What advances to expect in prostate cancer treatment in coming years?

Posted by soli @soli, Aug 20 10:49am

My PSA is still undetectable as I approach the one-year mark. Given my high-risk pathology and biology, however, I realize that biochemical recurrence (BCR) is still possible sometime in the future, despite my efforts to reduce that risk through exercise, better sleep, and an “anti-cancer” diet.

Hopefully, these efforts will help prevent BCR—or, if it does occur, perhaps delay it long enough for imaging and treatments to improve substantially.

With that in mind, we are just learning that Moderna and Merck announced that a personalized mRNA cancer vaccine reduced the risk of melanoma recurrence and spread in a late-stage trial. It makes me wonder: Could similar personalized treatments become available for prostate cancer recurrence relatively soon?

What other advances might we realistically expect in the coming years, particularly in:

* Hormone therapy, including treatments that are more effective and/or have fewer side effects
* Radiation therapy: treatments with real-time targeting, and smaller margins
* Imaging, especially since current scans often cannot detect small amounts of recurrent prostate cancer unless PSA has risen to a higher level
* Personalized or immune-based treatments such as cancer vaccines

I’d really appreciate it if anyone who has researched these developments could share what you have found. I think it would be helpful for all of us to stay informed—not only so we understand what may be coming, but also so we know what questions to ask our doctors and, hopefully, have some things to look forward to.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for Jeff Marchi @jeffmarc

@calipiotr
The cut back in money for medical research has hurt all research. Some people that were in prostate cancer clinical trials were just cut off because the money was cut off.

The way things are going right now there’s nothing that’s going to be possible in the next two years to achieve what you’re asking for.

It wouldn’t matter of 90% of the people asked for this it wouldn’t happen now.

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@jeffmarc
With enough funding and sufficient pressure on politicians in charge of the funding it is very safe to state that with application of AI technology prostate cancer would be curable disease or just chronic condition without significant symptoms. AT this moment all is needed is concentrated effort of everyone affected. The current cancer related organizations so far has not achieved that goal. But one more time within 10 years with AI technolgy cancer should be curable.

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Profile picture for calipiotr @calipiotr

Hello everyone, I have been diagnosed with prostate cancer but still doing tests to figure out the stage. SO far just prostate itself but will do pet scan to check for metastasis. I believe that finding cure for cancer with modern AI technology is very possible. However, without specific organization, seems like none of the current ones can do it, that would put a pressure on Congress and politicians from both parties to establish type of Manhattan Project for cancer cure it may not happen. But with strong political and financial push it would be very realistic for benefit of everyone to have a cure within 10 years. We do need " 10 Years for Cancer Cure" organization that would push this agenda to the front and saved lives of everyone on this board and beyond.

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@calipiotr
The cut back in money for medical research has hurt all research. Some people that were in prostate cancer clinical trials were just cut off because the money was cut off.

The way things are going right now there’s nothing that’s going to be possible in the next two years to achieve what you’re asking for.

It wouldn’t matter of 90% of the people asked for this it wouldn’t happen now.

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I certainly wish you the very best with your own cancer journey and hope you have a good outcome.

I agree that it would be wonderful if we could make major breakthroughs in cancer treatment over the next 10 years. The challenge is enormous, of course, because cancer isn’t one disease but many different diseases with very different biology.

There have been some interesting private initiatives recently proposing a kind of “Manhattan Project” approach to cancer research, including efforts involving philanthropists and major cancer institutions. But given the enormous scale and complexity of the challenge, I believe a truly concerted effort would ultimately require substantial government support as well.

We are all hoping the next decade brings some major breakthroughs, despite the huge challenges of fighting a greatly varied and highly adaptive and elusive disease.

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Hello everyone, I have been diagnosed with prostate cancer but still doing tests to figure out the stage. SO far just prostate itself but will do pet scan to check for metastasis. I believe that finding cure for cancer with modern AI technology is very possible. However, without specific organization, seems like none of the current ones can do it, that would put a pressure on Congress and politicians from both parties to establish type of Manhattan Project for cancer cure it may not happen. But with strong political and financial push it would be very realistic for benefit of everyone to have a cure within 10 years. We do need " 10 Years for Cancer Cure" organization that would push this agenda to the front and saved lives of everyone on this board and beyond.

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Thank you jeffmarc for always be willing to answer questions whether good or bad

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Profile picture for asolidrock @asolidrock

What are your options if you become castrate resistant with an aggressive form of cancer

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@asolidrock
Your options are the same as they are if you are not castrate resistant.

When I became castrate resistant, I was put on Casodex and 15 month later Zytiga. 2 1/2 years later Orgovyx. I did stay on ADT since some cells are still controlled by it And will not grow.

This may work for some aggressive cases it may not work for others, It’s very similar to what we talk about everybody’s different when it comes to prostate cancer.

Some people can try the drugs but end up on chemo or Pluvicto.

I wish there was an easy answer.

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Profile picture for TommyG @tdgillett

Is MyProstateScore 2.0 (also MPSC-2) considered an "advance"? Anybody on the forum have experience--good or bad--using MPSC-2?

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@tdgillett
The PSE test does pretty much the same and is 94% accurate. This is much more accurate than the MPSC-2 test

Here is a table for comparison?

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Is MyProstateScore 2.0 (also MPSC-2) considered an "advance"? Anybody on the forum have experience--good or bad--using MPSC-2?

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Profile picture for Woodbutchertoo @herbertlancaster

@asolidrock standard of care has changed a bit. It used to be pretty much chemotherapy and continue hormone therapy.
There are a few more options out there, but a lot depends on the nature of your particular Cancer.
In my case, I was PSMA heterogeneous. (that just means that my particular Cancer does not express much PSMA) Most newer approved treatments require PSMA expression by your cancer cells to be targeted. Some folks, about 20% of the people like me, don’t have much of that.
So I had to go a different route. That’s why I went to clinical trial route

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I was just curious because so many here have been there. I have mentioned it to my oncologist and he made some recommendations in case I become castrate resistant. Thanks so much to everyone on here for your heartfelt advice. May God bless you all.

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Trials: I believe Johns Hopkins concluded an 'off the shelf' vaccine injected on three occasions.
It seemed to prevent the expected metastasis rate by 30%. The group chosen had to be treatment naive. I do not not know what the follow-up has been. Incidentally Pluvicto has been approved by
the FDA for hormone sensitive metastatic disease. Presumably CMS will approve it for Medicare Medicaid patients if not already. A newer FDA approved dye used in PSMA PET CT scans has improved radiologist diagnostic scores.

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