New treatments

Over the last few years, several new treatments for prostate cancer have been developed. This page has information about these new treatments and how they treat prostate cancer.

Abiraterone (Zytiga®): A new type of hormone therapy for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to other types of hormone therapy or chemotherapy. Abiraterone is also effective in men who haven’t yet had chemotherapy.

Enzalutamide (Xtandi®): A new type of hormone therapy for men with advanced prostate cancer that is no longer responding to hormone therapy or chemotherapy. Enzalutamide is also effective in men who haven’t yet had chemotherapy.

Cabazitaxel (Jevtana®): A new type of chemotherapy for men with advanced prostate cancer that has stopped responding to hormone therapy and the chemotherapy drug docetaxel (Taxotere®).

Radium-223 (Xofigo®): A new treatment for men with prostate cancer that has stopped responding to hormone therapy, has spread to the bones and is causing symptoms.

Which treatment should I have first?

There are a few new treatments for prostate cancer, and we don’t yet know the best order to have them in. For example, we don’t know whether having one treatment first might affect how well another treatment works in the future. There are clinical trials looking at the best order to have new treatments in.

Some treatments are only available for men who have already had another treatment. For example, cabazitaxel chemotherapy is only available for men who have already had docetaxel chemotherapy.

Talk to your doctor or nurse to find out which treatments might be suitable for you.

What is cabazitaxel?

Cabazitaxel (Jevtana®) is a new type of chemotherapy. It can’t cure prostate cancer, but it may help men to live longer. It can also help control or delay symptoms.

  • Who can have cabazitaxel?  

    Cabazitaxel is suitable for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to hormone therapy and the chemotherapy drug docetaxel (Taxotere®).

    Cabazitaxel is licensed for use in the UK, but it's not widely available on the NHS in England, Scotland and Wales, or through the Health and Social Care (HSC) service in Northern Ireland. This is because the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC) have not recommended it.

    If you live in England, you may be able to get cabazitaxel through the Cancer Drugs Fund. If you live in Scotland, Wales or Northern Ireland, your doctor may be able to apply for you to get cabazitaxel if they think it’s suitable for you.

    Read our information about getting new treatments for more on how to get treatments that are licensed but aren’t available on the NHS. For more information on cabazitaxel, speak to your doctor or nurse, or call our Specialist Nurses.

  • How does cabazitaxel treat prostate cancer?  

    Cabazitaxel is a chemotherapy treatment. Chemotherapy uses anti-cancer drugs to kill cancer cells.

    Cabazitaxel is given through a drip (an intravenous infusion). This usually involves passing the drug through a thin tube into a vein in your arm. It is given once every three weeks for up to ten treatments.

    In a clinical trial, men who were given cabazitaxel lived about two and a half months longer than men who were given a different type of chemotherapy.

  • What are the side effects of cabazitaxel?  

    Like all treatments, cabazitaxel can cause side effects. These will affect each man differently, and you might not get all the possible side effects. If you get any side effects, talk to your doctor or nurse. They can help find ways to manage them.

    Some of the common side effects include:

    • being more likely to get an infection
    • anaemia, which is a low level of red blood cells, and can cause fatigue and feeling short of breath
    • bruising more easily
    • diarrhoea (loose and watery bowel movements)
    • feeling or being sick (nausea or vomiting)
    • constipation (difficulty emptying your bowels).

What is radium-223?

Radium-223 (Xofigo®) is a new drug for men with prostate cancer that has spread to the bones and has stopped responding to hormone therapy.

Radium-223 delays bone symptoms of advanced cancer, such as bone fractures, and can reduce bone pain. It may also help men live longer. In a recent clinical trial, men who received radium-223 at the same time as their usual treatments lived about four months longer than men who took a placebo. A placebo is a dummy treatment, such as an injection of water or salt water.

Radium-223 is licensed for use in the UK, but it’s not widely available on the NHS. If you live in England, you may be able to get it through the Cancer Drugs Fund. If you live in Scotland, Wales or Northern Ireland, your doctor may be able to apply for you to get it if they think it’s suitable for you. Read more about getting new treatments.

You can also get radium-223 through a clinical trial.

  • How does radium-223 treat prostate cancer?  

    Radium-223 is a radioactive substance that is injected into a vein. It collects in bones that have been damaged by prostate cancer. It kills the cancer cells in the bones, but doesn’t damage many surrounding healthy cells.

  • What does treatment involve?  

    Radium-223 is injected into a vein through a small tube inserted into your arm (a cannula). The injection only takes a few minutes. You will normally have an injection every 4 weeks, for up to 6 injections. You can usually go home straight after the treatment.

  • What are the side effects of radium-223?  

    Because radium-223 does not cause much damage to the surrounding healthy cells, it doesn’t usually cause severe side effects. If you do get side effects they may include:

    • feeling and being sick (nausea and vomiting)
    • diarrhoea (loose and watery bowel movements)
    • low levels of blood cells called platelets.

    For more information about radium-223 speak to your doctor or nurse, or call our Specialist Nurses.

References

Updated: May 2015

  • Full list of references used to produce this page  

    Bahl A, Oudard S, Tombal B, Ozguroglu M, Hansen S, Kocak I, et al. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial. Ann Oncol. 2013 May 30;24(9):2402–8

    Brasso K, Thomsen FB, Schrader AJ, Schmid SC, Lorente D, Retz M, et al. Enzalutamide antitumour activity against metastatic castration-resistant prostate cancer previously treated with docetaxel and abiraterone: a multicentre analysis. Eur Urol. 2014

    De Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels J-P, Kocak I, et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. The Lancet. 2010 Oct;376(9747):1147–54

    Huber ML, Haynes L, Parker C, Iversen P. Interdisciplinary critique of sipuleucel-T as immunotherapy in castration-resistant prostate cancer. J Natl Cancer Inst. 2012 Feb 22;104(4):273–9

    Kantoff PW, Higano CS, Shore ND, Berger ER, Small EJ, Penson DF, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med. 2010 Jul 29;363(5):411–22

    NHS England. National Cancer Drugs Fund list Ver 4.2. 2015

    Parker C, Nilsson S, Heinrich D, Helle SI, O’Sullivan JM, Fosså SD, et al. Alpha Emitter Radium-223 and Survival in Metastatic Prostate Cancer. N Engl J Med. 2013;369(3):213–23

    Sheikh NA, Petrylak D, Kantoff PW, dela Rosa C, Stewart FP, Kuan L-Y, et al. Sipuleucel-T immune parameters correlate with survival: an analysis of the randomized phase 3 clinical trials in men with castration-resistant prostate cancer. Cancer Immunol Immunother. 2012