Prednisone Side Effects in Men

Prednisone in Men

Many men prescribed prednisone wonder: what are the prednisone side effects in men? How will the adverse effects in males differ from those in females?

I searched many articles, prescription drug databases, and patient support groups to compile this list of prednisone side effects in men.

Since prednisone is a steroid, it affects men differently than women.

Check out this video to explain in more depth which adverse effects of prednisone men might expect.

Watch now!

Find out what you can do to fight back!

Why Side Effects: The Chemical Structure of Prednisone

As an introduction into the reason why many of the side effects in men appear, we need to understand the basic science. Prednisone isn’t alone in the body. It looks like other structures, other signals, called hormones.

You see prednisone there below, and in the second image, below, on the left (cortisol). On the right in the second image below, you can see all the different hormones that are in our bodies, including steroid hormones.

Prednisone is mimicking cortisol on the top, or our “wear and tear” hormone, that affects our ability to deal with stress.

On the bottom, there are the sex hormones:

• The female hormones, progesterone and estrogen
• The male hormone, testosterone
• They all look pretty similar: they all have these four six-sided circles  that connect and kind of match each other.

Prednisone mimics cortisol and sex steroid hormones like testosterone, estradiol, and progesterone. This explains many of the prednisone side effects in men.

Prednisone Chemical Structure is similar to Testosterone, Estrogens and Progesterone

Our bodies can get confused when taking prednisone. It can interfere with the normal rhythm of these hormones and the cascade, how they switch between structures, can be messed up. That’s where the side effects come from.

Prednisone Side Effects in Men

Hormonal Issues

I’ll explain how prednisone affects men differently than women by first showing how changes in female hormones cause side effects, then how changes in male hormones cause prednisone side effects.

Female Hormones: Progesterone and Estrogens

• Prednisone Side Effects from Female Hormones:
  • Breasts: bigger, tender
  • Penis: smaller
  • Hot flashes
  • Mood like a menopausal woman

Because prednisone looks like those female hormones progesterone and estrogen, some men report changes in their physical anatomy.

Breast Changes from Prednisone

This is very rare. Don’t think, “Oh no, my doctor prescribed prednisone. I’m going to get man boobs!” No; this is very, very rare. It’s possible that a man could have changes in his breasts.

Male breasts might become tender. They might get a little bit bigger. Often prednisone causes weight gain and fat redistribution, and that might happen in the breast area.

Penis Changes from Prednisone

Two men report that their penis is smaller while taking prednisone than it usually is. Usually, these things go back to normal when you stopped taking prednisone. Read below for details about sperm.

Like a Menopausal Woman

So even in men, hot flashes are possible. You think, “I’m a man, there’s no way I’m going to feel like I’m in menopause.” Prednisone can make you feel like you’re a menopausal woman and you can get hot flashes with the sweating, the redness, the flushing, and even the mood changes.

Testosterone-Related Changes from Prednisone

Because prednisone is structurally similar to testosterone, these next side effects are related to the level of the male hormone, testosterone, changing while on prednisone.

• Male Hormones
  • Voice
  • Sperm
    • Dysmotility
    • Lower count
  • Sex Drive
  • Acne

Voice Changes from Prednisone

The male hormones like testosterone can change things like your voice. So you might get a little huskier voice than usual. It might give you a higher voice than usual. It’s just unpredictable and rare, but it’s possible.

Sperm & Fertility Changes from Prednisone

Either the sperm can have dysmotility, which means they can’t swim as well. They’re just not built to swim quite as well as they’re used to. Or the sperm might have a lower count. So it’s possible to have a little bit less fertility while on prednisone because essentially there’s not the right balance of hormones of the estrogen and the progesterone to the testosterone in the body to create the most fertile environment.

Sex Drive While on Prednisone

Men in support groups have shared that they have less sex drive at high doses of prednisone. They report that as the dose of prednisone gets lower, their drive tends to recover as well.

Acne from Prednisone

Prednisone is well-known for causing many skin issues. One of those may be hormonally-related to the testosterone, being acne.

Muscle Wasting from Prednisone

Prednisone is NOT an anabolic steroid, which would build muscles. Instead, it causes muscles to waste away. While not necessarily a male-specific side effect, for some men, this can be disheartening.

One man called to let me know that he was a competitive bodybuilder, and since taking prednisone, he’d lost so much muscle mass, he could no longer compete. I recommended he continue weight lifting (under his doctor’s supervision) and eat a diet rich in collagen and protein.

Here are some collagen supplements I recommend.

Psychiatric Side Effects

• Men are less likely to have psychiatric side effects of prednisone.
• But when they do, men are more likely to have these psychiatric side effects:
  • Mania
  • Delirium
• ‘Roid Rage

Mood changes and psychiatric side effects of prednisone are different in men and women. Men often have less overall psychiatric side effects than women. But when men do get psychiatric side effects, they can be more extreme.

Men are more likely to become psychotic, to have mania, and feel totally unlike themselves. 

Another possibility is a kind of crazy delirium; to just be incoherent and babbling and not “with it” at all.

Just not feel like your normal self. That is more typical in men than in women. And all of those changes are more likely when you’re on a higher dose.

So don’t worry: It’s not you. It’s the medicine. It’s a side effect!

So don’t feel like, “Oh no, I am going crazy!”

Because this medicine is making you feel crazy. While you do need to get legitimate treatment for it, take comfort that it’s not you. So don’t feel like you have a personal failing in any way; give yourself grace, get the help you need. And it will go away most of the time when you stop taking prednisone.

Read More…

• 3+ Ways to Cope with Prednisone Mood Swings
• Mental Health Side Effects: The Real Price of the Cheap COVID treatment

Hair

• Alopecia: Hair Loss
• Hirsutism: facial hair changes

Now, what about hair? Hair loss is more common in women than men but it is possible in men as well.

A change in facial hair can happen in men as well.

Women notice that they start getting facial hair that they never had before. So it’s possible because of those strange hormonal changes that men can also have facial hair changes.

Bones

One of the most important things you can do for long-term consequences is preventing bone loss. Prednisone is the #1 drug that causes osteoporosis. According to the doctors who prescribed prednisone the most, anyone who’s taking doses over 7. 5 mg a day should be taking vitamin D and calcium.

Men have less osteoporosis than women than post-menopausal women, but it’s still likely.

Avascular necrosis, a terrible prednisone side effect causing bone death in the hip, can happen to anyone, young or old, male or female. So if you’re ever having hip pain that wasn’t there before, make sure you talk to your doctor about it.

What can you do about all of these side effects?

I’ve got my best tips for you on the Prednisone Checklist.  Get the checklist by signing up in the form below!

Free Prednisone Checklist

Signs, Symptoms & Side Effects of Prednisone (Steroid) Abuse

Even though prednisone is not an addictive medication, it can cause uncomfortable withdrawal symptoms. Learn some of the common signs and symptoms of prednisone use.

Article at a Glance:

• When someone takes prednisone, their body reduces levels of naturally produced cortisol
• When prednisone use stops, cortisol levels stay low for a few days
• With lower-than-normal cortisol, people may experience withdrawal symptoms
• Withdrawal symptoms can be uncomfortable, but permanent damage is unlikely
• Withdrawal symptoms can be avoided with a prednisone taper

Side Effects of Prednisone Misuse

Uncomfortable prednisone side effects can happen even with appropriate use, but some people can also experience unpleasant prednisone withdrawal symptoms.

Prednisone is a synthetic steroid that mimics the natural hormone cortisol. The body uses cortisol to regulate a variety of factors like weight, appetite, mood and the immune system.

Even though prednisone is not an addictive substance, it can be abused and produce withdrawal symptoms, even with appropriate use.

The side effects of prednisone and prednisone withdrawal can be treated by a doctor. With a doctor’s help, patients whose bodies developed a prednisone dependency can receive a tapering regime to alleviate as many withdrawal symptoms as possible.

Symptoms of drug withdrawal are often associated with drug abuse. Prednisone abuse is uncommon even though some people experience a short-lived euphoria when they take it. Adrenal glands are efficient at adjusting the level of cortisol it releases, so the pleasurable effects experienced, if any, stop a few days after first using prednisone.

Abruptly stopping steroid use can lead to steroid withdrawal syndrome (SWS). Most prescribers will avoid SWS by tapering prednisone slowly, which allows the adrenal glands enough time to increase the amount of cortisol they make to move back to normal levels.

If a person currently takes prednisone and are experiencing side effects, to counteract these, they may need to speak with their doctor about a dosage adjustment. If a prednisone dependency develops, prednisone withdrawal can occur if the steroid use is stopped. There are certain signs and symptoms that people can anticipate if prednisone withdrawal is expected.

Physical Symptoms of Prednisone Withdrawal

There are many symptoms of prednisone withdrawal. When prednisone is stopped without tapering, the following physical symptoms may occur:

• Abdominal pain
• Coma
• Salt cravings
• Darkened patches in the skin
• Decreased consciousness
• Dehydration
• Diarrhea, nausea, and vomiting
• Dizziness when standing
• Fever
• Headache
• Seizures
• Hypotension
• Reduced appetite and weight loss
• Weakness, fatigue or slow movement

The symptoms of SWS resemble the symptoms of Addison disease, which is a disease where the body doesn’t make enough cortisol. The difference between the two is that SWS will get better with time and Addison disease requires a lifetime treatment with oral steroids like prednisone.

Psychological Symptoms of Prednisone Withdrawal

What are the side effects of prednisone?

Prednisone psychological side effects from SWS include:

• Lethargy
• Malaise
• Psychiatric symptoms like hallucinations and false beliefs

Other Prednisone Side Effects

While taking prednisone, it can produce different side effects in men and women.

Examples of prednisone side effects in men:

• Erection problems
• Low sex drive

Examples of prednisone side effects in women:

• Excess hair growth
• Irregular periods or periods that stop

Effects of Short-Term Prednisone Withdrawal

Prednisone short-term side effects tend to go away on their own.

The short term effects of prednisone withdrawal are uncomfortable but do not cause permanent side effects as long as a person’s adrenal glands are functioning properly. A prednisone taper is the most common treatment for withdrawal symptoms and can be tailored to last as long as a person’s body needs.

Effects of Long-Term Prednisone Withdrawal

Prednisone long-term side effects that linger after a person stopped prednisone use may mean they have an underlying adrenal disorder.

If a person experiences prednisone withdrawal for weeks or months after stopping prednisone, they should schedule a visit to their doctor. Long-term withdrawal may be evidence of an underlying adrenal disorder that requires treatment.

Intervention for Prednisone Withdrawal

Prednisone and other steroids must be tapered slowly to allow the adrenal glands to readjust how much cortisol they make. A typical taper regimen can last anywhere from days to weeks, depending on the dose of prednisone a person used and how long they were using it. Most regimens lasting longer than five days need a taper.

Taper regimens usually step down every three to five days. Here is an example:

1. Prednisone 20 mg daily for five days
2. Prednisone 10 mg daily for five days
3. Prednisone 5 mg daily for five days

While prednisone is not addictive, many prescription medications are. If you or a loved one live with an addiction to a prescription or illicit drug, contact The Recovery Village today. Call to speak with a representative about how addiction treatment can work for you.

Editor – Thomas Christiansen

With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more

Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP

Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

Read Previous
Prednisone Withdrawal & Detox: What to Expect

Anfinson, Theodore J; Channappa, C; Vo, HT.  “Drug Dependence Involving Prednisone:[…]f the Literature.” Psychopharmacology Bulletin, 2008. Accessed June 19, 2019.

Liu, Dora; et al. “A Practical Guide to the Monitoring a[…]osteroid Therapy.” 2013. Accessed June 19, 2019.

National Library of Medicine. “Addison Disease: MedlinePlus Medical Encyclopedia.” 2016. Accessed June 19, 2019.

National Library of Medicine. “Cushing Syndrome: MedlinePlus Medical Encyclopedia.” 2015. Accessed June 19, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.

Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy

Review question

We reviewed the evidence for the benefits and harms of using corticosteroids to treat chronic inflammatory demyelinating polyradiculoneuropathy (CIDP).

Relevance

CIDP is a rare paralyzing disorder that occurs when nerves outside the brain and spinal cord become inflamed. It causes slowly developing weakness and numbness of the extremities. Some patients have periods of exacerbation (worsening) followed by improvement or remission. We wanted to find answers to two questions: first, how beneficial is corticosteroid treatment; and second, whether one type of corticosteroid treatment is better than another. This is an update of a review first published in 2001 and updated in 2014.

Study profile

We found one randomized controlled trial (RCT) addressing each question. We didn’t find any new challenges for this update.

In a 1982 US study, daily prednisone tablets for 12 weeks were compared with no treatment. Thirty-five people took part in it. Fourteen participants received prednisone (10 males and 4 females, mean age (median) 46.5 years) and 14 participants did not receive prednisone (9men and 5 women, mean age (median) – 50 years). Participants and investigators knew which treatment participants were receiving (i.e., the study was not blinded), which carries the risk of bias.

The second study compared two six-month corticosteroid regimens: daily standard doses of prednisolone tablets and high doses of dexamethasone tablets for four days each month. This trial was carried out in several European centers, the results of which were presented in 2010. Forty-one people took part, but one withdrew from the study after the first day. did not want to continue participating in the study, and his diagnosis was incorrect. Patients who continued to participate, 24 of whom (18 men and 6 women, mean age 59. 9 years) received dexamethasone monthly, and 16 (10 men and 6 women, mean age 60.8 years) received daily prednisolone.

None of the studies received financial support from commercial organizations. Both studies were funded by an academic center or philanthropic foundations.

Main results

None of the included studies reported our preferred primary outcome, which was disability assessment.

After 12 weeks in the prednisone versus no treatment trial, 12 of 19 prednisone treated participants improved compared to 5 of 16 no prednisone participants, based on neurologists’ measurement of disease severity. Thus, when taking prednisone, improvement was observed approximately twice as often. The small number of participants in the trial and its limitations meant that even with this difference, we are not sure of the size of any effect of prednisone. The study authors did not report in detail on side effects, but one person who received prednisone died. In practice, corticosteroids are commonly used in CIDP based on favorable results from non-randomized trials. It is well known that corticosteroids cause side effects, especially when people take large doses for a long time.

In an RCT comparing two regimens of corticosteroid treatment, 10 of 24 participants on monthly dexamethasone and 6 of 16 participants on daily prednisolone recovered and discontinued treatment after one year, indicating similar effects. Changes in grip strength and muscle strength scores were also likely to be similar between treatment groups. Monthly dexamethasone and daily prednisolone had similar side effects, except that insomnia and moon face were less common with high-dose monthly dexamethasone therapy.

Quality of evidence

The benefits and harms of prednisone in CIDP have not been determined. The quality of the evidence is rated as very low as there is only one small randomized trial available with a high risk of bias.

Monthly dexamethasone and daily prednisolone may have similar benefits in CIDP, but monthly dexamethasone may have fewer side effects.

Date

Evidence is current to 8 November 2016.

If you found this evidence helpful, please consider donating to Cochrane. We are a charity that produces accessible evidence to help people make health and care decisions.

Donate

Translation notes:

Translation: Galimova Elina Ruslanovna. Editing: Prosyukova Ksenia Olegovna, Yudina Ekaterina Viktorovna. Project coordination for translation into Russian: Cochrane Russia – Cochrane Russia on the basis of the Russian Medical Academy of Continuing Professional Education (RMANPE). For questions related to this transfer, please contact: [email protected]

Taxanes as first and second line chemotherapy for metastatic prostate cancer

Prostate cancer (PC) is one of the most common cancers in men. More than 600,000 new cases of this disease are registered annually in the world, and in a number of countries where its highest incidence is noted (USA, Canada, countries of northern Europe), it took first place in the structure of oncological pathology in men [1,2].

In the Russian Federation in the last decade, there has been a rapid increase in the incidence of prostate cancer from 11,580 newly diagnosed cases in 2000 to 28,552 in 2011. Unfortunately, in more than half of patients, the disease is registered in common forms, in the treatment of which hormone therapy (HT) occupies the main place [3].

It is possible to achieve stabilization of the disease by blockade of androgens in more than 80% of patients, but the average time to progression after HT in metastatic PCa is only about 2 years [4].

Despite the castration level of testosterone, in almost 80% of these patients within 12-24 months the disease progresses with the development of the castrate-refractory form [5].

The group of such patients is characterized by the absence of the effect of standard hormonal treatment: the growth of prostate-specific antigen (PSA) against the background of castration testosterone levels, the progression of lymph nodes and/or bone and visceral metastases. Their average life expectancy without additional therapy does not exceed 6-12 months [6].

Modern chemotherapeutic drugs are effective in reducing PSA levels, tumor regression from loco-regional lesions and metastatic foci, improve the quality of life of patients, increase the time to progression and overall survival [7].

The FDA-approved combination of mitoxantrone and prednisolone was the “gold standard” for mpc treatment before the advent of taxanes. However, it has been established that this regimen has only a symptomatic effect, with virtually no effect on relapse-free survival and life expectancy of patients [8].

In 2008, a large multicenter randomized phase III study TAX 327 was completed, including a treatment analysis of 1006 patients with metastatic castrate refractory PCa [9].

The study compared the effectiveness of 2 different regimens – a combination of docetaxel and prednisolone and a combination of mitoxantrone and prednisolone.

All patients were randomized to:

• docetaxel (Taxotere) 30 mg/m2 weekly, 5 injections every 6 weeks;
• docetaxel (Taxotere) 75 mg/m2 every 3 weeks;
• mitoxantrone 12 mg/m2 every 3 weeks.

Patients in all three groups received additional prednisone. The median life expectancy was 19.2 months. in the 2nd group (docetaxel every 3 weeks), 17.8 months. in the 1st group (docetaxel weekly) and 16.3 months. in the mitoxantrone group. About a quarter of patients treated with docetaxel noted a significant improvement in the quality of life. Approximately half of patients treated with docetaxel had a 50% decrease in PSA. Side effects of docetaxel therapy included grade III-IV neutropenia in 32% of patients who received the drug every 3 weeks, and only in 1.5% of patients who received it weekly. Other side effects included weakness, alopecia, diarrhea, neuropathy, peripheral edema, decreased sexual function. It was concluded that the three-week regimen of docetaxel was superior in terms of palliative effect and life expectancy [10].

Similar results were obtained in a domestic study (TANDEM) with a similar design [11].

The SWOG 9916 study [12] was conducted in 2004 to investigate the possibilities of improving the effectiveness of modern chemotherapy by combining it with additional HT.

After randomization into two groups, men with castrate refractory prostate cancer were treated as follows:

• Group 1 – docetaxel (Taxotere) at a dose of 60 mg/m2 on day 2, estramustine – 280 mg orally 3 times per day from
  1st to 5th day every 3 weeks;
• Group 2 – mitoxantrone at a dose of 12 mg/m2 every 3 weeks against the background of prednisolone – 5 mg 2 times a day for a long time.

This study revealed a significant improvement in long-term treatment outcomes in patients treated with docetaxel in combination with estramustine (life expectancy – 17. 5 months in group 1 and 15.6 months – in group 2, p=0 .02; time to progression – 6.3 and 3.2 months, respectively, p <0.001), however, the increase in toxicity due to the inclusion of estrogen in the treatment regimen and the need to reduce the dose of cytostatics did not allow us to recommend this option for use in wide clinical practice, although the combination of cytostatic therapy with another variant of HT (medical or surgical castration) is recognized by most authors as appropriate.

We conducted a study that included 60 patients with HRP.

Two groups of patients were identified:

Group 1 (n = 31) received docetaxel (Taxotere) at a dose of 75 mg/m2 every 3 weeks + LHRH agonists (drug castration).

Group 2 (n = 29) received monotherapy with docetaxel (Taxotere) at a dose of 75 mg/m2 every 3 weeks.

Serum testosterone level in all these patients before inclusion in the study was significantly higher than castration level (1.7 nmol/l), since all of them received antiandrogens (bicalutamide) at a high dose for at least 3 months after the registration of castrate resistance, after which for a month did not receive hormonal therapy to register the withdrawal syndrome.

In both groups, patients were approximately comparable in age, degree of tumor differentiation and the nature of previous treatment. By the nature of bone metastasis, most of the patients in both groups met the Soloway 3-4 criteria.

Ensuring a high quality of life in patients with metastatic prostate cancer is a decisive factor in choosing a treatment regimen; for this, the level of pain syndrome and the activity status of patients were assessed as components of the quality of life. The level of pain gradation was assessed according to the WHO four-point scale, the assessment of the general condition was assessed according to the Karnovsky system.

The use of docetaxel (Taxotere) in combination with a luteinizing gonadotropin-releasing hormone analog (a-LHRH) improved the activity status in 5 (16.1%) patients of the first group and in 3 (10.3%) patients of the second group (p =0.06), which, combined with a decrease in the level of pain in 41.9% of patients in the first group and in 37. 9% (p<0.05) in the second, demonstrates a positive effect of therapy on improving the quality of life.

A positive response in the form of a decrease in PSA by more than 50% was noted in an equal number of patients – 11 in each group, but if this decrease occurred in the first group in the majority of patients (10) after the 2nd and 3rd courses, then in the second group, this effect was noted in 6 patients only after the 4th and 5th courses of docetaxel.

The progression of the tumor process in the form of the appearance of additional foci 6 months after the start of chemotherapy was observed in 9 patients of the first and 13 patients of the second group. The average life expectancy of patients who did not receive the next line of therapy was 15.5 months. in the 1st group and 13.6 months. – in the 2nd.

In recent years, the search for a structural modification of taxane derivatives has continued, which would have an additional antitumor effect after the development of resistance to known drugs. As a result of a slight modification in the structure of docetaxel, a new drug, cabazitaxel, was created, which overcomes resistance to cell cultures in vivo and in vitro and demonstrated activity in docetaxel-sensitive and docetaxel-resistant cell models.

The ability of the drug to overcome the blood-brain barrier and effectiveness in lesions of the spine and spinal cord (antitumor activity and symptomatic effect) was shown [13].

The TROPIC (Treatment of Hormone-Refractory Metastatic Prostate Cancer Previously Treated with a Taxotere-Containing Regimen) phase 3, randomized, multicenter trial comparing cabazitaxel with mitoxantrone in metastatic docetaxel-resistant PCa showed that the use of cabazitaxel ( Dzhevtan) significantly increased the median overall survival (15.1 months versus 12.7 months) and reduced the risk of death by 30% [14]. 2 years after the start of treatment, 28% of patients were alive, while in the group of patients treated with mitoxantrone, only 17% of patients remained alive by this time. Significantly increased the period without disease progression – 2.8 months. compared with 1.4 months. in the control group [15].

In this work, a rather high hematological toxicity of the drug was noted in the form of the development of febrile neutropenia. However, a number of studies (for example, the German Compassionate Use Program – CUP) have shown that the implementation of the recommendations of the American Society of Clinical Oncology for the prophylactic administration of leukopoiesis stimulants provides a more than twofold reduction in the likelihood of developing this complication [16].

Since October 2012, we have been monitoring 18 patients who received from 6 to 9courses of docetaxel (11 under medical castration and 7 without HT). In 17 of them, progression of the tumor process was noted: the appearance of new bone foci in 7 patients, in 2 patients iliac and para-aortic enlarged lymph nodes were identified and morphologically verified, in 1 patient metastases in the lungs appeared, in the remaining 7 patients a persistent increase in PSA during therapy (more than 6 months). In 1 patient, the reason for discontinuation of docetaxel treatment was severe polyneuropathy after 7 courses of therapy, although the PSA level remained stable. 8 patients continue to receive treatment with cabazitaxel (Jevtana) against the background of positive PSA dynamics for 8 to 3 months, in 5 patients stabilization was observed for 4-6 months, after which progression was noted, another 5 patients were transferred to other treatment options against the background of registration PSA rise after 3 courses of cabazitaxel treatment.

A decrease in the level of leukocytes was noted in all patients who received more than two courses of cabazitaxel, however, the appointment of leukopoiesis stimulants already at the first signs of leukopenia made it possible to avoid serious complications (leukopenia of grade 3-4 was noted only in 5 patients without severe consequences).

There were no cases of febrile neutropenia in our observations. None of the patients treated with cabazitaxel (Jevtana) was discontinued due to toxic complications. Thus, the sequential administration of taxanes – docetaxel (Taxotere) in the first line and cabazitaxel (Jevtana) in the second line – can increase the life expectancy of patients with metastatic PCa and improve the quality of life. Cytostatic first-line therapy should be carried out against the background of continued castration therapy.

Authors: Mishugin S.V., Skvortsova T.N., Sokov D.G., Rusakov I.G.

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2. https://seer.cancer.gov/statfacts/html/prost.html (accessed April 12, 2011)
3. Malignant neoplasms in Russia in 2011. Ed. IN AND. Chissova, V.V. Starinsky, G.V. Petrova, 2013.
4. Prostate Cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up, Ann Oncol 2012
5. B.Ya.Alekseev, ANAndrianov Possibilities and mechanisms of action of hormonal therapy in patients with castration-resistant prostate cancer. Oncourology 2113 No. 1, pp. 34-43.
6. Kish J, Bukkapatnam R, et al. The treatment challenge of hormone-refractory prostate cancer. Cancer Care;2001;8(6):487-495.
7. HarrisKA, Reese DM. Treatment options in hormone-refractory prostate cancer: current and future approaches. Drugs 2001;61:2177-92.
8. Kantoff P.W., Halabi S., Conaway M. et al. Hydrocortisone with or without mitoxantrone in men with hormone-refractory prostate cancer: results of the Cancer and Leukemia Group B 9182 study. J Clin Oncol 1999;17:2506–13.
9. Berthold DR, et al. Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer: updated survival in the TAX 327 study. J Clin Oncol 2008;10;26(2):242-5.
10. Tannok I.F., de Wit R., Berry W.R. et al. Docetaxel plus prednisolone for advanced prostate cancer N Engl J Med. 2004; 351: 1502 – 12.
11. Karyakin O.B. Russian experience with Taxotere in the treatment of metastatic hormone-refractory prostate cancer: results of the TANDEM descriptive study.