Immuno Targeting Increases Disease
Immunotherapy can be effective against prostate cancer treatment, provided they include new therapies beyond vaccine therapies andcheckpoint blockades. At Envita, we have been instrumental in combining different types ofadvanced immunotherapies moving beyond the scope of PD-1, PD-L1, or CTLA-4 inhibitors and other smart drugs.
Targeted Prostate Cancer Treatment Options To Help Patients Outperformstandardized Treatment Models
An early diagnosis and subsequent prostate gland removal may not be enough to prevent the cancer from recurring as anadvanced prostate cancer, a few months or years later. At Envita Medical Centers, a world-class integrative center forPrecision Oncology, we have been treating late-stage and complicated cancers for over 20 years using the latest inmedical research and technology to give our patients a greater chance to respond to care.
Our revolutionary new treatments provide alternatives to invasive surgeries which can be damaging to the immunesystemand potentially lead to further cancer spread. Envitas powerful and personalized combinations of leading-edgeconventional treatments and advanced natural therapies have proved beneficial for patients of all stages of disease.Even those with stage IV metastatic castration-resistant prostate cancer or those who had been sent to hospiceby other well-established cancer centers have benefitted from our treatments and are leading healthy, disease-freelivestoday.
Just One Weapon Against Cancer
Before treatment with PLUVICTOTM is recommended, patients undergo a to determine if their tumor contains the PSMA target. If it does not, PLUVICTOTM would not be appropriate, explained Dr. Wong. At Duke we treat you as an individual. Each case is discussed among a multidisciplinary team of surgeons, radiation oncologists, medical oncologists, radiologists, and nuclear medicine specialists. He emphasized that PLUVICTOTM is not for everyone and is just one weapon in the arsenal for fighting cancer. Our team will determine how and if this new option fits in with all the others we offer.
Duke can provide PLUVICTOTM and other novel treatments because it is a Comprehensive Cancer Center with the latest advances in diagnosing and treating prostate cancer. Duke is also recognized as a Comprehensive Radiopharmaceutical Therapy Center of Excellence, which requires strict adherence to safety and treatment criteria that ensures the best care for patients.
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Help Getting Through Cancer Treatment
People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.
Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.
Different types of programs and support services may be helpful, and can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.
The American Cancer Society also has programs and services including rides to treatment, lodging, and more to help you get through treatment. Call our National Cancer Information Center at 1-800-227-2345 and speak with one of our trained specialists.
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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Treatment For Locally Advanced Prostate Cancer
Prostate cancer that has spread to tissue around the prostate may be treated with radiation therapy, surgery, or hormone therapy. Sometimes two of these treatments are combined.
Radiation therapy uses high-energy X-rays or protons to destroy the cancer. This treatment has improved with newer technologies, so there are fewer side effects and complications than in the past. Radiation therapy usually is combined with hormone therapy.
External beam radiotherapy, or EBRT, uses high-energy rays, such as X-rays, to destroy the cancer. It is usually given in multiple doses over several weeks. Radiation destroys tissue, so it may damage the nerves along the side of the prostate that affect your ability to have an erection. If you already have bowel problems, external radiation may cause your symptoms to get worse.
Two common forms of external radiation are:
- Conformal radiotherapy . This uses a three-dimensional planning system to target a strong dose of radiation to the prostate cancer. This helps to protect healthy tissue from radiation.
- Intensity modulated radiation therapy . This uses newer 3D-CRT technology to target the cancer.
The two most common surgeries are:
In some cases, men will have radiation therapy after a prostatectomy, especially if the tumour could not be completely removed by surgery.
Clinical Trials For Advanced Disease
Clinical trials are investigational studies that are conducted to find new treatments in the fight against prostate cancer. The drug development process can take many years and is well regulated by federal agencies. Many times, participation in a clinical trial is a way to receive a promising new drug that has not yet been approved by the FDA. Several new drugs are currently under investigation for advanced prostate cancer. .
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Radiation As Adjuvant Or Salvage Therapy After Surgery
Several randomized trials have evaluated the use of adjuvant radiation therapy to the prostatic bed following surgery for patients at high risk of recurrence . Those include EORTC 22911, SWOG 8794, ARO 96-02/AUO AP 09/95, and FinnProstataX, as well as the ongoing RAVES, GETUG-AFU 17, and RADICALS-RT studies. Recent research has further highlighted the role of early salvage radiation therapy with concomitant ADT for those with biochemical recurrence after prostatectomy, to avoid overtreatment associated with adjuvant radiotherapy. This is reflected in the current AUA/ASTRO guidelines.
What Are The Treatment Options For Prostate Cancer
Prostate cancer is most often found in early stages. When it is found early, there are a number of treatment choices available. Once I had enough information, I was better able to choose a treatment for me. Ken 1-800-4-CANCER Thinking About Treatment Choices Active surveillance, surgery, and radiation therapyare the
Living With Prostate Cancer
Receiving a prostate cancer diagnosis can be stressful. Even though most people who receive a diagnosis of prostate cancer live for many years after receiving the diagnosis, treatment can be exhausting and cause side effects that impact your quality of life.
Many resources are available to help you get through these difficult times:
Children Benefit From Reduced Radiation Exposure
Since proton therapy is targeted, it can be particularly effective in treating children, who are more sensitive to the effects of radiation. The precision of protons means children have a reduced chance of radiation side effectssuch as growth and developmental problems, as well as secondary tumors later in life. The center has radiation oncologists who specializes in proton therapy treatment for children.
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Researched And Perfected For More Than 60 Years
As of 2018, over 170,000 people worldwide have received proton therapy at centers in Europe, Asia and the United States. It was first used to treat patients in 1955 in a research setting, but its use was limited because imaging techniques at the time could not accurately pinpoint tumors. The FDA approved proton therapy in 1988, following advances in imaging technology, such as CT, MRI and PET scans. The first hospital-based treatment center opened in Loma Linda, California in 1990. Fred Hutchinson Cancer Center – Proton Therapy opened in 2013.
- A goal of less radiation delivered to healthy tissue and critical structures adjacent to the treatment area
- Ability to deposit a larger dose in the targeted area if needed
- Fewer side effects and faster recovery due to precise delivery of radiation to target area
- Precise application is ideal for a wide range of tumors
- Precise targeting gives proton beam therapy a significant advantage over standard radiation therapy when treating tumors near vital organs
If you have a solid tumor near a vital organ, or a recurrent tumor, you are a prime candidate for proton therapy.
1895German physicist W.C. Roentgen discovers X-rays, making detection of tumors in the body much easier and non-invasive. Roentgen later wins the Nobel Prize in Physics for this discovery.
Envita Medical Centers Medical Team
- Physicians with MD, ND, DO, DO, MD, medicallicenses
- Nurses trained in precision treatment delivery
What defines Envita Medical Centers is not just the specialized physicians we employ or the advanced technology webring in from all over the globe it is not just the attention to detail and knowledgeable staff or the comfortingenvironment we provide our patients. What defines Envita is the undeniable truth that every patient who has thecourage to come to Envita and walk through our doors discovers the incredible healing and compassionate care that canonly exist in a clinic that is radically focused on patient outcomes we provide a focused team of people with anexceptional heart for serving our patients.
Envita Medical Centers doesn’t make any guarantee of outcomes. Results are not typical and willvary from person to person and should not be expected.
We firmly believe that with God all things are possible! When you are a patient here you arent just a number, youare family. We give each and every one of our patients the love and attention you would give a family member and thatlove persists through every member of our staff.
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What If You Have Metastatic Hormone
If your doctor tells you that you have this type of metastatic prostate cancer, it means your cancer responds to hormone therapy
Most prostate cancer cells need male sex hormones, including androgens like testosterone, to grow. A type of hormone therapy like androgen deprivation therapy could slow the growth of mHSPC by lowering the level of these hormones.
You could also ask your doctor if youÃ¢â¬â¢re eligible for any clinical trials.
Still, some people with mHSPC prefer to avoid or delay getting treatment with an option called active surveillance. ThatÃ¢â¬â¢s when your doctor keeps close tabs on your health but doesnÃ¢â¬â¢t give you treatment unless test results show your cancer is getting worse.
You could ask your doctor if watchful waiting is an option for you.
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
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Castrate Resistant Prostate Cancer
Eventually, almost all metastatic prostate cancers become resistant to androgen ablation. In patients with castrate serum testosterone levels , castrate-resistant prostate cancer is defined as 2-3 consecutive rises in PSA levels obtained at intervals of greater than 2 weeks and/or documented disease progression based on findings from computed tomography scan and/or bone scan, bone pain, or obstructive voiding symptoms.
Rarely, a rise in PSA may reflect failure of LHRH treatment to control testosterone secretion, rather than the development of castrate-resistant disease. Therefore, the testosterone level should be measured when the PSA rises. If the serum testosterone level exceeds castrate levels, changing the antiandrogen therapy may drop the PSA and delay the need for other therapy.
Prior to the development of the most recent therapies, the median time to symptomatic progression after a rise in the PSA level of more than 4 ng/mL was approximately 6-8 months, with a median time to death of 12-18 months. Since then, however, the latter figure has increased.
Little information is available about the impact of maintaining hormone suppression when androgen-independent progression occurs, but the general consensus among specialists is that the treatment should continue. The reasoning is that tumor cells are still hormone sensitive and may grow faster if the testosterone is permitted to rise.
Treatments For Metastatic Castration
Castration-sensitive prostate cancer is cancer that is being controlled by keeping the testosterone level as low as would be expected if the testicles were removed . Metastatic prostate cancer is prostate cancer that has spread to other parts of the body.
The goal of treatment is to help you live longer and try to improve your quality of life. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.
Treatment options for metastatic castration-sensitive prostate cancer may include a combination of the following:
- hormone therapy
- watchful waiting
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Genomic Identification Dives Deep Into Your Specific Cancer
A key factor in prostate cancer treatment includes diving deep into your specific cancer to treat the causes drivingthedisease, an often-ignored facet in standard NCCN guideline treatments. The majority of the patients following theseone-size-fits-all protocols do not get access to genomic testing, which is a part of precision oncology.
At Envita, Every Patients Entire Treatment Plan Is Based on Our Detailed Precision Algorithms!
Lessthan 20% of cancer patients get access to precision oncology, and the limited few who do get precision care,receive a watered-down version of Envitas detailed precisionalgorithm. At Envita, we not only run in-depth genomic testing for all our patients, but our detailed precisionalgorithm analyses many more parameters than standard oncology precision testing to identify and treat each patientsunique cancer drivers.
Envitas Detailed Precision Algorithm Decodes Patient-Specific Cancer Drivers to Help in theJourney Towards Remission.
Bone Protection In Patients Receiving Androgen Blockade
Two drugs, the bisphosphonate zoledronic acid and the RANKL inhibitor denosumab, have been approved to treat osteoporosis secondary to androgen deprivation. Zoledronic acid is administered as an intravenous infusion. Denosumab is administered subcutaneously. These drugs are given along with supplemental vitamin D and calcium. Patients should be monitored regularly for hypocalcemia. Both agents are associated with a low incidence of osteonecrosis of the jaw. Both drugs delay the risk of skeletally-related events by relieving bone pain, preventing fractures, decreasing the need for surgery and radiation to the bones, and lowering the risk of spinal cord compression.
A double-blind, placebo-controlled, multicenter study in men with primary or hypogonadism-associated osteoporosis found that over a 14-month period, treatment with zoledronic acid reduced the risk of vertebral fractures by 67%. New morphometric vertebral fracture occurred in 1.6% of men taking zoledronic acid and in 4.9% taking placebo. Patients receiving zoledronic acid had significantly higher bone mineral density and lower bone-turnover markers. However, the rate of myocardial infarction was higher in the treatment group .
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Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, its 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
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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Treatments To Help Manage Symptoms
Advanced prostate cancer can cause symptoms, such as bone pain. Speak to your doctor or nurse if you have symptoms there are treatments available to help manage them. The treatments above may help to delay or relieve some symptoms. There are also specific treatments to help manage symptoms you may hear these called palliative treatments. They include:
This is the team of health professionals involved in your care. It is likely to include:
- a specialist nurse
- a therapeutic radiographer
- other health professionals, such as a dietitian or physiotherapist.
Your MDT will meet to discuss your diagnosis and treatment options. You might not meet all the health professionals straight away.
Your main point of contact might be called your key worker. This is usually your clinical nurse specialist , but might be someone else. The key worker will co-ordinate your care and help you get information and support. You may also have close contact with your GP and the practice nurses at your GP surgery.
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