Medication For Prostate Cancer Treatment

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.

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 .

If Your Coverage Is Denied Follow These Steps To Appeal Your Case:

Ask your health plan which guidelines they used to formulate the denial.

Submit documentation clearly stating the reason for the requested service. Health plans make their coverage decisions based on the documentation you provide, so its in your best interest to provide complete information up front. Print out any information that supports your position. Keep copies of all medical documentation. In many cases, your physician can provide the medical documentation you need. Your physician can also discuss the denial with your health plans physician reviewer.

You can also ask your doctor to appeal to the insurance company directly. Sometimes the insurance company needs very specific medical details to approve a test or treatment.

Follow up with your health plan if it hasnt responded in a timely manner.

If your appeal is not overturned on the first try, request a second appeal. Most plans also provide a third level of appeal. If all levels of appeal are overturned, consider filing with an independent review board or the insurance commissioner. At this point, you may require a lawyer. Be persistent, factual, and adhere to all requests and requirements of the health plan.

While this process may seem like a lot of work, it is absolutely worth it if it means you can choose the care option that is best for you. Work with your doctor to find and fund the best treatment you possibly can.

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What Is The Best Medication For Prostate Cancer

The best prostate medication for you depends on the severity of your case, your stage of cancer, medical history, and any medications you may already be taking that may cause negative interactions. Consult your doctor or pharmacist for medication recommendations. The following are commonly used prostate cancer drugs.

Best medications for prostate cancer
Drug name
250 mg tablet taken daily on an empty stomach usually with steroids	Joint swelling or pain, cough, and hot flashes

A doctor will determine the best dosage of the medication for you according to your medical condition, age, weight, diagnosis, cancer stage, etc. Other side effects may occur since this is not a complete list.

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Early Versus Delayed Treatment

For men who need hormone therapy, such as men whose PSA levels are rising after surgery or radiation or men with advanced prostate cancer who dont yet have symptoms, its not always clear when it is best to start hormone treatment. Some doctors think that hormone therapy works better if its started as soon as possible, even if a man feels well and is not having any symptoms. Some studies have shown that hormone treatment may slow the disease down and perhaps even help men live longer.

But not all doctors agree with this approach. Some are waiting for more evidence of benefit. They feel that because of the side effects of hormone therapy and the chance that the cancer could become resistant to therapy sooner, treatment shouldnt be started until a man has symptoms from the cancer. This issue is being studied.

Does Medicare Cover Breast Cancer

Medicare pays 100% of the cost of an annual breast cancer screening. Part A pays for inpatient breast cancer surgery or breast implant surgery after a mastectomy. Breast surgeries done at a doctors office or outpatient center are covered by Part B.

Part B also covers breast prostheses after a mastectomy.

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Other Prostate Cancer Therapies

Depending on your type of cancer, your progression in the disease, and whether or not you have metastatic prostate cancer, your doctor may recommend other treatments including:

• Cryotherapy: Cryotherapy uses extremely cold temperatures targeted directly at affected cancer tissue to kill cancer cells and impede growth. Cryotherapy is still a new technology being used in clinical trials and there are few studies yet that give statistical data on the effectiveness of the procedure.
• Immunotherapy: A burgeoning field in cancer treatment is immunotherapy. Immunotherapy harnesses the power of a person’s immune system to help kill off cancer cells and prevent regrowth. Immunotherapies work by hacking the immune system and enabling the bodys immune response to more directly impact cancer cells. It is generally administered intravenously.Currently, there are two FDA-approved therapy options for advanced prostate cancers that have either spread or are proving hormone therapy-resistant. These are Provenge, a vaccine derived from the patients immune cells that attacks proteins inside the cancer cell and Pembrolizumab. Immunotherapies may be added to the treatment regimen of men utilizing radiation therapy, pre-chemotherapy, or for men who have metastatic prostate cancer. These new medications are associated with thyroid disorders, adrenal dysfunction, and rarely, diabetes insidious, a disorder with excessive urination and thirst due to the loss of ADH, the water hormone.

Chemotherapy For Prostate Cancer

Patients who no longer respond to hormone therapy have another option.

The chemotherapy drug docetaxel taken with or without prednisone is the standard chemotherapy regimen for patients who no longer respond to hormone therapy. Docetaxel works by preventing cancer cells from dividing and growing. Patients receive docetaxel, along with prednisone, through an injection. Side effects of docetaxel are similar to most chemotherapy drugs and include nausea, hair loss, and bone marrow suppression . Patients may also experience neuropathy and fluid retention.

Docetaxell, when used with or without prednisone, was the first chemotherapy drug proven to help patients live longer with advanced prostate cancer. The average survival was improved by about 2.5 months when compared to mitoxantrone with or without prednisone. Docetaxel has the best results when given every three weeks as compared to weekly dosing.

Cabazitaxel is another chemotherapy drug, used in combination with the steroid prednisone, to treat men with prostate cancer. Cabazitaxel is used in men with advanced prostate cancer that has progressed during, or after, treatment with docetaxelâââââââ .

Side effects in those treated with cabazitaxel included significant decrease in infection-fighting white blood cells , anemia, low level of platelets in the blood , diarrhea, fatigue, nausea, vomiting, constipation, weakness, and renal failure.

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What Are Some Emerging Therapies For Prostate Cancer

Because prostate cancers can act so differently, they need different types of treatment. New research is focusing on precision medicine. The goal is to have tailored treatment for each person from the very beginning. Since there are so many different types of prostate cancer, precision medicine needs to cover a lot of bases. Its important to remember that not all emerging therapies are right for everyone. And the FDA hasnt approved some of these treatments yet. If you have advanced prostate cancer, talk to your team about whether you should try these emerging therapies:

• PARP inhibitors: These medications stop prostate cancers from growing. They can help people with metastatic prostate cancer who have mutations in their BRCA1, BRCA2, and DDR genes.

• Prostate membrane-specific antigen radionuclide therapy: PSMA radionuclide therapy delivers radiation directly to prostate cancer cells. A recent study showed that people with metastatic prostate cancer who received this therapy lived longer.

• Focal therapies: Focal therapies use heat, cold, or electricity to kill cancer cells in the prostate gland and limit damage surrounding tissues. Therapies include focal irreversible electroporation, high-intensity focused ultrasound, cryotherapy, and focal laser ablation. These therapies are still investigational .

How To Increase Your Chances For Coverage If You Think The Testing Or Treatment May Be Denied

Take time to fully understand your health insurance plan before you begin treatment. This will help you to avoid surprises once youve started treatment. Here are some steps to take:

Obtain an updated, complete copy of your health plan .

Ask questions. Talk with your employers health benefits department. Call your health plans customer service line. Ask about any policies not included in the benefit book, such as appeal processes and how denials are formulated. Explore what legal health insurance requirements your state mandates.

Get a letter of referral from your physician that clearly indicates that he or she strongly recommends a particular treatment.

If coverage is an issue with your HMO, consider switching to a PPO plan with the same provider. The best time to make the change is during open enrollment or at policy renewal time.

Shop around for other insurance companies and switch to a provider that is known for approving the treatment being recommended. However, be careful not to cancel your original coverage until the new coverage takes effect.

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How Can I Manage These Side Effects

It is important to manage any side effects you are having so that you can continue treatment. Listed below are tips on how to manage the side effects of androgen deprivation medications.

Sexual Dysfunction & Body Image Problems

ADT causes a loss of libido in most men. This tends to happen within the first few months of therapy, followed by erectile dysfunction . Libido often comes back a few months after androgen deprivation therapy has been finished. Depending on other cancer treatments and other medical problems, erectile function also can come back for many men.

Talk with your partner and your healthcare providers. Learn about ED. Ask for help from your urologist, who is trained in the treatment of ED. Finally, think about seeing a sex therapist, which can be helpful for couples facing these side effects.

Osteoporosis

Osteoporosis is when you have thinning of the bones that can lead to fractures . There are things you can do to lower your risk of a fracture and to strengthen your bones.

Take 1000 IU of vitamin D-3 daily.

Your healthcare provider may check blood levels of vitamin D with the 25-OH Vitamin D blood test.

Do not take more than 2000 IU of vitamin D3 a day unless directed by your healthcare provider.

Bone strengthening exercises.

Before you start an exercise program, check with your healthcare provider first. If you have cancer that has spread to your bones, a healthcare provider should help you see if weightlifting is safe for you.

Radiation Therapy In Metastatic Crpc

Approximately 90% of advanced PCa patients will develop bone metastases. Radiation therapy is an important therapeutic option for of bone disease. Patients with isolated, painful bone lesions may be treated with palliative external beam radiation. Additionally, oligometastatic disease may be treated to slow progression. Systemically administered, bone targeted radiopharmaceuticals can be used for control of bone predominant disease. Radium-223 is an alpha particle emitting agent approved for the treatment of mCRPC patients with symptomatic bone lesions, without visceral disease. Patients in the ALSYMPCA trial receiving radium-223 had an improvement in OS as well as significant improvements in skeletal- and pain-related outcomes.20 Treatment with radium-223 alone has been shown effective in comparison to placebo however, there are several ongoing studies investigating combinations with other approved agents in mCRPC.

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Thinking About Taking Part In A Clinical Trial

Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they’re not right for everyone.

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials.

• Clinical Trials

Just One Weapon Against Cancer

Before treatment with PLUVICTOTM is recommended, patients undergo a PSMA-PET/CT scan 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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Side Effects Of Chemotherapy

All chemotherapy drugs work in slightly different ways, making it challenging to predict side effects for individual patients. Dosages, drug combinations and drug responses will vary from patient to patient.

The American Cancer Society lists the following as the most common side effects of chemotherapy:

• Increased risk of infections

• Easy bruising or bleeding

Fees For Services In Hospital

If youre treated as a public patient, Medicare pays for your treatment, medicines and care while you are in hospital, and for follow-up care from your treating doctor in an outpatient clinic.

For private patients in a public or private hospital, Medicare pays 75% of the Schedule fee for services provided by your doctor. If your doctor charges more than the Schedule fee, your health fund may pay the gap fee or you may have to pay it as an out-of-pocket cost. You will also be charged for hospital accommodation, operating theatre fees and medicines. Private health insurance may cover some or all of these costs, depending on your policy. You may have to pay an agreed amount of the hospital fee , depending on the type of hospital cover you have. Fees charged by private hospital emergency departments are not covered by Medicare or private hospital cover.

Before being admitted to hospital as a private patient, ask:

• your doctor for a written estimate of their fees , who else will care for you , and how you can find out what their fees will be
• your private health fund what costs they will cover and what youll have to pay some funds only pay benefits for services at certain hospitals
• the hospital if there are any extra treatment and medicine costs.

Health funds make arrangements with individual doctors about gap payments. Choosing to use the doctors and hospitals that take part in your health insurers medical gap scheme can help reduce out-of-pocket costs.

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What Foods Can Kill Prostate Cancer Can Prostate Cancer Be Reversed By Diet

The question of whether certain foods can kill or reverse prostate cancer is a complicated one that is still being researched by scientists. What we do know, however, is that there seems to be some correlation between diet and health and that in some regions where diets are more plant-based are more prevalent than here in Western countries, aggressive prostate cancers occur less frequently. For sustained health, many doctors recommend adopting a diet that is high in fruits and vegetables and whole grains and low in animal-based and processed foods.

Do All People With Bph Require Medication

A person may not need treatment for a mildly enlarged prostate that is not causing significant symptoms. In such cases, a person may need to visit a urologist for regular checkups and may need treatment only if the symptoms become problematic.

If the symptoms of BPH begin to bother a person, a doctor may prescribe medication to shrink the prostate or stop its growth. This may reduce associated symptoms such as:

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Advanced And Recurrent Cancer

If prostate cancer spreads beyond the prostate, it usually spreads to the bones. This is called secondary cancer or metastasis. Cancer in the bones can be painful and might lead to bone fractures or other complications.

Treatment to prevent prostate cancer from spreading to the bones, or to relieve symptoms associated with secondary cancer in the bones may include:

• bisphosphonates, which can help strengthen bones, and is also used in men who have had hormone therapy
• external beam radiotherapy, which can help relieve bone pain
• monoclonal antibodies such as denosumab injected under the skin to help protect bones
• corticosteroids, which can relieve pain and lower PSA levels
• radiopharmaceuticals , which are injected into the body and settle in areas of damaged bone, where they can destroy cancer cells
• pain medications.

Prostate cancer may recur after treatment. The cancer can recur in the prostate or somewhere else in the body, and is classified as local or distant .

If prostate cancer has come back, the type of treatment you have may depend on how your primary cancer was treated. You might have the same treatment again, or a different treatment.