Video: Side Effects of Prostate Cancer Chemotherapies | Ask a Prostate Cancer Expert, Mark Scholz, MD

Alex: So, Dr. Scholz, we have three chemotherapies we've learned before in other videos with Taxotere, Jevtana, and now Carboplatin (which is not approved in prostate, but you've mentioned that and you are using it). What are the side effects of these different chemotherapies and what are—this is kind of a strange thing to say—but what are the "hacks" that patients can do--Internal things that you know as a medical oncologist to help mitigate those side effects? 

Dr. Scholz: So, there's a lot of things that can be done to cut back on side effects from chemotherapy. As we repeatedly ask people to do, we try and get people to exercise. Exercise has been shown to reduce the side effects of hormone therapy, of radiation therapy, and it also reduces the side effects of chemotherapy. So, since fatigue is the number one problem with these medicines and with all these treatments, the exercise counteracts that and it's important to sustain it. Even though these treatments cause fatigue, if people can push through it and do some exercise, they feel a whole lot better. So that's number one. 

Number two is because there are low blood counts, there are medicines that can build blood counts up. Make the red cells grow more prolifically, make the white cells grow. Neupogen, Procrit, Aranesp are the names of some of these injectable medicines. They're kind of pricey and so some physicians aren't using them as a preventative but we typically do because we don't want patients to get into trouble and then try to dig them out of the ditch. We want to keep them out of the ditch to start with. So, the insurance companies have been pretty good about covering them, so we don't usually run into payment issues and those medicines do make a big difference. 

The problems with hair loss aren't as bad as with some other types of chemotherapy, but they can be notable. For breast cancer, patients who are getting chemotherapy can put ice caps on to keep blood flow away from the scalp and those are very effective. They're not covered for men. They are covered for women, but they work in men, and so they can be, again, somewhat expensive because insurance companies may push back and not cover it like they would for breast cancer, but for men who are really determined to not lose their hair the process of icing the scalp during the chemotherapy infusion works very well. 

And speaking of icing, the chemotherapy can cause the taste buds to malfunction and food tastes really kind of goofy when people are on Taxotere and Carboplatin and Jevtana, and the sucking on ice-cubes during the infusion will shunt the blood flow away from the tongue and help preserve that. Same thing for fingernails. As we've mentioned in a previous video, the things that are growing quickly (our hair, our fingernails) are the most susceptible to damage from the chemotherapy, so if people keep their fingers on ice and keep the blood flow off the fingertips, it helps preserve the normal fingernails. 

So, these are just some of the little tricks that we've learned because, as a prostate cancer specialty practice we use these medicines a whole lot and they make a big difference.