TREATMENT OPTIONS


 Nerve sparing radical prostatectomy


State-of-the-art external beam radiotherapy


Seed Brachytherapy


Patient Information For High Dose Rate Hdr Prostate Brachytherapy


Hormonal therapy


 Prostatic cryotherapy


Systemic chemotherapy


Radioactive intravenous Strontium


Access to state-of-the-art clinical trial


Patient Information for Radiotherapy


  1. Pain relief for metastatic bone disease


  1. Clinical Trials


Systemic chemotherapy


Chemotherapy is the term used for drug treatment of cancers. Many chemotherapy drugs now available are much better tolerated than previously, so patients nowadays have fewer and less intense side effects. In addition, there are many more supportive medications available (for example, anti-nausea dugs) to make the experience more reasonable for patients.

In Australia, chemotherapy has not been used frequently for prostate cancer. Over the past decade, however, a few medical oncologists have had training and experience in the USA, where chemotherapy is widely used for prostate cancer. As a result, their expertise has led to an increase in interest around the use of chemotherapy for prostate cancer.

In general, chemotherapy is restricted to the treatment of men with prostate cancer once hormones have failed. Men with hormone refractory prostate cancer (HRPC) have few treatment options. These include chemotherapy, clinical trials, radiotherapy, or palliative carer. So for those who wish to be relatively aggressive about the treatment for their prostate cancer, often chemotherapy represents their best chance of controlling the disease for a little while. However, once men develop hormone refractory prostate cancer, their prognosis is poor, as chemotherapy is not always successful, and some may not tolerate treatment very well, meaning that chemotherapy has to be stopped. Men should seek the opinion of their medical oncologist of they are contemplating chemotherapy.

There are quite a few chemotherapy drugs in common use. As of August 2005, the best single drug for HRPC is docetaxel (‘Taxotere’ is the trade name). This has become the standard of carer in the USA based on the results of two large randomised Phase III (comparative) studies, released last year. These results showed that men treated with Mitoxantrone and Prednisolone lived, on average, 14 months, while those treated with docetaxel and Prednisolone lived, on average, 17 months. While this does nor seem much of an increase in life prolongation, this is the first time that either chemotherapy (or hormones) has been shown to improve survival on men with advanced (metastatic) prostate cancer.

In general, men should always discuss with their oncologist whether they are taking any herbal or nutritional supplements. These are not necessarily harmless, and could interfere with either chemotherapy drugs or cause side effects in their own right.

There is no particular diet than can be recommended for men with prostate cancer. While there are some epidemiological studies that suggest an intake high in animal fats may increase the risk of prostate cancer, no change in diet once the diagnosis of prostate cancer has been made has shown any difference in outcome. As a result, it is probably wise to have a balanced diet.

Questions to ask your medical oncologist

For further information about chemotherapy click here