While a diagnosis of advanced prostate cancer can be scary, there are steps you can take to access the best treatment for you. But exactly what advancements are being made to better treat patients living with advanced prostate cancer? In the past several years, there have been significant developments in medications used to treat advanced prostate cancer. One of the main treatments used for prostate cancer is hormone therapy and for many years these treatments, known as androgen deprivation therapy, worked by depleting levels of testosterone. This works because testosterone fuels cancer cells and when you reduce the levels of testosterone, you are taking away the “food” the cancer cells need to grow. Unfortunately, in many cases, testosterone therapy tends to fail after some time. Researchers believed that cancer cells developed a resistance.
Self-sufficient cancer cells
Continued research on advanced prostate cancer therapies has shown that rather than building a resistance, advanced prostate cancer cells start to create their own testosterone, creating their own fuel. This research actually began back in the 1990s and showed that certain medications could drastically reduce testosterone levels, more so than other androgen deprivation therapies. The medical and research communities could not, however, determine how these new treatments should be used and who would most benefit from them. It was not fully understood why advanced prostate cancer cells became “resistant” to these hormone therapies. Researchers believed that if they were resistant to previous treatments, they would be resistant to these as well. But this was before researchers discovered that the cancer cells themselves were producing testosterone to make up for the depleted levels in the body. This discovery didn’t come about until the early 2000’s.
Attacking the source
Once scientists better understood what was occurring, researchers at the London Institute of Cancer Research began to grasp how they could tackle this specific cancer by targeting testosterone production. Professor Malcolm Mason, an expert at Cancer Research UK and whose patients were a part of the more recent studies, describes advanced prostate cells as being “addicted to male sex hormones” not hormone-resistant. The original androgen deprivation therapies worked by depleting testosterone made by the body (both in the testicles and adrenal glands), but, because the prostate cancer cells themselves were continuously producing more testosterone, the cells could continue to grow.
Several new hormone therapy medications have been approved over the past few years. These medications work to directly shut off all hormone production, even when it was produced by cancer cells. These medications are used after the original hormone therapy has stopped working. As with the original hormone therapy medications, they can be used in combination with chemotherapy and radiotherapy.
Although most men aren’t bothered by severe side effects, these new medications can cause side effects, such as:
- Fluid retention
- High blood pressure
- Liver problems
- Drop in potassium levels
- Bone pain
- Hot flashes
If you are living with advanced prostate cancer, your doctor should discuss the possible side effects from the different medications. You can then work with your doctor to determine which, if any, of the new hormone blocking medications would be best for you.
According to the American Cancer Society, prostate cancer is the second most common cancer in men in the United States. Around 220,800 men were newly diagnosed in 2015 and during that year, there were 27,540 deaths. Most men who develop prostate cancer don’t die from it; almost three million men in the U.S. are living with a diagnosis of prostate cancer.