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NCCN Guidelines for Patients


Prostate Cancer, Version 1.2016

diarrhea, and low counts of neutrophils (neutropenia)

with or without fever. Neutrophils are a type of white

blood cell.

Docetaxel is also used to treat metastases after

ADT fails to stop cancer growth. Three-week cycles

are also advised. The number of cycles you receive

should be based on how much the drug is helping

and the severity of side effects.

Cabazitaxel is an option if docetaxel fails to work.

However, the benefits of cabazitaxel are small and

the side effects can be severe. You should not take

cabazitaxel if your liver, kidney, or bone marrow is not

working well or if you have severe neuropathy.

You may have a severe allergic reaction within a

few minutes of receiving cabazitaxel. Common side

effects are fatigue, neuropathy, hematuria, back pain,

bruising, shortness of breath, cough, joint pain, and

hair loss. Severe stomach and intestinal problems,

illness from too few white blood cells, and kidney

failure may occur.

Not all of the side effects of chemotherapy 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.


Radiopharmaceuticals are drugs that contain

a radioactive substance. Radium-223 is a

radiopharmaceutical that is injected into the body to

treat prostate cancer that has spread to the bone. It

may improve survival time. It may also delay bone

problems and the need for radiation to treat pain.

Since the chemical makeup of radium-223 is similar

to calcium, it travels to bone damaged by cancer.

Once it reaches the bone, it delivers radiation that

kills the nearby cancer cells. The radiation doesn’t

travel far so healthy tissue is spared.

Radium-223 may lower blood cells counts. Thus, you

may get infections and bruises and have unusual

bleeding or fatigue. Since radium-223 leaves the

body through the gut, other common side effects are

nausea, diarrhea, and vomiting.

89Sr (strontium-89) and 153Sm (Samarium-153) also

are radiopharmaceuticals. They haven’t been shown

to extend life. However, they may relieve pain caused

by cancer metastases in the bone. They also may

cause a decrease in the number of blood cells.


Overview of cancer treatments Radiopharmaceuticals