Docetaxel Use In High
The phase 3NRG Oncology/RTOG 0521 trial aimed toevaluate if there was any benefit to adding docetaxel chemotherapy tostandard treatment with long-term androgen suppression plus radiotherapy in men with prostate cancer considered to have high-risk disease withoutevidence of metastasis.1 Docetaxel had been routinely used in menwith metastatic castration-sensitive prostate cancer with improvements in overallsurvival , therefore, there was interest to study its impact in a differentsubgroup of men with prostate cancer.1
Thisinitial study led by Rosenthal and colleagues found that docetaxel improved OSfrom 89% to 93% 0.69 90% CI, 0.49 to 0.97 one-sided P = .034). There was also a decrease inthe 6-year rate of distant metastasis in the docetaxel group compared with the AS + RT-only group . Finally, thedocetaxel group had a higher 6-year disease-free survival rate of 65%compared with 55% in AS + RT . This study had a medianfollow-up of 5.7 years. Recently, new longer-term data from the same study witha median follow-up among survivors of 10.4 years was published by Sandler andcolleagues.2
Similarly,the cumulative incidence of distant metastasis was lower in the docetaxelCT + AS + CT group at 20% compared with theAS + RT only group at 22% , although this againwas not statistically significant . There was no statistical difference in the number ofpatient deaths between the 2 groups, and no new treatment-related grade 5toxicities were reported.
What Are Male Sex Hormones
Hormones are substances that are made by glands in the body. Hormones circulate in the bloodstream and control the actions of certain cells or organs.
Androgens are a class of hormones that control the development and maintenance of male characteristics. The most abundant androgens in men are testosterone and dihydrotestosterone .
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .
Lupron Depot And Lab Tests
You may have reduced levels of certain hormones in your body during your treatment with Lupron Depot. If you have any lab tests that look for hormones, the results of the tests may be incorrect.
Its recommended that you wait 3 months until after youre done with Lupron Depot treatment before having these tests. This way, the results are less likely to be incorrect. Talk with your doctor about any tests you have scheduled while taking Lupron Depot to ensure your lab results will be accurate.
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Chemotherapy For Prostate Cancer As A Treatment Option
Chemotherapy, while a common treatment for many other types of cancers, is generally used in more advanced cases of prostate cancer. But chemotherapy is usually the first that springs to mind when people think of cancer treatment options.
Chemotherapy is the use of drugs that work to kill cancer cells. However, for prostate cancer treatment, chemotherapy is generally used to help slow down the disease rather than eradicate it. Another treatment used alongside chemotherapy is immunotherapy. Immunotherapy is where cells are taken out of your body, sensitized to cancer cells also from within your body, and re-introduced into your body to fight the cancer cells. For more on these treatments, watch Dr. Richard Bevan-Thomas in the video below:
Richard Bevan-Thomas MD: When a man thinks of prostate cancer or cancer in general, the first thing routinely that comes to mind is thinking about chemotherapy. Chemotherapy is where we give drugs that actually cause the death of cancer cells. In prostate cancer, chemotherapy is used in the later stages of the disease, so when we talk to men about prostate cancer, chemotherapy is not one of the first thing that comes up unless we start seeing a more advanced disease.
My Employer Wasnt That Helpful When I Told Him About Having Prostate Cancer What Can I Do
Although lots of employers are very supportive, some can be less understanding, especially if theyve not had experience of supporting an employee with cancer before. You could try explaining some of the issues or give them some information leaflets to read. If your employer is struggling to know how to help you, a nurse or other health professional at your hospital may be willing to speak to them or write a letter to them explaining what your needs are.
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What Are The Anti
- enzalutamide
This is not all the information you need to know about flutamide for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full flutamide information and discuss this medicine and any questions you have with your doctor or other health care provider.
- Johnson DB, Sonthalia S. Flutamide. . In: StatPearls . Treasure Island : StatPearls Publishing 2021 Jan-. Available from:
- Patient education: Treatment for advanced prostate cancer . Revised Oct. 5, 2021. Up To Date. Accessed Nov. 5, 2021 at
- Hormone Therapy for Prostate Cancer. American Cancer Society. Last revised Sept. 23, 2021. Accessed Nov. 5, 2021 at
- Flutamide. Drug Information. Up To Date. Accessed Nov. 5, 2021 at https://www.uptodate.com/contents/flutamide-drug-information
Does Chemo Work On Prostate Cancer
When is chemotherapy used? Chemo is sometimes used if prostate cancer has spread outside the prostate gland and hormone therapy isnt working. Recent research has also shown that chemo might be helpful if given along with hormone therapy. Chemo is not, however, a standard treatment for early prostate cancer.
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Standards Of Care In Hormone Therapy
Most doctors agree that hormone therapy is the most effective treatment available for patients with advanced prostate cancer. However, there is disagreement on exactly how and when hormone therapy should be used. Here are a few issues regarding standards of care:
Timing of Cancer Treatment
The disagreement is due to conflicting beliefs. One is that hormone therapy should begin only after symptoms from the metastases, like bone pain, occur. The counter belief is that hormone therapy should start before symptoms occur. Earlier treatment of prostate cancer is associated with a lower incidence of spinal cord compression, obstructive urinary problems, and skeletal fractures. However, survival is not different whether treatment is started early, or deferred.
The only exception to the above, is in lymph node-positive, post-prostatectomy patients, given androgen deprivation as an adjuvant immediately after surgery. In this situation, immediate therapy resulted in a significant improvement in progression free survival, prostate cancer specific survival, and overall survival.
Length of Cancer Treatment
The disagreement in this situation is between continuous androgen deprivation and intermittent androgen deprivation.
Combination vs. Single-Drug Therapy
Types Of Chemotherapy For Prostate Cancer
Chemotherapy drugs for prostate cancer are typically given into a vein as an infusion over a period of several hours. This can be done in a doctors office, chemotherapy clinic, or in a hospital setting. Some drugs are given as a pill.
Chemotherapy is given in cycles, with each period of treatment followed by a rest period to give you time to recover from the effects of the drugs.
Cycles are most often two or three weeks long.
The length of treatment for advanced prostate cancer is based on how well it is working and what side effects you have.
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Understanding The Conventional Cancer System
Standard oncology insists on following typical chemotherapy protocols, despite documentation that indicates ineffectiveness with advanced stage cancers. Why, do you ask?
Well, you should know that virtually all cancer Center use fundamentally identical variations of protocol regimens because they follow each other. In fact, the more prestigious the organization, the more this occurs. It is not uncommon to attend their respective board meetings and hear the discussion repeatedly return to using the same old non-proven method.
Unbelievably, most new and innovative cancer information and treatments are coming from outside the United States. “It doesn’t work,” or “It isn’t proven” seem to be the popular answers given to patients with alternative curiosities. This is ironic, knowing that research indicates that traditional treatments ARE regularly being proven to NOT work
Physical Emotional And Social Effects Of Cancer
Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.
Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.
Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.
Before treatment begins, talk with your doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.
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Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
- chemotherapy
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
When Is Chemotherapy Used To Treat Prostate Cancer
Chemotherapy is a cancer treatment that involves taking drugs that kill rapidly dividing cells. Chemicals in these drugs can kill cancer cells and healthy cells in your body that quickly divide such as bone marrow and hair cells.
According to the American Cancer Society, chemotherapy is not a standard treatment for early prostate cancer. Its most likely to be used for aggressive cancer or cancer that has started growing outside the prostate.
Most men receiving chemotherapy for advanced prostate cancer will also receive androgen deprivation therapy or anti-hormone therapy.
Chemotherapy may also be used to treat castrate-resistant prostate cancer . CRPC is a type of prostate cancer that stops responding to hormone therapy. Prostate cancer needs male sex hormones to grow, and hormone therapy aims to lower male sex hormones to slow tumor growth.
showed that docetaxel is the first chemotherapy drug that improved the survival rate of men with prostate cancer. Today, its the most commonly used chemotherapy drug to treat prostate cancer.
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Can A Man Have A Child After Prostate Cancer Treatment
Modern radiation techniques are designed to limit this exposure, but it is not always possible to prevent all exposure and still achieve the desired outcomes. Most men will be sterile after radiation treatment for prostate cancer. Talk to your oncology team about sperm banking if you wish to father a child in the future.
Are There Any Late Effects Of Prostate Cancer Treatment
Late effects can happen months to years after cancer treatment has ended. The risk of late effects depends on the areas included in the field of radiation and the radiation techniques that were used. Some of the potential late effects of radiation to the prostate include: Most men will be sterile after radiation treatment for prostate cancer.
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Hormone Treatment Fights Prostate Cancer
Hormone therapy for prostate cancer has come a long way in the past few decades. Not so long ago, the only hormonal treatment for this disease was drastic: an orchiectomy, the surgical removal of the testicles.
Now we have a number of medications available as pills, injections, and implants that can give men the benefits of decreasing male hormone levels without irreversible surgery.
I think hormonal therapy has done wonders for men with prostate cancer, Stuart Holden, MD, Medical Director of the Prostate Cancer Foundation.
Hormone therapy for prostate cancer does have limitations. Right now, its usually used only in men whose cancer has recurred or spread elsewhere in the body.
But even in cases where removing or killing the cancer isnt possible, hormone therapy can help slow down cancer growth. Though it isnt a cure, hormone therapy for prostate cancer can help men with prostate cancer feel better and add years to their lives.
On average, hormone therapy can stop the advance of cancer for two to three years. However, it varies from case to case. Some men do well on hormone therapy for much longer.
Docetaxel To Treat Prostate Cancer
Docetaxel is currently approved in the US for the treatment of head and neck cancer, gastric cancer, breast cancer, prostate cancer, and non-small cell lung cancer, and it is commercialized under the brand name Taxotere, by the pharmaceutical company Aventis Pharmaceuticals, Inc. On May 19, 2004, the FDA approved docetaxel for injection for use in combination with prednisone for the treatment of metastatic, androgen-independent prostate cancer, explain the National Cancer Insitute. Safety and efficacy were demonstrated in TAX327, a randomized, multicenter global clinical trial designed to evaluate chemotherapy with docetaxel and prednisone in the treatment of men with metastatic, hormone-refractory prostate cancer.
The study that revealed the efficacy of docetaxel included 106 patients who were treated with mitoxantrone and prednisone, weekly docetaxel and prednisone, or docetaxel once every three weeks and prednisone. The third group was the one with greater results improving survival, with a median survival of 18.9 months, compared to 16.5 months for the patients treated with mitoxantrone and prednisone. The approved dose for this indication is 75 mg/m2 docetaxel given intravenously as a one-hour infusion every 21 days on Day 1 plus 5 mg oral prednisone twice daily for 10 cycles, informed the National Cancer Institute. Adverse events included anemia, neutropenia, infection, nausea, vomiting, anorexia, and fatigue.
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Chemo Drugs Used To Treat Prostate Cancer
For prostate cancer, chemo drugs are typically used one at a time. Some of the chemo drugs used to treat prostate cancer include:
- Docetaxel
- Mitoxantrone
- Estramustine
In most cases, the first chemo drug given is docetaxel, combined with the steroid drug prednisone. If this does not work , cabazitaxel is often the next chemo drug tried .
Docetaxel and cabazitaxel have been shown to help men live longer, on average, than older chemo drugs. They may slow the cancers growth and also reduce symptoms, resulting in a better quality of life. Still, chemo is very unlikely to cure prostate cancer.
Other chemo drugs being studied for use in prostate cancer include carboplatin, oxaliplatin, and cisplatin.
When Is Hormone Therapy Used
Hormone therapy may be used:
- If the cancer has spread too far to be cured by surgery or radiation, or if you cant have these treatments for some other reason
- If the cancer remains or comes back after treatment with surgery or radiation therapy
- Along with radiation therapy as the initial treatment, if you are at higher risk of the cancer coming back after treatment
- Before radiation to try to shrink the cancer to make treatment more effective
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Questioning The Experts May Send You Away Empty
When an oncologist explains whether or not a therapy is “working,” the reality might not be so black and white. Such conventional cancer treatment protocols are laden with “let’s wait and see language.” In simple terms, if an individual lives five years or more from the beginning of treatment, than that treatment for cancer was considered a success, or that “it worked.”
Because we live in an age of information surplus, more patients are questioning such results and asking better questions about their care. And, that is an excellent thing. The actual results with traditional treatments alone are far more ominous than one might think.
How Often Do You Have To Have Radiation Therapy For Prostate Cancer
This type of radiation can be used to try to cure earlier stage cancers, or to help relieve symptoms such as bone pain if the cancer has spread to a specific area of bone. You will usually go for treatment 5 days a week in an outpatient center for at least several weeks, depending on why the radiation is being given.
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Chemotherapy For Prostate Cancer
Chemotherapy refers to any type of therapy that uses chemicals to kill or halt the growth of cancer cells. While chemotherapy is unlikely to cure prostate cancer, it may provide some benefits to patients. For example, it may be used:
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To relieve symptoms associated with very advanced or metastatic disease, improving the patients quality of life
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To improve the outcome of prostate cancer surgery if administered for a short time after the procedure
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To work in conjunction with hormone therapy and improve the patient outcome
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To prolong the life of a prostate cancer patient who no longer responds to hormone therapy
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To treat men with advanced prostate cancer who carry the AR-V7 gene variant
When Hormone Therapy Stops Working
After some months or years the hormone treatment usually stops working and the cancer starts to grow again. Your doctor might recommend stopping or changing hormone treatment at this stage.
If youre having anti androgens and your PSA level has started to rise again your doctor might get you to stop taking them. In some cases this can cause the cancer to shrink and stop growing for some time. This is called anti androgen withdrawal response .
There are different treatment options for when hormone therapy stops working, such as chemotherapy or steroids.
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