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.
Rna Molecule Suppresses Prostate Tumor Growth
- Washington University School of Medicine
- A new study has identified an RNA molecule that suppresses prostate tumors. The scientists found that prostate cancers develop ways to shut down this RNA molecule to allow themselves to grow. According to the new research — conducted in mice implanted with human prostate tumor samples — restoring this so-called long noncoding RNA could be a new strategy to treat prostate cancer that has developed resistance to hormonal therapies.
Many patients with prostate cancer are treated with drugs that lower or block hormones that fuel tumor growth. While the drugs are effective for a time, most patients eventually develop resistance to these therapies.
A new study from Washington University School of Medicine in St. Louis has identified an RNA molecule that suppresses prostate tumors. The scientists found that prostate cancers develop ways to shut down this RNA molecule to allow themselves to grow. According to the new research — conducted in mice implanted with human prostate tumor samples — restoring this so-called long noncoding RNA could be a new strategy to treat prostate cancer that has developed resistance to hormonal therapies.
The study is published Nov. 5 in Cancer Research, a journal of the American Association for Cancer Research.
Drugs That Stop Androgens From Working
For most prostate cancer cells to grow, androgens have to attach to a protein in the prostate cancer cell called an androgen receptor. Anti-androgens are drugs that also connect to these receptors, keeping the androgens from causing tumor growth. Anti-androgens are also sometimes called androgen receptor antagonists.
Drugs of this type include:
They are taken daily as pills.
In the United States, anti-androgens are not often used by themselves:
- An anti-androgen may be added to treatment if orchiectomy or an LHRH agonist or antagonist is no longer working by itself.
- An anti-androgen is also sometimes given for a few weeks when an LHRH agonist is first started to prevent a tumor flare.
- An anti-androgen can also be combined with orchiectomy or an LHRH agonist as first-line hormone therapy. This is called combined androgen blockade . There is still some debate as to whether CAB is more effective in this setting than using orchiectomy or an LHRH agonist alone. If there is a benefit, it appears to be small.
- In some men, if an anti-androgen is no longer working, simply stopping the anti-androgen can cause the cancer to stop growing for a short time. This is called the anti-androgen withdrawal effect, although they are not sure why it happens.
Enzalutamide , apalutamide and darolutamide are newer types of anti-androgens.
These drugs are taken as pills each day.
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Checking Your Hormone Therapy Is Working
Youll have regular blood tests to check the level of a protein called prostate specific antigen . PSA is a protein made by both normal and cancerous prostate cells. It is in the blood in small amounts in all men, unless they have had their prostate gland completely removed.
While the hormone therapy is working, the level of PSA should stay stable or may go down. But if prostate cancer cells are starting to grow and develop, the level of PSA may go up. Then your doctor may need to change your treatment. They will discuss this with you.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someone’s risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.
Considering Complementary And Alternative Methods
You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.
Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.
Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.
In Chicago A New Approach To Gay And Bisexual Men With Prostate Cancer
A new clinic focuses on patients left grappling with the aftermath of treatment in ways that are rarely appreciated by doctors.
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CHICAGO Matthew Curtin learned he had prostate cancer after a routine physical examination in October 2019, when test results indicated there was a problem. A biopsy confirmed the news, and doctors told him that surgery to remove his prostate was the best option.
The surgery went well, and, two years later, there is no indication that the cancer has returned. But for Mr. Curtin, 66, diagnosis and surgery were only the beginning of a clinical and psychological and emotional adventure one he felt that many urologists were not equipped to handle, because he was gay and the majority of doctors and their patients were not.
Post-treatment symptoms are similar for all prostate cancer patients, including urinary incontinence, erectile dysfunction, diminished libido and loss of ejaculate. But researchers are finding that those changes may echo through the lives of gay and bisexual men in unexpected, and sometimes more difficult, ways.
The obstacles can be physical and emotional, and may be reflected in patients relationships with their partners. And they may present a challenge to medical professionals more attuned to the relationship needs of straight men.
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Which Is Better For Prostate Cancer: Surgery Or Radiation
The question of which is better for your specific prostate cancer can only be answered by you in consultation with your doctor and its dependent on the type and stage of cancer you have as well as personal factors such as health and age. Both options can achieve optimal outcomes and both have their own potentials for risk and side effects.
Dry Orgasm And Infertility
Both the prostate and the glands responsible for semen production are removed during surgery, which is a common prostate cancer treatment. If you received this treatment, youd still be able to have an orgasm but youd no longer ejaculate.
This means that youll no longer be fertile. If you plan to have children in the future, you may consider banking your sperm before your surgery.
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What Is Radiation Recall
Radiation recall is a rash that looks like a severe sunburn. It is rare and happens when certain types of chemotherapy are given during or soon after external-beam radiation therapy.
The rash appears on the part of the body that received radiation. Symptoms may include redness, tenderness, swelling, wet sores, and peeling skin.
Typically, these side effects start within days or weeks of radiation therapy. But they can also appear months or years later. Doctors treat radiation recall with medications called corticosteroids. Rarely, it may be necessary to wait until the skin heals before continuing chemotherapy.
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The Positive Impacts Of Predict Prostate
Here in the UK we have a widely available decision tool to support men in choosing treatment for prostate cancer called Predict Prostate.
According to David Thurtle who helped to develop the tool with the Urology Foundation:
Every patient who is diagnosed with localised prostate cancer has to make a decision about what to do next, whether to monitor the cancer carefully or to pursue upfront treatment. If treatment is chosen, more decisions need to be made about which treatment is right.
Providing accurate survival predictions is one of the hardest things a clinician is asked to do. As part of his research David surveyed nearly 200 prostate cancer specialists to assess perceptions around survival following prostate cancer diagnosis, and likelihoods of recommending treatment.
The results demonstrated huge variations in clinician perception of long term survival, with predictions of prostate cancer death ranging from 5-95% in some clinical scenarios.
Unsurprisingly, the likelihood of recommending treatment varied significantly too. Counselling patients with the best information available isnt always straight-forward, but this tool hopes to inform and standardise that process.
TFTC consultant urologist is a strong advocate for Predict Prostate and has seen the positive impact it has on his patients:
He describes how Predict Prostate helps shift the conversation with patients from the drastic to the realistic.
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Tips To Get The Most From Your Follow
Write down any questions or concerns beforehand
Itâs easy to forget what you want to say once youre at your appointment.
Bring someone with you
It can be hard to take everything in at your appointments. Some people find it helpful to take someone with them, to listen and discuss things with later. If your appointment is on the phone, you could ask a friend or family member to listen with you.
It can help to write things down during or after your appointment. Theres space for this in the appointment diary in our booklet, Follow-up after prostate cancer treatment: What happens next?
Ask to record your appointment
You could do this using your phone or another recording device. You have the right to record your appointment if you want to because its your personal data. But let your doctor or nurse know if you are recording them.
Ask for help
If there is anything bothering you, let your doctor or nurse know.
Ask for copies of any letters
If your appointment is at the hospital, ask for a copy of the letter that is sent to your GP. This will happen automatically at some hospitals. It will help to remind you of what was said at your appointment. If you donât understand the letter, call your main contact at the hospital or contact our Specialist Nurses.
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Coping With Side Effects Of Radiation Therapy
EveryoneÃ¢s experience with radiation therapy is different. Side effects vary from person to person, even when given the same type of treatment. Before your treatment, ask your health care team which physical side effects are possible and what to watch for. There can also be emotional side effects, and seeking out mental health support to help with anxiety or stress is important. Ask your health care team about ways to take care of yourself during the treatment period, including getting enough rest, eating well, and staying hydrated. Ask whether there are any restrictions on your regular exercise schedule or other physical activities.
And, continue talking with the team throughout your treatment. Always tell your health care team when side effects first appear, worsen, or continue despite treatment. That will allow your health care team to provide ways to help you feel better during and after treatment.
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Treatment Of Prostate Cancer
Early detection is the best way to start treatment. Treatment will come in various forms and will be dependent on the stage at which cancer has gotten to. The treatments can also have side effects. These treatments are:
When in doubt, you notice symptoms, have a family history of prostate cancer or are in the age risk zone, you can consult with our doctor when you call 080 8111 1121. Early screening is the best chance against prostate cancer. You can also book a PSA blood test by contacting the same number above.
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Radiation Therapy Versus Surgery
In 2014, the Agency for Healthcare Research and Quality found insufficient evidence to determine whether any type of radiation therapy results in fewer deaths or cancer recurrences than radical prostatectomy does in patients with clinically localized prostate cancer. The importance of dose escalation in disease control complicates the extraction of meaningful conclusions from current radiation therapy treatments .
Brachytherapy has also been compared with surgery in the management of early-stage disease. Direct comparisons are not readily available, but preliminary data from most centers suggest that permanent prostate implants yield comparable local control and biochemical disease-free rates.
Valid comparisons of surgery and radiation therapy are impossible without data from randomized studies that track long-term survival rather than PSA recurrence. Variation in radiation techniques and dosage administered the variable use of androgen ablation, which improves survival in intermediate- and high-risk disease and the variable impact on the quality of life complicate comparison using uncontrolled studies.
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What The Researchers Did
Dr. Rose and his colleagues speculated that this doubling occurs infrequently in the general medical community. To investigate, they looked at 80,750 prostate cancer cases documented in the Veterans Affairs database between 2001 and 2015. They focused specifically on differences between men who either were or were not taking 5-ARIs when they were diagnosed with prostate cancer. The men on 5-ARI inhibitors had been taking the drugs for a median of 4.8 years before the prostate cancer was detected.
Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
- whether the cancer has spread to other parts of your body
Medications For Prostate Cancer
Other names: Cancer, Prostate Carcinoma of Prostate
Prostate cancer is a cancer that occurs in the prostate, which is a small, walnut-sized gland that is located just below the bladder in men and which surrounds the urethra .
Prostate cancer is common, and many men have a slow-growing form of prostate cancer. Death, when it happens, is usually from other causes rather than the cancer itself. However, some prostate cancers are aggressive and can quickly spread outside the confines of the prostate. These are associated with a lower rate of survival.
Intermittent Versus Continuous Hormone Therapy
Most prostate cancers treated with hormone therapy become resistant to this treatment over a period of months or years. Some doctors believe that constant androgen suppression might not be needed, so they advise intermittent treatment. The hope is that giving men a break from androgen suppression will also give them a break from side effects like decreased energy, sexual problems, and hot flashes.
In one form of intermittent hormone therapy, treatment is stopped once the PSA drops to a very low level. If the PSA level begins to rise, the drugs are started again. Another form of intermittent therapy uses hormone therapy for fixed periods of time for example, 6 months on followed by 6 months off.
At this time, it isnt clear how this approach compares to continuous hormone therapy. Some studies have found that continuous therapy might help men live longer, but other studies have not found such a difference.
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