Chemotherapy involves a schedule, or cycle, of regular infusions at the hospital, as well as ongoing tests and monitoring. Chemotherapy for prostate cancer is usually given in 3-week cycles, to allow your body time to recover between treatments. Each infusion treatment lasts around one hour.

On average, most people with prostate cancer receive 6 cycles of chemotherapy, but this can vary from person to person. If your prostate cancer was discovered to have spread initially, you will only have 6 cycles. People with advanced prostate cancer may need more cycles.

Your medical team will discuss the cycle length with you before you start chemotherapy.

Chemotherapy is a commonly used treatment for prostate cancer that has spread or is advanced. Not everyone diagnosed with prostate cancer will need to have chemotherapy. Your health care team will advise you if this treatment option is likely to be beneficial for you.

If you are having chemotherapy, your specialist will develop a personalised treatment plan that considers your individual needs and circumstances. Your treatment plan will most likely cover:

• which chemotherapy drugs you will need
• what your treatment will involve
• how often you need to have the chemotherapy infusions
• where you need to have the infusions
• wow to manage the possible side effects
• which tests you need to have before, during and after your treatment
• whether you need any other treatments.

• Infections – While having chemotherapy, you may be more likely to get infections as your white blood cells count is lower than normal (white blood cells are part of your immune system and help fight infection).
• Tiredness and weakness
• Bleeding or bruising easily
• Fluid retention – You may get swollen ankles or legs.
• Mood changes – You may feel down, anxious or depressed. Mood changes are expected during chemotherapy, but speak to your specialist if you are struggling to cope.
• Bowel changes – You may develop diarrhoea or constipation; your specialist can give you medication to help with these issues.
• Numbness in the hands or feet (peripheral neuropathy) – Chemotherapy can affect your nerves, causing numbness.
• Sore or dry mouth – You may get mouth ulcers or inflamed gums.

There are many steps you can take to manage the side effects of chemotherapy. Some medications exist to help you manage side effects, including:

• steroids – these can lower your risk of side effects and help the chemotherapy to be more effective, but they also have side effects; speak to your specialist about the pros and cons of steroids and how to take them safely
• anti-sickness drugs – also known as anti-emetics, these drugs can help with the nausea and vomiting associated with chemotherapy
• antibiotics – a course of antibiotics to help lower your risk of getting an infection during chemotherapy
• G-CSF – a drug called G-CSF (‘granulocyte-colony stimulating factor’) can help your body produce more white blood cells if your count is too low.

Your specialist will give you more information about these medications and whether you may benefit from them.

To manage the side effects and stay as healthy as possible, try to follow these tips:

• Avoid close contact with people who are sick.
• Wash your hands regularly.
• Eat a healthy diet and avoid processed foods high in fat and salt.
• Choose soft, moist foods.
• Find foods you enjoy eating.
• Avoid spicy, acidic foods.
• Avoid strong-smelling foods.
• Eat smaller meals high in calories.
• Try eating sweets or lollies if your appetite is low.
• Avoid alcohol and smoking, to stay as healthy as possible.
• Drink plenty of fluids – at least 8 glasses of water each day.
• Use a soft toothbrush to avoid bleeding gums.
• Avoid using floss and toothpicks.

In the days before each chemotherapy treatment, you will need to have blood tests to check your levels of blood cells. This is to check that you have a safe amount of blood cells to tolerate the treatment, because low levels can increase your risk of infection.

You may also need tests to check your kidney and liver function. Your medical team will tell you which tests you need and when you need to have them done.

Your treatment will take place at the hospital, usually in the outpatient infusion centre.

• When you arrive, you will be registered and met by your nurse before being directed to your infusion chair.
• The nurse will go over important details with you, such as your consent, your medications and the possible side effects.
• They will place a cannula into a vein to start the chemotherapy.
• The infusion will last anywhere from 30 minutes to 6 hours, depending on the number of drugs to be infused.

Between treatments, you can continue to live life as usual. You don’t have to avoid pregnant women or children, but do try to stay away from sick people as you may be at a higher risk of infection. Always tell any other health care professionals (such as dentists) that you are having chemotherapy.

If, at any time, you are concerned about a side effect or symptom, call your medical specialist or emergency contact.