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Health & Medicine for Senior Citizens

Four New Drugs Will Change Prostate Cancer Care, Colorado Expert Says

Hope this will lead to making prostate cancer a disease a patient is more likely to die with than from

By Garth Sundem

3 Key Points

Four new drugs could transform prostate cancer from terminal to chronic disease

Not just chemo — new, targeted drugs act in novel and interesting ways

These drugs mark first major advances in prostate cancer care in nearly 15 years

Feb. 16, 2012 - After a decade and a half of near stagnation, four new drugs could help make advanced prostate cancer a chronic illness instead of a terminal disease, a leading Colorado prostate cancer expert says.

“It’s not just chemotherapy. The drugs have different and innovative methods of action. One is a bone protective agent; another’s a more effective hormone agent; another is radiotherapy; and the final one is the first drug tested for cancer immunotherapy,” says E. David Crawford, MD, investigator at the University of Colorado Cancer Center and head of urologic oncology at University of Colorado Hospital.

“Even without the addition of any more drugs, we may now have the tools that in combination will allow us to extend the survival prognosis of a prostate cancer patient long enough to make prostate cancer a disease a patient is more likely to die with than from,” Crawford says.

 

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Along with Thomas Flaig, MD, Crawford describes these advances in prostate cancer treatment in a recent review for the journal Oncology.

First is the drug Denosumab, which Crawford says, “has three uses in protecting the bones of prostate cancer patients.”

It can prevent bone fractures in patients with existing bone metastasis; it can prevent osteoporosis in patients whose calcium is depleted as a side-effect of hormone therapy; and (pending FDA approval) it has been shown to hold off the occurrence of bone metastasis for an average of four months in patients whose spiking PSA scores predict the likely onset of bone involvement.

Second is the drug Alpharadin, which is one of a novel and exciting class of “radiopharmaceuticals” – drugs that emit radiation and allow doctors to precisely deliver radiation to tumor sites. In the case of Alpharadin, it emits alpha rather than beta particles, which allows more precise tumor targeting of bone metastasis sites with less collateral damage to surrounding bone marrow.

Third, the drug Prostvac is the first “immunotherapy” drug used for the treatment of cancer. The drug acts like a vaccine, priming the immune system to recognize and thus fight against prostate cancer cells. In a phase II clinical trial of 125 patients, the drug extended the median survival time from 16.6 to 25.1 months.

Finally, the drug Abiraterone Acetate completely suppresses the body’s ability to make testosterone, which many prostate cancers need to grow (as opposed to previous drugs, which hoped to out-compete testosterone with estrogen, or imperfectly controlled testosterone production).

Crawford notes that these drugs are being approved for use only after more established therapies have failed and hopes that in coming years science may accelerate the use of these drugs to first-line therapies.

“Before we just had hormone therapy, then we got chemo, and each therapy we added packed on another couple months of survival. Now with these news drugs we’re tacking on even more time. The light at the end of the tunnel is the hope that we’ll turn this into a chronic disease and now we might have the tools that in some combination will do it,” Crawford says.

Notes: To learn more about these and other cutting-edge strategies to combat advanced prostate cancer, refer for Crawford and Flaig’s recent review, Optimizing Outcomes of Advanced Prostate Cancer: Drug Sequencing and Novel Therapeutic Approaches.

Links to More on Prostate Cancer in SeniorJournal.com

Cardiovascular Deaths Not Linked with ADT for Prostate Cancer but Lower All- Death Risk May Be

Study should be 'generally reassuring' to most men with unfavorable-risk prostate cancer considering ADT, because it was associated with improved survival  - Dec. 7, 2011

Prostate Cancer Patients Considering Suicide May Find Help in New Concept

Patients who have these negative thoughts before surgery are more likely to have a lower perceived quality of life 3 months afterwards

Oct. 31, 2011

Influential Panel Giving Thumbs Down To Routine PSA Test for Prostate Cancer

See links to other comments and reports on this recommendation

By Scott Hensley, NPR News

Oct. 10, 2011

New Models Predict Likelihood of Erectile Function Return After Prostate Cancer Treatment

Problem still there but it helps men make better informed decisions with realistic expectations - watch video report

Sept. 20, 2011

New Surgery-Free Treatment for Enlarged Prostate Avoids Sexual Dysfunction

Prostatic artery embolization as effective as popular TURP surgical method; more than half of senior men have enlarged prostate; also silodosin a new treatment for prostatitis

May 18, 2011


Ten Ways to Improve Communications, Make Better Decisions About Your Cancer Care

Michigan researchers outline how to improve communication about the risk

Sept. 20, 2011

Concern Is Growing That the Elderly Get Too Many Medical Tests; Little Benefit

Growing skepticism about widespread, routine screening for cancer and other ailments of people in their 70s, 80s and 90s

By Sandra G. Boodman, Kaiser Health News

Sept. 13, 2011

Prostate Cancer Patients Live Much Longer with Hormone Therapy Added to Radiation

Larger graphs of prostate cancer cases and deaths 1987-2007 below story

ADT therapy works well with intermediate grade cancer, not so well with low grade; only two grades tested in this trial

July 15, 2011

Medicare Bites Bullet to Cover Expensive Provenge, Prostate Cancer Drug for Bad Cases

CMS also to continue expensive breast cancer drug, Avastin; Sipuleucel-T activates immune system to defend against prostate cancer; first approved autologus cellular immunotherapy

July 1, 2011

Cancer Death Rates Continue Decline That Began in Early 1930s Says Cancer Society

Cancer Statistics 2011 shows among men the reduction in lung, prostate, and colorectal cancers is nearly 80% of decline; among women, almost 60% of decrease in breast and colorectal - see chances of seniors getting cancer

June 17, 2011

Drug Approved to Treat Nail Fungus Found to Delay Chemo in Advanced Prostate Cancer

Itraconzole slows prostate cancer progression but has potential of serious side effects

June 3, 2011

Rising PSA Levels May Sometimes Lead to Negative Biopsies But Usually Means Cancer

News study shows nearly 70 percent with rising PSA eventually get prostate cancer

May 18, 2011

 

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