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Treating Advanced Prostate Cancer

(continued)

Chemotherapy for Prostate Cancer continued...

The safety of cabazitaxel (Jevtana)  and its effectiveness were established in a single, 755-patient study. All study participants had previously received docetaxel (Taxotere). The study was designed to measure overall survival (the length of time before death) in men who received cabazitaxel (Jevtana) in combination with prednisone as compared to those who received the chemotherapy drug mitoxantrone in combination with prednisone. The median overall survival for patients receiving the cabazitaxel (Jevtana)  was 15.1 months compared with 12.7 months for those who received the mitoxantrone regimen.

Side effects in those treated with cabazitaxel (Jevtana) included significant decrease in infection-fighting white blood cells (neutropenia), anemia, low level of platelets in the blood (thrombocytopenia), diarrhea, fatigue, nausea, vomiting, constipation, weakness, and renal failure.

 

 

Provenge for Advanced Prostate Cancer

Provenge (sipuleucel-T) is a "vaccine" for advanced prostate cancer that helps prolong survival.

Provenge isn't your everyday vaccine. It's an immune therapy created by harvesting immune cells from a patient, genetically engineering them to fight prostate cancer, and then infusing them back into the patient.

It's approved only for treatment of patients with few or no prostate cancer symptoms whose cancer has spread outside the prostate gland and is no longer responding to hormone therapy. 

Once a cancer grows beyond a certain point, the immune system has a hard time fighting it. One reason is that cancer cells look a lot to the immune system like normal cells. Another reason is that tumors may give off signals that manipulate the immune system into leaving them alone.

Provenge bypasses these problems. The treatment first removes a quantity of dendritic cells from a patient's blood. Dendritic cells show pieces of tumor to immune cells, priming them to attack cells that carry those pieces.

The patient's doctor ships the cells to Provenge's manufacturer, Dendreon, which then exposes them to Provenge. Provenge is a molecule made inside genetically engineered insect cells.

Once these cells have been exposed to Provenge, they're shipped back to the doctor who infuses them back into the patient. This is done three times in one month. The first infusion primes the immune system. The second and third doses spur an anticancer immune response.

The most common side effect is chills, which occurs in more than half of the men that receive Provenge. Other common side effects include fatigue, fever, back pain, and nausea. Provenge has been remarkably safe. However, clinical trials suggest that the treatment might be linked to a slightly increased risk of stroke

Endocrine Drugs for Prostate Cancer

Drugs work as well as prostate cancer surgery (orchiectomy -- removal of the testicles) to reduce the level of hormones in the body. Most men opt for drug therapy rather than surgery. The three types of endocrine related drugs approved to treat advanced prostate cancer include luteinizing hormone-releasing hormone (LHRH) analogs, luteinizing hormone-releasing hormone (LHRH) antagonists, and antiandrogens.

WebMD Medical Reference

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