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What are some promising new therapies for prostate cancer?

Dr. Jeanne Morrison, PhD
Family Practitioner

A variety of new and different treatment options for prostate cancer are currently being studied. Surgeons are looking at new ways to use cryosurgery to freeze cancerous tissue on the prostate, while doctors are looking into different dosages and schedules for radiation therapy. New forms of hormone therapy and chemotherapy are being developed and tested. Combinations of hormone therapy, chemotherapy, and biological therapy using vaccines to boost the immune system are the forefront of prostate cancer treatment. Immune checkpoint inhibitors are thought to be able to alert the body's immune system to attack cancer cells—cancer cells that normally hide using the immune system's own "checkpoints" that prevent attacks on the body's normal cells. Targeted therapy is another method, using drugs that alter the way cancer functions (such as blocking the growth of blood vessels to tumors). Another exciting avenue of treatment may lie in high-intensity focused ultrasound, which uses pulses of high-intensity sound to destroy cancerous tissue in the prostate.

Doctors are improving prostate cancer care through research and development of newer and better drugs, radiation techniques, and surgical techniques. This helps to find better therapies for all stages of the disease which can help increase our success and hopefully lead to fewer side effects for patients.

As of today, the newest therapy for prostate cancer is a drug known as enzalutamide (Xtandi) which used for those patients with hormone refractory prostate cancer that have failed or are intolerant to chemotherapy. This drug is also in trial for earlier use in metastatic prostate cancer. There are many other therapies in clinical trials for all stages of prostate cancer, but the data is too early to determine which will be promising.

Up to 30,000 men die from prostate cancer each year. But new drugs and treatments are giving oncologists hope that they can beat the disease. Researchers are trying to develop tests to determine which prostate cancers are aggressive, and whether certain people should be tested at all. In this video, William Oh, MD, an oncologist at The Mount Sinai Medical Center, discusses the future of prostate cancer treatment.

Dr. Marc B. Garnick, MD
Hematologist & Oncologist

In 2011, the FDA approved abiraterone (Zytiga) tablets to be used in combination with prednisone for treating metastatic castration-resistant prostate cancer in men who have already undergone chemotherapy. Another drug, called MDV3100 (targeted therapy), is available only to men participating in prostate cancer clinical trials. The side effects of abiraterone include abnormal liver function. The side effects for MDV3100 include fatigue, nausea, labored breathing and appetite loss.

Dr. Danny S. Sperling, MD
Diagnostic Radiologist

Regular PSA screening over the past few decades has given rise to a huge increase in the diagnosis of low-risk prostate cancers, which has in turn resulted in significant over-treatment of the disease. Men suffer considerable deterioration of their quality of life when they experience incontinence, erectile dysfunction and other complications of common prostrate cancer treatments such as prostatectomy and radiation. A targeted treatment such as focal laser ablation destroys the cancer while avoiding these critical problems.

Essentially, laser ablation is extremely precise and even lesions located near more sensitive areas, such as the neurovascular bundles and near the urethra, can be safely ablated. The MRI and special software allow precise monitoring of temperature within the tumor and adjacent structures in real time. By using a technology called MRI thermometry, the MRI is essentially converted into a virtual thermometer. Small amounts of temperature changes are converted into an image on the ablation software, which allows the doctor to detect how much tissue is destroyed at one time. They can also control the amount of energy transmitted by the laser so that the surrounding healthy tissue and structures aren't harmed. 

The whole procedure is typically done in one hour or less. Patients go home about 20 minutes after the procedure, and no urine catheter is usually needed.

Some advances in prostate cancer treatment include: new screenings and tests, improved surgical techniques (robotic surgery) and more targeted radiation therapy. Watch me explain how doctors are improving cancer treatments.

Software is helping people make decisions about their prostate cancer treatment. The software allows you to enter your prostate-specific antigen (PSA) level, your Gleason score and other things that determine your risk for death and side effects. It also does an interview, where you go through the different side effects of treatment and observation, and you get to express your preferences through a simple choice exercise. People are then seen in a clinic with a report that suggests the top three evidence-based choices that are consistent with their preferences. The report also informs doctors what these preferences are, so they can make sure to address what's specifically important to that particular man.

Men with advanced prostate cancer are treated have new options. In this video, Simon Hall, MD,  a urologist at The Mount Sinai Medical Center and director of the Deane Prostate Health and Research Center, discusses these new therapies.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.