Knowing and Choosing The Right Drugs for Advanced Prostate Cancer

When first treated, advanced prostate cancer usually “plays by the rules.” It yields to hormone treatments and goes into remission. But sometimes cancer cells can outsmart the treatments thrown at them. Prostate cells learn how to thrive, even without male hormones. Doctors call this condition hormone refractory prostate cancer. They treat it with chemotherapy.

Recently, the U.S. Food and Drug Administration has approved docetaxel (Taxotere) for this use. The drug, which is used against a number of cancers, can increase survival in men with hormone refractory prostate cancer. It is a new and exciting step forward in dealing with this disease.

Atrasentan (Xinlay) This promising drug, now in clinical trials, comes in pill form. It blocks a protein called endothelin, which is thought to help spread cancer cells. Atrasentan has few side effects, and in early tests it has increased survival and quality of life of men with hormone refractory prostate cancer.

Toremifene (Fareston) blocks hormone receptors on the prostate cancer cell. Currently it is used to treat breast cancer in women and is still in clinical trials for men. The side effects appear to be mild.

Sipuleucel-T (Provenge) Another promising drug still in clinical trials is a vaccine that is custom made from a patient’s own cells. The vaccine combines a man’s immune system cells with a protein that is found in most prostate cancer cells plus a substance called GM-CSF. This combination helps the immune system recognize the cancer as a threat so that it will attack the tumor cells as a foreign invader. In clinical trials, sipuleucel-T caused few side effects, most commonly fever and chills lasting one or two days. In early tests it has increased survival in men with advanced prostate cancer.

Other experimental treatments In addition to atrasentan, other treatments that target specific genetic changes in prostate cancer cells are under development now. Many of these drugs are still in very early clinical trials. Clinical trials is Research studies that test new treatments in patients, under carefully controlled conditions. Clinical trials are the standard by which doctors and scientists measure the worth of new therapies.

Source: Cancercare

Advanced Prostate Cancer and Treatment

Prostate cancer affects 233,000 men in the United States every year. Ideally, doctors prefer to find the disease in its earliest, most treatable stages. But for men living with advanced prostate cancer, the prognosis is getting better all the time, with a number of effective treatments available.

Today, the standard for treating advanced metastatic prostate cancer is hormonal therapy. This type of treatment was begun in the early 1940s, when doctors discovered that the male hormone testosterone acts like a fertilizer, encouraging the cancer to grow. In those days, they often removed the testicles in order to take away the source of the testosterone and send prostate cancer into remission. That type of surgery for prostate cancer isn’t used much in the United States anymore, although in some parts of the world it still is. Without male hormones, prostate cancer retreats—goes into remission—often for many years. Removing the testicles is a drastic-sounding solution.

The new research found that the men are being diagnosed with prostate cancer at younger ages, likely due to more extensive screening. Also, younger men are more likely to be treated with prostatectomy, have less aggressive cancers, and have a better chance of survival after 10 years compared with older men. However, among men with advanced prostate cancers, the youngest men (aged 35 to 44 years) have a particularly poor prognosis compared with older men. These young men are more likely to die from cancer or another cause sooner than older men with similar forms of cancer.

In other hand British researchers said that Oral sodium clodronate improves overall survival in advanced prostate cancer patients but doesn't reduce the risk of death in those with localized disease

The trials examined the effects of sodium clodronate in patients with advanced (311 men) or localized prostate cancer (508 men). The advanced prostate cancer patients who received the drug had a 23 percent lower death rate than patients who took a placebo. After five years, overall survival was 30 percent among men who took oral sodium clodronate and 21 percent among those in the placebo group. After 10 years, the survival rates were 17 percent and 9 percent, respectively, the researchers found.

However, the drug offered no improvement in overall survival to men with localized prostate cancer. After 10 years, the survival rates were 48 percent and 51 percent, respectively.

Advanced Prostate Cancer Treatment

Deciding on the best treatment is not always straightforward and a number of factors have to be taken into account. The most important of these are:
• your general health
• your age
• where the cancer is and the symptoms it’s causing
• the likely side effects of treatment
• your views about the possible side effects of treatment, and how much you are willing to risk side effects for the possible benefits in controlling the cancer
• which treatments, if any, you have had before.

Before you have any treatment, your doctor will explain its aims to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other treatments that may be available
• any significant risks or side effects of the treatment.

When prostate cancer has spread beyond the prostate gland and is affecting other parts of the body, it can no longer be cured. However, treatment can usually be given to control the cancer for as long as possible, relieve any symptoms and improve quality of life.

Most men with advanced prostate cancer are recommended to have hormonal therapy. A range of hormonal therapies are available.

Surgery to remove the prostate gland is not suitable for men with advanced prostate cancer, but occasionally a trans-urethral resection of the prostate (TURP) can be useful to relieve problems with passing urine.

Chemotherapy may be used if hormone therapy is no longer able to control the cancer. Radiotherapy is sometimes used to treat bone pain.

Treatments to relieve symptoms may also be given, such as painkillers. Each of the treatments has different benefits and side effects.