Chemotherapy has been shown to unequivocally improve prognosis of advanced prostate cancer patients.
The survival was found to be improved by an average of 10 months with addition of chemotherapy to long term hormone therapy in a large clinical trial.
Prognosis without chemotherapy was 71 months and prognosis with chemotherapy was 81 months.
But this extra benefit from chemotherapy comes at a cost.
Chemotherapy can be toxic with occasional life threatening side effects. Some elderly patients are frail and others may have diseases affecting heart, lung and brain.
So some patients after carefully weighing up benefits and risks might decline chemotherapy.
This need to weigh up risks and benefits is sometimes very difficult for both patients and doctors before a decision is reached whether to opt for chemotherapy or not.
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Access the BMJ article at: http://bmj.com/cgi/content/full/bmj.m519