When patients experience either hormone refractory cancer or prostate cancer bone metastasis, doctors may begin chemotherapy. Chemotherapy that is used in the treatment of prostate cancer can be administered by intravenous injection (IV) or orally as pills, capsules, or liquids. Chemotherapy is given in cycles of treatment followed by a recovery time. The entire treatment generally lasts three to six months, depending on the type of chemotherapy medications given.
Some doctors use chemotherapy in small and frequent doses, such as daily oral pills or frequent low dose injections. Small doses can benefit patients by increasing the exposure time to the therapy in addition to lowering the occurrence and severity of side effects. Some patients use venous access devices, which are used for frequent low dose injections. Patients do not go to their doctor’s office for this prostate cancer treatment, but receive their therapy through a machine. A small device called a port is placed on top of the skin. The port connects to a tube, which then connects to the vein. Through these connections, the venous access device supplies the body with low doses of chemotherapy drugs.
Chemotherapy
Drugs
Doxorubicin
(Adriamycin) works by binding to the DNA of a cell and inhibits the production of protein. The drug is administered intravenously and has been known to cause serious tissue damage if the solution escapes from the vein. Escaped doxorubicin will cause pain, redness, and swelling around the injection site.
Estramustine
phosphate (Emcyt) is known as an alkylating agent. The drug is taken in the form of a capsule. Patients are encouraged to take the capsule with a full glass of water one hour before or two hours after a meal. Doctors also encourage patients not to take estramustine phosphate with dairy products because dairy may affect the chemotherapy’s effectiveness.
Etoposide
(VP-16) is a chemotherapy drug used in the treatment of prostate cancer that can be taken orally or by infusion. When taken orally, etoposide comes in a liquid-filled capsule. Patients should speak with their doctors about when they should take etoposide and what food or behaviors they may want to avoid. When taken by infusion, etoposide is diluted into a solution and given as a slow drip.
Mitoxantrone (Novantrone) belongs to the chemotherapy group called antineoplastics. Mitoxantrone is given in the form of injection at either the doctor’s office or at home. Patients taking mitoxantrone at home must carefully follow their doctor’s instructions. Mitoxantrone is sometimes taken with corticosteroids, such as prednisone. Prednisone is used to treat inflammation and has shown to be useful for patients with bone metastasis. Vinblastine (Velban) is another type of antineoplastic. This chemotherapy is given by injection through a cannula, which is a fine tube inserted directly into the vein. Antineoplastics may also be called anti-tumor antibiotics.
Drugs from the taxane
group used to treat prostate cancer are paclitaxel (Taxol) and docetaxel (Taxotere). Taxanes work by locking the microtubules that make up the cells cytoskeleton into place, so the cell dies when it tries to divide. Paclitaxel is administered as an infusion drip through a cannula. Docetaxel is administered by injections every three hours, every week, or every three weeks, depending on the doctor's prescriptions.
Vinorelbine (Navelbine) and Carboplatin (Paraplatin) are additional chemotherapy drugs a doctor may consider in the treatment of prostate cancer. While vinorelbine is an antineoplastic agent, carboplatin is an alkylating agent. Both may be administered as a single agent or used in combination with prednisone or other chemotherapy agents, such as docetaxel.
Chemotherapy drugs can cause serious and even dangerous side effects. Patients who are considering chemotherapy should speak with their doctors about which drug will benefit them the most, as well as what results and side effects can be expected with each drug.
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