Category: Trials

Is radiotherapy to prostate useful even after the cancer has escaped from prostate?

Yes, it can be helpful but only in certain circumstances.

Former US President Biden is in the news this week and multiple media outlets reports that Biden is having  radiation therapy to prostate along with hormone therapy.

The news outlets also indicate that Biden has aggressive prostate cancer which has spread to the bones.

Any spread of prostate cancer to bones is classified as stage 4 prostate cancer.

If cancer has NOT spread outside the prostate, the combination of radiation and hormones could be curative .

But, with stage 4 prostate cancer, radiation is generally not curative. This is because once the cancer cells have spread, it is extremely difficult to eradicate those cancer cells permanently. 

A large UK trial ( STAMPEDE trials) found that “Radiotherapy to the prostate did NOT improve overall survival for unselected patients with newly diagnosed metastatic prostate cancer”

So if radiation does not improve survival, why did the oncologists offer radiation therapy to Biden?

Full medical details are not available and so it is difficult to give a definitive answer in Biden’s case.

There are few possibilities.

In the above mentioned STAMPEDE trial , in a smaller select group of patients, Radiation therapy did improve overall survival in men with a low metastatic burden. ( ie fewer cells have spread).

One can only speculate whether that’s been the case with regards to Mr Biden.

References

  1. CNN. Biden starts radiation therapy for aggressive form of prostate cancer. By Kevin Liptak, Fadel Allassa. UPDATED OCT 11, 2025, 11:28 AM PUBLISHED OCT 11, 2025, 10:01 AM
  2. BBC news. Biden receiving radiation therapy for prostate cancer. By Jaroslav Lukiv. Published 11 October 2025.
  3. Lancet. Stampede trial. Radiotherapy to the primary tumour for newly diagnosed, metastatic prostate cancer (STAMPEDE): a randomised controlled phase 3 trial.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information research only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options, which are relevant and specific to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Cancer Vaccine for the nasty skin cancer Melanoma

Vaccines based on mRNA played a significant role during COVID pandemic .

A Cancer vaccine based on mRNA is showing lot of promise in a type of skin cancer called melanoma.

Results presented at the ASCO meeting in Chicago show better survival outcome compared to the current standard immunotherapy.

Confirmatory trials are in progress to provide further evidence for this personalised vaccine.

References

Guardian: ‘Extremely impressive’: melanoma jab trial results excite doctors. Andrew Gregory. Health editor. Mon 3 Jun 2024 22.00 BST

ASCO Abstract. Individualized neoantigen therapy mRNA-4157 (V940) plus pembrolizumab in resected melanoma: 3-year update from the mRNA-4157-P201 (KEYNOTE-942) trial.

ASCO Trials in Progress. INTerpath-001: Pembrolizumab with V940 (mRNA-4157) versus pembrolizumab with placebo for adjuvant treatment of high-risk stage II-IV melanoma.

Disclaimer: Please note – This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog are NOT, in any way whatsoever, intended to be a substitute for professional advice. The blog is NOT previewed, commissioned or otherwise endorsed, in any way, by any organisation that the author is associated with. The views expressed in this blog likely represents some of the author’s personal views held at the time of drafting the blog and MAY CHANGE overtime, particularly when new evidence comes to light.

Should chemotherapy be used before radiotherpy for bladder cancer?

Yes, chemotherapy given before surgery or radiotherapy for invasive bladder cancer improves cure rates and survival rates.

But there is also strong U.K. data to show that Chemotherapy given along with Radiotherapy is useful because it makes radiotherapy work better .

Should chemotherapy be given before radiotherapy and then followed by more chemotherapy along with radiotherapy ?

There is lot of scientific debate on this question and well known U.K. experts are favouring this “double chemo” approach in-spite of inconclusive new data published in the European Urology journal.

The NICE guidelines on bladder cancer also favours this approach of “double” chemotherapy ( before as well as along radiotherapy).

It is a question that ideally needs to addressed in clinical trials .

Read my views expressed in a letter published in the Journal European Urology

Reference: Re: Syed A. Hussain,
Nuria Porta, Emma Hall, et al. Outcomes in Patients with Muscle-invasive Bladder Cancer Treated with Neoadjuvant Chemotherapy
Followed by (Chemo)radiotherapy in the BC2001 Trial. Eur Urol 2021;79:307–15

Disclaimer: Please note- This blog is NOT medical advice. This blog is NOT a expert medical opinion on various topics. This blog is purely for information only and do check the sources where cited. Please DO consult your own doctor to discuss concerns and options relevant to you. The views expressed in this blog represent the author’s views held at the time of drafting the blog and may change overtime, particularly when new evidence comes to light. The blog is not previewed, commissioned or otherwise endorsed by any organisation that the author is associated with. The views expressed in this blog are not, in way whatsoever, intended to be a substitute for professional advice.

New treatment combination for advanced Kidney cancers

The treatment of kidney cancer has dramatically changed in the last decade. More treatments are in pipeline and there was more exciting news this week.

Upfront immunotherapy in combination with other agents is very promising in 1st line treatment of advanced kidney cancers.

Data presented at ESMO ( European Society of Medical Oncology) shows that the combination of Nivolumab and Cabozantinib is better than Sunitinib alone.

“Nivolumab and Cabozantinib” combo joins the other combos “Nivolumab and Ipililumab” and “Pembrolizumab and Axitinib “ as 1st line options

Disclaimer: Please note- This blog is NOT medical advice. This blog is purely for information only and do check the the sources where cited. Please consult your own doctor to discuss concerns and options relevant to you.

The views expressed in this blog represent the author’s views held at the time of drafting the blog and is likely to change overtime, particularly when new evidence comes to light. The blog is not necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.