Prostate cancer experts discuss advanced treatments
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11/24/08 Seán Kinane
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Seven researchers revealed advanced treatments for prostate cancer this afternoon at the Moffitt Cancer Center on the University of South Florida’s Tampa campus. The progress is significant because this year nearly 29,000 men will die of prostate cancer and more than 186,000 new cases of the disease will be diagnosed, according to the National Cancer Institute.

Prostate cancer often occurs in older men. It forms in the tissues of the prostate, a male reproductive gland located between the bladder and the rectum.

Kenneth Pienta, a professor of Internal Medicine and Urology at the University of Michigan Comprehensive Cancer Center, said that researchers “have made amazing progress over the last 15 years.”

“In the early 90s when I started in this field, the five-year survival for prostate cancer was about 60 percent. … Now in 2008, we’re approaching 99 percent survival at 10 years. And a lot of that has to do with screening and better treatment – you know, surgery and radiation – but it also comes from a lot of progress that we’ve made in understanding the disease better, and how to treat it better with hormones and how to treat it better with chemotherapy.”

Despite this, about 30,000 people still die each year from prostate cancer, Pienta said. His response is to treat the disease as an ecosystem, targeting the micro-environment where the cancer cells occur. Another researcher focusing on the micro-environment of cancer cells is Christopher Logothetis, director of the Prostate Cancer Research Program at the University of Texas Cancer Center.

“Blocking this gene, which we now can do with some drugs, is having very dramatic responses in patients with prostate cancer. But this supports the notion that remodeling the micro-environment – that is the nest in which the cancer resides – is critical to cancer growth, the cancer is dependent on that, and now we can show that by blocking this we can actually disrupt it. And the consequence of that disruption is that the cancer will shrink, to the patient’s benefit."

Arul Chinnaiyan, professor of Pathology and Urology at the University of Michigan Medical School, studies what are called “gene fusions” that he says occur in a majority of prostate cancers.

“We believe that we’ve identified the initiating mutation that potentially causes prostate cancer. So knowing what actually triggers the process of prostate cancer allows us to develop more specific diagnostics for the disease as well as potentially develop therapies against the disease.”

Prostate cancer patients face a variety of treatment options, including radiation therapy and hormone therapy. These treatments can also be used in combination. That option is good for otherwise healthy patients, but worse for unhealthy patients, according to Harvard University’s Anthony D’Amico, a professor at the Dana-Farber Cancer Institute and Brigham and Women’s Hospital.

“But it seems to have the best, or most benefit in people who are [otherwise] healthy, and in fact, no benefit or maybe a detriment in people who are not healthy. … People with heart disease who undergo hormonal therapy may not always benefit. There’s a caveat here … as more studies on this evolve, it becomes clear that as the prostate cancer gets more advanced, the [benefit if the] addition of the hormonal therapy outweighs its risk."

Daniel Petrylak is a researcher at the Colombia University Medical Center and is developing new ways to treat patients with castration-resistant prostate cancers who don’t fully respond to hormone treatment to reduce the body’s quantity of the male hormone androgen.

Daniel Lin, director of the Division of Urologic Oncology at the University of Washington, is developing new cancer markers beyond the traditional PSA marker that can be detected in the blood of patients with prostate cancer. These include CTC or circulating tumor cells.

The University of Florida College of Medicine’s Johannes Vieweg said most cancers cannot be treated with a single silver bullet; instead a multimodal approach is needed, including using antibodies to induce a cancer patient’s immune response.

Photo by Seán Kinane/WMNF

Moffitt Cancer Center

Moffitt’s prostate cancer information page

National Cancer Institute

NCI’s prostate cancer information page

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