Tag: Hormone therapy

How long can a man with aggressive prostate cancer live?

Many people were shocked by the news that president Joe Biden, aged 82, has been diagnosed with aggressive prostate cancer.

Prostate cancer is quite common in men in their eighties. Nearly two third of men in eighties would have prostate cancer and most of these men do not die of prostate cancer! This is because lot of the cancers in elderly men are low to medium risk.

But men who develop aggressive prostate cancer are at higher risk of death from prostate cancer. Aggressive prostate cancer can spread to bone and other organs.

It has to be pointed out that aggressive prostate cancer is not immediately terminal in vast majority of men, even if the cancer has spread to bone.

With modern hormone treatments, men can have a prognosis of many years.

References

  1. BBC. Joe Biden diagnosed with ‘aggressive’ prostate cancer
  2. CRUK. Prostate Cancer incidence statistics .
  3. CRUK. Prostate cancer survival statistics.
  4. NEJM. Apalutamide for Metastatic, Castration-Sensitive Prostate Cancer.
  5. Lancet. Abiraterone acetate plus prednisolone with or without enzalutamide for patients with metastatic prostate cancer starting androgen deprivation therapy: final results from two randomised phase 3 trials of the STAMPEDE platform protocol.

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.

Should hormone therapy be used before or after prostate radiotherpy?

Combination therapy with Hormone therapy and Radiotherapy is used with curative intent for treatment of prostate cancer.

There is some debate which treatment should be started first. At present, the hormone therapy is started first and radiotherpy is started second at a later date.

This is because many previous clinical trials, which found beneficial effects for the combination therapy, involved starting hormones first.

One advantage of starting hormone therapy immediately and delaying the start date of radiotherpy is that hormone therapy shrinks the size of prostate before radiotherpy . This greatly helps when image-guided Radiotherpy is planned later on.

A group of high Calibre researchers and authors from Canada and USA have published paper arguing in favour of radiotherpy starting first and starting hormones afterwards.

Some of the authors behind this paper in Journal of Clinical oncology have previously published seminal, practice changing, papers in field of prostate cancer.

My personal view, is that we have to wait for confirmatory evidence before changing the current practice.

I have to resort to the megaphone of a provocative headline grabbing title so that oncologists won’t uncritically accept the conclusion of the paper

Read the original paper and my published response .

Adjuvant Hormone Therapy After Prostate Radiation: Is This Data Torture?

Santhanam Sundar , MD and Micheal Ocathail, MD. Nottingham University Hospital NHS Trust, Nottingham, United Kingdom

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 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 the author is associated with. The views expressed in this blog are not in way intended to be a substitute for professional advice.

New oral medication approved for Prostate Cancer

Advanced Prostate cancer can be successfully controlled for many years by hormone therapy.

Until now, the hormone therapy, which is widely used widely used, involved either hormone injections or hormone implants.

The FDA in USA has recently approved a new novel oral medication for prostate cancer. It acts quickly and has been proven to be highly active. It is taken as a daily oral medication. It is reasonably well tolerated.

It is not known when the medication would be approved in UK and Europe.

References

(1) NEJM. Oral Relugolix for Androgen-Deprivation Therapy in Advanced Prostate Cancer

(2) FDA approval. FDA approves relugolix for advanced prostate cancer.

(3) Information about Relugolix. FDA: HIGHLIGHTS OF PRESCRIBING INFORMATION. and FULL PRESCRIBING INFORMATION.

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 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 necessarily endorsed by any organisation the author is associated with and views are not substitute for professional advice.