Chemotherapy

What is chemotherapy?

Chemotherapy is a treatment for advanced prostate cancer (cancer that has spread from the prostate to other parts of the body).

It uses anti-cancer (cytotoxic) drugs to kill cancer cells, wherever they are in the body. It won’t get rid of your prostate cancer, but it aims to shrink it and slow down its growth.

Chemotherapy is usually used to treat advanced prostate cancer. It can sometimes be used to treat localised and locally advanced prostate cancer alongside other treatments.

Download or order our chemotherapy fact sheet

Who can have chemotherapy?

Chemotherapy for advanced prostate cancer

Chemotherapy is usually only an option if you’ve been diagnosed with prostate cancer that has spread from your prostate to other parts of your body (advanced prostate cancer).

• Chemotherapy as a first treatment for advanced prostate cancer. If you’ve just been diagnosed with advanced prostate cancer, you might be offered chemotherapy as part of a triplet therapy. This helps many men to live longer, and may help to delay symptoms such as pain.

• Chemotherapy as a further treatment for advanced prostate cancer. You might be offered chemotherapy later on if your cancer is no longer responding to hormone therapy. This may help some men to live longer, and can help to improve and delay symptoms.

You need to be fairly fit to have chemotherapy because the side effects can be harder to deal with if you have other health problems. If your doctor thinks you might benefit from chemotherapy, they will do some tests to make sure it is suitable for you.

Chemotherapy for localised and locally advanced prostate cancer

You usually won't have chemotherapy on its own if you have:

• localised prostate cancer (cancer that is inside the prostate and hasn't spread out of it)
• locally advanced prostate cancer (cancer that has spread just outside the prostate).

This is because other treatments work better. This is different from some other types of cancer, which are often treated with chemotherapy first.

But chemotherapy is sometimes used in addition to other treatments to treat some localised and locally advanced prostate cancer that your doctor thinks could have a high chance of spreading to other parts of the body. Chemotherapy may be used alongside radiotherapy and hormone therapy.

Chemotherapy to treat rare prostate cancers

There are different types of prostate cancer, and some of these are rare. Chemotherapy can be used to treat rare types of prostate cancer, such as small cell prostate cancers. If you have been diagnosed with a rare type of prostate cancer, you may have a different type of chemotherapy that isn’t discussed on this page. Read more about rare prostate cancers or speak to our Specialist Nurses.

What are the advantages and disadvantages of chemotherapy?

Everyone's experience of prostate cancer is different and what may be important for one person might be less important for someone else. So speak to your doctor or nurse about your own situation.

Advantages

• Chemotherapy might shrink the cancer or slow down its growth. This can help you to live longer.
• It can help improve or delay symptoms such as pain, which can improve how you feel in your day-to-day life.
• Most people will have chemotherapy in the hospital outpatient department and will not need to stay overnight.
• You may have more regular check-up and tests. Some people find this reassuring.

Disadvantages

• You will need to have hospital appointments every few weeks.
• Chemotherapy affects each person differently, and it may not work so well for everyone.
• It can cause side effects, which can be difficult to deal with. But there are usually ways to manage them.
• Some side effects, like hair loss, can be hard to hide from other people. This can be a problem if you haven't told people about your diagnosis.
• You may be given steroid tablet to take alongside chemotherapy. These can cause side effects too.
• Some side effects, like infections, can be fatal if they are not treated. But this is very rare. If you're worried, talk to your doctor or nurse.

Deciding to have chemotherapy

The thought of having chemotherapy and the side effects that come with it can be difficult. If you’re offered chemotherapy, speak to your doctor or nurse before deciding whether to have it. They can talk you through the advantages and disadvantages, tell you about other treatment options and help you decide if chemotherapy is right for you.

It may help to take some time to think about what matters to you. Try writing down the advantages and disadvantages based on your own situation and what feels right for you

Talking things through with someone you trust, like a loved one, can also help. You may find it helpful to read about other people’s experience of chemotherapy on our online community. Or you could chat to someone who has had chemotherapy through our One-to-One Peer Support Service. And if you have questions or need more information, our Specialist Nurses are here to help.

We’ve included a list of possible questions to ask below.

Are there other treatment options for advanced prostate cancer?

Some men with advanced prostate cancer have hormone therapy on its own. When this stops working there are other treatments available, such as newer types of hormone therapy. Ask your doctor or nurse about other possible treatments, including any clinical trials, before you decide.

Will chemotherapy affect other treatments I’m having?

If you're having hormone therapy, you'll usually keep having them alongside chemotherapy. This is because hormone therapy might still help to control your cancer.

Other medicines

Let your doctor know if you’re taking other medicines – including supplements (such as vitamins and minerals) or herbal remedies. You may need to stop taking them while you’re having chemotherapy, as they could interfere with your treatment.

What does treatment involve?

If you decide to have chemotherapy, you will be referred to an oncologist (a doctor who specialises in cancer treatments), and a chemotherapy nurse.

Your doctor or nurse will discuss your treatment plan with you. They’ll explain which medicines you’ll have, what the treatment will involve and what the possible side effects may be. They’ll also tell you about any tests you’ll need before, during and after your treatment.

If you start chemotherapy soon after you’ve been diagnosed, alongside hormone therapy, you will have up to six sessions (also called cycles) of treatment. There is no set time when you should start chemotherapy and it is different for every man. It’s usually fine to start chemotherapy any time up to three months after starting hormone therapy.

If you’ve already had hormone therapy, chemotherapy may be given as a course of up to 10 sessions. But this might not be the same for everyone, and you may be able to stop your chemotherapy sessions early if your doctor thinks you no longer need them.

You’ll usually have treatment every three weeks. To begin with, your doctor will monitor you after each session to check that your treatment is working and you don’t have too many side effects.

Before each treatment session

A few days before each session you’ll have a blood test to check the levels of different blood cells (your blood count). This is important because chemotherapy can cause the level of white blood cells, red blood cells, and platelets to drop.

If your white blood cell count is low, you might not be able to have your treatment as planned. White blood cells fight infection. If your white blood cell count is too low, you are at risk of getting infections, which can make you very unwell. Your doctor may reduce the amount (dose) of chemotherapy they give you. Or they might delay the session until your white blood cell count returns to normal. You may also be given a drug called G-CSF (granulocyte-colony stimulating factor) to help your body produce more white blood cells. Read about the side effects of G-CSF.

If your red blood cell count is low, your blood may not be able to carry enough oxygen around your body. This can make you feel tired, weak and breathless. Your doctor may offer you a blood transfusion to boost your number of red blood cells. This will be given through a drip into a vein in your arm (intravenous infusion).

You will also have blood tests to check how well your liver and kidneys are working. This is because the liver and kidneys break down the chemotherapy drugs and get rid of them from the body. If they’re not working properly, the drugs will stay in your body for longer and you could have a higher risk of side effects.

Before each treatment session begins, your doctor or nurse will check how you’re feeling and how you’re dealing with any side effects.

Your doctor might decide to stop your treatment if you have severe side effects or your cancer continues to grow. If this happens, your doctor will talk to you about other treatment options. Everyone responds differently to chemotherapy. Some men find the side effects difficult to deal with and decide to stop treatment. If you want to stop treatment, speak to your doctor or nurse.

During your treatment

The chemotherapy will usually be given through a drip into a vein in your arm (intravenous infusion). Treatment normally takes about one hour and the tube (cannula) will be removed from your arm before you go home.

After each treatment session

Your hospital team will advise you on how to continue with life while having chemotherapy and who it's safe to be around. In general, most men continue with life as normal while having chemotherapy. It’s safe to be around other people when you’re having chemotherapy, including children and pregnant women.

If you go to the dentist or have any treatment for other health problems, let the dentist or doctor know that you’re having chemotherapy as it can affect other treatments.

Between appointments

If you have any concerns between your appointments, or get any new side effects or symptoms, contact your doctor or nurse. They can often help you find ways to manage them.

When you start your treatment, your chemotherapy nurse should give you details of who to contact at the hospital, including during the night and at weekends. Use this contact number, rather than calling your GP. Remember to call if you have any concerns, even if you think they’re not very important.

What are the side effects?

Like all treatments, chemotherapy can cause side effects. These will affect each man differently, and you might not get all the possible side effects. Most of them are temporary and will gradually go away after you finish treatment. Before you start treatment, talk to your doctor or nurse about the side effects. Knowing what to expect can help you deal with them.

Read more about the side effects of chemotherapy.

What happens afterwards?

After you finish your chemotherapy, you will have regular follow-up appointments to check how well your treatment is working and monitor any side effects. Your doctor or nurse will let you know how often you’ll have appointments.

You will have regular blood tests to measure your level of PSA (prostate specific antigen). Your doctor will also ask you about any side effects from your treatment and any symptoms you might have. If your PSA level falls, you may find that your symptoms start to get better.

Sometimes PSA levels can rise after having chemotherapy, then come back down again. A rise in PSA doesn’t necessarily mean that your chemotherapy isn’t working.

Are there further treatments available after chemotherapy?

If your cancer starts to grow again after you finish chemotherapy, you may be able to have other treatments. The aim of further treatment is to control your cancer and delay or manage any symptoms you might have, such as pain.

You might have more than one of the treatments we describe here. The treatments you are offered will depend on:

• how well you are
• any symptoms you have
• which treatments you’ve already had
• any other health problems you have.

Talk to your doctor or nurse about which treatments are available to you.Possible treatments include:

• more chemotherapy such as cabazitaxel or, less commonly, more docetaxel
• anti-androgens
• androgen receptor pathway inhibitors (ARPIs)
• PARP inhibitors, such as olaparib (Lynparza®)
• oestrogens
• radium-223 (Xofigo^®)
• new treatments and clinical trials.

There are also treatments you can have to help with symptoms of advanced prostate cancer. These treatments treat the symptoms but not the cancer itself. Read more about the symptoms of advanced prostate cancer and how to manage them.

Dealing with prostate cancer

Being diagnosed and living with prostate cancer can change how you feel about life. If you or your loved one is dealing with prostate cancer you may feel scared, stressed or even angry. There is no ‘right’ way to feel and everyone reacts differently.

Visit our wellbeing hub for information to help support you in looking after your emotional, mental, and physical wellbeing. If you are close to someone with prostate cancer, find out more about how you can support someone with prostate cancer and where to get more information.

Questions to ask your doctor or nurse

• How can chemotherapy help?
• How long will the treatment last, and how many sessions will I need?
• What are the possible side effects of chemotherapy, and how long will they last?
• Can I stop the treatment if I find the side effects difficult to deal with?
• Are there any other treatments available to me?
• Who should I contact if I have any questions during my treatment and how do I contact them?
• What happens if chemotherapy doesn’t work? Are there other treatments I can have later on?
• Are there any clinical trials I can take part in?

References and reviewers

Updated: November 2025 | Due for Review: November 2028