New Hormone Therapy Drugs
Testosterone drives prostate cancer growth, so medications often target it, says Timothy Daskivich, M.D., urologic oncologist at Cedars-Sinai Cancer in Los Angeles, CA. For many years, patients who progressed on traditional androgen deprivation therapy had few options other than chemo, he says. But new androgen receptor signaling inhibitors can provide excellent cancer control and responses in those patients and have shown improved survival chances in patients with metastatic and castration-sensitive disease when given in conjunction with traditional hormone blockade. These new drugs include abiraterone acetate, apalutamide, enzalutamide, and Orgovyx , the only androgen-deprivation therapy that comes in pill form.
Research Into The Quality Of Life Of Men With Prostate Cancer
More and more men are surviving prostate cancer. So researchers are interested in the quality of life of men who finish their treatment. They want to see which men are more likely to have side effects from their treatment.
They are also looking into the mental wellbeing and quality of life of men newly diagnosed with prostate cancer.
Improvements For Localized Cancers
There have been breakthroughs in the treatment of earlier-stage prostate cancers, too, which help to reduce the number of advanced cases in the long run. With respect to localized prostate cancer, one significant development has been the advent and expansion of active surveillance as a treatment option for men with low-risk prostate cancer, explains Dr. Haywood. For men with low-risk and very-low risk prostate cancer, this strategy avoids side effects of prostate cancer treatment while maintaining the ability to deliver definitive therapy when conditions dictate.
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How Psma Lights Up Cancer Cells
In 2021, the U.S. Food and Drug Administration issued national approval to two new prostate cancer imaging tests based on similar technology. On a PET scan, the test lights up the cancerous cells that would otherwise be hidden, enabling doctors to precisely target treatment.
Both advances in imaging and therapy rely on targeting PSMA, which is not found on most normal cells but is overexpressed in cancer cells, especially those that have spread. The PSMA molecule was cloned at MSK in the early 1990s.
The Molecular Imaging and Therapy Service, led by Heiko Schöder, played a key role in the development and testing of a slightly different PSMA-directed imaging technology at MSK.
This advance is the result of years of work by the community of physicians promoting the use of PSMA agents, Dr. Schöder says. Its gratifying to see a collaborative effort result in a breakthrough that has the potential to make a difference for so many patients with advanced prostate cancer.
Before receiving the therapy, patients in the VISION trial were scanned with PSMA-directed PET imaging to make sure enough PSMA was present in the cells to make them likely to respond to the treatment. If so, they received the radioactive drug by injection over four to six sessions, spaced six weeks apart.
As a next step, Dr. Morris and colleagues are looking into using the PSMA-directed therapy earlier rather than only after the prostate cancer has spread.
The Impacts Of A Late Prostate Cancer Diagnosis
New Zealand Institute of Economic Research principal economist Sarah Hogan. Photo: Supplied/SunLive.
A late diagnosis of prostate cancer not only contributes to negative health outcomes for New Zealand men, adversely affects their employment earnings by an average of $12,000 over four years, compared to no loss of earnings with an early diagnosis.
New research presented at the Prostate Cancer Foundation of New Zealands annual conference held at the end of August showed the findings.
The research was presented by Sarah Hogan, New Zealand Institute of Economic Research , Principal Economist at the conference, which this year focused on early detection and survivorship.
NZIER matched 969 prostate cancer participants to a non-cancer control group in terms of similar demographics, health status, health service utilisation, employment, earnings, and income support status.
While $12,000 in lost earnings over four years, was the average for the research group, the older men were at diagnosis seems to significantly impact lost earnings. We saw an average earning loss of $17,606 for men aged 60-64 at diagnosis versus $9,278 for younger men under 60, says Hogan.
This raises questions as to whether the health system, in relation to the diagnosis of prostate cancer, is disproportionately disadvantaging older men, who still have considerable earning potential for years to come.
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What Lies Ahead: Leading The Way With Alpha Therapies
The coming years will see even more powerful forms of radioactive therapy. The MSK laboratory of radiochemist Jason Lewis and other researchers are investigating the use of alpha particles, which have a much higher energy hundreds of times more potent than the photons used in conventional radiation or beta particles. Not only do alpha particles cause more damage when they slam into cancer cells but their path of destruction is more tightly focused, sparing normal cells.
MSK is building one of the nations first dedicated alpha particle GMP labs at a U.S. academic institution.
These radiopharmaceuticals that we are creating translate very well from bench to bedside, says Dr. Lewis, Chief of the Radiochemistry and Imaging Sciences Service and Director of the Radiochemistry and Molecular Imaging Probe Core Facility. When you see these striking responses to treatment, it brings real hope for the future and our patients.
Advances in radiotheranostics are supported by The Tow Foundation, long-time contributors to MSKs mission.
- A new FDA-approved drug could be an effective treatment against prostate cancer that has spread.
- The treatment uses a molecule that seeks out and attaches to a specific protein on the cancer cell surface called PSMA
- The technology delivers radiation that damages DNA and destroys the cancer cell..
Targeted Radiation Therapy And Psma
Scientists are also developing targeted therapies based on PSMA, the same protein that is being tested for imaging prostate cancer. For treatment, the molecule that targets PSMA is chemically linked to a radioactive compound. This new compound can potentially find, bind to, and kill prostate cancer cells throughout the body.
In a recent clinical trial, men with a type of advanced prostate cancer who received a PSMA-targeting drug lived longer than those who received standard therapies. Ongoing and planned clinical trials are testing PSMA-targeting drugs in patients with earlier stages of prostate cancer, and in combination with other treatments, including targeted therapies like PARP inhibitors and immunotherapy.
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Asian Men Unlikely To Seek Help For Prostate Enlargement Says The Sua
Although efforts in Singapore are rising to spread awareness of prostate enlargement, many Asian men still do not seek help. According to a recent survey by the Singapore Urological Association , one-third of men suffering from an enlarged prostate do not seek help, despite it being a highly treatable condition.
The reason why men don’t seek help? According to the survey, 50 percent of the respondents cited they believed it was part of “getting old”, whereas 12 percent claimed they were fearful of being diagnosed positive for prostate enlargement.Dr. Colin Teo, the chairman for SUA, believes misinformation is the biggest reason why Asian men do not get treated for this condition.
“Only 15 to 20 per cent of sufferers need surgery,” says Teo to TodayOnline.com. “Others can manage their condition through lifestyle changes or medication.”
Prostate enlargement, better known as benign prostatic hypertrophy , is a condition where the prostate enlarges and puts pressure on the urethra, making it difficult to pass urine. Although the condition isn’t fatal, it can make urination painful or unpredictable, putting a clamp on a man’s day-to-day and sex life. Many men believe BPH is just the cause of old age and cannot be treated, when in fact it is not clear what causes BPH.
Stay Active To Support Prostate Health
In addition to eating a healthy diet, you should stay active. Regular exercise pares down your risk of developing some deadly problems, including heart disease, stroke, and certain types of cancer. And although relatively few studies have directly assessed the impact of exercise on prostate health, those that have been done have concluded, for the most part, that exercise is beneficial. For example:
Get more information and the latest news about prostate health at www.HarvardProstateKnowledge.org.
Image: jacoblund/Getty Images
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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 some 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.
When To See A Doctor If You Have Symptoms
If your symptoms are related to an enlarged prostate , you and your doctor will weigh the risks versus the benefits of treatment. A major consideration is the extent to which your symptoms are interfering with your lifestyle. For example, if you work in an office or need to travel frequently, then having to use the bathroom often is probably disruptive to your lifestyle in a way that it wouldnt be if you were retired or worked from home. If your symptoms prevent you from engaging in enjoyable activities or if theyre noticeably worsening, discussing treatment options with your doctor is wise.
You can gauge the severity of your symptoms by completing a simple, seven-question, multiple-choice questionnaire to get whats called an International Prostate Symptom Score . Youll be asked questions such as, Over the past month, how often have you had to push or strain to begin urination? and, Over the past month, how often have you had a weak urinary stream? Based on your responses, youll be able to tally up an overall score. If yours falls in the range of moderate to severe, you should talk to a doctor about treatment.
If you are unable to urinate, youre experiencing a medical emergency and should seek prompt urgent care.
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What Is The Main Cause Of Prostate Cancer
No single cause of prostate cancer has been identifiednor can researchers conclusively state that any given factor causes the disease per se. Inherited genetic changes can sometimes be identified, and DNA-damaging chemicals in our environment may play a role.
Radiation, chemicals and inflammation can all cause mutations to cells DNA. When the cells divide, the mutations are repeated and can produce prostate cancer. These types of mutations occur within a mans body after exposure to the stimulus and are not inherited.
Other genetic defects are indeed inherited from a mans parents these mutations are called germline defects. Two of the most common germline defects are found in the BRCA1 and BRCA2 genes, whose job is to repair damage to cells DNA. When the BRCA genes are defective, DNA damage inside cells can accumulate and form tumors. Some men with aggressive prostate cancers have defective BRCA genes . BRCA genes are not alone, thoughrecent research has found 16 DNA-repair genes that may be implicated in prostate cancer. Other cancer-related germline defects include mutations to the ATM gene, which regulates cell growth the HOXB13 gene, which is involved in prostate development and the CHEK2 gene, which blunts the effect of testosterone on the growth of cancer cells.
While other factors no doubt contribute to a mans overall risk profile, genetic defects are probably the strongest single predictor of who will and will not develop prostate cancer.
Research Into Treatment For Prostate Cancer
Before new treatments can be introduced, they need to be tested thoroughly. This is so we can be sure that they work and that they are safe.
Go to Cancer Research UKs clinical trials database if you are looking for a trial for prostate cancer in the UK. You need to talk to your specialist if there are any trials that you might be able to take part in.
Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out on prostate cancer.
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Nutrition And Lifestyle Changes
Many studies have looked at the possible benefits of specific nutrients in helping to treat prostate cancer, although so far none have shown a clear benefit. Some compounds being studied include extracts from pomegranate, green tea, broccoli, turmeric, flaxseed, and soy.
One study has found that men who choose not to have treatment for their localized prostate cancer may be able to slow its growth with intensive lifestyle changes. The men in the study ate a vegan diet and exercised frequently. They also took part in support groups and yoga. After one year the men saw, on average, a slight drop in their PSA level. It isnt known if this effect will last since the report only followed the men for 1 year. The regimen may also be hard for some men to follow.
It’s important for men thinking about taking any type of nutritional supplement to talk to their health care team first. They can help you decide which ones you can use safely while avoiding those that might be harmful.
What Is Prostate Cancer
All cancers begin when cells somewhere in the body start to grow out of control. Prostate cancers get their start in the prostate gland and may spread from there to other body parts. When the cancer remains limited to the prostate, it is known as localized prostate cancer. If it is found to be a low grad cancer on biopsy, often no immediate treatment is necessary. Periodic monitoring can determine if the cancer is still growing. Intermediate and high grade localized cancer can be treated with surgery or radiation therapy. Men who dont have surgery might also be treated with a hormonal therapy called androgen deprivation therapy to block production of testosterone, a key hormone for the promotion of cancer growth.
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What Are Common Prostate Problems
Unfortunately, most men will experience some kind of prostate problem during their lifetime. Prostate problems are generally associated with three conditions: prostatitis, BPH, and cancer.
Benign Prostatic Hyperplasia , commonly called enlarged prostate, refers to the excessive growth of the gland that usually occurs after age 50 it can double or triple in mass during the latter decades of life. BPH is not caused by cancer .BPH can be considered an expected part of the aging process for most men. About half of cases are asymptomatic, but some men will experience problems. As the prostate expands in size, it effectively pinches off the urethra , making the muscular walls of the bladder have to work harder and causing problems with urination.
As with other cancers, prostate cancer is the abnormal growth of cells. Prostate cancer can be localized , regionally advanced or metastatic . Recent years have seen great advancements in prostate-cancer screening, testing and treatment.
Study Limitations And Continued Research
The study authors do note that using this combined treatment method is not without risks. They point out that it could increase the risk for certain bone marrow problems. They also note that a longer follow-up time would be necessary to confirm the full effectiveness of the treatment.
Dr. Kelvin Moses, director of the Comprehensive Prostate Cancer Clinic at Vanderbilt University Medical Center, who was not involved in this study, agreed that more follow-up research is needed, but said that the results so far are promising.
He explained for MNT that his study reinforces the importance of control of the pelvic lymph nodes either at the time of surgery, or in the setting of post-prostatectomy recurrence.
He added that t remains to be seen if the progression benefit translates to a reduction in metastasis or death from prostate cancer, but these results are promising and can change the paradigm for treatment of biochemical recurrence.
The study authors further note that, as imaging of the prostate improves, it will impact how this treatment method is applied. But the research provides overall encouraging results that survival rates can improve for those with prostate cancer with the right kind of treatment.
Dr. Hayley Whitaker, a cancer expert at the University College of London, who was not involved in this study, was enthusiastic regarding its results:
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