Docetaxel, Estramustine and Short Term Androgen Withdrawal for Patients With a Rising PSA After Local Treatment

- Patients will receive two medications; docetaxel and estramustine. Estramustine will be
taken orally three times daily for 5 days starting on day one. Docetaxel will be given
intravenously on day 2. These two drugs will be repeated every 3 weeks for a total of 4
cycles (12 weeks).

- Patients will also take dexamethasone for three days at the beginning of each cycle to
help decrease the risk of side effects.

- Patients will also take coumadin every day for three months while on the chemotherapy to
reduce the risk of blood clots.

- After 12 weeks the chemotherapy phase will be completed and patient will start on the
hormone therapy part of the treatment. Three weeks after the last chemotherapy
treatment, patients will start Casodex orally once daily.

- After taking Casodex for 1 week, patients will then start on Zoladex (an injection in
the abdomen) every 3 months for a total of 5 injections.

- During study treatment various blood tests will be performed to watch the disease. Study
treatment will stop after a total of 18 months (3 months chemotherapy and 15 months
hormone therapy). A physical exam and blood tests will be performed every 3 months for 2
years, every 4 months for the third year, and then every 6 months after that.

Inclusion Criteria:

- Histologically documented adenocarcinoma of the prostate

- Previous treatment with either radical prostatectomy or radiation therapy

- Post prostatectomy: PSA rising on at least two successive occasions at least two weeks
apart

- Post radiation therapy alone: PSA has to be rising as documented on two successive
occasions at least two weeks apart and also have doubled from the nadir post treatment
value

- ECOG performance status 0-1

- ANC > 1,500/mm3

- Platelet counts > 100,000/mm3

- SGOT and/or SGPT may be up to 2.5 x ULN

Exclusion Criteria:

- Documented local recurrence of prostate cancer or documented metastatic disease

- History of other malignancy within the last 5 years, other than curatively treated
basal cell carcinoma of the skin

- Medical condition requiring the use of concommitant corticosteroids

- Active infection

- Significant cardiac disease, angina pectoris or myocardial infarction within six
months

- Prior chemotherapy including estramustine, suramin

- Active thrombophlebitis or history of thromboembolic events in the six months
preceding study treatment

- Clinically significant neuropathy

- Elevated bilirubin above ULN