Personalizing Prostate Cancer Treatments
Treatment Options For a long time, our understanding of prostate cancer was limited. Patients had few treatment options. Fortunately, this is no longer the case today.
atients in Quebec now have access to an array of treatments that can vary, based on medical history and cancer level.
“The medications we use today all have the capacity to improve quality of life and life expectancy for patients with very advanced cancers,” says Dr. Fred Saad, Head of Urology Service and Urology Oncology at the Centre hospitalier de l’Université de Montréal (CHUM).
A New Generation of Therapy
Prostate cancer needs hormones to grow, namely androgen, a male hormone. Hormonal therapy helps reduce interactions of androgens, such as testosterone, with the disease.
Over the last few years, three new treatments were added to the list of medications approved for coverage under health insurance: one form of intravenous radiotherapy that attacks the bone metastases with more precision, and two second-generation hormonal drugs that can cease the production of testosterone in the cancer cells and block hormonal receptors. “The use of these new treatments that were developed in 2004 has enabled us in 2015 to double patients’ average life expectancy, while improving their quality of life,” explains Dr. Saad.
Better Targeting of Bone Metastases
Bone degradation, which was once an inevitable consequence of metastasis, can now be prevented or delayed thanks to the evolution in bone-targeted treatments.
“Radiotherapy is nuclear medicine,” explains Dr. Trung Nghia Nguyen, a hematologist-oncologist at the Hôpital Charle-LeMoyne. “This treatment targets cancer cells in the bone and can have positive results.”
The precision of this bone targeted treatment lowers the risk of fractures and other complications related to bone metastases, while reducing pain.
The new treatment is administered intravenously once every four weeks, over a period of six months. It has a calcium mimetic property, which increases its receptivity into the bones, and it emits localized radiation that does not affect cells away from the cancer. Patients can return home the same day and side effects are rare.
Developing the personalized approach
Dr. Nguyen explains that Prostate cancer is heterogenous. “Two people with the same cancer can experience very different evolutions of the disease.” This is why current research is trying to determine the hereditary and the environmental factors that cause it. A better understanding of this disease and its mutations could enable doctors to more accurately determine which treatments are best.
“Our current philosophy is to try to personalize treatments as much as possible so patients can live longer and enjoy a better quality of life,” Dr. Saad concludes.