Current Clinical Trials in Immunotherapy for Prostate Cancer.

The Prostate Cancer Research Institute (PCRI) has listed four (4) Phase 2 or Phase 3 clinical trials which are currently recruiting patients.  These trials all involve immunotherapeutic agents. The first is a Phase 3 trial of ProstAtak® coupled with standard radiation therapy for localized prostate cancer.  Patients should be newly diagnosed with intermediate to high risk disease, having received less than 6 months of hormonal therapy, and with no metastases or no local treatment.  The trial is recruiting in several states and at institutions such as Johns Hopkins and Walter Reed in Maryland and Memorial Sloan Kettering in New York.  Second, a Phase 2 study involving Ipilimumab (Yervoy®) with abiraterone acetate (Zytiga®) plus prednisone in chemotherapy and immunotherapy-naïve patients with progressive metastatic hormone-resistant prostate cancer is recruiting patients at Memorial Sloan Kettering in New York.  Ipilimumab is a human monoclonal antibody currently approved for the treatment of melanoma.  Third, another Phase 2 study involving Provenge® (Sipuleucel-T) coupled with immediate or delayed CTLA-4 blockade is recruiting in San Francisco.  CTLA-4 (cytotoxic T-lymphocyte-associated protein 4) is a protein receptor found on the surface of T-cells that down-regulates the immune system.  The CTLA-4 receptor acts as an “off” switch for the attack of cancer cells by T-cells.  Hence blocking the CTLA-4 receptor would enhance T-cell anticancer activity.  Finally, a Phase 3 trial (Prospect) involving Prostvac in men with few or no symptoms of metastatic, hormone-resistant prostate cancer is recruiting patients.  This Prospect trial has been described in a previous blog posted on August 5th, 2014.

News from Johns Hopkins on Urinary Incontinence, Kegel Exercises and Familial Prostate Cancer.

Urinary incontinence is a major complication of radical prostatectomy.  According to the November 9th Johns Hopkins Health Alerts (Prostate Disorders), incidence of serious incontinence from surgery at medical centers of excellence is low, around 3% whereas from overall national patient survey data, urinary incontinence is dramatically higher, around 50-60%.  For a clear description of the physiology of urinary incontinence, see the full Hopkins Health Alert.  An earlier issue of the Johns Hopkins Health Alerts (August 24th) described the Kegel exercises which strengthen pelvic floor muscles involved in urination.  These exercises are often prescribed before prostate surgery.

Studies performed on hereditary forms of prostate cancer at Johns Hopkins and the National Cancer Institute have shown that men with one close relative, such as a father or brother, with prostate cancer have a two-fold increase in the risk of developing the disease. If two close relatives are affected, there may be as much as a five-fold increase.  Although a great deal of research has been directed toward the roles of diet and dietary supplements in prostate cancer risk, the results have been inconclusive in terms of hard data.  There is a general consensus that a reduction in the consumption of red meat is associated with lower prostate cancer rates, but the reason is not known.  Cruciferous vegetables, such as broccoli, cabbage, and brussels sprouts, and leafy greens, such as kale and collards, contain compounds that seem to reduce prostate cancer risk.  A compound called lycopene, found in tomatoes and best absorbed from cooked tomatoes (as in sauce), is also thought to be helpful.  For a while, selenium and vitamin E were believed to have a significant effect on the risk of developing prostate cancer, but a large multi-institutional trial failed to show any benefit.  Regardless of diet, prostate health should be monitored at least once a year with a PSA and digital rectal examination. And it is not just the absolute value of the PSA that is important, but also the rate of rise from one year to the next. If the PSA goes up more than 0.5 ng/mL/year, regardless of the absolute value, there is a greater risk that prostate cancer may be developing. Under those circumstances, biopsy should be considered, assuming that there are no other special considerations related to overall health or personal preferences.

Do You Have Anything You’d Like to Discard?

Area of "discarded" zinneas
Area of “discarded” zinneas
"Discarded zinnias"
“Discarded zinnias”


In  our current disposable society, I am sure that we can all think about specific items that we would have no use for or difficult times in our lives that we would rather not re-live.  But the truth is that tough times can eventually mature and grow us and be a blessing while discarded items could be of use to others who would need them.  For readers of this website, prostate cancer could be classified as an item we’d rather discard if we could.  Some time ago, I had planted some zinnias which had bloomed beautifully in my garden but eventually withered and died leaving only a dead stalk, brown leaves and dried flowers which had produced some seeds.  I pulled the dead plants out of the ground and tossed them haphazardly into a wooded lot next to my home.  Several summer weeks went by with their Florida sun and afternoon rain.  One day, I was pleasantly surprised to see a row of multi-colored, fully-blooming zinnias in this vacant, wooded lot.  The dead plants had contained seeds which found their way into the sandy soil, had germinated and now produced beautiful flowers with no help from me.  Discarded yard waste contained the elements of life and eventually produced something of beauty and value.  Prostate cancer is a condition we’d rather discard if we could but even an undesirable condition such as this can possess value and provide blessings if subjected to the proper care and guidance.  The Bible speaks of a similar situation.  In the Old Testament book of Jeremiah 18:1-4, the prophet describes a potter who makes a vessel which is damaged and “spoiled” just as we are who have prostate cancer.  But Jeremiah goes on to say that the potter re-made the clay into a useful vessel which was pleasing to him.  At this point, you might ask of what possible value can one’s prostate cancer serve?  It can lead us into recognizing that we are all “terminal” at one stage of our lives.  Since we are all “eternal beings” with an eventual destination of either heaven or hell, it can lead us into focusing our relationships, thoughts, words and deeds in such as way that they have positive, eternal consequences for us and for those around us.  If we have a personal relationship with God through faith in His Son Jesus Christ, the Master Potter can make us into beautiful vessels for His glory even through our diseases.  Those with whom we come into contact can see that though our bodies may be “damaged”, God’s presence in our lives can shine through and we can be pleasing vessels to the Lord and to those around us.  It isn’t our efforts but if we submit our bodies to God (Romans 12:1-2),  His re-forming power does the work.  The apostle Paul wrote (2 Cor. 4:7) that “we have this treasure in earthen vessels that the excellence of the power may be of God and not of us.”  Nothing, not even prostate cancer, is unusable in God’s hands.  In conclusion, even a condition that we’d prefer to discard, can produce beautiful, valuable and meaningful results in the hands of the Master Potter just like my zinnias.  For those who do not have a personal relationship with God (the potter), having prostate cancer and its potential negative result can lead us into entering such a relationship and thereby gaining eternal life in an eventual new heaven and a new earth with a new, indestructible body.  If you want to have such a relationship, see the following website section.  Prostate cancer can have positive results.  For related thoughts, see the January, 2011 website post entitled “Don’t Waste Your Cancer”.