Are There Side Effects
The treatments for prostate cancer also can affect your body in other ways. Side effects can include:
- Bowel problems
- Loss of your ability to get a woman pregnant
- Leaky bladder or loss of bladder control. You might also need to pee a lot more often.
Side effects are another thing to think about when youâre choosing a treatment. If theyâre too tough to handle, you might want to change your approach. Talk to your doctor about what you can expect. They can also help you find ways to manage your side effects.
Finding Small Amounts Of Prostate Cancer Using Imaging And Psma
NCI-supported researchers are developing new imaging techniques to improve the diagnosis of recurrent prostate cancer. A protein called prostate-specific membrane antigen is found in large amountsand almost exclusivelyon prostate cells. By fusing a molecule that binds to PSMA to a compound used in PET scan imaging, scientists have been able to see tiny deposits of prostate cancer that are too small to be detected by regular imaging. The Food and Drug Administration has approved two such compounds for use in PET imaging of men with prostate cancer.
This type of test is still experimental. But the ability to detect very small amounts of metastatic prostate cancer could help doctors and patients make better-informed treatment decisions. For example, if metastatic cancer is found when a man is first diagnosed, he may choose an alternative to surgery because the cancer has already spread. Or doctors may be able to treat cancer recurrenceeither in the prostate or metastatic diseaseearlier, which may lead to better survival.
As part of the Cancer Moonshot, NCI researchers are testing whether PSMA-PET imaging can also identify men who are at high risk of their cancer recurring. Such imaging may eventually be able to help predict who needs more aggressive treatmentsuch as radiation therapy in addition to surgeryafter diagnosis.
Progress In Prostate Cancer Research
The American Association for Cancer Research Annual Meeting 2022 was held in New Orleans in April. Presentations covered topics from cancer prevention to basic biology to clinical studies to survivorship. This month, we highlight discoveries from the cancer biology lab: two new potential targets for prostate cancer therapy.
A New Approach to Targeting the Androgen Receptor in Advanced Prostate Cancer
The androgen receptor is the main driver of prostate cancer and the primary therapeutic target. Medications include standard hormone therapy and the newer agents abiraterone, apalutamide, darolutamide, and enzalutamide. However, tumors frequently develop resistance to AR-targeted therapy and progress. Novel strategies to target AR are needed.
PCF-funded investigator Luke Gilbert, PhD and colleagues conducted a study to identify new regulators of AR, which have potential as treatment targets for prostate cancer. The team used the gene technology called CRISPR to look for molecules that influence prostate cancers growth.
In ongoing studies, the team is further optimizing the chemistry and pharmacology of PTGES3 inhibitors, in order to develop a clinic-ready PTGES3 inhibitor that can be tested in clinical trials.
Take-home point: Researchers have used the gene-editing technology CRISPR to identify a potential new treatment target for prostate cancer called PTGES3.
Internal Clock Gene as a Potential Target for Prostate Cancer Therapy
About Prostate Cancer Foundation
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Studying Early Detection For Men At High Risk
Men with certain inheritedgenetic traits are at increased risk for developing prostate cancer. Examples of such traits include inherited BRCA gene mutations and Lynch syndrome. No clear guidelines exist for when or howor ifto screen men at high genetic risk for prostate cancer.
NCI researchers are using magnetic resonance imaging of the prostate in men at high risk to learn more about how often and how early these cancers occur. Theyre also testing whether regular scans in such men can detect cancers early, before they spread elsewhere in the body .
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.
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Treating Prostate Cancer That Has Spread To The Bones
Doctors are studying the use of radiofrequency ablation to help control pain in men whose prostate cancer has spread to one or more areas in the bones. During RFA, the doctor uses a CT scan or ultrasound to guide a small metal probe into the area of the tumor. A high-frequency current is passed through the probe to heat and destroy the tumor. RFA has been used for many years to treat tumors in other organs such as the liver, but its use in treating bone pain is still fairly new. Still, early results are promising.
In February 2008 Petes Prostate
It turned out that Pete had cancer. When I was first told I had prostate cancer, I didnt hear much else. Just the word cancer was a great shock, Pete said. Some men may find it hard to think of anything else for a while. The news that your cancer has returned after treatment can hit even harder and revive long-buried fears. When I learned nearly five years later my cancer had returned and was now in my bones, I didnt know what to think.
Prostate cancer is the second most common cancer found in men. More than 230,000 new cases will be diagnosed this year. Chances are you know someone who has prostate cancer or has been treated for it. More than 2.5 million men in the United States are survivors of prostate cancer. The survival rate is rising. Awareness, screening and better treatments are some of the reasons. If found at an early stage, prostate cancer has a very high chance of cure. Also, many prostate cancers that are found early may not be fast-growing or life threatening.
However, when prostate cancer spreads outside the prostate or reappears after initial treatment, it is known as advanced prostate cancer. Some men are told they have advanced prostate cancer when they are first diagnosed. Other men are diagnosed with advanced prostate cancer when their PSA levels rise months or years after surgery or radiation. At first, your doctor may suggest hormone therapy if you have advanced prostate cancer.
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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:
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 .
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 recurrence or biochemical recurrence.
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A New Treatment For Advanced Prostate Cancer Improves Survival In Phase 3 Clinical Trial
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Radiation therapy is getting more precise, enabled by technologies that make it easier to kill tumors while sparing their surrounding tissues. Some newer therapies are even given intravenously instead of by machines, and they deliver radiation particles directly to the cancer cell itself. One of these new therapies a sort of smart bomb targeted at malignant cells is now generating promising data for men with the most aggressive prostate cancer.
In early June, investigators reported results from a phase 3 clinical trial showing that among men who received the experimental treatment, there was nearly a 40% reduction in deaths over the course of the study, compared to men who did not.
The treatment is called lutetium-177-PSMA-617, or LuPSMA, and it has two components: a compound that targets a cancer cell protein called prostate-specific membrane antigen, or PSMA, and a radioactive particle that destroys the cells. Healthy prostate cells don’t contain PSMA, or do at very low levels. And some men with prostate cancer have more of the protein than others. Doctors can detect the protein using a specialized imaging scan.
Results after 21 months showed that cancer progression was delayed for longer among the LuPSMA-treated men: 8.7 months on average versus 3.4 months among the controls. The treatment was also associated with better overall survival: 15.3 months versus 11.3 months.
Patients On Active Surveillance
A critical need exists to develop effective nontoxic compounds that slow prostate cancer growth. One promising agent is curcumin, which is a widely reviewed nutraceutical that has previously been considered safe to consume.
Evidence from early phase clinical trials suggests curcumin might prolong survival among prostate cancer patients. The agent has shown early promising activity in preclinical prostate cancer cell lines.
UT Southwestern is the sponsor of the phase three Randomized, Double-Blinded, Placebo-Controlled Trial of Curcumin to Prevent Progression of Biopsy Proven, Low-Risk Localized Prostate Cancer in Patients Undergoing Active Surveillance. The primary outcome of the study is the number of patients who have progressed at 24 months of follow-up, defined using standard criteria for progression.
The reason we were attracted to curcumin is because of the interesting data in cell lines, but animal models have also shown it has potential to slow the growth rate of prostate cancer, says Dr. Lotan, who treats patients with bladder, prostate, kidney, ureteral, and testicular cancer. His nationally recognized research on urine and molecular markers helps to identify patients who are at higher risk for recurrent 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.
New Therapy For Aggressive Prostate Cancer Improves Survival
The experimental treatment relies on radioactive molecules that seek out tumor cells, a strategy that may be useful against other cancers.
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An experimental therapy has prolonged life in men with aggressive prostate cancer that has resisted other treatments, offering new hope to patients with advanced illness and opening the door to a promising new form of cancer therapy.
Among men who received the new therapy, there was a nearly 40 percent reduction in deaths over the course of the clinical trial, compared with similar patients who received only standard treatment, researchers reported on Wednesday.
Prostate cancer is the second-leading cause of cancer death among American men, after lung cancer an estimated 34,130 men will die of prostate cancer this year. One in eight men will be diagnosed with the disease at some point in their lives. The risk increases with age, and the cancer is more common in Black men.
The new treatment relies on a radioactive molecule to target a protein found on the surface of prostate cancer cells. The study, which followed 831 patients with advanced disease in 10 countries for a median period of 20 months, was published in The New England Journal of Medicine.
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Duke Cancer Center Offers New Treatment For Metastatic Prostate Cancer
Terence Wong, MD, PhD, and Stacy Wood, a Duke Health nuclear medicine technologist, provides treatment to a patient.
Men with advanced metastatic prostate cancer that has not responded to other treatments may now benefit from a new radiopharmaceutical treatment called PLUVICTOTM . Duke is one of the first cancer centers in the Southeastern region to offer PLUVICTOTM following its FDA approval in March 2022. Studies show it can extend the lives of people with this aggressive form of prostate cancer, even in the late stages, said Terence Wong MD, PhD, a nuclear radiologist at Duke Health.
Watchful Waiting Or Active Surveillance
Your doctor might suggest waiting to see if your tumor will grow or spread before you treat it. Most prostate cancer grows slowly. Some doctors think itâs better not to treat it unless it changes or causes symptoms. In watchful waiting, your doctor will closely track how the disease makes you feel. With active surveillance, youâll also get regular tests to check on the cancer.
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Please Describe The Work Being Done By The Prostate Cancer Theranostics And Imaging Center Of Excellence
PROSTIC is the Prostate Cancer Theranostics and Imaging Center of Excellence, and we seek to do state-of-the-art research to deliver new paradigms for treatment of prostate cancer by seamlessly integrating clinical trials, preclinical, and discovery research. We have a multidisciplinary team, including nuclear medicine, medical oncology, radiation, oncology, urology, and laboratory-based doctors and researchers in our hospital and we have a strong patient-centered philosophy.
PROSTIC has 3 main aims that we’re really working on every day. first aim is to accelerate clinical trials. When we started this program, we had around 5 clinical trials open and we’re hoping by the end of next year to have 10 clinical trials open. These are using PSMA imaging or PSMA-targeted therapy theranostics to treat men with prostate cancer. And with these investigator-initiated trials, we’re trying to find areas of high-impact need that are not being addressed by other global trials being done to date.
What Else Should You Consider
Remember, you have options, and itâs important to choose the one that works best for you. When choosing a treatment, think about:
- The risks. Talk to your doctor about the pros and cons of each type of therapy.
- The side effects. Consider whether or not youâre willing to deal with how the treatment might make you feel.
- Whether or not you need it. Not all men with prostate cancer need to be treated right away.
- Your age and overall health. For older men or those with other serious health conditions, treatment may be less appealing than watchful waiting.
American Cancer Society: âCan Prostate Cancer be Found Early?â âConsidering Prostate Cancer Treatment Options,â âHormone Therapy for Prostate Cancer,â âHow is Prostate Cancer Treated,â âProstate Cancer,â âWhat is Prostate Cancer?â âCryotherapy for Prostate Cancer,â âRadiation Therapy for Prostate Cancer,â âSurgery for Prostate Cancer,â âVaccine Treatment for Prostate Cancer.â
National Cancer Institute: âProstate Cancer Treatment.â
Prostate Cancer Foundation: âOther Treatment Options,â âProstatectomy ,â âRadiation Therapy,â âSide Effects,â âTreatment Options.â
UpToDate: âBone metastases in advanced prostate cancer: Management.â
Cancer.Net: âProstate Cancer: Types of Treatment.â
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