1) Financial Assistance for Prostate Cancer (PC) Patients; 2) Three New Commercially-Available Genetic PC Tests; 3) Phase 2 Clinical Trials for Metastatic PC Patients.

Fishing for information? Cornfield in Middletown Valley, Maryland; BJarne Gabrielsen photo
Fishing for information? Cornfield in Middletown Valley, Maryland; BJarne Gabrielsen photo

1) Payment Assistance for Under Insured Patients. The Patient Access Network (PAN) Foundation offers financial assistance to prostate cancer patients who lack full insurance coverage, allowing access to treatments previously out of reach. In 2012, PAN started an initiative to raise funds to provide castrate-resistant patients access to new and necessary treatments. To date, 2,200 men have enrolled and $22 million in financial assistance has been allocated. Current co-pay programs include treatments involving androgen receptor inhibitors,  immunotherapy, radioisotope and metastatic castrate-resistant prostate cancer. Travel assistance for treatments are also available. Application information and details can be found in the November 2013 PCRI Insights. 

2) Three new, commercially-available genetic tests for prostate cancer. Prolaris from Myriad Genetics and Oncotype Dx from Genomic Health can help obtain a more accurate measure of tumor aggressiveness. Both tests examine multiple genes in prostate cells that are removed at the time of biopsy. Polaris predicts the risk of ten-year mortality from prostate cancer while Oncotype Dx seeks to more precisely define the risk category of the individual prostate cancer. A third, Confirm MDx from MDxHealth can provide additional assurance that a negative biopsy is truly negative and that the needle did not simply miss the cancer. It is as accurate as a second biopsy without the unwanted complications.

3) Several specific open Phase 2 clinical trials for men with castrate-resistant, metastatic prostate cancer  are listed in the November 18th, 2013 PCRI Insights. These trials involve new therapeutic agents such as Provenge, Xofigo and Cabozantinib (XL184). Enrollment information, criteria and locations are found in the Nov. 18th issue.

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Radiation Therapy Meeting Highlights; IMRT Review.

PCRI Insights is published monthly by the Prostate Cancer Research Institute (PCRI) and is must-reading for men with prostate cancer. The November 2013 issue featured a summary of several pertinent abstracts of presentations given at a recent annual meeting of radiation therapists. One abstract presented cure rates achieved with intensity modulated radiation therapy (IMRT) combined with a boost from seed implants. IMRT is a refinement over existing radiotherapy modalities providing for a higher dose of radiation to the tumor while exposing surrounding tissue to less radiation. An excellent review of IMRT has been published in Cancer News. Another study compared the preservation of potency in young men treated with radiation as compared to surgery. A third study and commentary addressed the issue of when radiation therapy should be commenced after PSA relapse. Other abstracts addressed the issue of the timing of the use of hormone blockade accompanying radiation therapy. The final study examined the effect of the rate of PSA doubling on survival rates and times in relapsed prostate cancer patients originally treated with IMRT. Finally, it should be noted that the studies presented here focused on radiation therapy. A man considering treatment for prostate cancer is urged to consider additional modalities before deciding on a specific, personal course of treatment.

Highlights of 2013-continued. Inflammation,Diet and Prostate Cancer; FDA Approvalof Xofigo; and, a Guide to Genes and Prostate Cancer.

Chronic inflammation is suspected to play a role in numerous diseases such as heart disease, Alzheimer’s, arthritis and cancer. If this is the case, then could reducing chronic inflammation by dietary means reduce the incidence of prostate cancer for example? This question is being studied extensively and is the focus of an article in the December 20th issue of the Prostate Cancer Foundation NewsPulse. Researchers at Johns Hopkins are studying  prostate cells as they transition from normal to pre-cancerous and finally to cancerous. They speculate that inflammation may be an early factor inducing healthy prostate epithelial cells into the cancerous cycle. Since obesity is already linked to an increase risk of death from prostate cancer, could an anti-inflammatory diet have an effect on the incidence and severity of prostate cancer? A diet similar to the Mediterranean diet may be of help and is described in the NewsPulse article. Helpful foods include whole grains, healthy fats (as opposed to animal or trans fats), fruits and vegetables, spices such as ginger, garlic, cinnamon, and curcumin, green or oolong tea, nuts such as walnuts, oil-based salad dressing, omega-3 fatty acids derived from vegetable oils or flaxseed (as opposed to fish such as salmon), and others in the PCF article. While the anti-inflammatory diet includes many foods that may have health benefits for men with prostate cancer, further research is needed into specific components  and the dietary patterns as a whole in order to assess how this diet may affect men with prostate cancer. As always, be advised to consult with your medical professional.

A second major story in this year-end issue of the PCF NewsPulse cites the FDA approval in spring, 2013 of Xofigo, radium-223-chloride, also known as alpharadin for the treatment of men with advanced metastatic prostate cancer. Xofigo extends survival, improves quality of life, requires less opioid medication for bone pain and its resulting side effects, and reduces complications such as spinal cord compression and bone fractures which result from bone tumors. Additional information is available in the accompanying article. This website has also posted information on this agent in previous blogs dated November 5th, 2011, January 3rd, 2012, April 28th, 2012 and June 3rd, 2013.

The third article from NewsPulse provides an excellent summary of a number genes and their proposed involvement in prostate cancer. Specific genes include HOXB13 (associated with hereditary prostate cancer), the female breast cancer susceptibility genes BRCA1 and BRCA2, the fused genes TMPRSS2-ERG and others. This review would be useful for physicians as well as laymen.