Chemotherapy for prostate cancer: Clinical practice in Canada

Whereas prostate cancer was once deemed unresponsive to chemotherapy, there is now evidence that patients with metastatic castration-resistant prostate cancer can obtain a survival benefit from both first-line (docetaxel-based) and second-line (cabazitaxel-based) chemotherapy. The side effects of these agents have been shown to be predictable and manageable, particularly in North American centres. However, patient selection remains a key issue, with the aim of delivering each line of treatment at a time when the individual patient remains fit and well enough to tolerate a cytotoxic regimen. Hence, it is increasingly important for urologists and oncologists to work together to ensure timely consideration of the chemotherapeutic approach before it is precluded by a decline in performance status.