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Dr. Carlos Ramos, an advanced prostate cancer specialist at Advanced Urology Institute in Panama City uses immunotherapy and other treatments to help men with advanced prostate cancer. Photo Courtesy of Advanced Urology Institute.

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.

The first line of treatments aims to suppress production of the hormone testosterone, which contributes to prostate cancer growth. However, hormone therapy’s effectiveness diminishes over time, and the treatment eventually fails in more than 60 percent of men, indicating the disease may be progressing. It is at this transition point where the newest treatments can make a difference.

“There are treatment options now that we did not have before,” says Dr. Carlos Ramos, an advanced prostate cancer specialist at Advanced Urology Institute in Panama City, Fl. Since he started his practice 18 years ago, he says “we understand the disease better.”

One of the major advances, says Ramos, is immunotherapy, which teaches the body’s own system to attack prostate cancer. “As the process goes on, the cells become more and more sensitive to prostate cancer,” he explains. “You are using the patient’s own cells to recognize the patient’s own cancer.”

Freeport, Fl., resident Michael Topp was treated with immunotherapy last year – 19 years since he was first diagnosed with prostate cancer.

“We just went on with life, with regular visits to the urologist,” says Michael. His doctor changed his treatment when tests showed that the prostate cancer had progressed.

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. 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.

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.

Michael says he does not know all the science behind immunotherapy, but he understands the process: “The cells (that are treated) turn into Ninja Turtles and find the cancer that’s hiding. They go on search and destroy missions.”

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. 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, Ramos 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.

“It’s a very complex process to get (advanced prostate cancer treatments) approved through insurance, so we have to make sure we have all our Ts crossed and our Is dotted,” says Ramos, adding that his clinic has staff who specialize in this.

In addition, men with advanced prostate cancer in the Panama City area will now have greater access to immunotherapy treatment thanks to a new local cell collection center. Opened in February 2019, this center will allow men with advanced prostate cancer to have the cells needed for treatment collected (a process called apheresis) locally. Previously, men in need of cell collection services had to travel 105 miles, forcing many to forego this life-extending treatment.

Information Keeps People Living

“Prostate cancer has gotten to a point that we can treat it like we treat heart disease or hypertension,” says Ramos. “It can become a chronic disease.”

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.

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  1. 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.
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  3. 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
  4. 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.
  5. 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.
  6. Dendreon. Data on File (2016).
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  8. 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.
  9. 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.
  10. 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.
  11. 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

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