What is metastatic prostate cancer? Prostate cancer is a common cancer in older men, and is the most prevalent cancer among men in Europe and the United States. In China, the incidence is increasing year by year with the aging population and changing diet. Prostate cancer usually starts insidiously and progresses slowly, but often bone metastases have already occurred by the time it is detected, which is clinically known as metastatic prostate cancer. Metastatic prostate cancer is currently treated mainly with drug depot treatment because the proliferation of prostate cancer cells is usually dependent on androgens and apoptosis occurs after treatment with drugs that reduce androgen levels or counteract the effects of androgens. What is denervation-resistant prostate cancer? However, most prostate cancer patients progress to destructive resistant prostate cancer 2-3 years after destructive therapy, when PSA levels increase progressively despite continued use of destructive drugs, and patients develop clinical symptoms of progression such as difficulty urinating, hematuria, bone pain, and even paraplegia. After the onset of desmoid resistance, the current usual treatment regimen is docetaxel chemotherapy combined with desmoid therapy. This regimen can extend the survival time of most patients by about 5 months while reducing symptoms such as bone pain and dyspareunia. There are several other new drugs available for the treatment of desmoresistant prostate cancer, such as abiraterone, but these new drugs are not currently approved for marketing in China, and are expensive and only effective in extending survival time by 5-7 months. Why early combination chemotherapy? Early” combination chemotherapy refers to the use of combination chemotherapy regimens to treat metastatic prostate cancer as early as possible before the onset of denervation resistance. A study published in the New England Journal of Medicine in August 2015 reported that the use of combination chemotherapy regimens before the onset of disease resistance increased overall survival by 13.6 months and delayed the onset of disease resistance by about 10 months compared to the use of depression therapy alone. This result was obtained from a controlled clinical trial conducted over 9 years and including 790 patients. It should still be quite plausible. Are there any side effects of chemotherapy? It should be said that the side effects of docetaxel monotherapy are much less than those of classical combination chemotherapy, and that the overall benefits outweigh the risks. In particular, it is safer to administer chemotherapy early in the course of a patient’s health than when the disease has progressed and become debilitating. In these studies, allergic reactions occurred in about 2% of patients, fatigue in 4%, diarrhea, stomatitis, motor neuropathy and sensory neuropathy in less than 1%, thromboembolism in about 1%, and neutropenic fever in about 6% of patients. Nearly 90% of the patients successfully completed 6 cycles of chemotherapy. What is the cost of chemotherapy? Currently, our department is using imported docetaxel for chemotherapy, and the dose is adjusted according to the patient’s weight and response. The total cost of one cycle of chemotherapy is about 10,000 RMB, and the total cost of 6 cycles is about 60,000~70,000 RMB, and most of the cost is reimbursed by Shenzhen Social Security. Do I need to be hospitalized all the time during chemotherapy? It is not necessary. Each chemotherapy treatment requires about 3~4 days of hospitalization, and the interval between chemotherapy treatments is usually 3 weeks. Patients can go home to recuperate during this period. However, it is important to take rest, avoid crowded places, and return to the hospital for follow-up if you have any uncomfortable symptoms.