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.
“The tool box has expanded rapidly in the last few years,” says Dr. Sukumar Ethirajan, an advanced prostate cancer specialist at Kansas City Urology Care. “We can push the clock back on the disease, and patients can also achieve the quality of life they expect,” says Ethirajan, known as “Dr. ET” to his patients.
Retired Kansas City, Missouri police officer Patrick Patterson credits the new treatments for his good health.
“I just feel good about the treatments,” says Patterson, who spends his time with his wife, Josephine, and his 1 1/2-year old German Shepherd, Damien. Patterson stays active on his own and as a police department volunteer, helping to train new dogs and canine officers. Nearly 15 years as a canine officer stays with him: Patterson has already taught Damien how to search and find objects. “He’s really young, so I don’t want to put too much pressure on him.”
He’s also had plenty of time for fishing, his church, three grown children and seven grandchildren. Having prostate cancer has hardly limited his lifestyle, he says.
“I realized that the cancer is not a death sentence anymore.”
Personalized 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. Physicians now have 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.
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.
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.
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, Ethirajan 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.
Patterson was diagnosed with prostate cancer in 2015 and treated with immunotherapy earlier this year. The treatments involved having white blood cells collected and processed and then reinfused three days later.
“For the last few months, my PSA has been undetectable,” says Patterson.
Information Keeps People Living
Patterson encourages other men to get their PSA checked and talk to their doctors about prostate health. He knows of too many people who waited too long and were unable to receive the most advanced treatments.
Ethirajan agrees that patients benefit from working with their physicians. “The key is for patients to know that there is hope, even if the cancer shows signs of recurrence or metastasis. We have all these new options available now.”
For Patterson, he credits that his doctors found his cancer early and monitored its progression so that he could get the most advanced treatments. “It wasn’t like I went years, like some people do.”
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