What Have I Learned By Reading This
You learned about:
- Ways to get chemotherapy, and
- What to expect when you have chemotherapy.
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your chemotherapy treatment. This knowledge will help you take better care of yourself and feel more in control so that you can get the most from your treatment.
When Is Chemotherapy Given
Chemotherapy may be ordered for advanced prostate cancer that has not responded to hormone treatment. It is usually given for metastatic disease . Metastatic disease may be present at diagnosis or, in some cases, the cancer can return in a distant location months or years after initial treatment.
Chemotherapy is given to cause the cancer to shrink and, hopefully, to disappear. Even if the cancer does not disappear, symptoms may be relieved.
What Is Advanced Prostate Cancer
When prostate cancer spreads beyond the prostate or returns after treatment, it is often called advanced prostate cancer.
Prostate cancer is often grouped into four stages, with stages III and IV being more advanced prostate cancer.
- Early Stage | Stages I & II: The tumor has not spread beyond the prostate.
- Locally Advanced | Stage III: Cancer has spread outside the prostate but only to nearby tissues.
- Advanced | Stage IV: Cancer has spread outside the prostate to other parts such as the lymph nodes, bones, liver or lungs.
When an early stage prostate cancer is found, it may be treated or placed on surveillance . Advanced prostate cancer is not curable, but there are many ways to treat it. Treatment can help slow advanced prostate cancer progression.
There are several types of advanced prostate cancer, including:
Biochemical Recurrence
With biochemical recurrence, the prostate-specific antigen level has risen after treatment using surgery or radiation, with no other sign of cancer.
Castration-Resistant Prostate Cancer
Non-Metastatic Castration-Resistant Prostate Cancer
Prostate cancer that no longer responds to hormone treatment and is only found in the prostate. This is found by a rise in the PSA level, while the testosterone level stays low. Imaging tests do not show signs the cancer has spread.
Metastatic Prostate Cancer
- Lymph nodes outside the pelvis
- Other organs, such as liver or lungs
Metastatic Hormone-Sensitive Prostate Cancer
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Docetaxel: Role In Mcrpc
Up until 2004, there was still no standard front-line or second-line chemotherapy for mCRPC that improved OS. Treatment options for mCRPC at the time often included second-line hormonal therapy, radiation therapy, cytotoxic chemotherapy, investigational therapy, or supportive care. Chemotherapy was clearly shown to provide palliative benefit but no survival benefit, and the regimens available at the time, as aforementioned, were mitoxantrone, estramustine, or docetaxel.49
Docetaxel is a taxane derivative that works by binding to microtubules and preventing androgen receptor nuclear translocation and causing apoptosis through B-cell lymphoma phosphorylation.50 Studies using docetaxel as a single agent or in combination with estramustine showed objective response rates in up to 38% of patients, PSA declines of more than 50% in 69% of patients.51,52 These findings encouraged subsequent two trials: the TAX 327 trial and the Southwest Oncology Group 99-16 trial.
These two studies, primarily the TAX 327 and secondarily the SWOG 9916, have set the standard of care for men with mCRPC. Numerous subsequent combination trials have been performed in an attempt to improve upon the efficacy of docetaxel, but most of these have been largely negative trials.
Study Shows Which Patients With Advanced Prostate Cancer Will Benefit From Chemotherapy
24 June 2022
Researchers have recommended changes to how cancer patients are treated, after a new UCL-led study discovered that chemotherapy is significantly more effective for some men with advanced prostate cancer than others.
On average, docetaxel chemotherapy improved 5-year survival by 10% compared to standard hormone therapy, which works by reducing the levels of male hormones in the body to stop them from reaching the cancer cells.
And both treatments may be offered to all men diagnosed with advanced prostate cancer.
However, the research, which was presented at the American Society of Clinical Oncology and funded by Prostate Cancer UK, found that men who had many metastases when they were diagnosed benefitted most from docetaxel chemotherapy, with 39% surviving five years, compared to 26% who had hormone therapy alone.
Among those with many metastases who also had larger prostate tumours, 55% survived for five years after having the treatment, compared to just 20% of men who just had hormone therapy.
In this study, those with many metastases or high volume metastatic disease, had either four or more secondary tumours in the bones and/or any metastasis in an organ such as the liver or lungs.
Meanwhile, men with fewer than 4 bone metastases and who had been diagnosed with prostate cancer at an earlier stage, did not benefit from docetaxel chemotherapy at all.
Around 47,500 men are diagnosed with the cancer each year, with 6,000 cases classed as advanced.
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Finding Prostate Cancer Financial Assistance
Expenses associated with prostate cancer procedures, rehabilitation and therapy, and long-term health care will vary depending on the situation. Regardless of the specifics, the expenses can add up quickly for patients and their families. Finding financial support for prostate cancer treatments can be a burden.
If you need assistance with prostate cancer expenses, our nonprofit is here to help.
As your community-based fundraising source, you can work with Help Hope Live to access greater financial support for prostate cancer treatments. Together, we can raise funds to assist with unmet medical expenses and related costs from living with prostate cancer.
What Are Risk Factors For Prostate Cancer
The main cause of prostate cancer is unknown. However, several factors may increase the risk of developing the disease:
- Age: As you become older, your chances of acquiring prostate cancer increase. Most of the prostate cancer cases are observed in men over the age of 50 years.
- Ethnicity: Prostate cancer is more common in Black men and less common in Asian men for unknown reasons.
- Genetics: Men who have a parent or sibling who has had prostate cancer are at a slightly higher risk of developing prostate cancer.
- Obesity: Studies have revealed that obesity may potentially raise the risk of prostate cancer.
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Recurrence With Hormone Therapy
Hormone therapy shrinks your prostate cancer and kills many, but not all of your prostate cancer cells. Hormone therapy does not cure prostate cancer. It lowers the amount of testosterone in your body, which makes it harder for prostate cancer cells to grow. Testosterone is a hormone that makes you grow hair on your face and body, have a mans body shape, and controls your desire for sex. After taking hormones to control your prostate cancer for a period of time, sometimes a number of years, your prostate cancer cells may change. This change lets them grow in your body even if you have no testosterone. When this happens it is called hormone refractory prostate cancer. This means that some of your prostate cancer cells may start to grow even though you are on hormone therapy.
What Is Intermittent Adt
Researchers have investigated whether a technique called intermittent androgen deprivation can delay the development of hormone resistance. With intermittent androgen deprivation, hormone therapy is given in cycles with breaks between drug administrations, rather than continuously. An additional potential benefit of this approach is that the temporary break from the side effects of hormone therapy may improve a mans quality of life.
Randomized clinical trials have shown similar overall survival with continuous ADT or intermittent ADT among men with metastatic or recurrent prostate cancer, with a reduction in some side effects for intermittent ADT .
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Understanding The Recurrent Prostate Cancer
Recurrent prostate cancer is when prostate cancer returns after the initial treatment or partial to complete remission has occurred. This is due to the reemergence of surviving prostate cancer cells that have grown large enough to be detected.
Following a prostatectomy, your prostate-specific antigen levels being to decrease. Eventually, they are no longer detectible, which is an indication that prostate cancer is no longer present. However, there is no clear reference for a normal PSA. It differs between men and can be affected by a number of factors. Following your initial prostate cancer treatment, PSA levels should stabilize and be low enough to where theyre not detected on blood tests. In some cases, PSA levels begin to rise again, indicating a need for further tests.
Even if youve had a prostatectomy, prostate cancer can recur in the immediately surrounding tissue, lymph nodes, seminal vesicles, muscles that control urination, the rectum, the wall of the pelvic, or metastasize into lymph nodes and bones further away.
Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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Hormone Therapy Helps Some Prostate Cancer Survivors Live Longer
A study published in the New England Journal of Medicine in January 2017 indicates that men whose prostates are removed to treat prostate cancer are likely to survive longer if they take drugs to block the male hormone testosterone in addition to undergoing radiation therapy.
Unfortunately, its not that simple.
Impact Of Age On Treatment
The rising number of men diagnosed with prostate cancer is a result of increasing life expectancy as well as the current practice of screening by prostate-specific antigen blood tests.10 Besides PSA and Gleason score, age is considered a key prognostic factor in treatment decision making. Although organ-confined disease can be cured by radical prostatectomy and full-dose local radiation therapy, treatment options for advanced- stage disease remain palliative. They include active surveillance, or watchful waiting, early versus delayed hormonal therapy to control disease progression, and continuous or intermittent androgen deprivation. Observational studies of older men with early stage disease have suggested conservative management as a viable option.11,12
Chodak and associates12 evaluated 828 men who were managed expectantly in a series of nonrandomized trials. Median follow-up was approximately 6.5 years. Patients with poorly differentiated cancers had a 10-fold increased risk of death from prostate cancer as compared with men showing highly differentiated prostate cancer. A 5-year disease-specific survival of only 34% was found in men with poorly differentiated prostate cancer. In contrast a 5-year disease-specific survival of 87% was described in men with well-or moderately differentiated cancers.
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Chemotherapy For Prostate Cancer As A Treatment Option
Chemotherapy, while a common treatment for many other types of cancers, is generally used in more advanced cases of prostate cancer. But chemotherapy is usually the first that springs to mind when people think of cancer treatment options.
Chemotherapy is the use of drugs that work to kill cancer cells. However, for prostate cancer treatment, chemotherapy is generally used to help slow down the disease rather than eradicate it. Another treatment used alongside chemotherapy is immunotherapy. Immunotherapy is where cells are taken out of your body, sensitized to cancer cells also from within your body, and re-introduced into your body to fight the cancer cells. For more on these treatments, watch Dr. Richard Bevan-Thomas in the video below:
Richard Bevan-Thomas MD: When a man thinks of prostate cancer or cancer in general, the first thing routinely that comes to mind is thinking about chemotherapy. Chemotherapy is where we give drugs that actually cause the death of cancer cells. In prostate cancer, chemotherapy is used in the later stages of the disease, so when we talk to men about prostate cancer, chemotherapy is not one of the first thing that comes up unless we start seeing a more advanced disease.
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.
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How Is Help Hope Live Different From Gofundme
Help Hope Live differs from GoFundMe by:
- Verifying your medical need for complete donor confidence
- Enabling donations that are tax deductible
- Providing one-on-one fundraising help
- Managing all funds raised to protect your state-based benefits
- Paying bills directly allows you to focus on treatment and recovery
We are a nonprofit organization with more than 4 decades of fundraising experience and a 4-star Charity Navigator rating.
Additional Treatment After Surgery
Additional treatment can come with one of two approaches: treatment given as adjuvant therapy , or as salvage therapy . In the modern era, most additional treatment is given as salvage therapy because firstly this spares unnecessary treatment for men who would never experience recurrence, and secondly because the success rates of the two approaches appear to be the same.
Regardless of whether an adjuvant or salvage therapy approach is taken, the main treatment options following biochemical recurrence are:
- Radiotherapy this is the commonest approach. Because scans dont show metastatic deposits until the PSA is more than 0.5 ng/ml and because radiotherapy is more effective when given before this level is reached, the radiotherapy energy is delivered to the prostate bed. This is because we know that this is the commonest site of recurrence in most men, and that 80% of men treated in this way will be cured.
- Active surveillance this is appropriate for a very slowly-rising PSA in an elderly patient who has no symptoms.
- Hormonal therapy in many ways this is the least appealing option as it causes symptoms but does not cure anyone, although it does control the recurrence and lower the PSA.
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What Is Prostate Cancer
Prostate cancer is cancer that affects the prostate gland in men. Prostate cancer is the second-leading cause of cancer deaths for men in the US.
Growth in the prostate can be of two types
Prostate cancer starts in the prostate gland and may spread to the nearby areas: lymph nodes, organs, or bones in other parts of the body.
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Castrate Refractory Prostate Cancer: A Wider Range Of Options
In this section, we explain the treatments available at Birmingham Prostate Clinic for patients once their disease becomes resistant to hormone treatment, called castrate refractory prostate cancer. Two types of treatments are needed to:
- Control the cancer and prevent further spread of cancer
- Control or prevent the symptoms caused by the spread of prostate cancer to the bones
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Which Prostate Cancers Really Need Treatment
July 9, 2013 by Bert Vorstman
> some 75% of all prostate cancers diagnosed are classed as favorable-risk Gleason 6 > GENERALLY, MOST of these favorable-risk Gleason 6 stage T1c prostate cancers need NO treatment whether through focal therapy or whole gland treatment> GENERALLY, MOST favorable-risk Gleason 6 cancers do NOT PROGRESS while being monitored on ACTIVE SURVEILLANCE> 25% or less of prostate cancers detected are the high-risk significant prostate cancers and it is these cancers which demand treatment> NOT ALL PROSTATE CANCERS ARE EQUAL> more people die from drug resistant infections every year than from breast cancer and prostate cancer combined> the importance of prostate cancer is greatly overemphasized> the preoccupation with PSA prostate cancer screening and detection, particularly for the insignificant Gleason 6 prostate cancer, is disingenuous
THEREFORE, on both MOLECULAR and CLINICAL fronts, it is ABUNDANTLY CLEAR thatthe Gleason 6 prostate cancer is essentially,> INSIGNIFICANT> a MISNOMER and should NOT be called a cancer> grossly MISMANAGED and MISTREATED as if a significant high-risk cancer
Which prostate cancers really need treatment?> only some 25% of prostate cancers diagnosed are classified as high-risk> significant or high-risk prostate cancers needing treatment are: * men with Gleason 4+3, 4+4 and above * men with significant volume of 4s in a Gleason 3+4
Are There Side Effects With Chemotherapy
Yes, there can be side effects or unwanted changes in your body when you have chemotherapy. Side effects are different from person to person, and may be different from one treatment to the next. Some people have no or very mild side effects. The good news is that there are ways to deal with most of the side effects. The strong anticancer medicines used in chemotherapy are made to kill cells in your body that grow and divide very quickly. This is why you may have side effects with chemotherapy. Along with your prostate cancer cells, chemotherapy also kills healthy cells in your body that grow and divide very quickly. Some kinds of these healthy cells that may be affected by your chemotherapy treatment include: cells that make your hair grow, cells that make new blood cells, and cells that cover the inside of your mouth, stomach, and intestines. Most of the side effects slowly go away after you finish your chemotherapy. There are ways to make the side effects easier to deal with while you are having chemotherapy.
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