Taxotere (chemotherapy for prostate cancer) is administered intravenously usually in an cancer center or a hospital setting. Often the areas which are designated for chemo administration are referred to as infusion centers.

Taxotere is administered with either on a higher dosage schedule of once every three weeks (q3wk) or a lower dosage schedule of once every week (q1wk). The higher, once every three-week schedule, seems to be more effective in combating the disease. The lower dose, weekly schedule is used for those patients who are unable to tolerate the higher dosage protocol.

The most common side effect of chemotherapy is fatigue. About 50% of all men receiving Taxotere complain of moderate to very severe fatigue. Usually, the fatigue abates in about one week after the infusion. Men receiving the lower dosage report lower levels of fatigue, but their fatigue often lasts for a longer period post infusion.

Another common side effect is edema, or swelling of the feet and ankles. The swelling is a result of water retention and should be reported to your physician. Your doctor can prescribe a diuretic (water pill) to help your body expel the fluid. Do not ignore any signs of edema because it could also be an indication of other complications. Edema can be a sign of an abnormal removal of interstitial fluid caused by obstruction of the lymphatic system, for example due to pressure from a tumor or enlarged lymph nodes, destruction of lymph vessels by radiotherapy, or by infiltration of the lymphatics by an unrelated infection.

Taxotere can also have a significant impact on your blood. Anemia, or a low red blood cell count, can actually be the reason many men report fatigue. Anemia can be combated by taking Aranesp or Procrit which mimic a naturally occurring hormone that stimulate the body to produce more red blood cells.

Your white blood cells (WBC) can also be affect by Taxotere. A depressed WBC
impairs your immune system and opens you up to contracting other infections.
These infections can be very serious and lead to hospitalizations and even death.
Taking white blood cell growth factors such as Neupogen, Neulasta or Leukine
can stimulate your own production of white blood cells inorder to protect your immune system.

Taxotere can also irritate the liver. It seems to affect liver enzymes that cause the
irritation. Lowering the dosage of Taxotere allows the liver to recover.

Taxotere also affects the ability to taste things and it can also cause nausea. Both of these side effects make food less attractive and can cause unwanted weight loss. Many
men report that sucking on ice cubes during the actual infusion helps to reduce
these effects. There are also drugs (Zofran, Anzemet and Kytril) that can block the
feeling of nausea.

Rarer, but a not uncommon side effect is diarrhea. Mild diarrhea can be controlled with over the counter medications, but severe diarrhea may necessitate stopping the Taxotere.

Taxotere may also cause skin, nail and hair loss. Sometimes tear ducts will become irritated and not able to drain. Some men will also experience neuropathy, or a numbness or tingling in the toes and fingers. High doses of glutamine can minimize the neuropathy.

Despite all of these potential side effects, Taxotere has proven to be effective and to extend lives. The degree that a man may experience any side effect or even what side effect is not predictable, however many men do not experience or experience only very mild side effects. Your oncologist has many tools available to help you navigate the road of chemotherapy. Make sure that you let your doctor know what you experience and ask for help in combating any negative effects you might experience.

Joel T Noawk MA, MSW