Highlights

Drug Approvals

• In 2010, the FDA approved the chemotherapy drug cabazitaxel (Jevtana) for patients whose condition has worsened during or after treatment with docetaxel. Chemotherapy is sometimes recommended for men with prostate cancer that does not respond to hormone therapy.
• In 2010, the FDA approved the first prostate cancer “vaccine” for select men with advanced prostate cancer. Sipuleucel-T (Provange) uses a patient’s own immune cells to fight cancer. In clinical trials, it extended survival by about 4 months.

Hormone Therapy and Heart Risks

Androgen deprivation therapy (also called hormone therapy) is one of the treatment options (along with active surveillance, surgery, and radiation therapy) for men with prostate cancer. Hormone therapy commonly uses drugs called luteinizing hormone-releasing hormone (LH-RH) agonists. These drugs have been associated with possible increased risk for diabetes, heart attack, stroke, and sudden death.

In 2010, the American Heart Association, the American Cancer Society, and the American Urological Association issued a joint guideline recommending that men who receive hormone therapy have regular visits with their doctors to monitor their blood pressure, blood sugar (glucose), and cholesterol (lipid) levels.

Prostate Cancer Screening Guidelines

The American Cancer Society’s 2010 guidelines for early detection of prostate cancer recommend that men discuss with their doctors the uncertainties, risks, and potential benefits of screening for prostate cancer before deciding whether to be tested. Debate continues over whether the benefits of prostate specific antigen (PSA) screening outweigh the treatment risks for most men. In general, the current consensus is that there is no "one size fits all" guideline for who should receive prostate cancer screening and at what age.

Chemoprevention of Prostate Cancer

There is also debate as to whether 5-ARI drugs, which are used to treat benign prostatic hyperplasia (BPH), should be used for prevention of prostate cancer in high-risk men. Several recent studies suggested that finasteride (Proscar, generic) and dutasteride (Avodart) may reduce prostate cancer risk. However, other researchers think that these drugs do not prevent aggerssive, life-threatening prostate cancer but instead temporarily shrink low-grade tumors that probably would not become deadly.

Review Date: 07/26/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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