Ever since the research showing that men who are newly diagnosed with very aggressive prostate cancer have a significant life extension advantage if they move immediately to chemotherapy (with docetaxel) along with hormone therapy (ADT) there has been, what I can only describe as a paradigm shift in the clinical care of men with metastatic hormone-sensitive prostate cancer.
However, many men are very afraid to have chemotherapy as there remains concerns about the toxicity (side effects) of the drug.
A recent study, however, showed that the adverse events experienced by men who have early chemotherapy tends to be short-lived and that, overall, men treated with ADT and chemotherapy continue to enjoy a high quality of life.
According to Linda J. Patrick-Miller, PhD from the University of Chicago Medical Center “Many patients fear chemotherapy and think they are going to be sick for months and months but at about 6 months, patients felt almost ‘back to normal,’ and by 12 months, they felt as they did before treatment.” She also said that by 12 months after receiving the chemotherapy in combination with ADT men reported a better quality of life than those who had been only on ADT.
Miller’s study was presented at the Genitourinary Cancers Symposium 2016 (ASCO GU) in San Francisco. She did acknowledge, while receiving ADT and chemotherapy, men did experience symptoms. However, she also said that, “It did not have a long-term impact on overall quality of life or on their emotional well-being.”
Miller also said that when chemotherapy is used at this stage it isn’t like other cancer therapies, which might only confer a modest benefit. Prior research has showed that adding chemotherapy to hormone therapy at this stage does have a significant impact on a man’s potential survival. One could say, more bang for the buck.
In their quality-of-life analysis, Dr. Patrick-Miller and her colleagues utilized data from the pivotal ECOG E3805 CHAARTED trial.
If you are faced with this decision, given this finding and since you can always choose to stop the chemotherapy, I urge that you give it a try and stay around longer in this world and enjoy your life.
Genitourinary Cancers Symposium (GUCS) 2016: Abstract 286. Presented January 7, 2016.