New Breakthroughs And Treatment Options For Metastatic Castrate
In recent years, scientists have made some landmark discoveries in how to treat mCRPC. New treatments for this form of cancer are being found. Also, changes are being made to existing treatments so they work better. If you are diagnosed with mCRPC, your doctor may prescribe one of these treatments:
Vaccines or Immunotherapy. Usually, vaccines prevent infections. Lately, researchers have been looking into using vaccines to treat mCPRC. If your prostate cancer returns despite hormone therapy and is metastatic, your doctor may offer the cancer vaccine sipuleucel-T . Sipuleucel-T works by boosting the bodys immune system so it attacks cancer cells. This is the first vaccine that has been shown to help men with prostate cancer live longer. Other prostate cancer vaccines are also being studied.
New Hormone Therapies. Two new kinds of hormone therapies have helped men with mCRPC delay symptoms and live longer.
Androgen synthesis inhibitors. The oral drug abiraterone acetate stops your body and the cancer from making steroids . Because of the way it works, this drug must be taken with an oral steroid known as prednisone. Abiraterone is approved by the FDA for use before or after chemotherapy in men with mCRPC
A Breakthrough In Prostate Cancer
In a study published in the Cell Reports, cancer cells’ evolution holds the key to preventing patients’ treatment resistance.
Common hormone treatment involves decreasing androgen receptor activity–responsible for binding hormones such as testosterone and transportation deep within the cell.
Prostate cancer cells depend on such hormones, and blocking the receptors would, in turn, starve the cancer cells.
However, cancer cells can quickly adapt to the treatment and promptly change to resists hormone therapy and evolve to a more aggressive neuroendocrine subtype of prostate cancer.
The resistance occurs in up to 15% of patients. Currently, there are no established effective treatments for these potentially lethal forms of prostate cancer.
Researchers have evidence that tumor adaptation is enhanced by microRNA called miR-194. This leads to the development of neuroendocrine prostate in patients post-therapy. Successful inhibition of miR-194 may slow down and even prevent the growth of cancer cells.
The team found out that miR-194 significantly increased when androgen receptors were turned off. Evidence also suggests that miR-194 regulates genes’ process, creating proteins, which allowed the cancer cells to show features of neuroendocrine cancers that resist conventional hormone therapy.
Improvements For Localized Cancers
There have been breakthroughs in the treatment of earlier-stage prostate cancers, too, which help to reduce the number of advanced cases in the long run. With respect to localized prostate cancer, one significant development has been the advent and expansion of active surveillance as a treatment option for men with low-risk prostate cancer, explains Dr. Haywood. For men with low-risk and very-low risk prostate cancer, this strategy avoids side effects of prostate cancer treatment while maintaining the ability to deliver definitive therapy when conditions dictate.
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Scientific Advancements And Progress
Recent diagnostic and therapeutic breakthroughs, such as tech-enabled radiation therapy, active surveillance, and health literacy, are revolutionizing cancer treatment and increasing survival rates around the globe. Here are some of the more common forms of treatment:
Radiation Therapy
Some recent and more advanced therapies focus on delivering radiation particles intravenously directly to the cancer cell itself. Upon completion of one such experimental therapy, researchers noted a roughly 40% decrease in mortality among the men who took it during the course of the study. The medication, lutetium-177-PSMA-617, or LuPSMA, targets the PSMA protein found in cancer cells as well as the radioactive particle that causes the cells to die. The FDA approved this treatment for advanced prostate cancer in March 2022.
Active Surveillance
Researchers are attempting to discover a middle ground between not treating cancer at all and aggressive therapies because as men wait longer between treatments, they become more concerned about their condition. They took the enzalutamide named drug into consideration to see if it could slow the progression of cancer in men under active surveillance, and they discovered that compared to individuals who remained on active surveillance alone, it took the treated men six months longer for their PSA levels to rise. However, there is still much to be studied to authenticate the efficacy of this drug.
Post Treatment for Radical Prostatectomy
Know The Signs: The Symtoms Of Prostate Cancer You Should Look Out For
In most cases, prostate cancer doesn’t have any symptoms until the growth is big enough to put pressure on the urethra – that tube you pee through.
Symptoms include:
- Straining and taking a long time while peeing
- Feeling that your bladder hasn’t emptied fully
Many men’s prostates get larger as they age because of the non-cancerous conditions, prostate enlargement and benign prostatic hyperplasia.
In fact, these two conditions are more common than prostate cancer – but that doesn’t mean the symptoms should be ignored.
The signs that the cancer has SPREAD include bone, back or testicular pain, loss of appetite and unexplained weight loss.
Dr Matthew Hobbs, director of research at Prostate Cancer UK said the study shows that combining the drugs could give men up to 18 months of additional life.
“This will make a huge difference for these men, and if the full results confirm these findings, we want to see this combination approved on the NHS as quickly as possible, he said.
The second trial, the Stampede trial, focussed on high-risk prostate cancer.
It found that at the six-year point, men who had received standard treatment as well as AAP for two years had an improvement in metastasis-free survival from 69 per cent to 82 per cent.
They also had an improvement in overall survival from 77 per cent to 86 per cent, and an improvement in prostate cancer specific survival from 85 per cent to 93 per cent – compared to standard treatment alone.
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What Are Some New Diagnostic Methods For Prostate Cancer
Diagnosing prostate cancer isnt easy. Thats because the major tools the prostate-specific antigen test and prostate biopsy arent perfect. PSA levels can be high for reasons other than cancer, and they can be low even when someone has cancer. This makes it hard to know when someone needs a prostate biopsy. Some people end up getting prostate biopsies they dont need, while others can get biopsies too late. Even when done perfectly, the biopsy can miss the cancer cells and delay a diagnosis.
Once someone has a diagnosis of prostate cancer, theyll get a risk class. This risk class tries to predict how the cancer will behave over time. Teams usually pick treatments based on these risk classes. But the tools that help to assign a risk class arent perfect either.
Scientists are working to improve methods for diagnosis to overcome these limitations. The FDA hasnt approved some of these methods yet, and your insurance may not cover them. But even so, they might be right for you:
New Data Shows That Mridian Results In Reduced Side Effects
The goal of the UCLA study was to compare traditional CAT-scan-based radiation therapy to the newer MRIdian technology, on 100 prostate cancer patients. And the initial results were groundbreaking: Patients treated with MRIdian had reduced side effects through shorter treatments.
At this time, we only have data on side effects within 90 days of treatment. Within that time, MRIdian reduced urinary side effects by about 60 percent and eliminated bowel toxicities altogether, says Martin Fuss, MD, PhD, and Chief Medical Officer at ViewRay. Thats relevant not only because its more comfortable for the patients in the short-term, but also because early side effects often precede developing or permanent issues with urination or bowel function.
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Could Immunotherapy Finally Break Through In Prostate Cancer
The first therapeutic cancer vaccine, approved more than a decade ago, targeted prostate tumours. The treatment involves extracting antigen-presenting cells a component of the immune system that tells other cells what to target from a persons blood, loading them with a marker found on prostate tumours, and then returning them to the patient. The idea is that other immune cells will then take note and attack the cancer.
The 2010 decision by the US Food and Drug Administration to approve this vaccine called sipuleucel-T raised hopes for a surge of cancer treatments that use the bodys natural capabilities to destroy the enemy within. Immunotherapies have at least partially delivered on that promise in many types of cancer. But not in the prostate.
Part of Nature Outlook: Prostate cancer
Prostate cancer has been a big challenge in terms of getting immunotherapies to work, says Lawrence Fong, a cancer immunotherapist at the University of California, San Francisco. Even sipuleucel-T was not an unqualified success. It delivered a slight survival benefit, but had no effect on tumour size or symptoms.
Chemotherapy For Prostate Cancer
Patients who no longer respond to hormone therapy have another option.
The chemotherapy drug docetaxel taken with or without prednisone is the standard chemotherapy regimen for patients who no longer respond to hormone therapy. Docetaxel works by preventing cancer cells from dividing and growing. Patients receive docetaxel, along with prednisone, through an injection. Side effects of docetaxel are similar to most chemotherapy drugs and include nausea, hair loss, and bone marrow suppression . Patients may also experience neuropathy and fluid retention.
Docetaxell, when used with or without prednisone, was the first chemotherapy drug proven to help patients live longer with advanced prostate cancer. The average survival was improved by about 2.5 months when compared to mitoxantrone with or without prednisone. Docetaxel has the best results when given every three weeks as compared to weekly dosing.
Cabazitaxel is another chemotherapy drug, used in combination with the steroid prednisone, to treat men with prostate cancer. Cabazitaxel is used in men with advanced prostate cancer that has progressed during, or after, treatment with docetaxelâââââââ .
Side effects in those treated with cabazitaxel included significant decrease in infection-fighting white blood cells , anemia, low level of platelets in the blood , diarrhea, fatigue, nausea, vomiting, constipation, weakness, and renal failure.
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Docs Remove Eight Embryos From The Stomach Of A 21
“When I started training 15 years ago we were doing very basic radiotherapy, where you’d treat big, square areas of the body.
“Of course, cancer is never square and that meant you would a lot of healthy tissue accidentally, because that was the best we could do.
“We are so much more precise that we don’t hit much of the healthy tissue now”, she told The Times.
It comes as another team of experts have developed a new cocktail of drugs to treat the cancer.
Finding Small Amounts Of Prostate Cancer Using Imaging And Psma
NCI-supported researchers are developing new imaging techniques to improve the diagnosis of recurrent prostate cancer. A protein called prostate-specific membrane antigen is found in large amountsand almost exclusivelyon prostate cells. By fusing a molecule that binds to PSMA to a compound used in PET scan imaging, scientists have been able to see tiny deposits of prostate cancer that are too small to be detected by regular imaging. The Food and Drug Administration has approved two such compounds for use in PET imaging of men with prostate cancer.
This type of test is still experimental. But the ability to detect very small amounts of metastatic prostate cancer could help doctors and patients make better-informed treatment decisions. For example, if metastatic cancer is found when a man is first diagnosed, he may choose an alternative to surgery because the cancer has already spread. Or doctors may be able to treat cancer recurrenceeither in the prostate or metastatic diseaseearlier, which may lead to better survival.
As part of the Cancer Moonshot, NCI researchers are testing whether PSMA-PET imaging can also identify men who are at high risk of their cancer recurring. Such imaging may eventually be able to help predict who needs more aggressive treatmentsuch as radiation therapy in addition to surgeryafter diagnosis.
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Types Of Treatment For Prostate Cancer
First, lets recap prostate cancer treatment basics, which will depend on a range of factors, including cancer stage and symptoms. Early-stage cancers may be treated with active surveillance, meaning your doctor will closely monitor it to see if it starts to progress before actively treating it. Once treatment begins, it may include a combination of surgery, radiation, and hormone therapy. Advanced prostate cancers may be treated with a combination of hormone therapy, targeted therapy, chemotherapy, immunotherapy, and other drugs. So, whats new in the treatment field?
A Breakthrough For Prostate Cancer Patients
The TROG 15.01 SPARK Trial stands out for multiple reasons.
The use of KIM technology is one of the main contributing factors, as it is the first-ever cancer treatment with real-time motion and rotation monitoring. This Australian-developed method is perfect for finding the position of cancer targets in real-time during the radiation therapy process.
Co-Chair of the clinical trial, Professor Paul Keall said that the accuracy of this technology provides an opportunity for cancer patients to receive better treatment, without the added time or bodily stress.
If the target moves, KIM detects this motion and enables this movement to be corrected so that the beam is always directed at the cancer target, he said.
In addition to real-time motion and rotational monitoring success, the SPARK Trial was also the first treatment with real-time adaptive radiotherapy on a standard cancer radiation therapy system combined with multileaf collimator tracking.
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New Treatment Approved For Late
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
In late March, the FDA approved a new therapy for advanced prostate cancer that is metastasizing, or spreading, in the body. Called Pluvicto , and delivered by intravenous infusion, the treatment can seek out and destroy tumors that are still too small to see with conventional types of medical imaging.
Pluvicto is approved specifically for men who have already been treated with other anticancer therapies, including chemotherapy and hormonal therapies that block the tumor-promoting hormone testosterone. The drug contains two parts: one that binds to a protein on prostate cancer cell surfaces called PSMA, and a radioactive particle that kills the cancer cells. Most normal cells do not contain PSMA, or do only at very low levels. This allows Pluvicto to attack tumors while sparing healthy tissues.
To confirm whether a man is eligible for the drug, doctors first inject a radioactive tracer that travels the bloodstream looking for and then sticking to PSMA proteins. Cancer cells flagged by the tracer will show up on a specialized scanning technology called positron-emission tomography. About 80% of prostate cancer patients have PSMA-positive tumors for those who do not, the treatment is ineffective.
Immunotherapy: Vaccines For Prostate Cancer
Immunotherapies are treatments that harness the power of the immune system to fight cancer. These treatments can either help the immune system attack the cancer directly or stimulate the immune system in a more general way.
Vaccines and checkpoint inhibitors are two types of immunotherapy being tested in prostate cancer. Treatment vaccines are injections that stimulate the immune system to recognize and attack a tumor.
One type of treatment vaccine called sipuleucel-T is approved for men with few or no symptoms from metastatic CRPC.
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Patient 60 Is Given Alpha
Medical pioneers in Israel say they have, for the first time, successfully treated a prostate cancer patient using alpha-radiation injecting a radioactive isotope into the tumor.
Alpha Tau Medical has been running clinical trials of the treatment for patients with skin cancer, breast cancer, and oral cavity cancer, with promising results.
But this is the first time in the world that the revolutionary therapy called Alpha DaRT has been used to treat a patient with prostate cancer, the companys CEO Uzi Sofer tells NoCamels. It directly damages the cell DNA, creating double-strand breaks which kill the cancer cells.
The patient, a 60-year-old man with an aggressive form of prostate cancer, felt no pain after the two-hour outpatient procedure and went home the same day from the Rambam Health Care Center in the northern Israeli town of Haifa.
He will return 50 days later to have the prostate surgically removed. Alpha DaRT is designed to destroy the tumor without harming the healthy tissue around it.
The historical event that we had last week is that this is the first time that we are treating an internal organ the prostate and that will give us a very, very good sign of internal organs, Sofer explains, noting that Jerusalem-based Alpha Tau Medical aims to use its Alpha DaRT therapy for treatment of GBM glioblastoma brain tumors, pancreatic cancers, and tumors in the liver, in the future.
Brain Has Evolved To Protect Humans From Traumatic Experiences
We feel truly sad for only six seconds at a time which is the brains mechanism for protecting us from emotional harm.
This is the amount of time it takes for chemicals which are linked to sadness in the brains emotion centre to be released and then reabsorbed. Any feeling that lasts longer is the brains consciousness reliving the experience of the feeling.
Experts say this is an evolutionary tool that has allowed humans to survive traumatic experiences without becoming emotionally overwhelmed.
They were then followed for more than four years.
In the group given darolutamide there was a 32 per cent reduced risk of death and a 65 per cent increase in progression-free survival the time before the disease begins to advance again.
One patient to have benefited from the triplet treatment is father-of-three and grandfather-of-nine Roger Downes, 78.
The retired airport worker from Essex was diagnosed with advanced prostate cancer five years ago, after being rushed to A& E suffering pain in his groin and blood in his urine.
Scans showed the disease had already spread into his pelvis.
He had eight weeks of chemotherapy along with standard hormone pills and darolutamide and continued on the tablets after the chemo had finished.
He has been on them ever since.
He said: ‘The cancer has disappeared from my pelvis and I’m told my PSA levels are normal.
‘Now I wake up and think, today is another good day.
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