Prostate Cancer: Overall Survival And Beyond
Treatment Options The recent development of new therapeutic options for metastatic castration resistant prostate cancer (mCRPC) is giving fresh hope to men suffering with the disease.
mCRPC is a form of prostate cancer that is resistant to traditional treatments that lower testosterone and other androgens, depriving the body of the hormones that feed cancer cells. It’s an aggressive cancer that spreads to other parts of the body with debilitating consequences. Until recently, for men whose prostate cancer had returned despite ongoing hormone therapy, the only option was chemotherapy.
New options with increased efficacy
“Since I started working in this field 20 years ago, the life expectancy for the average patient with mCRPC has more than doubled,” explains Fred Saad, Professor and Chief of Urology and Director of G-U Oncology at the University of Montreal Hospital Centers. “For the majority of patients that are progressing in the standard way, these new treatments are extremely effective.”
The years of investment and research have started to pay off and since 2010, several new treatments for mCRPC have become available to the medical profession. Even more recent is the development of new oral therapies for patients whose cancer has already failed both traditional hormone therapy and chemotherapy.
“A study also showed a 35 percent improvement of survival in patients taking the new treatments,” says Professor Saad. “These new hormonal-based therapies are really targeting both the tumour and the cause of PSA elevation. More than 70 percent of mCRPC patients will see significant PSA declines: that’s a tremendous response.”
More than prolonging life
Just as important as prolonging survival, these new treatments help improve quality of life, reduce pain, and enable sufferers to be active. It’s now possible that men with mCRPC can live a life of relative normality, enjoying family dinners and picking their kids up from school. Simply extending life is no longer the base expectation for men with mCRPC.
These breakthrough treatments are extremely easy to administer, have minimal side effects, and are easy to tolerate for the vast majority of patients. These three factors go a long way to improving a patient’s quality of life. “Even though chemotherapy is extremely effective, it has undeniable side effects and many patients don’t feel fit enough to go through with the treatment,” says Professor Saad.
Kim N. Chi, Professor of Medicine, University of British Columbia and Medical Oncologist, BC Cancer Agency, believes that improved quality of life and a reduction in pain is paramount for patients suffering with mCRPC.
“Many times my patients tell me, yes, they want to live longer, but number one on their list of priorities is actually living better,” says Professor Chi. “With these new medications, many patients can decrease or altogether stop taking morphine and codeine, so they’re also avoiding the side effects associated with those narcotics.”
When patients with mCRPC are not experiencing symptoms or side effects they are more mobile, more active, and generally happier. “Quality of life often trumps quantity of life,” says Professor Chi.
Professor Chi thinks that we’ll continue to see breakthroughs as more time and talent is invested in discovering treatments for mCRPC. “With this age of genomics, big data and collaboration, I think we’re going to see increased understanding around the biology and progression of the disease,” he says. “We’ve got multiple breakthroughs happening from multiple angles.”
Concerted research continues to be conducted. Some of Canada’s best scientific minds are working around the clock to improve the prognosis for men diagnosed with mCRPC. “We are continuously working and trying to improve on our results,” says Professor Saad. “We’re trying to build an approach in which we can make as much of a dent in the disease as we can, as early as possible.”