Chemotherapy

A medicine that kills cancer cells around the body. It is an anti-cancer drug, often, but not always, given by a drip into your arm.

What is chemotherapy?

  • Chemotherapy is a medicine that kills cancer cells around the body.
  • Watch our short animation to learn more about chemotherapy.

Important things to know

  • Chemotherapy is often given when your prostate cancer has spread to other parts of your body. This is called advanced or metastatic prostate cancer. 

Bone Metastases

 

Who can have chemotherapy?

You can have chemotherapy if:

  • You are newly diagnosed with advanced prostate cancer.
  • You have advanced prostate cancer that has been treated with hormone therapy that no longer works. This is called castration-resistant or hormone-resistant prostate cancer. 

     

Who can’t have chemotherapy?

You may not be able to have chemotherapy if:

  • Your general health is not very good 
  • You have other serious long-term diseases or conditions 
  • You have severe liver disease 
  • You have a low number of white blood cells.

 

What are the benefits of chemotherapy?

Chemotherapy cannot cure your cancer but: 

  • It can slow down the progress of your cancer and extend your life
  • It means that you can carry on with your normal activities if you feel able 
  • It does not cause you any pain
  • It helps with symptoms like pain so that your everyday life is less affected. 
Image
John chemotherapy
“The side effects tended to be temporary and I knew that after that Wednesday."
John
Frequently asked questions (FAQs) about chemotherapy
  • Cancer cells can grow and reproduce (divide) very quickly. 

 

Normal cells and cancer cells

 

  • Chemotherapy helps to stop these fast-growing cells from reproducing and growing.
  • The chemotherapy can travel around the body in your bloodstream. This means that it can reach the prostate cancer cells wherever they are in the body. You may hear this be called systemic therapy. 

The chemotherapy can also attack fast-growing healthy cells. 

  • These include:
    • Skin and hair cells.
    • Cells in your bone marrow. Bone marrow is a spongy tissue found in some bones. It makes all your red and white blood cells.
    • Cells that line your digestive system. This system breaks down food so that it can be absorbed into the blood. The digestive system stretches from your mouth to your anus. 

What does this mean for me?

  • This means that you will get some side effects. They will normally disappear once you have finished your chemotherapy. 
  • You will have your chemotherapy once every three weeks. This is called a cycle. The number of cycles you have will depend on:
    • The medicine that you are taking 
    • The type of prostate cancer. 

       

If you have metastatic prostate cancer and have not had hormone therapy before: 

  • Usually six cycles.

 

If you have had hormone therapy that no longer works (castration-resistant prostate cancer): 

  • Usually 10 cycles.

 

The dose that you get will depend on your:

  • Body weight 
  • Height 
  • General condition – health and fitness
  • Length of time between treatments. 

     

Black man and doctor looking at a scan

 

  • Your doctor will calculate the correct dose for you. They may change the dose and cycle length depending on: 
    • Your blood results
    • Any side effects you may have.
  • The most common chemotherapy medicines for prostate cancer are:
    • Docetaxel (Taxotere)
    • Cabazitaxel (Jevtana).
  • You will usually be given docetaxel first. 
  • You may get cabazitaxel if your prostate cancer comes back after treatment with docetaxel.
  • You will need to have some blood tests a few days before you start each cycle of your chemotherapy. This is to check whether your levels of red and white blood cells are normal. 
Blood in test tube
  • You should not feel any pain during the treatment. 
  • But some side effects of the treatment may cause discomfort. For example, sores in your mouth. 
  • You will need to take time off to:
    • Go for your chemotherapy 
    • Have blood tests.
  • Otherwise, you can carry on working normally if you feel able to do so.
  • You usually have chemotherapy at the hospital as an outpatient. 
  • A nurse will put a small, flexible tube into the vein in your arm or your hand using a needle. This is called a cannula. This will feel the same as having a blood test. 

 

cannula in vein in arm of older white man

 

  • The tube is then connected to a drip (intravenous infusion). 
  • The medicine infusion takes about one hour. 
  • When it has finished, the cannula will come out. You should then be able to go home. 

 

Black man having chemotherapy talking to a female doctor
  • Chemotherapy is usually given with hormone therapy. This happens if you are newly diagnosed with metastatic prostate cancer. Go to our hormone therapy page for more information (the link will open in a new tab).

     

tablets and capsules

  • You will get steroid tablets alongside your chemotherapy. These can help with side effects and make the chemotherapy more effective. Your doctor will decide the amount and exactly when you take them. The most common steroids are called prednisolone and dexamethasone. They are usually given as a tablet. 

 

  • Anti-sickness tablets can help you stop feeling or being sick. You may get these before each chemotherapy session and for a few days after.
  • Your chemotherapy can interact with other medicines. These include herbal medicines. You may get worse side effects or have a very bad reaction. Some medicines will stop your chemotherapy from working properly. Tell your doctor about any other medicines that you are taking. These include nutritional supplements. For example:
    • Vitamins and minerals 
    • Herbal supplements 
    • Over-the-counter medicines (e.g., cold remedies, etc). 

       

  • If you need dental or other treatments, always tell the healthcare professional that you are having chemotherapy. This includes nurses, other doctors, pharmacists or dentists.

     

  • You may be advised not to have certain vaccinations while you are having chemotherapy. Talk to your doctor before getting any vaccinations.

     

  • You may get side effects with your chemotherapy. These may affect your ability to drive, use tools or machines. If this happens, do not drive or use any tools or machines. Speak to your healthcare team for more information.

     

  • Docetaxel and cabazitaxel contain alcohol. Please speak to your healthcare team if you are addicted to alcohol. You may also be advised not to drive after your treatment. This is because the docetaxel can raise your blood alcohol limit. 

     

  • Do not stop taking your steroid tablets without talking to your doctor. If you have been taking them for more than a few days, you usually need to reduce your dose gradually. You may be given a steroid treatment card. This will give instructions for you (the patient) and information for other healthcare professionals that you may see. 

Our services search tool will allow you to search for hospitals near you that offer chemotherapy (the link will open in a new tab).
  
 

About this information

  • This information was published in March 2023. We will revise it in March 2024.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page (this link will open in a new page).

What is risk?

  • Risk is the chance something bad could happen when we do something. Even simple things such as walking down the stairs can have risks. But we take risks because we think it will be worth it. We need to think about both the benefits and risks of what might happen when we do something.
  • You should always ask your healthcare team about both the benefits and risks of any treatment.
  • Remember if they tell you about a risk, it doesn‘t mean it will happen to you. They may say one man in ten who has this treatment will have a side effect. But they can't tell you if you will be the ‘one’ man who gets this side effect.

 

Image
 showing a see saw with risk on one side and benefits on the other
What are the risks of chemotherapy?

Not everyone will get the same side effects. Your doctor will talk to you about the possible risks and benefits of your chemotherapy.

During the infusion 

This may affect more than one in 10 people. You may have the following allergic reactions:

  • Flushing of your skin, skin reactions or itching
  • Feeling tight in the chest or problems breathing
  • Fever or chills
  • Back pain
  • Low blood pressure.

If you have any of these symptoms, please tell a member of the healthcare team straight away. 

 

Between infusions

 

Very common side effects

Affects MORE THAN 1 in 10 people

  • Infections due to the decrease in white blood cells – these are important in fighting infection
  • Decrease in the number of red blood cells can cause anaemia 
  • A shortage of platelets in your blood (thrombocytopenia) – platelets are a type of blood cell that help your blood to clot 
  • Fever – if you think you have a fever, tell your doctor straight away 
  • Allergic reactions – see above
  • Loss of appetite/not feeling hungry (anorexia)
  • Problems sleeping (insomnia)
  • Feeling of numbness or pins and needles or pain in joints and muscles
  • Headache
  • Change in your sense of taste
  • Inflamed (red/swollen) eyes or more tears in the eyes
  • Swelling around the body, hands, feet, legs (lymphoedema)
  • Shortness of breath
  • Sore and red throat and nose
  • Nose bleeds
  • Cough
  • Sores in the mouth
  • Feeling or being sick
  • Diarrhoea or constipation 
  • Pain in the stomach
  • Heartburn (indigestion)
  • Hair loss – in most people this will return to normal when the treatment has finished
  • Redness and swelling of the palms of your hands and soles of your feet – this may make your skin peel off. This can also happen on other places on your body
  • Change in the colour of your nails or losing your nails
  • Muscle aches and pains, back pain or bone pain
  • Tiredness or flu-like symptoms
  • Weight gain or loss
  • Chest infection

Common side effects

May affect UP TO 1 in 10 people

  • Fungal infection in your mouth (oral thrush)
  • Dehydration. Losing more fluids than you take in
  • Feeling dizzy
  • Problems with your hearing
  • Low blood pressure, very quick heartbeat or uneven (irregular) heartbeat
  • Heart failure – the body is not able to pump blood around the body properly
  • Inflammation of your food pipe (oesophagus)
  • Dry mouth
  • Problems with swallowing – may be painful
  • Bleeding (haemorrhage)
  • High levels of chemicals called enzymes in your liver
  • Raised blood sugar (diabetes)
  • Decrease in the amount of potassium, calcium and phosphate in your blood.

 

Electronic Medicines Compendium (EMC)

  • The EMC contains the most up-to-date, approved and regulated prescribing and patient information for all UK licensed medicines.
  • You can find more information about the side effects of this treatment in the leaflet that comes with your medicine or from the Electronic Medicines Compendium.
  • You can see the patient information leaflet for docetaxel.

 

Steroids

You may also get side effects from the steroids that you are taking. These may include:

  • Indigestion or heartburn
  • Increased appetite
  • Problems sleeping
  • Changes in mood, feeling irritable and feeling anxious
  • Increased risk of infections
  • High blood sugar
  • Weakening of the bones
  • High blood pressure
  • Puffiness in the face.

For more information, see the patient information leaflet that you will find inside the steroid tablet box.

Not everyone will get the same side effects. Your doctor will talk to you about the possible risks and benefits of your chemotherapy. 

Very common side effects

Affects MORE THAN 1 in 10 people

  • Decrease in the number of red (anaemia), or white blood cells (which are important in fighting infection)
  • Decrease in the number of platelets (which results in increased risk of bleeding)
  • Loss of appetite (anorexia)
  • Stomach upsets including feeling sick (nausea), being sick (vomiting), diarrhoea or constipation
  • Back pain
  • Blood in the urine
  • Feeling tired, weak or lack of energy.

Common side effects

May affect UP TO 1 in 10 people

  • Alteration of taste
  • Shortness of breath
  • Cough
  • Abdominal pain
  • Short-term hair loss (in most cases normal hair growth should return)
  • Joint pain
  • Urinary tract infection
  • Lack of white blood cells associated with fever and infection
  • Feeling of numbness, tingling, burning or decreased sensations in hands and feet 
  • Dizziness
  • Headache
  • Decrease or increase in blood pressure
  • Uncomfortable feeling in the stomach, heartburn or belching
  • Stomach pain
  • Piles (haemorrhoids)
  • Muscle spasm
  • Painful or frequent peeing
  • Leeking pee (urinary incontinence)
  • Kidney disease or problems
  • Sore in the mouth or on lips
  • Infections or risk of infections
  • High blood sugar
  • Problems sleeping (insomnia)
  • Mental confusion
  • Feeling anxious
  • Abnormal feeling or loss of sensation or pain in hands and feet
  • Trouble with balance
  • Rapid or irregular heartbeat
  • Blood clot in the leg or in the lung
  • Skin feeling flushed
  • Pain in mouth or throat
  • Rectal bleeding
  • Muscle discomfort, aches, weakness or pain
  • Swelling of the feet or legs
  • Chills
  • Nail disorder (change to the colour of your nails or nails detaching)

 

Electronic Medicines Compendium (EMC)

  • The EMC contains the most up-to-date, approved and regulated prescribing and patient information for all UK licensed medicines.
  • You can find more information about the side effects of this treatment in the leaflet that comes with your medicine or from the Electronic Medicines Compendium.
  • You can see the official patient information leaflet for cabazitaxel (this link will open in a new external tab)

 

Steroids

You may also get side effects from the steroids that you are taking. These may include:

  • Indigestion or heartburn
  • Increased appetite
  • Problems sleeping
  • Changes in mood, feeling irritable and anxious
  • Increased risk of infections
  • High blood sugar
  • Weakening of the bones
  • High blood pressure
  • Puffiness in the face.

For more information, see the patient information leaflet that you will find inside the steroid tablet box.

  • The information on the risks comes from very large clinical studies. These typically involved thousands of people being watched over many years. 
  • There may be local data from your area. You can ask your healthcare team if they have this information too. 

About this information

  • This information was published in March 2023. We will revise it in March 2024.
  • References and bibliography available on request.
  • If you want to reproduce this content, please see our Reproducing Our Content page This page will open in a new tab).

What is the impact?

  • We asked real visitors to the infopool to share their experience of this treatment. They told us how this treatment had impacted their everyday lives in a number of different areas.
  • The numbers and images below represent how many people said this treatment had impacted them a ‘lot’ in each of the different areas.
  • For example, imagine it says ‘25 in 100’ underneath ‘physical and social wellbeing’. This means that 25 out of 100 people who shared their experience of this treatment told us it impacted their 'physical and social wellbeing' a lot. However, it would also mean that 75 out of 100 people said it had not impacted them a lot.

Physical and social wellbeing

Enjoying activities such as walking or going out to the pub

93 out of 100

Effect on relationships

Ability to make good connections with others

59 out of 100

Sexual activity

Ability to reach sexual arousal, either physically or emotionally

75 out of 100

Sense of self

Knowing who you are and what motivates you

73 out of 100

Wellbeing and quality of life

Feeling good and functioning well in your personal and professional life

80 out of 100

Mental and emotional health

Ability to think clearly, make good decisions, and cope with your emotions

89 out of 100

Fatigue

Feeling of constant physical and/or mental tiredness or weakness

91 out of 100