Prostate cancer is the second leading cause of death in American men, but the latest prostate cancer treatments provide hope and new choices for men facing this disease. The newer drugs show promise for extending the life span of men with late-stage metastatic prostate cancers that have spread despite other therapies such as castration and, in some cases, chemotherapy.
The approach of each treatment is unique and differs in administration from infusion to oral tablet to injection. Each of the treatments discussed here has a different approach to treating prostate cancer. One of the treatments uses the body’s own cells to treat the cancer, another affects hormone production, and the newest one uses a form of radiation to target bone tumors. But what each one of these latest prostate cancer treatments has to offer is another treatment option for patients and doctors.
Immunotherapy With Provenge
Provenge (sipuleucel-T) is an immunotherapy that uses the body’s own cells to fight cancer. Provenge is considered a positive approach to treating prostate cancer because it works with the body and does not cause damage, unlike some other therapies such as chemotherapy, radiation or hormone therapy.
Provenge is a drug that is leading the way for how we will be treating other kinds of cancers in the near future. It is a treatment for men with metastatic prostate cancer, which means the cancer has spread to the bones or other organs. It is used in men with minimal symptoms who do not require narcotic pain medication for their cancer. It treats men whose prostate cancer continued to get worse despite hormone therapy. It can be used after chemotherapy (after waiting a certain amount of time) or before the chemotherapy treatment.
Each dose of Provenge involves collecting a patient’s blood in a process similar to donating blood. Certain cells are harvested, and the remaining blood is returned to the patient. The harvested cells are modified, or trained, to attack the prostate cancer. Then the cells are put back in the patient’s body a few days later via an infusion. Treatment usually involves three doses given over five weeks.
In clinical trials, men who took Provenge extended life an average of 4.1 months longer than men who took a placebo. It is tolerated pretty well by patients. The most common side effects include muscle aches and pains, joint pain, fatigue, fever, chills, headache, and nausea.
At more than $90,000, Provenge has a high price tag, but it is usually covered by most health plans and Medicare. Patients can apply for financial assistance from the drug’s manufacturer, Dendreon. Dendreon may even reimburse patients in need for expenses such as copays, co-insurance or deductibles. The drug may be free for uninsured patients or patients who demonstrate financial hardship.
Lowering Testosterone With Zytiga
Zytiga (abiraterone acetate) is a hormone therapy used for prostate cancer patients whose cancer has spread after chemotherapy. It is for late-stage, castration-resistant prostate cancer.
Zytiga is an oral medication that the patient takes once a day. The dose is accompanied by the steroid prednisone, which is taken two times per day. Treatment lasts about eight months on average. Zytiga targets a protein (called cytochrome P450 17A1), which plays a large role in producing testosterone. How is Zytiga different from other hormone therapies? Zytiga is the only therapy that actually reduces testosterone produced in the body at three different locations: the testes, the adrenal glands and the prostate tumor.
According to studies, men who took Zytiga lived 3.9 months longer than men who took a placebo. The drug has several common side effects such as cough, diarrhea, retention of fluids, heartbeat disorders, high blood pressure, hot flashes, swelling of joints, low potassium, muscle aches, respiratory infections, upset stomach, frequent urination and urinary tract infections. The prednisone taken with Zytiga can be associated with immune system weakness and makes the patients susceptible to infection.
Zytiga is the least expensive of the three new medications. It costs $40,000 for an eight-month course of treatment. Most insurance companies and Medicare cover Zytiga. The manufacturer has financial assistance available for eligible patients.
Treating Metastasized Bone Tumors With Xofigo
Xofigo (radium-223) is an injectable medication that is the most recent prostate cancer treatment to gain Food and Drug Administration approval (on May 15). This new medication is for hormone-resistant prostate cancers that have spread to the bones but not to other organs. Xofigo cannot be used with chemotherapy.
Xofigo contains radium, a heavy metal. It delivers shortwave radiation directly to bone tumors without harming the surrounding tissues. This kills the prostate cancer cells in the bones. Xofigo is given in six injections every four weeks.
Men who took Xofigo in clinical trials lived three months longer than men who took the placebo. Its most common side effects are nausea, diarrhea, vomiting and swelling of the ankles, legs and feet.
The complete course of therapy for Xofigo costs $69,000. Patients need to check with their insurance companies to see if they have coverage for this new medication. If not, Bayer has patient assistance programs in place to help with the cost of the drug. Uninsured patients and patients whose insurance companies do not cover Xofigo may be able to get Xofigo free of charge. Bayer also assists eligible patients with copays and other expenses associated with taking Xofigo.
Latest Prostate Cancer Treatments Offer Choices
The good news is that today’s prostate cancer patients have more treatment choices available to them than even just a couple of years ago. From immunotherapy to testosterone suppression to drugs that treat bone tumors, there are many treatments from which patients with prostate cancer can choose based on their symptoms, coverage and doctor’s advice.