How to make prostate cancer patients better tolerate chemotherapy ?

In patients with incurable & widespread prostate cancer, one of the treatment option is a combination of three treatments (“TRIPLET THERAPY”)

This TRIPLET combination involves CHEMOTHERAPY given with HORMONE INJECTIONS and HORMONE TABLETS.

But many prostate cancer patients are frail and elderly with multiple other medical problems. So chemotherapy is not used in those patients and only Hormone tablets and injections are used .

The DOUBLET combination of HORMONE INJECTIONS and HORMONE TABLETS do a good very job indeed and frail patients are spared the nasty side effects from chemotherapy.

A study presented at the annual congress of European Society for Medical Oncology at BERLIN shows that if chemotherapy at a lower dose and is given every 2 weeks rather the typical every 3 weeks , then chemotherapy is better tolerated. The 2 weekly schedule resulted in statistically significant and clinically meaningful reduction in the incidence of severe side effects.

References

  1. ARASAFE : ESMO daily reporter. Is less more for patients with genitourinary cancers? 17 Oct 2025 Christoph Oing
  2. ESMO . LBA92 – 3-weekly docetaxel 75 mg/m2 vs 2-weekly docetaxel 50 mg/m2 in combination with darolutamide + ADT in patients with mHSPC: Results from the randomised phase III ARASAFE trial

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Is radiotherapy to prostate useful even after the cancer has escaped from prostate?

Yes, it can be helpful but only in certain circumstances.

Former US President Biden is in the news this week and multiple media outlets reports that Biden is having  radiation therapy to prostate along with hormone therapy.

The news outlets also indicate that Biden has aggressive prostate cancer which has spread to the bones.

Any spread of prostate cancer to bones is classified as stage 4 prostate cancer.

If cancer has NOT spread outside the prostate, the combination of radiation and hormones could be curative .

But, with stage 4 prostate cancer, radiation is generally not curative. This is because once the cancer cells have spread, it is extremely difficult to eradicate those cancer cells permanently. 

A large UK trial ( STAMPEDE trials) found that “Radiotherapy to the prostate did NOT improve overall survival for unselected patients with newly diagnosed metastatic prostate cancer”

So if radiation does not improve survival, why did the oncologists offer radiation therapy to Biden?

Full medical details are not available and so it is difficult to give a definitive answer in Biden’s case.

There are few possibilities.

In the above mentioned STAMPEDE trial , in a smaller select group of patients, Radiation therapy did improve overall survival in men with a low metastatic burden. ( ie fewer cells have spread).

One can only speculate whether that’s been the case with regards to Mr Biden.

References

  1. CNN. Biden starts radiation therapy for aggressive form of prostate cancer. By Kevin Liptak, Fadel Allassa. UPDATED OCT 11, 2025, 11:28 AM PUBLISHED OCT 11, 2025, 10:01 AM
  2. BBC news. Biden receiving radiation therapy for prostate cancer. By Jaroslav Lukiv. Published 11 October 2025.
  3. Lancet. Stampede trial. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

New treatment option for advanced prostate cancer patients

Advanced prostate patients were treated with hormone injections only in the past. When these advanced cancer patients were no longer responding to those hormone injections, tablets such as Enzalutamide , Apalutamide and Abiraterone were added to the hormone injections.

A new combination has become available for use in these patients.

Data presented at the ESMO Congress 2024 (Barcelona, 13–17 September) demonstrated the potential of combining Enzalutamide and Radium 223 injections.

The combination Enzalutamide and Radium 223 injections was better than Enzalutamide tablets alone.

The combination is likely to become a standard of care for these patients.

The only caveat is that a lot of advanced cancer patients are nowadays treated with hormone injections and tablets upfront. This trial data does not directly apply to these patients.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.