Since the 1940’s, we have known that men with cancer outside the prostate, advanced prostate cancer, could have their disease slowed down by removing the male hormone testosterone. You can think of testosterone as being both a food and a fertilizer for prostate cancer. This hormone is made in the testis. Until the 1980’s, this required castration (surgical removal of the testicles). New medicines were developed to prevent the testes from manufacturing testosterone, so a man could have a “chemical castration” by receiving a shot every few months. This treatment alone slowed down the progression of the cancer so much than many men could live a decade even though the cancer was widespread. This was such a breakthrough that the men who discovered it received a Nobel Prize.
Sometimes, however, a man’s prostate cancer mutates, and is able to grow without the stimulation from testosterone. This is termed “Castrate resistant prostate cancer”, or CRPC. This special subset of men had no hope, until 2008.
In 2008, a breakthrough occurred. It was learned that a brand new form of therapy was effective for CRPC. This medicine, Provenge, is a kind of “immunotherapy”. It uses one’s own immune system to fight off and kill the prostate cancer. This opened a watershed of therapies. Where urologists had nothing to use before 2008, now we have 5 therapies, with many more on the close horizon. In addition to Provenge, we now have Zytiga, Xtandi, Xofigo, Taxotere, and Jevtana. At Regional Urology, we have active research studies enabling patients to have access to three other breakthrough products to treat CRPC, and this is constantly being updated.
If you are found to have CRPC, you qualify to enter our “Advanced Prostate Cancer Clinic”. This enables you to have monthly visits which assess:
- Cancer progression, measured by frequent blood tests and radiographic tests such as PET, MRI, and CT
- Lab tests to analyze your body’s metabolism and response to your treatment
- Bone strength and health
- Effectiveness of your medicine (whether or not you should change therapy)
- Whether or not you qualify for a new research program
Regional Urology was one of the leaders in the country to establish such an Advanced Prostate Cancer Clinic. In fact, many of the therapies used around the world were first tested here before the rest of the country or world had access to them. Our research facility is second to none, because our patients are second to none. We strive to maintain our place on the frontline of science to offer our patients the best care available.