Prostrate Cancer Research Institute featured an
interview on “Living with advanced
prostrate cancer” with Dr Mark Scholz from Prostate Oncology Specialists. Dr
Scholz’s approach to salvage treatments are precise and effective.
Below are some extracts of the interview.
Men
with advanced prostate cancer tend to live longer than men with other types of
cancer. One major reason is because prostate cancer doesn’t usually spread to
critical organs like the brain, the liver or lungs. Another reason is the
availability of so many effective treatments.
Men
with ROYAL BLUE (advanced prostrate cancer) who have never had hormone therapy
should start testosterone inactivating pharmaceuticals (TIP) beginning with
Lupron and Casodex in combination.
Men
who have become resistant to Lupron should take Provenge to boost their immune
system. Studies show that Provenge works better when treatment is started as
early as possible.
Potent
medications to strengthen the bones —Xgeva and Zometa—are routine
treatment for bone metastases. There have three benefits: Inhibiting cancer
growth in the bones, reducing bone pain; and counteracting calcium loss caused
by hormonal therapies.
After
Provenge men in ROYAL BLUE the first step should be to stop Casodex and start
one of the following three options:
1.
Second-line TIP such as Zytiga or Xtandi
2.
Chemotherapy with Taxotere or Jevtana
3.
Xofigo, a form of injectable radiation
Three
additional treatment options can be considered if these first three options are
no longer effective:
1.
Combination chemotherapy using Carboplatin or Xeloda with a Taxane or the
combination of both Revlimid and Avastin added to a Taxane.
2.
The “off label” use of XL-184, a medication being researched for prostate
cancer but already FDA-approved to treat thyroid cancer
3.
Other investigational medications
Fatigue
is one of the biggest challenges faced by men in ROYAL. Stimulants such as
Provigil or Nuvigil may be helpful, but
the most important priority is consistent, diligent exercise. An aggressive
and imaginative treatment plan should be designed that has the specific goal of
attaining and maintaining a complete remission.
The above extracts are taken from Prostrate Cancer
Research Institute. Read the whole interview here.
Take care
Allen Lai
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