Enzalutamide Improves Survival In Patients With Metastatic Prostate Cancer
Summary
In an international randomizedphase III clinical trial, the hormone therapy enzalutamide extended survival in men with metastatic prostate cancer that had progressed during treatment with androgen deprivation therapy. Participants in the trial had not received chemotherapy.
New England Journal of Medicine, June 1, 2014.
Background
Early in their development, prostate cancers need relatively high levels of male sex hormones to grow. The testes are the main source of androgens, and treatments that stop the testes from producing male sex hormonesknown as hormone therapy or androgen deprivation therapy are therefore a common treatment for androgen-sensitive prostate cancer. However, most prostate cancers eventually become castrate resistantthat is, they can grow even when androgen levels in the blood are very low. ADT does not block production of the small amount of androgen that is made by the adrenal glands and by prostate cancer cells themselves, and this low level is sufficient to fuel the growth of castrate-resistant prostate cancers.
Enzalutamide is among several hormone therapies that have been developed to prevent the androgen-fueled growth of castrate-resistant prostate cancers. This drug works by keeping androgens from binding to the androgen receptors on prostate cancer cells.
The Study
Men in the trial were randomly assigned to receive 160 mg of enzalutamide or a placebo taken orally once daily.
Results
- Posted:June 27, 2014
Fighting Stage 4 Lung Cancer With Precision Oncology
We had a chance to talk with Thomas the other day from his home in Newfoundland. Heres what he said
CTOAM adds something into the cancer equation that nobody else has, and that is bringing medical science. There is no other organization or group that I have come across that talks about medical science. And that is the huge addition here.
Another thing is support. The availability of Alex and Michelle just being able to call them and get the support I need going forward.
So those two things in particular and their determination to get things done. And then looking ahead further from here
You know, I believe that CTOAM is prepared to support me to get the job done and get me into remission. I believe that youll do whatever it takes. And that if anyone can do it, you can.
And so those kinds of things are my takeaways at this pointand that gives me a lot of confidence and a lot of hope.
Ill say it even makes me kind of excited about the possibilities going forward but I hesitate to use the word excitement when Im talking about cancer.
But I feel hopeful, very hopeful, that you guys are the people who are going to make my life worth living. And, you know, five days ago I celebrated my 75th birthdayand I want to celebrate my 90th for sure. And you guys are my hope.
Thank you so much for sharing that with us, Thomas.
Prostate Cancer Survival Rates: What They Mean
As cancer diagnoses go, prostate cancer is often a less serious one. Prostate cancer is frequently slow-growing and slow to spread. For many men, prostate cancer is less serious than their other medical conditions.
For these reasons, and possibly because of earlier detection of low-grade prostate cancers, prostate cancer has one of the highest survival rates of any type of cancer. WebMD takes a look at prostate cancer survival rates and what they mean to you.
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Pathological Stage: A Look At The Actual Cancer Cells And Their Distribution Within The Pelvic Area
This system assesses how pervasive the cancer cells are within and around the prostate. These stages begin at T2.
T2: The tumor is located in the prostate only.T3: The tumor has breached the prostate border on 1 or more sides.T3b: The tumor has begun to grow in the seminal vesicles.T4: The tumor has grown into other neighboring structures, like the bladder, the rectum, or the pelvic wall.
What I Wish People Knew About Metastatic Breast Cancer
Women with metastatic breast cancer think about fighting cancer very differently than women who dont have a stage 4 diagnosis. If you have advanced cancer, these women understand what youre going through.
The term metastatic breast cancer describes breast cancer that has spread beyond the breast to the bones, liver, brain, or another organ. Even if the cancer is found in another organ, its still referred to as breast cancer and is treated as such.
While metastatic breast cancer is terminal and cannot be cured, because of improved treatments more women are living longer than ever with it. Even so, a lack of information and many misconceptions about this diagnosis persist.
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Common Questions About Stage 4 Mesothelioma
- Is mesothelioma terminal?
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Mesothelioma is a terminal cancer. While many patients go into remission, especially with treatment, there is no cure for mesothelioma. Life expectancy with advanced-stage mesothelioma cancer depends largely on the extent of tumor growth and how well you respond to treatments.
- Can stage 4 mesothelioma be treated?
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Yes, stage 4 mesothelioma is primarily treated with chemotherapy and palliative care. Chemotherapy can alleviate symptoms and extend survival. Palliative care helps patients cope with pain and other symptoms, improving their quality of life.
- What is the life expectancy of someone with late-stage mesothelioma?
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The life expectancy of stage 4 mesothelioma is about one year with treatment. Electing chemotherapy can extend the survival of those with mesothelioma by several months. Without treatment, people with late-stage mesothelioma live an average of six to eight months.
- Are there any survivors of stage 4 mesothelioma?
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Many survivors have lived a long time with stage 4 mesothelioma. For example, Andy Ashcraft lived with stage 4 mesothelioma for more than seven years. His treatment included chemotherapy, immunotherapy and medical marijuana.
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Infection And The Immune System
Looking at people who have had a spontaneous remission of their cancers, its quickly noted that most of these regressions are associated with an acute infection. Infections often result in a fever and stimulation of the immune system.
We know that our immune systems have the ability to fight off cancer. That is, in fact, the logic behind immunotherapy. Immunotherapy medications, while still in their infancy, have resulted in dramatic remissions of cancer for some people, even in the advanced stages of cancer. These drugs work in different ways, but a common theme is that they essentially enhance the ability of our own immune systems to fight cancer.
Infections which have been associated with spontaneous remission include diphtheria, measles, hepatitis, gonorrhea, malaria, smallpox, syphilis, and tuberculosis.
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Proactive Steps You Can Take
Diet and Exercise
According to the Prostate Cancer Foundation, a few minor changes to eating habits can be helpful for those dealing with the effects of prostate cancer. The organization recommends incorporating vegetables into many of your meals and minimizing fat intake from red meat and dairy products. The group also recommends getting vitamins from food sources like whole grains and vegetables as opposed to vitamin supplements. It is particularly important to get calcium from food sources, namely dark green leafy vegetables and low-fat dairy foods.
Coping and support
If you or a loved one has prostate cancer, its important to remember that you are not alone: More than 150,000 men are diagnosed with prostate cancer every year, according to the Prostate Cancer Foundation.
Still, it is normal for men diagnosed with prostate cancer to feel alone, uncertain or fearful. Support groups are an excellent resource for men with prostate cancer, providing a community with whom to share encouragement, information and emotional support. These groups range from online communities with people who can help answer questions to groups of men diagnosed with prostate cancer or family members of those diagnosed. They are sometimes facilitated by mental health professionals and experts in the field of prostate cancer.
Palliative care
Palliative care can include any of the following:
What Is The Treatment For Advanced Prostate Cancer
No matter where prostate cancer spreads, its still treated as prostate cancer. Its harder to treat when it reaches an advanced stage.
Treatment for advanced prostate cancer involves targeted and systemic therapies. Most men need a combination of treatments and they may have to be adjusted from time to time.
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Imaging Of Metastasis Status In Prostate Cancer Patients
The screening for PSA level in the serum of patients was introduced in the late 1980s and enabled a dramatic increase in early PCa detection . On the other hand, PSA is not solely a PCa-specific biomarker and, as such, leads to overdiagnosis and overtreatment of clinically insignificant cases, representing a significant burden for patients . Moreover, absolute PSA level does not always correlate with prognosis . Therefore, more specific and sensitive PSA-based values like PSA density , PSA velocity , free-to-total PSA , and PSA doubling time are seen as options with stronger predictive value. For example, PSADT is defined as the length of time for two-fold PSA level increase. A PSADT < 6 months is strongly associated with metastatic disease, increased PCa mortality , and relapse . Nonetheless, the reported benefit of PSADT in PCa management did not enter clinical routine and some studies even reported discrepant results indicating that further studies are required to determine the reliability of PSADT and other available biomarkers .
Psa And Gleason Score
Two other important factors that doctors and specialists use to assess cancer cells are the prostate specific antigen and the Gleason score.
PSA levels: PSA is a protein that appears in higher levels in the bloodstream when there is a problem with the prostate. Normally, PSA levels in the blood are very low, and a test cannot detect them. However, in some circumstance, such as prostate cancer, PSA levels start to rise.
Screening for prostate cancer uses a blood test for PSA. If PSA levels are high, the doctor may recommend further tests to see if prostate cancer is present.
There are various other reasons why PSA levels may rise, including sexual stimulation or an infection.
The grade and Gleason score: Different types of cancer cell act differently. Some types, or grades, are more aggressive and can spread more easily. The Gleason score and grade are different measures, but they both reflect how likely it is that a tumor will spread, and how quickly it will do so. Either a biopsy or surgery can determine the types of cancer cells present in the prostate tissues.
Nearly 50% of males have a condition known as prostatic intraepithelial neoplasia by the time they are 50 years old. PIN is when there are changes in the cells that line the prostate gland.
High grade PIN is not cancer, but the cells can become cancerous in the future. For this reason, a doctor may recommend treatment to remove the cells.
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Survival Rate For Stage 4 Cancer Depends On Factors Like The Cancer Types Treatments Patients Health Condition Etc Work With Your Doctor For Best Results
When one is diagnosed to have Stage IV cancer, the immediate concern is if the person will be able to survive the disease. This concern, also medically known as the prognosis, depends on many factors, including availability of treatment and ones general health condition. Knowing what stage ones cancer is mostly determines his probability of surviving based on research. Cancer staging therefore helps the doctor to advise the patient about his condition and what forms of treatment are suitable, and to predict his survival rate in the next few years.
Cancer survival rate refers to the percentage of patients afflicted with a certain form of cancer who survive the disease for a specified amount of time. Statistics often refer to a five-year period where scientific surveys on these patients are based, although these data do not specify whether the patients are still undergoing treatment or are completely cancer-free after five years. An over-all five-year survival rate of 80% would mean that for every 100 patients with the disease, 80 would probably live for at least another five years, and 20 would probably not survive this period of time.
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How Would I Treat Stage 4 Prostate Cancer
- I would stop all the foods that cause cancer, and stop using all the household and bodycare products that leach toxins into the body.
- I would change to those foods that resonate with my body through personal testing as I describe in my book.
- I would only eat fresh organic foods, grains, nuts and seeds properly prepared and soaked to reduce the phytic acid cooked nourishing broths and meats from grass-fed and pastured animals and eat raw, unpasteurized dairy and eggs which have a completely different profile than conventional cancer-causing, factory-farmed and produced foods which are loaded with toxins.
- I would stop all harmful foods listed on this site and in my book. For end stage prostate cancer, I would stop all sugar and its substitutes. Why? They feed the cancer.
- I would undergo cleansing short fasts with freshly made vegetable juices if personally tested Yes. I would do a liver flush, or many, to rid the body of major toxins quickly and easily.
- I would ensure that if couldnt get adequate sun on my skin, I would at least take an adequate dosage of Vitamin D3 levels.
- I would take aloe vera juice each day and test for which supplements my body needed like zinc and magnesium.
And more
End stage prostate cancer could then no longer find a host in my body for I would have changed the conditions that I either knowingly or unknowingly created that led to it.
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Outlook For Locally Advanced Prostate Cancer
Many men with locally advanced prostate cancer have treatment that aims to get rid of their cancer. For some men, this treatment can be very successful and they may live for many years without their cancer coming back or causing them any problems. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment. Read more about the risk of your cancer coming back.
Some men with locally advanced prostate cancer will have treatment that aims to help keep their cancer under control rather than get rid of it completely. For example, if you have hormone therapy on its own, it can help to keep the cancer under control, usually for several years. And there are other treatments available if your hormone therapy stops working.
Home » Frequently Asked Questions » Lung Cancer » How Long Can You Live with Stage 4 Cancer without Treatment?
Stage 4 cancer usually has spread to multiple places in the body, meaning you can live only a few weeks or a few months.
In rare cases, some people may survive for several months or even a year with stage 4 cancer, with or without treatment. Some studies have found that attempting to aggressively treat cancer that has reached stage 4 can actually lead to a drop in the quality of the patients remaining life.
How Long Can You Live With Prostate Cancer With No Treatment
Studies have shown that between 86% and 98% of men with LPC do not die from their cancer in all age groups, the researchers wrote. In fact, more than 95% of patients with LPC live at least 10 years after their diagnosis, whereas only 25% of patients in this study expected to live more than 10 years.
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Prognosis And Survival For Prostate Cancer
If you have prostate cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for prostate cancer.
Prostate Cancer Survival Rates Are Favorable Overall
Thinking about survival rates for prostate cancer takes a little mental stretching. Keep in mind that most men are around 70 when diagnosed with prostate cancer. Over, say, five years, many of these men will die from other medical problems unrelated to prostate cancer.
To determine the prostate cancer survival rate, these men are subtracted out of the calculations. Counting only the men who are left provides what’s called the relative survival rate for prostate cancer.
Taking that into consideration, the relative survival rates for most kinds of prostate cancer are actually pretty good. Remember, we’re not counting men with prostate cancer who die of other causes:
- 92% of all prostate cancers are found when they are in the early stage, called local or regional. Almost 100% of men who have local or regional prostate cancer will survive more than five years after diagnosis.
- Fewer men have more advanced prostate cancer at the time of diagnosis. Once prostate cancer has spread beyond the prostate, survival rates fall. For men with distant spread of prostate cancer, about one-third will survive for five years after diagnosis.
Many men with prostate cancer actually will live much longer than five years after diagnosis. What about longer-term survival rates? According to the American Society of Clinical Oncology, for men with local or regional prostate cancer:
- the relative 10-year survival rate is 98%
- the relative 15-year survival rate is 95%
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