Table of Contents

Chapter 7: The Role of Chemotherapy

e. What if the Chemotherapy Doesn’t Work?

When the chemotherapy is working, some men might find symptom relief, while others might find that their metastases have shrunk. But nearly all men will show a drop in their PSA levels, which is why the PSA level is used as an important indicator of whether the chemotherapy is doing its job.

But remember that no two cancers are the same and no two people react to chemotherapy drugs in the same way. So if your PSA doesn’t fall, if you don’t find symptom relief, or if your metastases don’t stop growing, don’t be discouraged. You might just need to start on a different type of drug or combination of drugs to see a better result.

Because very few drugs will score a home run in every person, second-line chemotherapy has a long and valued tradition in the treatment of cancer. They’re not second-rate drugs; in fact, they might be the drugs that other men are using first. The important thing is that the second-line drug works somewhat differently than the first, so you’ve got another chance to see a benefit.

In the end, you might find yourself using two, three, or even four different chemotherapy drugs over the course of your disease. You might join one or more clinical trials to see if a new drug regimen works well, and you might obtain small benefits at each step of the way. The key is to stay focused on staying strong and to work with your healthcare team to find the treatment path that’s right for you.