Table of Contents

Chapter 7: The Role of Chemotherapy

When most people think of treatments for cancer, three things come to mind: surgery, radiation therapy, and chemotherapy. In fact, in nearly all cancers, chemotherapy is a mainstay of treatment, and is often one of the first options employed.

However, this has not been the case for prostate cancer, and, until recently, chemotherapy was used only to relieve symptoms associated with very advanced or metastatic disease.With the publication of two studies in 2004 showing that the use of docetaxel (Taxotere) can prolong the lives of men with prostate cancer that no longer responds to hormone therapy,more and more doctors are recognizing the potential benefits of chemotherapy for the men they treat with advanced prostate cancer.

As we discussed in Chapter 6, in earlier stages of prostate cancer, most of the cells are sensitive to changes in testosterone. And, because a primary goal of all cancer therapies is to interfere with the growth of cancer cells as directly as possible, drugs that target testosterone are employed first. But as the cancer progresses and the hormoneindependent cells start to take root, therapies that can control the growth of or kill these types of cancer cells as well become important players in the fight against this disease.

Therefore, it’s not surprising that chemotherapy has been used as a treatment option at the latest stages of disease. But it also helps to explain why some researchers are looking at using it in earlier stages—if chemotherapy and other hard-hitting anti-cancer therapies can be used earlier,we might be able to slow the growth of the hormoneindependent cells and prolong further the lives of men with prostate cancer.

In this Chapter, we’ll look at how the drugs being used and developed today are changing the way we view the role of chemotherapy in the management of advanced prostate cancer.