New Therapy May Fight Prostate Cancer
Researchers Say Experimental Treatment Is Effective for Advanced Prostate Cancer
June 19, 2009 — Mayo Clinic researchers say an experimental treatment may have cured two patients whose prostate cancers were so advanced they had been considered inoperable.
Both patients were reportedly free of cancer after treatment with a combination of hormone therapy, an experimental immunotherapy, and surgery.
No one was more surprised than their doctors. “This is certainly not the way we thought it would go,” Mayo urologist and immunologist Eugene Kwon, MD, tells WebMD.
He adds that the point of the treatment had been to buy some time for patients whose cancers appeared to be incurable.
The two men were originally enrolled in a study designed to determine if treatment to suppress testosterone , followed by treatment with an experimental immunotherapy called ipilimumab, could slow the progression of advanced prostate cancer.
“The goal was to see if we could modestly improve upon current treatments,” Kwon says.
The 85 patients in the study were not considered candidates for surgery, but several showed such dramatic regressions in their cancers that they left the trial in order to have it.
Kwon admits that this was done in the first patient not because the study investigators thought it was a good idea, but because the patient’s wife insisted.
More than a year and a half later, that patient shows no signs of prostate cancer, Kwon says.
Prostate Cancer Treatment Options Mayo Clinic
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As Mayo Clinic invests hundreds of millions of dollars into proton beams, the wait continues for decisive evidence that the treatments.
proton therapy for prostate cancer as “idolatry.”.
Cipi Chemo Immunotherapy Percutaneous Injections
Envita has several other advanced treatment options for late stage and refractory to care cancers like prostatecancer. Procedures like CIPIâ¢, or Chemo ImmunotherapyPercutaneous Injection, utilize advanced world-class testing and precision genetic targets to provide uniquetreatment options for patients suffering from prostate cancer. CIPI⢠was developed by Envita Medical Centers as aunique form of tumor chemoembolization designed to treat inoperable tumors that are fibrous and difficult to penetratethrough traditional intravenous chemotherapy. CIPI⢠has the potential to revolutionize the treatment of late-stageprostate cancer by treating common sites of metastasis, including bone, kidney, pancreas, spleen, and more.
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Speak With A Patient Care Expert Now
Many patients find their way to Envita Medical Centers because they have a resistant form of cancer and theconventional options for treatment have been exhausted with little to no results. We offer a different approach tocancer treatment by combining the latest in research-based naturopathic and conventional treatment options from aroundthe world and not just the United States. Every level of the treatment Envita provides is more personalized and moretargeted in our clinical opinion than standard regimens. When you are a patient at Envita you are not a number, youare a person, and we take care of our patients, offering a compassionate top-level customer service and care. There ismuch more we would love to discuss with you about your prostate cancer including our proprietary methods for attackingresistant cancers. If you or a loved one is suffering from prostate cancer or any other form of cancer, please contactour Patient Care Coordinators at 866-830-4576. Our Patient Care Coordinators are experts in their fields and can helpset you on the path to recovery. May God bless you on your journey to healing.
Treatment Options For Enlarged Prostate
For men over 50, prostate problems are common. The prostate gland is located just below the bladder and surrounds the top portion of the urethra, which is the tube that drains urine from the bladder. The prostate’s primary function is to produce the fluid that nourishes and transports sperm.
As men age, the prostate gland tends to grow larger. Benign prostatic hyperplasia, also called prostate gland enlargement, can cause uncomfortable urinary symptoms, such as blocking the flow of urine out of the bladder, or bladder, urinary tract or kidney problems. Fortunately, a wide variety of treatments are available for enlarged prostate, including medication, minimally invasive therapies and surgery.
On the next Mayo Clinic Radio program, Dr. Mitchell Humphreys, a Mayo Clinic urologist, will highlight prostate health and treatment options for benign prostatic hyperplasia. Also on the program, Dr. Francisco Lopez-Jimenez, a Mayo Clinic cardiologist, will discuss sex after a heart attack. And Dr. Bruce Levy, a Mayo Clinic orthopedic surgeon, will share how his patients’ experiences with lack of privacy during surgery led him and his wife to found a new company, COVR Medical.
To hear the program, find an affiliate in your area.
Use the hashtag #MayoClinicRadio, and tweet your questions.
Mayo Clinic Radio is on iHeartRadio.
Access archived shows or to the podcast.
Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.
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While Waiting For Chronos Select Wisely
The goal of focal therapy is to treat only the area with the most aggressive tumor, known as the index tumor, while leaving the remaining gland and its surrounding structures alone, according to Derek Lomas, MD, PharmD, a urologist at the Mayo Clinic in Rochester, Minnesota, in an explanatory article. “This approach is widely accepted in other types of cancer. For example, we commonly treat kidney cancers by removing or ablating only the tumor while leaving the rest of the kidney intact.”
However, some focal therapies also include approaches known as hemiablations, in which a full half of the prostate is destroyed, and approaches that leave very little of the gland behind.
Each of the modalities used for focal therapy has “unique indications, risks, and benefits and uses a different energy source for ablation,” Lebastchi and colleagues write in their essay.
They assert that focal therapy can provide oncological efficacy similar to radical prostatectomy or radiotherapy “while considerably reducing or even eliminating functional morbidities, such as incontinence and erectile dysfunction.”
Overall, they say focal therapy offers an opportunity for improved care because there is “an increasing body of emerging evidence demonstrating a favorable adverse effect profile with oncological control similar to whole-gland treatment options.”
Mayo Researchers: Dramatic Outcomes In Prostate Cancer Study
Full details in Discovery’s Edge, Mayo Clinic research publication
Mayo Clinic
ROCHESTER, Minn. — Two Mayo Clinic patients whose prostate cancer had been considered inoperable are now cancer free thanks in part to an experimental drug therapy that was used in combination with standardized hormone treatment and radiation therapy. The men were participating in a clinical trial of an immunotherapeutic agent called MDX-010 or ipilimumab. In these two cases, physicians say the approach initiated the death of a majority of cancer cells and caused the tumors to shrink dramatically, allowing surgery. In both cases, the aggressive tumors had grown well beyond the prostate into the abdominal areas.
“The goal of the study was to see if we could modestly improve upon current treatments for advanced prostate cancer,” says Eugene Kwon, M.D., Mayo Clinic urologist and leader of the clinical trial. “The candidates for this study were people who didn’t have a lot of other options. However, we were startled to see responses that far exceeded any of our expectations.”
“The tumors had shrunk dramatically,” says Michael Blute, M.D., Mayo urologist, co-investigator and surgeon, who operated on both men. “I had never seen anything like this before. I had a hard time finding the cancer. At one point the pathologist asked if we were sending him samples from the same patient.”
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Target Your Prostate With Precision
More precision means less damage to healthy tissue in the urethra, bladder, bowel, and sexual organs than with traditional radiation, potentially offering fewer short- and long-term side effects and secondary cancers.
With conventional X-ray therapy, surrounding healthy tissue gets a considerable dose of radiation, which can lead to side-effects and secondary cancers down the road. With proton therapy, treatment is delivered precisely to the tumor, so less radiation is delivered to the surrounding healthy tissue.
With prostate cancer, you have a wide variety of treatment options that depend on who you are and what your cancer requires: options like surgery, chemotherapy, hormone therapy, radiation and more. Conventional radiation exposes surrounding healthy tissue to excess radiation, which can potentially lead to side-effects and secondary cancers down the road. With surgery, there is a greater chance of some serious side effects, such as incontinence. Proton therapy, delivers radiation precisely to the prostate, so less radiation is delivered to the surrounding healthy tissue.
Proton therapy takes advantage of a unique characteristic of protonsthey deliver their maximum dose of radiation, known as the Bragg Peak, right before they come to a stop. Thats how the damage is concentrated on the cancer, protecting healthy tissue.
Newer Treatments For Early
Researchers are looking at newer forms of treatment for early-stage prostate cancer. These new treatments could be used either as the first type of treatment or after unsuccessful radiation therapy.
One treatment, known as high-intensity focused ultrasound , destroys cancer cells by heating them with highly focused ultrasonic beams. This treatment has been used in some countries for a while, and is now available in the United States. Its safety and effectiveness are now being studied, although most doctors in the US dont consider it to be a proven first-line treatment for prostate cancer at this time.
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Prostate Cancer Genetic Testing
At Envita Medical Centers we have been treating late-stage prostate cancer for nearly 20 years and we have found thatpatient-tailored genetic testing is the first step in providing a treatment protocol that is designed specifically forthe patient. We use next-generation genetic testing which can help pinpoint the medications and natural agents bestsuited for treating your unique form of prostate cancer. This in-depth proprietary genetic testing is beyond what mostbig-name cancer hospitals can offer. The results derived from this advanced testing provides us a more intense look atyour cancerâs genetic make-up and helps us select the treatments your cancer will most likely respond to. Our uniqueapproach to testing goes beyond just genetic targets and will also provide information on toxins, infections, andother harmful agents that could be restricting and limiting treatment efficacy, further allowing us to personalizeyour treatment and create a multifaceted approach that treats your prostate cancer and its potential causes.
‘routine’ Use Of Focal Therapy For Prostate Cancer In Next 5 Years
Nick Mulcahy
There will be “routine application” and “broader acceptance” of minimally invasive focal therapies for early-stage prostate cancer within the next 5 years in the United States, predict a trio of clinicians in a new essay July 28 in JAMA Surgery.
They maintain that focal therapy offers a “middle ground” between two extremes: treating the whole gland with radical prostatectomy or radiotherapy, and not treating immediately via active surveillance or watchful waiting.
Focal therapy typically treats the primary lesion within the prostate, while leaving the rest of the gland intact. Most often performed with cryoablation or high-intensity focused ultrasound , it can also be carried out with a variety of technologies, including transurethral ultrasound ablation and focal laser ablation.
The shift to focal therapy will coincide with maturing, long-term data from studies with various technologies, predict the authors, led by Amir Lebastchi, MD, a urologist at the University of Southern California.
“Standard adoption of focal therapy is ultimately dependent on the availability of robust level I evidence, which in turn will drive medical societies and payees,” the authors also write.
But payees are already making changes, even without such data, they add.
I do expect its use will in fact increase in the next 5 years.
The challenge with focal therapy regardless of energy modality remains patient selection and accurate ablation zone definition, he added.
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What Is That Evidence
In the essay, Lebastchi and colleagues point to a number of single-arm studies with encouraging efficacy and safety results. They also highlight a phase 3, randomized trial that they were involved in: this compared focal therapy with active surveillance in early-stage disease, and uniformly showed better posttreatment biopsy and conversion-to-prostatectomy results with the focal therapy out to 4 years .
However, that study did not have an active treatment comparator. For that gold standard, there is now anticipation for results from the CHRONOS trial in the United Kingdom, especially part A of the trial, which compares radical therapy to focal therapy , with 5-year progression-free survival as the primary outcome. That trial is slated for completion in 2027.
Until then, the lack of prospective randomized clinical trials and long-term follow-up “hinder acceptance in the urology community,” the essay authors comment.
Meanwhile, careful patient selection is very important, they say.
The latest relevant guidelines state that appropriate candidates are men with a solitary, well-defined index lesion patients with bilateral multifocal lesions or very advanced tumors that are not appropriate for the focal approach.
A multidisciplinary international expert panel recently convened to establish guidance for clinicians offering focal therapies and then published a consensus statement to advise practitioners and researchers.
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What You Can Expect
External beam radiation for prostate cancer is conducted using a linear accelerator â a machine that directs high-energy beams of radiation into your body. As you lie on a table, the linear accelerator moves around you to deliver radiation from many angles. The linear accelerator delivers the precise dose of radiation planned by your treatment team.
External beam radiation therapy is typically:
- Given on an outpatient basis
- Administered five days a week over several weeks
Each treatment session usually lasts less than an hour. Most of that is preparation time. The actual radiation treatment only takes a few minutes.
During a treatment session:
- You lie down in the position determined during your radiation simulation session.
- You might be positioned with customized immobilization devices to hold you in the same position for each therapy session.
- The linear accelerator machine may rotate around your body to deliver radiation beams from different directions.
- You lie still and breathe normally during the treatment.
- Your radiation therapy team stays nearby in a room with video and audio connections so that you can talk to each other.
- You shouldn’t feel any pain. Speak up if you don’t feel comfortable.
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What To Expect During Your Appointment
Typically, patients with prostate cancer would need to make a few appointments with specialists at different locations to learn about treatment options. At Wellstars STAT Clinic for Prostate Cancer, men and their partners meet with multiple specialists to discuss treatment options in the same place, on the same day. Heres what to expect:
What is active surveillance?
Advanced treatment & technology
Wellstar invests in state-of-the-art technology to give men with prostate cancer access to leading treatments, including those delivered by CyberKnife, TrueBeam and da Vinci robotic technology as well as brachytherapy, SpaceOAR Hydrogel and innovative genetic therapies.
Da Vinci technology
Hydrogel
Prostate Cancer Causative Factors
Another key factor to treating prostate cancer is finding and treating the contributive and causative factors thatare driving the disease. There are many agents that can contribute to prostate cancer including weight, diet andenvironmental factors. However, there has been increased reporting of BRCA genes being connected with metastasizedprostate cancer and it is estimated that men with a mutated BRCA 2 gene are seven times more likely to developprostate cancer than the general population. Envita is one of the top clinics in the nation for treating not onlycancer but the root causes of that cancer. Treating the root causes of your prostate cancer helps to reduce the chanceof reoccurrence and also aids in sustained progression against your prostate cancer. If genetic factors like the BRCAgenes and epigenetic-oncogene relations are not being addressed in your prostate cancer treatment you may be ignoringa key factor to overcoming your disease. By treating the genetics and the epigenetics of your disease we aim to attackthe cause of your cancer and some of the factors that could be making it resistant to treatment.
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