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UPMC Lecture Spotlights Advances in Prostate Cancer
By Carole Reinert Lucas
There’s good news for men living with advanced prostate cancer – a recent study has found that chemotherapy can prolong life.
As part of its A Reason to Hope lecture series, the UPMC Cancer Centers sponsored a discussion on new advances in the treatment of prostate cancer on September 30.
Gurkamal Chatta, M.D., associate professor and co-program leader, cancer and aging program with the University of Pittsburgh Cancer Institute and Jeffrey R. Gingrich, M.D., associate professor, department of urology, University of Pittsburgh School of Medicine shared some of the findings from the American Society of Clinical Oncology’s most recent meeting.
According to Dr. Chatta, “Chemotherapy probably translates to a survival advantage.”
Drs. Chatta and Gingrich reviewed the findings from a phase 3 clinical trials using the chemotherapy agent docetaxel, also known by the brand name Taxotere that was conducted with 1,000 men with advanced prostate cancer who had stopped responding to hormone therapy.
In this study, the men were randomly assigned to three different groups. One group received weekly doses of prednisone and docetaxel. A second group received these same medications but at a higher dose. And the third group received weekly doses of prednisone and mitoxantrone.
Mitoxantrone has been used to treat prostate cancer for approximately 15 years and while it has been found effective for pain relief, it has not been found to extend life.
The men in this study who received the chemotherapy agent docetaxel had an increased survival rate and a decrease in their PSA.
“Docetaxel is the new standard of care,” says Dr. Chatta. “It can prolong life.”
Docetaxel is currently used to treat breast cancer and lung cancer. Until now, chemotherapy has not been used to treat prostate cancer. The U.S. Food and Drug Administration recently approved docetaxel, combined with prednisone, to treat advanced prostate cancer that is no longer responding to hormone therapy.
In the past, the treatments for prostate cancer included watchful waiting, surgery, radiation therapy and hormone therapy.
In the watchful waiting stage, the condition is closely monitored without treatment until symptoms appear or change. Surgically removing the lymph nodes in the pelvis or removing the prostate, surrounding tissue and nearby lymph nodes is another treatment option. Radiation therapy is used to kill the cancer cells and shrink tumors. Hormone therapy is used to block the action of the hormones which can stop the cancer cells from growing.
By adding chemotherapy to the mix, physicians have a greater ability to tailor the treatment to the individual. Chemotherapy is currently recommended only for those with advanced prostate cancer.
The doctors also spoke briefly about other clinical trials currently underway.
One study involves Thalidomide, which gained notoriety in the 1950s and 1960s after it caused birth defects in the newborns of mothers who took the drug.
It’s now known that Thalidomide interferes with the blood supply of anything that grows fast and according to Dr. Chatta, the preliminary studies combining Thalidomide and docetaxel looks promising as a potential treatment for prostate cancer.
Another study is looking at ways to interfere with the prostate cancer from spreading to the bone and researchers are also trying to see if the combination of selenium and vitamin E can prevent prostate cancer.
Currently UPMC Cancer Centers is conducting eight clinical trials for different stages of prostate cancer. Those interested in learning more details about these trials should visit www.upmccancercenters.com/trials. Click on ‘listing of available clinical trials’ and then type the word ‘prostate’ in the keyword search.
Dr Gingrich advises those living with prostate cancer to follow some of the same advice that’s given to prevent the disease.
“What helps to prevent prostate cancer might help slow the progression,” explains Gingrich. “Men who eat a low fat diet have less of an incidence and less progression. There’s less incidence with a diet high in soy products and high amounts of cooked tomatoes contain lycopene, which has the potential to help slow down the progression.”
Prostate Cancer Questions and Answers
What is prostate cancer?
Prostate cancer is a malignant tumor of the prostate gland. The prostate is located in front of the rectum and right below the bladder.
How common is it?
Prostate cancer is the most common type of cancer found in American men. According to the American Cancer Society, prostate cancer affects 1 in 9 men. It causes 31,500 deaths per year.
Who’s considered high risk for developing prostate cancer?
African American men are more than twice as likely as Caucasian men to be diagnosed. The risk increases as men age, with men over 65 at highest risk. If you have a close male relative (brother, father, uncle, grandfather) who has prostate cancer, your chance of developing it increases.
What are the symptoms?
Usually there are no symptoms in the early stage of prostate cancer. Sometimes men can notice a change in urination flow, the frequency or urgency; erectile difficulties; or pelvic, hip or back pain.
How is it detected?
Two tests are used to detect prostate cancer; the prostate-specific antigen (PSA) blood test and the digital rectal examination (DRE). The PSA test measures proteins made by prostate cells. If the level is high, it means there’s a greater chance that cancer is present. The DRE enables a physician to check for lumps or enlargements of the prostate.
When should a man receive these tests?
If you’re an African American or have a close male relative who has prostate cancer, you should have a PSA and DRE at age 45. Other men should have the tests annually at age 50.
What happens if the tests are abnormal?
The next step is a biopsy to determine if the tests were accurate.
How important are the PSA and DRE tests?
These tests are vital in detecting the cancer. As with any form of cancer, the earlier it’s detected the better chances a person has for survival.
What causes prostate cancer?
No one knows for sure but some studies have shown that a diet high in red meat and dairy products appears to stimulate the growth of prostate cancer cells.
What’s recommended to prevent prostate cancer?
Decrease the amount of fried foods and fatty foods like burgers, fries and cheese in your diet and increase the amount of fruits and vegetables. Exercise and don’t smoke or chew tobacco.
Where can I get more information?
Call the American Cancer Society at 1-800-ASC-2345 or visit www.cancer.org.
