Chemotherapy is usually used in cases of prostate cancer that are in the refractory period or fairly advanced stages. It may also be recommended for individuals who have distant metastasis as a result of their prostate cancer.
The standard for chemotherapy for prostate cancer is Docetaxel (Taxotere®). It is given concurrently with a steroid called Prednisone. Efficacy of Docetaxel was reported in 2004 in the New England Journal of Medicine. This research was led by Dr. Ian F. Tannock, here at The Princess Margaret, and it showed benefit prolonging survival and improving quality of life. Dr. Tannock is continuing his research looking for other drugs that might improve the response to Docetaxel if given at the same time. His goal is to develop effective treatments for advanced prostate cancer, by extending the utility of current treatments with minimal increase in toxicity.
Chemotherapy is a systemic (system-wide) treatment that uses medication to destroy cancer cells. It affects all the cells of the body is it circulates through the blood stream. The chemotherapy drugs act in rapidly-dividing cells (ie. cancer cells) by interrupting steps in their cell division causing them to die. This kind of treatment takes advantage of the rapidly-dividing nature of cancer cells, and helps to stop the proliferation of cancer.
Since chemotherapy is systemic, healthy cells and tissues are affected by it as well. For example, blood cells are also rapidly-dividing cells and are damaged during chemotherapy. But normal cells in the body have a chance to recover from chemotherapy treatments, while cancer cells do not.
In cases of Prostate Cancer, chemotherapy is usually prescribed as a salvage therapy for advanced prostate cancer especially with distant metastasis.
Prostate cancer is extremely sensitive to hormonal treatments. Chemotherapy is only considered when the disease is considered hormone-resistant. This is when some cancer cells grow despite testosterone suppression, and threaten to spread. Hormone-resistant cancer will be identified by a rising PSA score, new lesions in bone/CT scans, and/or the appearance of symptoms (mainly pain).