Men with prostate cancer often survive 15 years or longer after learning they have the disease, but prostate cancer remains one of the five most common cancers and the second most frequent cause of cancer-related death among men.¹’² Today, fewer people are being screened for the disease, and many are unaware of new treatment approaches that can extend life.
In 2012, the U.S. Preventive Services Task Force (USPSTF) made a controversial recommendation to abandon routine screening for all men using a blood test that measures levels of a protein called prostate specific antigen, or PSA. Despite a reversal of this recommendation in 2018, a disturbing trend has emerged – more men are being diagnosed with prostate cancer after the disease has progressed into the more dangerous advanced stage, and the once-declining prostate cancer death rate has stalled.³
As the standard of care for prostate cancer has evolved in the past decade, a number of new treatment options have become available for men with advanced prostate cancer – those whose cancer recurs after radiation or surgery.⁴
The first line of treatments aims to suppress production of the hormone testosterone, which contributes to prostate cancer growth.⁵ However, hormone therapy’s effectiveness diminishes over time, and the treatment eventually fails in more than 60 percent of men,⁶ indicating the disease may be progressing. It is at this transition point where the newest treatments can make a difference.
Prostate cancer “caught me by surprise,” says David Strausser, 70, who learned his prostate cancer had spread in early 2016. Now, he says, he is “doing pretty good,” thanks to some of those new treatments. He even lets his dog, Ruby, “walk him” every day for about two miles.
Newer Treatment Options for Advanced Prostate Cancer Offer Hope
The introduction of advanced treatment options for prostate cancer required a shift in thinking for physicians. In the past, doctors rarely ordered bone scans or other tests to pinpoint the cancer when it became more serious, because there were few options besides pain management and chemotherapy to offer. Some physicians chose to not even tell patients that their cancer had progressed.
Things are very different today. In the past three decades, physicians have had an array of new therapies available to treat men in the advanced stages of the disease, including anti-androgen therapy, radiopharmaceuticals, chemotherapy and immunotherapy.⁷
Among these, immunotherapy is one of the most exciting categories of cancer treatments to emerge in the past decade and works differently than other cancer treatments. This is truly “personalized” medicine using a patient’s own cells to stimulate the body’s immune system to target and attack the prostate cancer cells.
“It’s very exciting to be able to help guys you couldn’t help before,” says Dr. Ben Martin, an advanced prostate cancer specialist at Central Ohio Urology Group in Gahanna, Ohio. “We are getting closer and closer to being able to target the cancer more specifically.”
The availability of such new, more effective treatment options is a good thing for patients, but it demands careful disease management. There are important questions about when to give each of these therapies and what sequence provides the greatest positive impact on survival.
However, if men don’t know their options or don’t have access to prostate cancer specialists who can best guide them, they may miss the opportunity for these newer treatments.⁸ The right treatments at the right times may help patients live better and longer.
Close Monitoring Takes on New Importance
Diligent monitoring is crucial, especially for immunotherapy. Studies show that treatment with immunotherapy may extend life.⁹ However, to have the best chance of successfully boosting the patient’s own immune system, immunotherapy treatment should be administered before the cancer has done too much damage to the immune system. This is because treatment works best when the immune system is not overly damaged.¹⁰ This typically is before a patient has any pain or other symptoms, so a combination of blood tests and bone scans are essential.
“Immunotherapy is best right at the first signs of the cancer starting to progress,” says Martin. “You hope to catch it before the patient actually feels any pain or is having any problems.”
Regular blood tests to measure PSA help spot when the prostate cancer becomes more aggressive. High or steady increases in PSA levels are signs of active prostate cancer. However, catching the disease when it spreads requires additional methods such as imaging with CT-scans or other advanced imaging technologies, which help doctors spot prostate cancer that may have spread to the bones or other organs.¹¹
Now, urologists want men with prostate cancer to understand if they get their PSA tests and bone scans on the schedule their doctor recommends, there may be treatments that can boost the body’s own cancer-fighting power and help them live longer.
“After my immunotherapy treatments, I used to joke that they put some Ninja warriors into my blood cells,” says Strausser. “All those Ninja warriors are still fighting.”
Specialized Clinics Optimize Treatment
To support the changing treatment landscape, a growing number of specialized urology care clinics have emerged, where patients can get a full range of services provided by nurses, doctors and other professionals who focus only on advanced prostate cancer.
With an emphasis on improved quality of life, Martin and many other urologists at these clinics have expert staff who help patients navigate the treatment journey. Just helping sort out the treatment options or financial issues can make a difference.
Strausser attends prostate cancer patient support groups, both for his own benefit and to share his experience with others. “I wanted to meet somebody who had the exact same thing that I had and had all the same treatments. I never found that person, but I’m still looking,” he says. “The nurses at the advanced prostate cancer center are also a big part of the process. They’re people I can call anytime.”
Information Keeps People Living
Strausser’s advice for anyone who will listen: “Get it checked out. I’m living proof that you have to watch those things.”
“We have some patients who just don’t come in for checkups or don’t ever get tested, and we find the cancer too late,” says Martin. “Getting checked for prostate cancer early and following up gives us a chance to keep the disease under control longer.”
The contents and information in this Dendreon-provided and sponsored article are for informational purposes only and not intended as a substitute for professional medical advice. If you think you may have a medical emergency, dial 9-1-1 or contact your doctor immediately.
- National Cancer Institute. Common Cancer Sites – Cancer Stat Facts. seer.cancer.gov. https://seer.cancer.gov/statfacts/html/common.html. Published 2018. Accessed July 31, 2018.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7-30. doi:10.3322/caac.21442
- Negoita S, Feuer EJ, Mariotto A, et al. Annual Report to the Nation on the Status of Cancer, part II: Recent changes in prostate cancer trends and disease characteristics. Cancer. 2018;124(13):2801-2814. doi:10.1002/cncr.31549
- Prostate Cancer Foundation. Choosing a Treatment Option – PCF. https://www.pcf.org/about-prostate-cancer/prostate-cancer-treatment/choosing-treatment-option/. Accessed July 31, 2018.
- Prostate Cancer Foundation. Hormone Therapy for Prostate Cancer – PCF. https://www.pcf.org/about-prostate-cancer/prostate-cancer-treatment/hormone-therapy-prostate-cancer/. Accessed July 31, 2018.
- Dendreon. Data on File (2016).
- Denmeade SR, Isaacs JT. A history of prostate cancer treatment. Nat Rev Cancer. 2002;2(5):389-396. doi:10.1038/nrc801
- Bowers E. How to Pick Your Advanced Prostate Cancer Medical Team. Everyday Health. https://www.everydayhealth.com/hs/conditions/how-pick-advanced-prostate-cancer-medical-team/. Published 2014. Accessed July 31, 2018.
- Prostate Cancer Foundation. Immunotherapy for Prostate Cancer – PCF. https://www.pcf.org/about-prostate-cancer/prostate-cancer-treatment/immunotherapy-prostate-cancer/. Accessed July 31, 2018.
- Crawford ED, Petrylak DP, Higano CS, et al. Optimal timing of sipuleucel-T treatment in metastatic castration-resistant prostate cancer. Can J Urol. 2015;22(6):8048-8055. http://www.ncbi.nlm.nih.gov/pubmed/26688132. Accessed July 20, 2018.
- Hricak H, Choyke PL, Eberhardt SC, Leibel SA, Scardino PT. Imaging Prostate Cancer: A Multidisciplinary Perspective. Radiology. 2007;243(1):28-53. doi:10.1148/radiol.2431030580