Docetaxel for Prostate Cancer
Chemo is used when prostate cancer has spread (metastasised) to other organs. Docetaxel is usually the first chemo drug administered combined with Prednisone (a steroid). Although chemo usually doesn’t cure prostate cancer, it can slow it down and help the patient to live longer and with a better quality of life. If Docetaxel does not work, or quits working, the doctor moves on to another chemo drug. Docetaxel makes the cell’s supporting structure stiff, so that it cannot grow or multiply. Cancer cells multiply uncontrollably and if a cell is stopped from dividing (mitosis) it will die.
Docetaxel for Breast Cancer
Docetaxel is used in combination with other chemo drugs after breast cancer surgery where:
- Cancer cells remain after surgery;
- Cancer has metastasised (spread to other organs); and
- Cancer has spread to the lymph nodes after surgery.
Docetaxel first received FDA approval under the brand name Taxotere in 1996, specifically to treat breast cancer. In 2011 the FDA approved the first docetaxel generic, under the brand name Hospira.
Docetaxel has successfully halted breast cancer in a high percentage of patients, but has not been shown to be more effective than Taxol in treating breast cancer.
Docetaxel For Lung Cancer
Docetaxel is used to treat non-small cell lung cancer. It was FDA approved as a second line treatment in 1999, and as a first line treatment in 2002. Survival rates vary depending on the cancer stage and the patient’s health, along with other factors. In first stage treatment, many patients showed a good prognosis, with survival of 5+ years. For all stages of cancer, the prognosis varies depending on many factors and it is good to work with your doctor to plan a treatment that will give the best result.
Docetaxel Side Effects
Side effects of docetaxel chemotherapy depend on many factors such as the patient, the type and stage of cancer, docetaxel dose, and can include:
- Vomiting/ diarrhea;
- Mouth sores;
- Breathing difficulty;
- Flu symptoms;
- Bruising or bleeding from orifices (nose, mouth, etc.);
- Swelling or abnormal retention of fluids;
- Painful urination;
- Black stools;
- Skin rash or peeling;
- Decreased/increased blood pressure;
- Chest pain;
- Numbness, pain, pinprick tingles;
- Muscle pain;
- Eye burning, itching, redness, discharge, swelling, tearing;
- Skin inflammation at injection site;
- Menstrual cycle disruption;
- Finger and toenails loosen or fall off;
- Temporary or permanent hair loss;
The above is not a complete list of possible side effects. What happens is that Docetaxel also attacks/kills normal cells, but with most of the side effects, when the chemo stops the cells recover/replenish and side effects go away. However, for as many as 10-15% of patients who experienced hair loss, their hair does not grow back, ever.
Docetaxel Package Insert
The Docetaxel package insert is different than the one they had a few years ago. On page 34, under Cutaneous side effects, it finally says “Cases of permanent alopecia (hair loss) have been reported.”
This is under the Post-Marketing Experiences section, where the drug is approved by the United States Food and Drug Administration (FDA) to be sold in the United States and the FDA continues to monitor it for the long haul as a large group of the population take the drug, and some survive the cancer but they may have problems from the chemo drug. On page 1 of the 62 page FDA Label it says after the writing, “Revised: 12/2015.”
This revision included a warning about permanent hair loss, which the company, Sanofi-Aventis, withheld from the FDA for ten years longer than they gave the information to European medical officials (2005); Health Canada got the information in 2013.
Of course, finding this information is like reading a lengthy adhesion contract, because people are unlikely to read the 62 page label; they just trust their doctors, most of whom had no idea of this side effect until it was disclosed to the FDA. Because of the company’s lack of disclosure, many patients who, having survived cancer, find themselves without body hair for the rest of their lives have filed suit against Sanofi-Aventis. Sanofi is also guilty of misbranding for funding bogus studies which claimed their Docetaxel product Taxotere worked better than another product, Taxol which is available and does not cause permanent hair loss.
People Should Know About the Risk of Permanent Hair Loss
People have a right to be involved in their therapy. If two treatment choices are equal in terms of effectiveness and only one carries a high risk of irreversible baldness, the patient may choose to avoid that possibility. Cancer survivors want to put the illness behind them and move on. Permanent loss of hair is a constant reminder. This can have emotional, psychological and financial implications.
Implications of Permanent Hair Loss After Chemo
While temporary hair loss after chemo exists across multiple drugs, it grows back, and programs exist to deal with the cost of hair loss such as wig purchases. The programs do not assist those with permanent hair loss, so lifetime cost is borne by the individual suffering this side effect. In addition, many individuals suffer loss of income, particularly in jobs that require them to present themselves in a certain way.
In addition to the financial burden of permanent hair loss, the emotional trauma can be devastating, especially for people who lose all body hair including facial. One Canadian woman afflicted with loss of all body hair said people stare at her when she goes out in public.