The most common side effect of Provenge (sipuleucel-T) reported is chills and shivers; men describe the experience by saying they feel as if they have the flu. In most cases, the solution is a dose of Benadryl along with a little time.
The first step in the administration of Provenge is to have a procedure called a Leukapheresis. A Leukapheresis is a process that separates some of your white blood cells (T cells or the immune cells) from your whole blood and then returns the remaining cells to you. The process only removes a small portion of your T cells, which are quickly replaced by your body.
The Leukapheresis is performed by using either two large bore needles or by a central venous catheter (CVC).
If the needles are utilized, one will be placed into a vein of each of your arms. One needle is then used to remove your whole blood and bring it to the machine that will separate out the T cells, and the other is used to return your remaining blood cells.
Using the needle system requires that you have good veins that are easily accessible. Using the two needle system requires that during the entire time of the Leukapheresis, which can last for four hours, your arms will be immobilized. Being immobilized will mean that you will be unable to walk around or go to the restroom.
Sometimes finding a good vein will require that you receive multiple needle sticks before a good vein is found. It is also possible that a vein fails during the procedure; needing additional needle sticks to find another.
Many men elect not to use the two needles, but instead, have a central venous catheter implanted. A central venous catheter (CVC), is a catheter surgically placed into a large vein. Usually, for Provenge, the catheter is placed into the chest, but it can also be put into the groin, the neck or through veins in the arm (also known as a PICC line).
The insertion of a CVC is done as day surgery and will cause you some pain or discomfort for a few days post surgery. It will also require special attention to keep the CVC and the surrounding skin clean.
Using a CVC makes the entire process of getting Provenge easier and more comfortable than the two-needle system. If you do have a CVC inserted, you will not have any needle sticks during the Leukapheresis or for the infusion of Provenge. With the CVC you will also be able to move around, walk and go to the restroom during both procedures.
When the Leukapheresis is completed the collection bag containing your T cells is shipped to a company called Dendreon where the cells are treated, or Provenge is made. After the T cells have been treated and pass a rigorous quality control process, they are shipped back to you to be infused back into you.
Cancer ABCs does have a few additional suggestions that will make getting Provenge a little bit easier.
1- Make sure that your insurance company has approved the treatment and will pay for it. Provenge, as well as the Leukapheresis and infusion, are very expensive.
2- Give serious consideration to having the catheter implanted and have it put in a few days before the first Leukapheresis.
3- Cover the catheter with some Glad Press-and-Seal so that you will be able to shower.
4- Restrict your fluids before the Leukapheresis, especially if you do not use a catheter. If you use the needles, you can’t get up and go to the restroom during the three-to-four hour process.
5- When you go bring friends, DVDs, music, your phone and a computer to entertain you.
Provenge is most effective when it is administered early in the course of your prostate cancer. Cancer ABCs believes that the optimum time to get Provenge is immediately upon becoming castrate resistant (your PSA climbs despite being on ADT and after confirming that you are castrated). However, it can be administered later on with good results, but its benefits might not be as good as it would be with an earlier administration.
Joel T. Nowak, MA, MSW wrote this Post. Joel is the CEO/Executive Director of Cancer ABCs. He is a Cancer Thriver diagnosed with 5 primary cancers - Thyroid, Metastatic Prostate, Renal, Melanoma and a rare cancer, Appendiceal Cancer.