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Chemotherapy with docetaxel

Chemotherapy is a type of cancer treatment that uses chemicals to destroy cancer cells. Chemotherapy drugs can be injected into the bloodstream to attack cells throughout the body. They can also be applied directly to the tumour.

Your doctor may recommend the chemotherapy docetaxel to manage castration-resistant prostate cancer. The drug relieves pain caused by the tumour or metastases. If effective, it allows you live longer and with fewer symptoms and side effects.

Docetaxel is administered through an IV in an outpatient setting at a hospital or clinic. The treatment lasts 1 hour and it is usually repeated 10 times, once every 3 weeks. During the course you will take the steroid drug prednisone, which generally comes as a pill. You need to take prednisone twice a day for 5-10 cycles.

Docetaxel may cause side effects. Many of these are mild and can be managed at home. Side effects of docetaxel may include:

  • Lower levels of white blood cells
  • Anaemia
  • Hair loss
  • Fluid retention
  • Vomiting
  • Allergic reactions
  • Fatigue
  • Diarrhoea
  • Nail changes
  • Loss of appetite

Treatment after chemotherapy

After you have been treated with docetaxel, your doctor can recommend treatment with hormonal therapy or another chemotherapy drug. The main hormonal treatments are abiraterone acetate and enzalutamide. Cabazitaxel is the chemotherapy drug most commonly used in these cases. You could also receive a second course of docetaxel. Your doctor will discuss the different treatment options to find the best one for you.

Abiraterone acetate

If your treatment with docetaxel was ineffective, your doctor may recommend hormonal treatment with abiraterone acetate. If effective, this drug can relieve pain, lower the level of PSA in the blood, slow the growth of the tumour and the metastases, and allow you to live longer.

Side effects of the treatment include fatigue, lower levels of potassium in the blood, high blood pressure, swelling or discomfort of the joints, and fluid retention. Abiraterone acetate is always administered in combination with the steroid drug prednisone to manage the effects the drug can have on your blood pressure.

Enzalutamide

Your doctor may recommend hormonal treatment with enzalutamide. If effective, this drug can lower the level of PSA in the blood, slow the growth of the tumour and the metastases, and allow you to live longer.

Possible side effects of the treatment are a feeling of weakness, back pain, diarrhoea, and fatigue.

Cabazitaxel

If docetaxel was not effective, your doctor may recommend treatment with the chemotherapy drug cabazitaxel. If effective, cabazitaxel will relieve pain, lower the level of PSA in your blood, slow the growth of the tumour and metastases, and allow you to live longer.

The side effects of cabazitaxel include a severe drop in white blood cells, and diarrhoea. Your doctor will recommend medication to manage these effects.

Discuss with your doctor which type of treatment after docetaxel is best for your individual situation.

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