1. Systemic treatment for metastatic prostate cancer
Ian Ingledew
Consultant Nurse
Gloucestershire Oncology Centre

2. Docetaxel (Taxotere) IV Chemotherapy With daily Prednisolone (TXP)
21 day cycle
6-10 cycles
STAMPEDE Trial (May 2015)

3. Docetaxel (Taxotere) Side effects Hair loss
Myelosuppression (risk of neutropenic sepsis)
Fatigue
Diarrhoea
Peripheral sensory neuropathy (Can be long term/permanent)

4. Enzalutamide (Xtandi)
4 Tablets daily
Monthly assessment
Homecare
Side effects
High BP, fatigue, hot flushes, headaches, memory problems, seizures (rare)

5. Abiraterone (Zytiga) 2 tablets daily
With Predisolone (reduces side effects)
Monthly assessments
Side effects
Fluid retention, high BP, diarrhoea, hypokalaemia, abnormal LFTs

6. Cabazitaxel (Jevtana)
IV chemotherapy
With daily Prednisolone
21 day cycle
Side effects similar to Docetaxel

7. Radium 223 (Xofigo) For bone metastases IV drug (in Nuclear Medicine)
28 day cycle
Up to 6 cycles
Drug mimics calcium so readily taken up by bones.
Delivers radiation over short distances

8. Radium 223 (Xofigo) Side effects Increase in pain initially Diarrhoea
Myelosuppression (Hb >100g/L)