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40

NCCN Guidelines for Patients

®

Prostate Cancer, Version 1.2016

4

Overview of cancer treatments Immunotherapy | Chemotherapy

be inserted into your scrotum. Your testicles won’t

be removed with LHRH agonists but these drugs will

shrink your testicles over time.

Side effects of antiandrogens are like those of ADT.

When an antiandrogen is used with an LHRH agonist,

diarrhea is a major side effect. Other side effects

include nausea, liver problems, breast growth and

tenderness, and tiredness. Estrogens also increase

risk for breast growth and tenderness as well as blood

clots. Ketoconazole can cause low cortisol levels and

cause health problems when taken with other drugs.

Abiraterone with prednisone is a newer hormone

therapy. While taking abiraterone, you should be

tested for high blood pressure (hypertension), low

potassium (hypokalemia), fluid buildup (edema), and

problems with your adrenal glands, heart, and liver.

You could also have hot flashes, fatigue, diarrhea,

vomiting, constipation, coughing, shortness of breath,

joint or muscle pain, and lung or urinary infections.

Enzalutamide is also a newer hormone therapy. A rare

but severe side effect of enzalutamide is seizures.

Common side effects include fatigue, hot flashes,

diarrhea, headaches, pain, not feeling hungry,

constipation, lung infections, swelling, shortness of

breath, weight loss, headache, high blood pressure,

dizziness, and a feeling that things are spinning

around (vertigo). The chance that you may fall is

greater when taking enzalutamide.

Not all of the side effects of hormone therapy are

listed here. Please ask your treatment team for a

complete list of common and rare side effects. If a

side effect bothers you, tell your treatment team.

There may be ways to help you feel better. Some

ways to reduce risks of hormone therapy are

discussed in Part 6, but your treatment team can tell

you more.

Immunotherapy

Sipuleucel-T is a drug that uses your white blood cells

to destroy prostate cancer cells. In a lab, your white

blood cells from a blood sample will be changed by a

protein so they will find and destroy prostate cancer

cells. Common side effects of this drug include chills,

fever, nausea, and headache. These effects don’t

appear to last for long. Serious heart problems rarely

occur.

Chemotherapy

Chemotherapy, or "chemo," is the use of drugs to kill

cancer cells. Some chemotherapy drugs kill cancer

cells by damaging their DNA or disrupting the making

of DNA. Other drugs interfere with cell parts that are

needed for making new cells.

Docetaxel and cabazitaxel are chemotherapy drugs

used to treat advanced prostate cancer. They may

improve survival, delay or relieve symptoms, and

reduce tumor growth and PSA levels. Mitoxantrone

hydrochloride may relieve symptoms caused by

advanced cancer. Read Part 7 for more details on

chemotherapy.

See

Guide 2

for a list of drugs used to treat prostate

cancer. The chemotherapy drugs used to treat

prostate cancer are liquids that are injected into a

vein. The drugs travel in the bloodstream to treat

cancer throughout the body. Chemotherapy is given in

cycles of treatment days followed by days of rest. This

allows the body to recover before the next cycle.

Docetaxel is an option for some men who are taking

ADT for the first time. In this case, six 3-week cycles

are advised. Side effects may include fatigue,

weakness or numbness in the toes or fingers

(neuropathy), inflammation of the mouth (stomatitis),