PROSTATE PROS Episode 8: Approaching Chemotherapy

Listen: https://soundcloud.com/prostate-oncology/pp-e008

Modern chemotherapy is much more tolerable and much more effective than what we previously had.” – Dr. Scholz 

For many people the word chemotherapy triggers a lot of fear.  Whether this fear stems from the assumption that chemotherapy has dreadful side effects or that a chemotherapy recommendation signals the last possible effort for managing the cancer, chemotherapy can be a frightening treatment recommendation for patients and loved ones.  Fortunately, with improvements in modern medicine, these fears are no longer necessary. With the help of an experienced expert, side effects of chemotherapy can be easily managed through exercise, medications, or changing the treatment schedule. Chemotherapy is not always used as an end-of-the-road therapy, it can be used as a preventative measure or to put men with metastatic prostate cancer into remission.  Chemotherapy is a very powerful anti-cancer drug that can be very beneficial to men with prostate cancer.  

Protocol

There are two main types of chemotherapy for prostate cancer: Taxotere and Jevtana.  The most common treatment protocol is an infusion given intravenously every three weeks.  This requires a one to two hour doctor visit. These three week cycles are typically continued for four to eight total cycles.  For men with prostate cancer, chemotherapy is not typically used as a monotherapy, instead it is used in combination with other therapies like radiation and hormone therapy.  

Sequencing 

Because chemotherapy is used in combination with other therapies it is important that chemotherapy is given at in the correct sequence with the other treatments to insure highest cure rates with the lowest risk of side effects.  

  • Chemotherapy and Hormone Therapy: When used in combination with hormone therapy, chemotherapy can put patients into a remission, where they are able to stay off chemotherapy for a long period of time and in some cases even stop the hormone therapy completely.  Hormone therapy and chemotherapy can be given simultaneously.  
  • Chemotherapy and Radiation: Radiation and chemotherapy can both lower blood counts.  Therefore, radiation is given before or after chemotherapy, not simultaneously, to minimize the chances of blood counts being overly affected.   
  • Chemotherapy and Immunotherapy: Chemotherapy and immunotherapy are not to be used in combination.  Chemotherapy suppresses the immune system while immunotherapy works to build the immune system.  The opposite ways these two medicines work causes them to cancel each other out. If a patient will be treated with both chemotherapy and immunotherapy during their prostate cancer journey, there must be a period of time separating the two treatments so that neither affects the benefit of the other.  

Correctly sequencing chemotherapy with other treatments can be tricky and requires an experienced expert to help minimize side effects and maximize cure.

Side Effects

Modern chemotherapy and supportive medicines can help reduce the unwanted side effects like nausea and fatigue that many people attribute with chemotherapy.  

As is the case with most treatment options for prostate cancer, the best thing a man can do while on chemotherapy is to commit to regular exercise.  Exercise greatly minimizes the fatigue which may present as a side effect of chemotherapy.  

One way to counteract side effects is by switching to a lower dosage, a more frequent infusion schedule, or by changing from Taxotere to Jevtana.  Jevtana is shown to be generally better tolerated but insurance companies typically require patients try Taxotere before switching to Jevtana.  

Conclusion

When used under the right circumstances, chemotherapy can be lifesaving for men with prostate cancer.  Chemotherapy has improved over the last several decades and side effects are mild and manageable. Keep in mind that chemotherapy is a very powerful medication and treatment should be administered and monitored by a medical oncologist who has plenty of experience with treating prostate cancer with chemotherapy.  

Minimizing the Side Effects of Chemotherapy Blog by Richard Lam, MD on PCRI.org: https://pcri.org/indigo-1/2017/9/18/minimizing-the-side-effects-of-chemotherapy 

ASCO 2019 Chemotherapy Sequencing Findings: https://www.prostateoncology.com/2019/06/18/asco-2019-updates-for-royal/ 

Listen to Dr. Scholz on the Live Long and Master Aging Podcast with Peter Bowes: http://www.llamapodcast.com/ 

The Key to Prostate Cancer: 30 Experts Explain 15 Stages of Prostate Cancer: keytopc.com 

Take the prostate cancer staging quiz: keytopc.com

Have questions or topics you think would be great for PROSTATE PROS? Email

podcast@prostateoncology.com

Subscribe, rate, and review on Apple Podcasts

Check out more episodes on podcast.prostateoncology.com 

Join the conversation, follow us on twitter: @keepprostate

Leave a Reply

Your email address will not be published. Required fields are marked *