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admin 25.11.2015

Prostate cancer has the highest survival rates among most cancer types affecting people all over the world.
Health organizations continue to place awareness programs so that more men can go for testing to avoid the risks of developing prostate cancer. Surgery: This is a very common type of prostate cancer treatment and it is done by the complete removal of the prostate glands. Radiation Treatment: This method is done by the use of radiation to kill and destroy the mutated cells within the prostate and other affected areas surrounding the gland.
Alternative Procedures: There are other alternative treatment options which include immunotherapy where the immune system is boosted to fight the cancer. The Your Prostate Your Decision public service announcement features Joe Torre and urges patients to discuss genomic testing with their physicians.
A large national survey conducted by Kelton, a large independent research firm, and supported by MHN, PHEN, ZERO and Genomic Health, revealed that general awareness around prostate cancer aggressiveness and treatment options is low. Despite continued research supporting active surveillance, only 10 percent of men surveyed and 27 percent of women surveyed correctly linked it with prostate cancer instead of with other diseases.
Misconception regarding prostate cancer risk and the need for immediate treatment is widespread: 47 percent of men surveyed believe prostate cancer is high-risk, 51 percent believe it is life-threatening, and 59 percent believe it is best treated immediately.
Created in response to the alarming lack of awareness of prostate cancer, Your Prostate Your Decision was developed to provide multi-media tools to help patients have discussions with their health care team. Developed in collaboration with the University of California, San Francisco (UCSF) and Cleveland Clinic, the Oncotype DX prostate cancer test helps physicians and their patients confidently choose the most appropriate treatment based on an individualized risk assessment.
Men’s Health Network (MHN) is a national non-profit organization whose mission is to reach men, boys, and their families where they live, work, play, and pray with health awareness messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation. ZERO - The End of Prostate Cancer is a national nonprofit organization with the mission to end prostate cancer. NOTE: The Genomic Health logo, Oncotype, Oncotype DX, Recurrence Score, and DCIS Score are trademarks or registered trademarks of Genomic Health, Inc. Baseball Hall-of-Famer and prostate cancer survivor Joe Torre talks about how a genomic test helps personalize prostate cancer treatment options.
Dan is a prostate cancer patient who used a genomic test called Oncotype DX to determine that he did not need surgery. More than 50% of prostate cancer is low risk, yet the majority of men are likely to choose surgery when a less invasive approach such as active surveillance might be appropriate. Baseball Hall-of-Famer and prostate cancer survivor Joe Torre encourages men to ask about a genomic test to help determine their best treatment plan. Patients with metastatic castration-resistant prostate cancer (mCRPC) have a poor prognosis, and those patients with metastases are expected to survive ≤19 mo [1]. Current, ongoing, and future landscape in the management of castration-resistant prostate cancer. Sipuleucel-T is an autologous vaccine consisting of individually collected antigen-presenting cells that are exposed to the fusion protein prostatic acid phosphatase and granulocyte colony-stimulating factor (GCSF), and then reinfused in the patient at weeks 0, 2, and 4. The scientific evidence of this approach results from large, retrospective series that identified patients who might be good candidates for reexposure [13], [14], and [15]. Enzalutamide (ENZ) acts as an androgen receptor (AR)-signaling inhibitor, and it was evaluated in the Multinational, Phase 3, Randomized, Double-blind, Placebo-controlled, Efficacy and Safety Study of Oral MDV3100 in Patients with Progressive Castration-Resistant Prostate Cancer Previously Treated with Docetaxel-Based Chemotherapy (AFFIRM) trial, which randomized 1199 mCRPC patients to receive ENZ or placebo [6]. More than 90% of patients with CRPC have bone metastases, which are a major cause of death, disability, and decreased quality of life, as well as increased cost of treatment [24]. Orteronel (TAK-700) selectively blocks 17,20-lyase, resulting in fewer mineralocorticoid effects than AA [27]. Galeterone (TOK-001) has combined activity: It inhibits the human CYP17 enzyme, it has pure antagonistic activity toward the AR, and it inhibits the binding of androgens to both mutant and wild-type AR [28].
ARN-509 is a full antagonist to AR overexpression: It inhibits androgen-dependent gene description, and it impairs nuclear translocalization and DNA binding of AR [30]. ODM-201 is another antiandrogen with similar mechanisms of actions as described for ENZ and ARN-509 [30].
Heat shock proteins (HSPs) have been identified as AR coactivators and chaperone proteins that are increased in PCa cell lines after castration [31].
Cabozantinib is another promising bone-targeting agent that inhibits both vascular endothelial growth factor and met proto-oncogene (hepatocyte growth factor receptor; MET). As the newly emerging hormonal treatment options are used with increasing frequency in the management of mCRPC patients, it has become evident that resistance to these drugs develops [1]. In vitro studies suggest that one mechanism of action for taxanes is inhibition of microtubule-dependent AR translocation to the nucleus, impairing AR signaling and reducing PSA expression. Axel Heidenreich has received honoraria from Astellas, Amgen, Dendreon, Ferring, IPSEN, Jansen Cilag, Sanofi Aventis, and Takeda, and he has received research grants from Astellas and Sanofi Aventis. Prostate cancer affects only men and many organizations are creating awareness on the importance of regular checkups for early detection. Prostate Cancer Diagnosis: It is advised that you should always attend regular routine tests because it can help with early detection hence save your life at an early stage. Prostate Cancer Treatment Options: The treatments are various and it will largely depend on the patienta€™s general health condition, the progress or stage of the cancer and their preferences which is determined by their financial ability. 2.Prostate radiation this is the use of radiation machines to completely destroy the cancerous cells. 3.Hormone therapy is done to reduce the levels of androgens hormones which are produced in the testicles.
Having a professional doctor is the best as you will be ensured of receiving the best medical care for prostate cancer.
If you have been diagnosed with prostate cancer, you will want to learn and understand your treatment options, along with the risks and benefits of each. In order to determine if you have prostate cancer your physician will examine you, review your PSA results and biopsy results. The whole prostate is removed with the seminal vesicles, the deferent canals (which conduct the sperm), part of the bladder neck and the surrounding lymph nodes. This surgical intervention is invasive and involves the use of general anesthesia for 3 to 4 hours and hospitalization for a number of days. At the localized stage (stages T-1 or T-2) a radical prostatectomy can be curative but it usually results in impotence and can result in moderate to severe urinary incontinence. Like any other major surgery it can also have complications and can have a prolonged recovery time. This treatment involves the use of very high-energy rays directed at the prostate gland using a special machine.


Radiotherapy does not require anesthesia and the treatment is usually done on an outpatient basis.
Patients are usually treated five days per week in a cancer clinic over a period of seven or eight weeks with each session lasting a few minutes. Late side effects can also include soilage of stool because of damage to the rectal sphincter. It is a slow growing type of cancer which is not easy to detect early unless test are done. During the medical checks the doctor will do a rectum examination which will show the state of the glands.
It is the best option when the cancerous cells are still within the gland and have not spread out to other organs. The doctor will place pellets into the prostate glands and use radiation to destroy the cancerous cells. It is usually commended by doctors in addition to other types of treatments for example the tumor can be shrunk through chemotherapy and then surgically removed. Separately, 51 percent of women surveyed believe prostate cancer is high-risk, 43 percent believe it is life-threatening, and 62 percent believe it is best treated immediately. This genomic test measures the level of expression of 17 genes across four biological pathways to predict prostate cancer aggressiveness. As a leader in the fight against prostate cancer, ZERO advances research, encourages action, and provides education and support to men and their families.
Forward-looking statements are subject to risks and uncertainties that could cause actual results to differ materially, and reported results should not be considered as an indication of future performance. As patients’ disease progresses, quality of life deteriorates, and until recently, few treatment options were available. The results of the Randomized Study Comparing Docetaxel Plus Dasatinib to Docetaxel Plus Placebo in Castration-Resistant Prostate Cancer (READY) and the Aflibercept in Combination with Docetaxel in Metastatic Androgen-Independent Prostate Cancer (VENICE) trial were disappointing [11] and [12].
Patients who responded with a ≥30% decrease in prostate-specific antigen (PSA) level, maintained for at least 8 wk after first exposure to docetaxel, demonstrated a positive PSA response in about 55% to 60% of the cases during reexposure without increasing treatment related toxicity. The risk of seizures was slightly elevated in the ENZ group, with a frequency of 0.6% versus 0% in the placebo group. The potential advantage of ODM-201 is that it does not cross the blood–brain barrier and so might prevent the development of seizures. Quite recently, antisense oligonucleotides targeting HSP27 were evaluated in a phase 2 clinical trial including 72 patients chemotherapy-naïve mCRPC patients who received OGX-427 plus prednisone versus prednisone alone. In a prospective, randomized, placebo-controlled, phase 2 clinical trial, 171 mCRPC patients were enrolled to receive cabozantinib (100mg daily) or placebo [32].
Although the exact mechanisms are not completely understood, various hypotheses have been generated based on in vitro and in vivo studies. AA impairs AR signaling by reducing CYP17-dependent androgen production, as well as by directly binding to AR and reducing AR signaling in a dose-dependent manner.
David Pfister has received honoraria from Astellas, IPSEN, Jansen Cilag, and Sanofi Aventis.
Updated analysis of the phase III, double-blind, randomized, multinational study of radium-223 chloride in castration-resistant prostate cancer (CRPC) patients with bone metastases (ALSYMPCA). Management of metastatic castration-resistant prostate cancer (mCRPC) after an initial good response to first-line docetaxel (D): a retrospective study on 270 patients (pts). This is important because it will increase your survival rates as compared to a patient who started treatment at an advanced stage. During the physical examination you will explain to the doctor those symptoms of prostate cancers which are frequent urination, painful urination, difficult to maintain an erection, constant back and thigh pains. The testing done the digital rectal examination and prostate specific antigen tests and this will clearly indicate the status of the prostate glands.
Technology has brought many benefits in health systems as they are able to employ the use of modern equipments to undertake the process.
Traditional cancer treatments, like the ones on this page, are options, but the risk factors must be weighed. That is why it is highly recommended that you go for routine medical checkups because it can save your life. In case the glands shows some signs of abnormal growth and shape then the doctor will do biopsy test on a sample taken to determine the progression of the disease. The process usually takes weeks to complete and you will need your family for support and encouragement. This first-of-its-kind national effort aims to address concerning results of a large national survey that found low general awareness about prostate cancer aggressiveness and treatment options, underscoring the need for better understanding of active surveillance as a treatment plan. The website includes a host of resources around genomic testing, including a free downloadable patient brochure and an eligibility quiz to identify whether a patient might be eligible for a genomic test such as Oncotype DX.
The company is applying its world-class scientific and commercial expertise and infrastructure to lead the translation of massive amounts of genomic data into clinically-actionable results for treatment planning throughout the cancer patient’s journey, from screening and surveillance, through diagnosis, treatment selection and monitoring. Several new therapies have shown an improvement in overall survival for patients with mCRPC who have already received chemotherapy with docetaxel (Fig.
It has to be considered, however, that only patients with a good Eastern Cooperative Oncology Group performance status of 0–1, asymptomatic or mildly symptomatic osseous metastases, and absence of visceral metastases were included in the trial. There are two ongoing phase 3 clinical trials in the prechemotherapy (n = 1454) and postchemotherapy (n = 1083) landscape of mCRPC that are evaluating the oncologic activity of orteronel.
Despite the absence of steroid cotreatment, no adrenal mineralocorticoid excess was observed and a phase 2 trial is underway. ENZ-4176 is a novel, nucleic acid–based antisense oligonucleotide against AR, which results in selective and specific downregulation of AR mRNA and protein [30].
At 12 wk, 71% and 40% of the patients were progression-free after OGX-427 or prednisone, respectively.
Importantly, increased intracellular expression of CYP17 in biopsied metastatic lesions in CRPC patients who were treated with AA was associated with longer time on treatment. In a recent report comprising 60 patients, cross-resistance between AA and ENZ was demonstrated with a PSA response rate of only 5% in mCRPC patients who received AA after progressing on ENZ. This raises concerns regarding the potential for cross-resistance between microtubule inhibitors and hormonal therapies such as AA. Axel Merseburger has received honoraria from Astellas, IPSEN, Jansen Cilag, and Sanofi Aventis. The treatments given in the initial stages are not as severe and thorough as the ones given in the later stages.


Digital examination is among the tests that are usually done and it will determine the status of the prostate glands.
There are treatment alternatives to surgery that can be very effective for localized prostate cancer, including High Intensity Focused Ultrasound (HIFU). After proper diagnosis, treatment is started and we have various options available all around the globe because of the advance in science and technological innovations that have brought about the use of latest equipments in medicine. Make sure that you enlist professional doctors who will give you proper consultation and treatments. The organization’s efforts are implemented through its national "Rally Against Prostate Cancer (RAP Cancer)" initiatives which include the annual African American Prostate Cancer Disparity Summit. A decline of ≥50% in PSA level was observed in 50% and 20% in the OGX-427 group and in the prednisone group, respectively.
Respectively 5% and 75% of patients treated with cabozantinib had a confirmed partial response and stable disease.
Having an understanding on prostate cancer will enable you handle the disease and cope well from it.
In addition to this widely adopted test, Genomic Health provides the Oncotype DX colon cancer test, the first multi-gene expression test developed for the assessment of risk of recurrence in patients with stage II and stage III disease, and the Oncotype DX prostate cancer test, which predicts disease aggressiveness in men with low risk disease.
The impact of these new data on daily clinical practice, treatment sequencing, and best care for individual patients is not yet fully understood. Furthermore, measurable disease response occurred in 44% and 0% of the OGX-427 group and the prednisone group, respectively. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. Abiraterone acetate for treatment of metastatic castration-resistant prostate cancer: final overall survival analysis of the COU-AA-301 randomised, double-blind, placebo-controlled phase 3 study.
Updated interim analysis (IA) of COU-AA-302, a randomized phase III study of abiraterone acetate (AA) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC) without prior chemotherapy [abstract 5].
Multiple rechallenges for castration-resistant prostate cancer patients responding to first-line docetaxel: assessment of clinical outcomes and predictive factors.
The interval from the last cycle of docetaxel-based chemotherapy to progression is associated with the efficacy of subsequent docetaxel in patients with prostate cancer. Exploratory analysis of the visceral disease (VD) patient subset in COU-AA-301, a phase III study of abiraterone acetate (AA) in metastatic castration-resistant prostate cancer (mCRPC) [abstract 14].
A multicenter population-based experience with abiraterone acetate (AA) in patients with metastatic castration resistant prostate cancer (mCRPC) [abstract 113].
Impact of on-study corticosteroid use on efficacy and safety in the phase III AFFIRM study of enzalutamide (ENZA), an androgen receptor inhibitor [abstract 6].
Outcomes in elderly patients with metastatic castration-resistant prostate cancer (mCRPC) treated with the androgen receptor inhibitor enzalutamide: Results from the phase III AFFIRM trial [abstract 16]. Long-term responders to enzalutamide (ENZA) during the phase III AFFIRM trial: baseline characteristics and efficacy outcomes [abstract 20]. Cabazitaxel plus prednisone for metastatic castration-resistant prostate cancer progressing after docetaxel: results from the German compassionate-use programme. Cabazitaxel adverse events are manageable in senior adults with metastatic castration-resistant prostate cancer (mCRPC): results of the European Compassionate Use Programme.
Denosumab versus zoledronic acid for treatment of bone metastases in men with castration-resistant prostate cancer: a randomised, double-blind study.
Denosumab and bone-metastasis-free survival in men with castration-resistant prostate cancer: results of a phase 3, randomised, placebo-controlled trial. Safety and activity of the investigational agent orteronel without prednisone in men with nonmetastatic castration-resistant prostate cancer and rising prostate specific antigen: updated results of a phase II study [abstract 4549]. ARMORI1: safety of galeterone (TOK-001) in a phase I clinical trial in chemotherapy naive patients with castration resistant prostate cancer [abstract CT-07].
The promise of heat shock protein inhibitors in the treatment of castration resistant prostate cancer. Cabozantinib in patients with advanced prostate cancer: results of a phase II randomized discontinuation trial. Antitumour activity of docetaxel following treatment with the CYP17A1 inhibitor abiraterone: clinical evidence for cross-resistance?. Information can be found on various sources, the internet is very resourceful as it has great websites with informative insights on prostate cancer.
The main cause of prostate cancer has not been established even though surveys have discovered that it is highly common among the black ethnic groups due to the high levels of testosterone hormones. As of June 30, 2014, more than 19,000 physicians in over 70 countries had ordered more than 465,000 Oncotype DX tests.
The most likely reason for the improved toxicity profile is the experience of the investigators, guideline-compliant application of GCSF even at cycle 1, and preventive measures with regard to the treatment of diarrhea. Interestingly, PSA changes did not correlate with the antitumor effects in bone metastases and soft-tissue lesions.
All eight patients were docetaxel-refractory and did not demonstrate any significant PSA response. The company is based in Redwood City, California with European headquarters in Geneva, Switzerland. The prostate gland is located below the bladder and it is responsible for the production of semen which is an important fertility element in male species.
These data seem to be important for the decision-making process about the most appropriate therapy for mCRPC patients following docetaxel chemotherapy. Cabozantinib has significant antitumor activity and a well-tolerated toxicity profile, so it might be well integrated into the therapeutic armamentarium to treat mCRPC.
Comparison of second-line treatments in patients with castration-resistant prostate cancer with PSA relapse after or during docetaxel chemotherapy [abstract 243]. In the TAX 327 trial, the PSA response was 45%, the median overall survival rate was 18.9 mo, and the objective remission rate was 12% [31]. Clearly, there are significant differences between first-line docetaxel and second-line docetaxel, supporting the hypothesis that docetaxel resistance might be triggered.



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