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Prostate cancer treatment : Dr. Nilesh D. Mehta

Prostate Cancer
Worldwide, prostate cancer continues to remain the most common cancer affecting men with an estimated 1,600,000 cases and 366,000 deaths annually. In the United States, 11 percent of men are diagnosed with prostate cancer over their lifetime, with the incidence generally rising with age. Prostate gland continues to enlarge as men grow older and this is a disease of men in their older age.
Unlike most other cancers that are metastatic and stage IV, prostate cancer is much more treatable and a lot of newer therapeutic approaches have been made available through clinical trials and research. Androgen deprivation is a concept that evolved decades ago and in the current therapeutic era, tweaks in the regimen are being made to bolster the responses.
Treatment of the disease when it has spread beyond the prostate gland is to utilise androgen deprivation therapy. Since testosterone is the fuel that propels the continued burning of the fire of the disease, most efforts are directed in eliminating the production or reducing or eliminating the action of testosterone. There have been major advances made in the field of prostate cancer treatment.

According to a recent SWOG ( SouthWest Oncology Group) S1216 study, funded by the National Cancer Institute (NCI), promising results emerged for prostate cancer patients. It tested the efficacy of the drug orteronel in these patients, pairing it with androgen deprivation therapy on the investigational arm and comparing that combination to androgen deprivation therapy plus bicalutamide. What is impressive is that this study showed a median overall survival of 70 months in the control arm. For patients with extensive disease prostate cancer, this news emanating from this clinical trial is indeed quite welcome.

“We are seeing the benefit of the advancements made in advanced prostate cancer therapy in the last decade, resulting in unprecedented improvements in survival of men with advanced prostate cancer in general, which is great news for our patients,” said study lead author Neeraj Agarwal, MD, a SWOG investigator with the Huntsman Cancer Institute at the University of Utah.

Besides the improvement in Prostate Specific Antigen ( PSA – blood test), men on the orteronel arm ( experimental) also had significantly improved median progression-free survival (47.6 months versus 23.0 months) Study S1216 was supported by the NCI, part of the National Institutes of Health (NIH), led by SWOG, and conducted by the NIH-funded National Clinical Trials Network (NCTN). The trial was funded by the NIH/NCI through grants CA180888, CA180819, CA180820, and CA180821, and in part by Millennium Pharmaceuticals, Inc. (Takeda Pharmaceutical Company LTD).

It is only through diligent clinical research that physicians are able to help cancer patients live longer. Participation in clinical research continues to be a top priority of several cancer centers. There has been a plethora of cancer research in a variety of cancers over the last decade which have allowed our patients to live longer with better quality of life.

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