NEW TREATMENTS AND TRIALS
Below is a selection of notices in the press in the last two years.
Abiraterone
There was a lot of media coverage in July 2008 about Abiraterone, which inhibits testosterone synthesis, being the new wonder drug for patients with advanced prostate cancer. It has now undergone more extensive trials. The drug has been developed with the Institute of Cancer Research (ICR) in London. Preliminary results of a trial of almost 800 men who took abiraterone acetate showed they lived almost four months longer than 400 others given a placebo.
Many were also able to live near-normal lives for a longer time, something they could not have done with chemotherapy, which is one of the standard ways of treating the disease as it advances. For those who took abiraterone acetate and the steroid prednisolone, the median survival time from the start of the trial was 14.8 months, compared to 10.9 months for those who took the steroid alone. John Neate, chief executive of the Prostate Cancer Charity, said the findings were "particularly important" as men with advanced prostate cancer "can quickly run out of treatment options". He added: "Abiraterone represents a significant move forward in the treatment of advanced prostate cancer."
At present Abiraterone is only available to those taking part in a clinical trial - but this is expected to change - so check. Hormone Therapy as well as radiotherapy "doubles survival chances" A research team from Australia and New Zealand found that hormone treatment lowers the levels of male hormones that can boost the growth of tumours. And that giving Neoadjuvant Androgen Deprivation Therapy (NADT) for six months - before and after radiotherapy - avoids the potential side-effects including impotence, high cholesterol and heart attack that can be caused by prolonged use.
Commenting in The Lancet, Chris Parker from London's Royal Marsden Hospital said: "[This] is an important trial, and has two clear messages for current clinical practice. First, it confirms that NADT significantly reduces mortality after radiotherapy for high-risk prostate cancer, and is a standard of care. Second, it helps to resolve the uncertainty regarding NADT duration, and strongly suggests that men receiving NADT should have at least six months' treatment."
The researchers followed up 802 men for 10 years, some of whom were only treated with radiation and others who also received either three or six months' worth of hormone therapy. They found there was an 11 per cent death rate among those who had the six-month NADT treatment combined with radiotherapy, compared with 22 per cent who just had radiation. Those who only had three months of the hormone therapy experienced no effect in their death rates or cancer spread. The authors concluded that the trial "shows that a large proportion of men with locally advanced prostate cancer can be treated successfully, with few late side-effects, with as little as 6 months of NADT (and a relatively low dose of radiation)."
Cabazitaxel "extends lives" of advanced prostate cancer patients. The study, led by Dr Johann de Bono from the Royal Marsden Hospital, compared survival times among 755 patients across 26 countries. Half were randomly assigned mitoxantrone, which is often prescribed because it helps alleviate symptoms, and half were assigned cabazitaxel.
While the median survival rate for the former was 12.7 months, for the latter it was 15.1 months. However, those taking it also exhibited worse side effects, most notably an increase in neutropenia, in which the body's immune system becomes depressed and more susceptible to infection.
Writing in The Lancet, the authors concluded: "Cabazitaxel is the first treatment to prolong survival for metastatic multi-drug-resistant prostate cancer in the post-docetaxel setting."
"On the basis of these results, cabazitaxel will become a standard of care for treatment of prostate cancer in this setting."
Developed by Sanofi-Aventis under the brand name Jevtana, cabazitaxel has already been granted approval by the US Food and Drug Administration (FDA). It is under consideration by the European Medicines Agency. Once approved the National Centre for Health and Clinical Excellence (Nice) will decide whether it is cost-effective to be prescribed on the NHS.
Statins may reduce recurrence of Prostate Cancer Statins are taken by around five million people in Britain to lower their cholesterol in order to reduce their risk of having a heart attack or stroke. New research suggests that the drugs might have anti-cancer properties. A study published in the journal Cancer has found that men taking statins at the time of their surgery to remove the prostate were 30 per cent less likely to show signs that the cancer was returning. Dr Robert Hamilton, of the Duke Prostate Centre at Duke University Medical Center in Durham, North Carolina, and a team at the University of Toronto, in Canada, studied 1319 men who had surgery. Just under one fifth were taking statins at the time of their surgery and the subjects were followed up for at least two years.
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2010 Cancer Patient Experience Survey
The results of the 2010 Cancer Patient Experience Survey have now been published; the full report is available on the Department of Health website 67,713 patients took part in the survey spanning a range of ages, genders, ethnic groups and cancer types. Below are the headlines regarding prostate cancer:
· In both 2000 and 2004 prostate cancer patients reported worse experiences than patients with other cancer types. The 2010 survey shows the experience of patients with prostate cancer is now similar to other tumour groups
· Prostate cancer patients are more positive than patients in any other cancer group about the provision of written information about the type of cancer and about choice of treatment. Although cancer patients (more generally) from ethnic minority groups have a less positive experience on communication issues
· 75% of prostate cancer patients said they were given written information about the type of cancer they had and it was easy to understand (compared to 41% for other cancers).
· 89% of prostate cancer patients said they were given a choice of different types of treatment (compared to 71% for other cancers).
· 73% of prostate cancer patients said the staff at their general practice definitely did everything they could to support them (compared to 60% for other cancers).
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