Prostate Cancer Treatment Advances
Oncologists and researchers continue to accumulate data through studies and clinical trials, but it takes years for new advances to become part of the standard of care. However, weve seen some notable prostate cancer treatment advances over the past few years that are now more widely available to patients. Some advances may attempt to improve treatment outcomes, while others may improve patients quality of life by reducing the severity of treatment side effects. While this is not a comprehensive discussion of advances in prostate cancer treatment, the following advancements are noteworthy.
How Prostate Cancer Is Treated
In cancer care, different types of doctorsincluding medical oncologists, surgeons, and radiation oncologistsoften work together to create an overall treatment plan that may combine different types of treatments to treat the cancer. This is called a multidisciplinary team. Cancer care teams include a variety of other health care professionals, such as palliative care experts, physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, and others.
The common types of treatments used for prostate cancer are described below. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.
Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patients preferences and overall health.
Cancer treatment can affect older adults in different ways. More information on the specific effects of surgery, chemotherapy, and radiation therapy on older patients can be found another section of this website.
Because most prostate cancers are found in the early stages when they are growing slowly, you usually do not have to rush to make treatment decisions. During this time, it is important to talk with your doctor about the risks and benefits of all your treatment options and when treatment should begin. This discussion should also address the current state of the cancer:
What Will Happen After Treatment
Youll be glad when treatment is over. But its hard not to worry about cancer coming back. When cancer comes back it is called a recurrence. Even when cancer never comes back, people still worry about it. For years after treatment ends, you will see your cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed.
Be sure to go to all follow-up visits. Your doctors will ask about your symptoms, examine you, and might order blood tests and maybe other tests to see if the cancer has come back.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life, making healthy choices and feeling as good as you can.
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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
What Are The Treatment Options For Aggressive Prostate Cancer
The majority of people with prostate cancer nearly 80% are diagnosed early and cured by their treatment, most often radiation or surgery.
But one in five of those diagnosed with prostate cancer has a more aggressive form of the disease. Even before the individual has received any treatment or experienced a recurrence, doctors can identify whether the cancer is likely to be more dangerous and aggressive.
Prostate cancer is determined to be high risk if it is distinguished by any of the following characteristics:
Physicians perform biopsies or take X-rays to determine a cancers grade and stage. The stage is based on the size of the primary tumor or the extent it has spread in the body. The grade describes the appearance of the cancer cells and tissue under a microscope: the more abnormal they are, the higher the grade.
What are the main treatment options for people with aggressive or high-risk prostate cancer and can the sequencing, or order in which different treatments are given, make a difference in overall effectiveness of these therapies?
Why Roswell Park for Prostate Cancer?
Find out what makes Roswell Park unique in treating prostate cancer.
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Questions To Ask Your Doctor Or Nurse
- What type of hormone therapy are you offering me and why?
- Are there other treatments I can have?
- What are the advantages and disadvantages of my treatment?
- What treatments and support are available to help manage side effects?
- Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
- How often will I have check-ups and what will this involve?
- How will we know if my cancer starts to grow again?
- What other treatments are available if that happens?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?
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Research In Prostate Cancer
We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat prostate cancer. They are also looking for ways to improve the quality of life of people with prostate cancer.
The following is a selection of research showing promise for prostate cancer. Weve included information from PubMed, which is the research database of the National Library of Medicine. Each research article in PubMed has an identity number that links to a brief overview . We have also included links to abstracts of the research presented at meetings of the American Society of Clinical Oncology , which are held throughout the year. You can find information about ongoing clinical trials from CanadianCancerTrials.ca and ClinicalTrials.gov. Clinical trials are given an identifier called a national clinical trial number. The NCT number links to information about the clinical trial.
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Advances In Targeted Therapy
PARP inhibitors are a type of targeted therapy drug designed to prevent the DNA of cancer cells from repairing the damage caused by cancer treatment. In May 2020, the FDA approved two PARP inhibitors, rucaparib and olaparib, to treat patients with metastatic castration-resistant prostate cancer whose cancer tumors have certain homologous recombination repair genetic mutations and who meet other treatment-related criteria. These drugs are the first of their type to be approved by the FDA to treat prostate cancer.
A New Treatment For Advanced Prostate Cancer Improves Survival In Phase 3 Clinical Trial
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Radiation therapy is getting more precise, enabled by technologies that make it easier to kill tumors while sparing their surrounding tissues. Some newer therapies are even given intravenously instead of by machines, and they deliver radiation particles directly to the cancer cell itself. One of these new therapies a sort of smart bomb targeted at malignant cells is now generating promising data for men with the most aggressive prostate cancer.
In early June, investigators reported results from a phase 3 clinical trial showing that among men who received the experimental treatment, there was nearly a 40% reduction in deaths over the course of the study, compared to men who did not.
The treatment is called lutetium-177-PSMA-617, or LuPSMA, and it has two components: a compound that targets a cancer cell protein called prostate-specific membrane antigen, or PSMA, and a radioactive particle that destroys the cells. Healthy prostate cells don’t contain PSMA, or do at very low levels. And some men with prostate cancer have more of the protein than others. Doctors can detect the protein using a specialized imaging scan.
Results after 21 months showed that cancer progression was delayed for longer among the LuPSMA-treated men: 8.7 months on average versus 3.4 months among the controls. The treatment was also associated with better overall survival: 15.3 months versus 11.3 months.
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New Model Improves Life Expectancy Estimates In Prostate Cancer Population
Investigators have developed and validated a simple prediction model for other-cause mortality among US patients with prostate cancer. These life expectancy estimates may outperform Social Security Administration life tables, according to a recent report.
The other-cause comorbidity-adjusted mortality model, which incorporates 8 predictors of OCM , provides more precise estimates of life expectancy. It can be used in accordance with National Comprehensive Cancer Network guidelines and has high potential to improve quality of care when patient life expectancy is a factor, a team led by Elizabeth C. Chase, PhD, of the University of Michigan in Ann Arbor, concluded in a paper published in BJU International.
NCCN guidelines generally recommend that men with prostate cancer who have a life expectancy of 10 years or more receive more aggressive treatment appropriate to their cancer stage, whereas men with a life expectancy less than 10 years receive less aggressive treatment. The NCCN recommends using SSA actuarial tables to predict life expectancy, but Dr Chase and colleagues pointed out that research suggests the SSA tables overestimate life expectancy of patients with distant disease and do not adjust for patient comorbidities, which can have a notable effect on life expectancy.
Reference
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Clinical Trial Opens New Way Of Treating Prostate Cancer
- Category
- Date
- 4 May 2022
A different way of treating people with prostate cancer will be investigated by researchers at the University of Leeds in a new clinical trial funded by Yorkshire Cancer Research.
The £1.1 million study will explore how radiotherapy can be made more effective for men whose cancer has come back following an initial course of treatment intended to cure it.
Although treatment for prostate cancer is usually successful, the cancer can sometimes return in the pelvis. When this happens, men are normally treated with very precise beams of radiation that directly target the cancer cells. However, even after this follow-up treatment, cancer can develop in other parts of the pelvis and go on to spread throughout the body.
Researchers will find out if treating a wider area of the pelvis with radiotherapy, and not just the part that is directly affected by the cancer, is better at stopping the cancer from spreading.
Our new clinical trial will test whether treating a wider area of the pelvis with radiotherapy works better and can be introduced as a routine option for patients.
Dr Ann Henry, School of Medicine
The trial, involving patients being treated at hospitals in Leeds, Sheffield and Hull, will be led by Dr Ann Henry, Associate Professor in Clinical Oncology in Leedss School of Medicine.
Our new clinical trial will test whether treating a wider area of the pelvis with radiotherapy works better and can be introduced as a routine option for patients.
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Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks, such as urinary incontinence and erectile dysfunction.
In extremely rare cases, problems arising after surgery can be fatal.
It’s possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.
After a radical prostatectomy, you’ll no longer ejaculate during sex. This means you will not be able to have a child through sexual intercourse.
You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
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Treating Prostate Cancer That Has Spread To The Bones
Doctors are studying the use of radiofrequency ablation to help control pain in men whose prostate cancer has spread to one or more areas in the bones. During RFA, the doctor uses a CT scan or ultrasound to guide a small metal probe into the area of the tumor. A high-frequency current is passed through the probe to heat and destroy the tumor. RFA has been used for many years to treat tumors in other organs such as the liver, but its use in treating bone pain is still fairly new. Still, early results are promising.
If Treatment Does Not Work
Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.
This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment, including a hospital bed, can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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New Advances Transform Treatment Of Prostate Cancer
Vincent Richeux
The way we treat prostate cancer has changed dramatically in recent years. Advances in MRI imaging have undoubtedly contributed to this change, both in terms of diagnosis by making targeted biopsies possible and in terms of our approach to treatment. The emergence of new treatments has also improved the prognosis of patients with metastatic cancer.
For an update on these advances, Medscape interviewed Guillaume Ploussard, MD, a urologist and oncologist at La Croix du Sud Clinic, Toulouse, France, and head of the French Urology Association’s prostate cancer subcommittee.
Medscape French Edition: The way we treat prostate cancer has changed dramatically in terms of diagnosis and therapeutic approach. In your opinion, what has been the most significant step forward in recent years?
Guillaume Ploussard, MD: The move towards personalized treatment options. Thanks to an improvement in imaging techniques and the contribution made by genomics, we can now better categorize a specific case of cancer, foresee how it will evolve, and adapt our therapeutic approach accordingly for each individual patient.
Our ability to obtain more precise MRI images, along with improvements made in training radiologists to interpret these images, has made us better at detecting prostate cancer. These advances in MRI mean we can identify the most severe cancer cases, which, in turn, stops us from starting treatment in patients who don’t need it.
Overview Of Treatment Options
Your treatment options will depend in part on whether your disease is localized, high risk, recurrent or advanced.
For nearly eight in 10 men with prostate cancer, the disease is diagnosed early, in the local or regional stages. Most will be cured. Active surveillance, watchful waiting, radiation therapy and surgery are the most common treatments.
Two in 10 men with prostate cancer are diagnosed with high-risk disease â localized prostate cancer that has a tendency to spread. Among these men, three or four in 10 will have cancer that comes back after treatment.
Doctors use hormone therapy, along with surgery and radiation therapy, to treat prostate cancers that might have spread. Learn more about the special considerations for treating high-risk or recurrent prostate cancer.
If your cancer has already spread when you are diagnosed , new treatments may put your cancer in remission and give you a good quality of life for years, even though the cancer canât be cured.
SCCA offers immunotherapy, hormone therapy, chemotherapy, radiation therapy and access to promising therapies in clinical studies that your community doctor may not know about.
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