

• Anxiety
• Difficulty transitioning back to everyday life
• Loss of identity

Despite undergoing treatments to stimulate new hair growth, many patients only see a slight improvement and up to 7 in 10 may ultimately choose to wear a wig or scarf to hide their permanent alopecia.

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How Is Chemotherapy Given

Chemo drugs for prostate cancer are typically given into a vein , either as an infusion over a certain period of time. This can be done in a doctors office, chemotherapy clinic, or in a hospital setting. Some drugs, such as estramustine, are given as a pill.

Often, a slightly larger and sturdier IV is required in the vein system to administer chemo. They are known as central venous catheters , central venous access devices , or central lines. They are used to put medicines, blood products, nutrients, or fluids right into your blood. They can also be used to take out blood for testing.

Many different kinds of CVCs are available. The most common types are the port and the PICC line.

Doctors give chemo in cycles, with each period of treatment followed by a rest period to give you time to recover from the effects of the drugs. Cycles are most often 2 or 3 weeks long. The schedule varies depending on the drugs used. For example, with some drugs, the chemo is given only on the first day of the cycle. With others, it is given for a few days in a row, or once a week. Then, at the end of the cycle, the chemo schedule repeats to start the next cycle.

The length of treatment for advanced prostate cancer is based on how well it is working and what side effects you have.

Numbness Or Tingling In Fingers Or Toes

Numbness or tingling in fingers or toes is often temporary and can improve after you finish treatment. Tell your doctor if you’re finding it difficult to walk or complete fiddly tasks such as doing up buttons.

Nail changes

During treatment your nails may change colour. This gradually goes after treatment as your nails grow.

Your nail might separate from the nail bed and look white or yellow. The nail may eventually fall off but usually grows back.

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Guide To Managing Side Effects Of Chemotherapy

Follow these simple rules to manage your side effects:

• Pay attention. Be aware of all expected and unexpected reactions to the drugs.

• Be proactive. Make a list of your medications. Talk with your health care providers about what signs to look for and when to call them.

• Relax and get well. Chemotherapy drugs are powerful and can take a toll on the body. Focus on getting well by finding ways to alleviate stress. These may include listening to music, doing yoga or stretching exercises, taking walks or watching TV.

• Keep a journal. Write down any physical and emotional changes you experience while taking the medications. A written list will make it easier for you to remember your questions when you go to your appointments. It will also make it easier for you to work with your health care team to manage your side effects.

• Consult your doctor. Talk with your health care providers about any side effects you experience. There are several drugs designed to help ward off or treat different side effects.

What Is The Most Important Information I Should Know About Docetaxel

You should not receive this medicine if you have:

• a low white blood cell count or
• a history of severe allergic reaction to docetaxel or to any medicine that contains polysorbate 80.

Tell your doctor about your complete health history and all medications you have used. Docetaxel can cause severe side effects including death, especially:

• if you receive high doses
• if you have liver disease or
• if you have non-small cell lung cancer and you have been treated in the past with chemotherapy that contains platinum .

Tell your doctor if you have ever had:

• liver disease
• tumor lysis syndrome
• fluid retention or
• if you drink alcohol.

Using docetaxel may increase your risk of developing other types of cancer . This risk may continue for several months or years after you have received docetaxel. Ask your doctor about your specific risk.

Docetaxel can harm an unborn baby or cause birth defects if the mother or the father is using this medicine.

• If you are a woman, do not use docetaxel if you are pregnant. You may need to have a negative pregnancy test before starting this treatment. Use effective birth control to prevent pregnancy while you are using this medicine and for at least 6 months after your last dose.
• If you are a man, use effective birth control if your sex partner is able to get pregnant. Keep using birth control for at least 3 months after your last dose.
• Tell your doctor right away if a pregnancy occurs while either the mother or the father is using docetaxel.

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