Author:
Dr.
John Maggioncalda
The goal of every Urologist is
to diagnose and treat prostate cancer early. The earlier the detection, the
greater the chance a treatment will lead to long-term survival. Sadly, some
patients progress even after their treatment and still others are diagnosed
with advanced disease from the very beginning of our interaction with them. The
next step for these patients is to ensure their testosterone level is very low.
This is usually accomplished by using an agent, or a combination of agents,
such as Lupron, Zometa, Eligard, or Casodex. These medicines will block the
body’s production of testosterone and its attachment to receptors in cells
preventing the growth of prostate cancer. Unfortunately, they work for a
variable amount of time, in some cases only 2-4 years. What next?
Recently, a new immunotherapy called Provenge has been approved for patients
with metastatic prostate cancer with rising PSA levels despite low, castrate
levels of testosterone.
Provenge is the first FDA
approved form of immunotherapy for the treatment of metastatic prostate
cancer. Patients must have a rising PSA, despite castrate levels of
testosterone, and some demonstrable form of metastatic disease by CT/MRI,
ultrasound or bone scan. Potential patients must also be healthy enough
to receive Provenge with at least a 6-month life expectancy and no or limited
pain from their metastases.
Provenge is not a form of
chemotherapy; it is considered immunotherapy. The treatment uses the
body’s own cancer fighting cells and energizes them to attack prostate cancer
cells. Once approved for treatment a patient will have blood drawn and
the immune cells separated from the red cells. These immune cells are
then stimulated so that they will begin attacking the prostate cancer
cells. The immune cells are reintroduced into the body after stimulation
and the process is repeated two more times. These three treatments are
all that is required and the total treatment takes 4-5 weeks. The side
effects of Provenge can include bruising from the needle sticks, fatigue,
backache, and low-grade fevers.
Once a patient receives
Provenge the progress of their disease will continue to be monitored by their
Urologist or Oncologist. There is often no direct reduction in a patient’s
PSA level after treatment but, studies have shown an improvement in overall
survival compared to subjects that did not receive the treatment.
Patients are still able to receive other forms of chemotherapy once Provenge is
administered.
If you are a patient with
metastatic, castrate-resistant prostate cancer, I encourage you to talk with
your Oncologist or Urologist about Provenge to see if it is an option for
you. Remember, not every patient may be a good candidate for Provenge.
The reality is that Provenge has no activity to fight against prostate cancer despite being said to train the immune system to attack the cancer. Most likely it is an ineffective treatment with potential detrimental effects. It appeared to "work' because the study control (so-called placebo)was suppressed or damaged. This product represents a disaster of clinical science in the modern medicine and has been tainted by some scam artists and physicians who want to make more money out of the poor patients. Patients who have been harmed are encouraged to file law suits. Feel free to see more information http://www.theprovengetrials.org/
ReplyDeleteThis response comes from Dendreon the makers of Provenge. As always, discuss your treatment options with your doctors.
Delete"The FDA approval was based on a significant improvement in overall survival shown in three well-designed, randomized, double-blind, controlled clinical trials - including the pivotal IMPACT trial - with remarkably consistent results shown across the trials as well as in numerous patient subgroups.
"The Provenge clinical data have undergone a rigorous scientific review process that included [an] FDA review process, a Center for Medicare and Medicaid Services national coverage determination, a Technology Assessment and the peer review of multiple publications. As evidenced by the FDA approval, CMS national coverage decision, and NCCN treatment guidelines, the PROVENGE data clearly demonstrated a significant patient survival benefit and support its use as a clinically meaningful treatment option for certain types of advanced prostate cancer."
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ReplyDeleteProstate Cancer Treatment
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