“What is Castration Sensitive Prostate Cancer?” you might wonder. It’s a condition where cancer cells are fueled by testosterone. Hormone therapy, often combined with other treatments, aims to deny these cells the testosterone they crave. For those exploring holistic health, natural prostate remedies can be an avenue to investigate. Following hormone therapy, chemotherapy might be introduced either as a standalone treatment or in conjunction with hormone treatment to further combat the disease’s spread and growth.
What is castration-sensitive prostate cancer?
UCLA experts present the case of a 61-year-old male with de novo metastatic castration-sensitive prostate cancer and present data from a phase III trial, PEACE-1, which shows adding sipuleucel-T to ADT can extend life in people suffering with this form.
The FDA recently approved abiraterone acetate (Zytiga), a new treatment for castration-sensitive prostate cancer, as an oral pill to be taken in combination with prednisone or prednisolone to minimize potential side effects from taking this drug. Abiraterone blocks an enzyme in your body that produces testosterone while simultaneously stopping cancer cells from absorbing it.
Other treatments for metastatic castration-sensitive prostate cancer may include radiation therapy and chemotherapy. Radiation uses high-energy rays or particles to destroy cancer cells in the prostate and elsewhere in the body; chemotherapy drugs kill cancer cells while helping the immune system fight it; among these drugs are docetaxel (Taxotere) and darolutamide (Ninavir) given in combination with ADT.
How is castration-sensitive prostate cancer treated?
Androgen receptor (AR) inhibitors can prevent cancer cells from growing by blocking testosterone production in the testicles. This treatment may be taken alone or combined with other drugs – sometimes known as hormonal therapy or medical castration.
Hormonal therapy is often combined with surgery and radiation to lower the risk of cancer recurrence and spread. Common treatments for hormonal therapy are hormones like Tamoxifen or Finasteride as well as drugs to inhibit activity of the prostate gland – this form of ADT.
Sipuleucel-T is an oral treatment with low risk and potential serious side effects, administered in clinic settings and designed specifically to target prostate cancer cells that have not yet spread beyond the prostate.
Clinical trials have demonstrated that adding chemotherapy agents to ADT can significantly improve outcomes in people living with metastatic colorectal cancer (mCSPC). Most recent research suggests that adding Abiraterone Acetate or Docetaxel as additional therapies improves outcomes both within high volume/risk subgroups as well as across all of mCSPC. As these drugs have now become part of standard care for this disease.
What are the symptoms of castration-sensitive prostate cancer?
Castration-sensitive prostate cancer symptoms may range from minor to severe depending on its size and location, including urinary issues, bone pain, fatigue and urinary incontinence. Your care team will find ways to mitigate the severity of these side effects.
Hormone therapy involves decreasing testosterone levels to help stop or slow the spread of castration-sensitive prostate cancer. It may be done surgically (either through testicle removal or drugs known as androgen deprivation therapy) or through pills that block testosterone function; additionally this type of treatment may also be given after the prostate has been surgically or transurethral resection of the prostate (TURP) surgery is completed.
If your prostate cancer has spread outside your bones, new treatments could be the key to keeping it under control. These include hormone therapy with Abiraterone Acetate and Prednisone or Prednisolone or chemotherapy treatments which destroy cancerous cells while simultaneously stopping them from growing further.
Docetaxel (Taxotere) combined with prednisone is currently the go-to treatment for metastatic castration-sensitive prostate cancer; however, another chemotherapy drug called cabazitaxel (Bosutinib), may improve survival more than docetaxel alone and is being researched further through clinical trials. Another alternative would be lutetium (177Lu) vipivotide tetraxetan (Pluvicto), an infusion of radioactive substance into bones which attacks cancerous cells within.
What are the treatment options for castration-sensitive prostate cancer?
Androgen deprivation therapy, commonly referred to as ADT, is one of the primary options available to men diagnosed with CSPC. ADT works by decreasing testosterone levels by blocking its action on androgen receptors – this in turn can slow prostate cancer cell growth. ADT may be administered alongside chemotherapy or radiation therapies as needed.
ADT may cause serious side effects, including bone pain, erectile dysfunction and low red blood cell count (anemia). To minimize or treat these side effects, taking certain medicines may help.
Watchful waiting is often the recommended treatment plan for patients at very low risk of disease progression, meaning no regular PSA tests, DRE exams or biopsies should be carried out. Treatment could begin if cancer begins to spread quickly or rapidly escalates; then hormone-lowering treatment such as ADT plus ARPIs such as either abiraterone acetate or apalutamide may be recommended depending on toxicity levels and comorbidities.
Vaccine therapy using sipuleucel-T (Provenge) may also be an effective option for some with early-stage CSPC who has not spread to other parts of their bodies, as it stimulates immune system responses against cancer cells. People at high risk of having their cancer come back can participate in clinical trials that test new treatments and assess potential improvements.