Health Conditions

What is on the horizon?

New and more effective treatments and prevention therapies for prostate cancer are constantly being researched. Two drugs that reduce the size of the prostate and are currently used to treat BPH have been studied as potential prevention therapies for prostate cancer. Results of the Prostate Cancer Prevention Trial, which studied the use of finasteride (brand name: Proscar), were recently reported. At the end of the study, the men taking finasteride were about 25% less likely to have developed prostate cancer than those getting a placebo. But the cancers that did develop in the men taking finasteride were more aggressive, meaning that they were more likely to grow and spread. Because of this study, it is not clear whether finasteride should be used at this time to prevent prostate cancer. Although this study did not show a clear-cut benefit for finasteride, a study is still being conducted to test whether another drug, dutasteride, might be helpful in preventing prostate cancer.

Other medications being studied include NSAIDS, biologic therapies, angiogenesis inhibitors, and chemotherapy medications. Nonsteroidal anti-inflammatory (NSAID) medications such as naproxen and ibuprofen inhibit an enzyme present in cancer cells of the prostate, but whether they truly have benefit in prostate cancer prevention is unclear at this time. Biologic therapy is also known as immunotherapy or biotherapy. In this treatment, the patient?s immune system is stimulated and becomes better able to fight the cancer. Angiogenesis inhibitors such as bevacizumab (Avastin) are also being tested in prostate cancer. Angiogenesis refers to the process where new blood vessels are formed that supply the cancer with blood flow and nutrients. If this process can be stopped, the tumor would die. A drug called thalidomide is also being researched for its similar effects. Chemotherapy is commonly used in other types of cancers, and current clinical trials are studying the effects of various chemotherapy medications and chemotherapy combinations on prostate cancer. Chemotherapy medications are taken by mouth or injected into the blood where the medication travels to the cancer and destroys it.

In addition to the testing of new medications, new radiation and surgical therapies are also being examined. Some areas of the United States have clinics that use proton beam therapy to treat prostate cancer. In this procedure, protons instead of x-rays are used to kill cancer cells. The effectiveness of this treatment compared to x-ray radiation is currently unclear. Another new surgical procedure is known as cryotherapy. Cryotherapy is a procedure that uses an instrument called a cryoprobe to freeze and destroy the tumor. The treatment is currently considered experimental due to variations in response to the procedure and a lack of long-term research. If effective, the treatment would be a good alternative for patients who do relapse after receiving radiation. Another treatment being studied includes high-intensity focus ultrasound. In this technique, a probe is inserted into the rectum and produces intense sound waves that kill the cancer.

Clinical trials now under way aim at improving the comfort and quality of life of prostate cancer patients. Investigations are also in progress to determine whether a diet low in fat and high in soy, fruits, and vegetables is effective in preventing the recurrence of prostate cancer.