Cancer Glossary | Definitions & Phonetic Pronunciations

Breakthrough Prostate Cancer Treatments Every Man Over 40 Should Know

Discover new treatments for prostate cancer, including PARP inhibitors, immunotherapy, and advanced imaging techniques for better outcomes.

Prostate cancer is one of the most prevalent cancers affecting men globally, particularly as they age. While prostate cancer is still a significant health concern, remarkable strides in research have led to new treatments that are changing the landscape of care. Men over 40, especially those with certain genetic mutations like BRCA or Lynch syndrome, need to be proactive in understanding the new treatment options available. These developments bring hope for better survival rates and a more personalized approach to care.

Precision Medicine for Prostate Cancer

For years, traditional treatments for prostate cancer such as surgery and radiation were the go-to options. However, the advent of targeted therapies has revolutionized how we approach the disease. These therapies are designed to specifically attack cancer cells, while leaving healthy tissues undamaged, which means fewer side effects and more effective treatments. Among the leading-edge options are:

PARP Inhibitors: These drugs are particularly effective for men whose cancer has specific genetic mutations, such as those found in the BRCA genes. PARP inhibitors block the enzyme responsible for repairing DNA damage in cancer cells, causing them to die off and preventing further growth.

Hormone Therapy: While hormone therapy has been a cornerstone of prostate cancer treatment for decades, newer agents like enzalutamide and abiraterone are significantly improving outcomes, especially in advanced or metastatic cases. These therapies work by reducing the levels of male hormones that can fuel the growth of prostate cancer cells.

Harnessing the Body's Defense System

Immunotherapy is another game-changer for prostate cancer treatment. It uses the body's immune system to attack cancer cells. A particularly promising type of immunotherapy involves checkpoint inhibitors. These drugs block certain proteins that cancer cells use to evade detection, allowing the immune system to recognize and destroy them. Research shows checkpoint inhibitors can be highly effective in treating various cancers, including prostate cancer, particularly when combined with other therapies.

Radioligand Therapy and Vaccines

Prostate cancer treatment is also benefitting from innovative approaches currently under investigation. These approaches hold great potential for treating advanced or hard-to-reach tumors:

Radioligand Therapy (PSMA Targeting): This targeted treatment uses radioactive molecules to specifically target prostate cancer cells, delivering radiation directly to tumors. PSMA, a protein found on the surface of prostate cancer cells, is the key target.

Prostate Cancer Vaccines: Experimental vaccines are being developed to boost the body's immune response against prostate cancer cells. While still in the early stages, these vaccines offer hope for long-term immunity against the disease.

High-Intensity Focused Ultrasound (HIFU): A non-invasive treatment option, HIFU uses high-frequency sound waves to destroy cancer cells without damaging surrounding tissues.

Detecting Cancer Early

In addition to treatment advancements, imaging techniques have become more sophisticated, allowing for earlier detection of prostate cancer and more effective treatment. PSMA-PET scans are one of the most promising developments, enabling doctors to spot even the smallest cancer deposits, which can lead to better treatment outcomes, particularly in recurrent or advanced cases.

The future of prostate cancer treatment is promising, thanks to the continued efforts of researchers and healthcare professionals. Men diagnosed with prostate cancer now have access to therapies that were once unimaginable, providing new hope for better survival rates and improved quality of life. As these treatments evolve, they offer more personalized options that cater to the individual's specific condition.

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Understanding The Stages Of Prostate Cancer: What Every Man Should Know

Imprtance of prostate cancer

One of the most prevalent tumours in males, particularly in those over 50, is prostate cancer. Although a diagnosis of prostate cancer is overwhelming, knowing the disease's   phases can assist inform treatment choices.

What is cancer of the prostate?

Prostate is a little semen-producing gland situated beneath the bladder. Prostate cancer begins when cells within the prostate start to multiply out of control or undergo mutation.

The significance of prostate cancer staging

Some prostate cancers can be aggressive and spread quickly, while others develop slowly and may not have an impact on a man's health for years. Knowing the stage gives doctors a better picture of the prognosis and helps them decide on the best course of treatment. The TNM staging approach, which stands for tumour, nodes, and metastasis, is the most widely used method for staging prostate cancer.

The four stages of prostate cancer a. Stage 1

Early stage localised cancer: At stage 1, the cancer is localised or is limited to a small area within the prostate. Due to increased PSA (prostate-specific antigen) levels, the tumour is frequently found via biopsy because it is typically too small to be felt during a digital rectal exam (DRE). Radiation therapy, surgery (prostateectomy), or active surveillance (watchful waiting) are possible forms of treatment.

b. Stage 2

Advanced locally but contained: In this stage even though the tumour is bigger or more obvious in stage 2, it is still regarded as localised. The cancer although still limited to the prostate, may have spread to other parts of the gland. The recommended treatment for this stage often includes independent or combination of surgery, radiation therapy. Hormone therapy may also be considered frequently to reduce the tumour size.

c. Step 3

Regional Dispersion (Cancer that has spread beyond prostate): By stage 3, the cancer progresses to adjacent tissues, including the bladder neck and seminal vesicles, in addition to the prostate. However, the cancer does not involve any distant organs, despite its local spread. Treatment is directed towards controlling the progression with, hormone, therapy radiation, and surgery.

d. Stage 4

Metastatic disease: At this stage, the disease has progressed to further distant organs, lymph nodes, or bones. This stage is frequently more difficult to cure and may involve chemotherapy, advanced hormone treatment, immunotherapy, or clinical trials. The focus of treatment moves to controlling the progression, reducing symptoms, and enhancing quality of life.

Additional important elements that impact the development of prostate cancer a. Gleason score

Aggressiveness of prostate cancer is rated using the Gleason score. The score ranges between 6 to 10. Higher scores indicate more aggressive malignancy. While scores 6 or 7 is regarded as intermediate a score of 8 or more denotes high-grade malignancy.

b. PSA levels

The prostate produces a protein called prostate-specific antigen (PSA). Although benign prostate problems like benign prostatic hyperplasia (BPH) can sometimes cause raised PSA values, higher PSA levels can also be a sign of prostate cancer or other prostate diseases.

c. Risk categories

Physicians may also use the low, middle, and high risk categories to categorise prostate cancer. These classifications consider Gleason scores, tumour size or extent, and PSA values.

Key takeaways

a. Early detection: Since prostate cancer develops slowly many men may not exhibit symptoms for years. However, with early detection prostate cancer has high cure rates and routine screening with PSA tests and digital rectal exams is highly recommended.

b. Personalised treatment: Depending on the stage and grade of prostate cancer and the general health, a variety of therapies are available, depending on their general health and the stage of the disease.

c. Managing risk factors: Prostate cancer risk factors include progressing age, men of certain ethnicity (generally African American males are more prone), and family history. Discussing the risk factors with your doctor about the risk factors.

d. Emotional impact: Receiving the diagnosis of prostate cancer can be emotionally taxing. Managing the psychological effects of cancer requires asking for help from friends, family, or a cancer support group.

Understanding the stages of prostate cancer can help men navigate their diagnosis and treatment decisions with greater confidence. Early detection, ongoing research, and advancements in treatment offer hope for better outcomes, even in more advanced stages of the disease.

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Prostate Cancer Salvage Radiation After RP Only Benefits Select Patients

Only a subset of patients with biochemically recurrent prostate cancer after radical prostatectomy (RP) will develop systemic progression and benefit from salvage radiation therapy (SRT), investigators suggested at the 2024 annual meeting of the Society for Urologic Oncology (SUO 2024) meeting in Dallas, Texas.

In a Mayo clinic database, 6881 patients experienced a rising PSA to 0.2ng/mL or higher, and 2109 (30.6%) received SRT. Systemic progression occurred in 947 patients (13.8%) over a median 9.8 years.

After time-dependent propensity-score matching 2109 patients with 2109 without SRT, receipt of SRT was significantly associated with a lower rate of systemic progression compared with observation at 10 years: 22% vs 29%, Spyridon Basourakos, MD, of Mayo Clinic in Rochester, Minnesota, reported on behalf of his team.

"Our findings demonstrated that SRT provided a 6.6% absolute reduction in metastasis risk at 5 years compared to surveillance alone, corresponding to a number needed to treat of 23 patients over 5 years and 15 patients over 15 years," he said in an interview. "These results emphasize that while many patients with biochemical recurrence have a relatively indolent disease course, a subset stands to benefit significantly from SRT."

Interaction analyses revealed that SRT was particularly effective in reducing metastasis risk among patients with positive lymph nodes, he added Patients with a pre-SRT PSA above 0.4 ng/mL had a significant 40% reduced risk of metastasis.

These findings may inform patient counseling and shared decision-making.

"While biochemical recurrence has a heterogeneous natural history — with most patients not progressing to metastasis — contemporary guidelines recommend salvage radiation therapy (SRT) for the majority of these patients," Dr Basourakos said. "These data support the importance of careful patient selection for SRT, in order to maximize benefit and minimize toxicity and costs from overtreatment."

Dr Basourakos' team is encouraging a randomized clinical trial to test early SRT versus observation for select patients with biochemical recurrence after RP. "Such a trial should incorporate advanced imaging modalities, such as PSMA PET/CT, to further optimize patient selection and treatment strategies."

References:

Basourakos S, Boorjian SA, Schulte PJ, et al. Quantifying the benefit of salvage radiation therapy for biochemically recurrent prostate cancer after radical prostatectomy. Presented at SUO 2024, December 4-6. Abstract 9.

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