A castration-resistant prostate cancer treatment in the new research

There are some forms of illness and disease that are viewed with a particular horror. Cancer is clearly one of those diseases. But where the cancer strikes can make a big psychological difference. Sometimes, the organ affected is considered in a relatively neutral way. No one wants cancer but, if it cannot be avoided, having it there is bearable. On other occasions, the site is significant for slightly different reasons. In a woman, for example, breast cancer can be treated by removal of some or all the breast. This is not immediately life-threatening but it does remove a primary sexual indicator. Many women feel less female missing one or both breasts. For men, the ultimate approach to dealing with prostate cancer would be castration, i.e. a complete surgical removal of all the affected parts. The problem with such surgery is two-fold. Men tend not to be happy at the thought of castration and, if the cancer is sufficiently far advanced that removal is considered appropriate, the survival rates are not very good. On average, men do not live more than three months after the surgery.

Cancer treatment evolution

Researchers have therefore been looking for ways of stabilizing the cancer without the need to engage in castration, whether by chemical or surgical means. Perhaps more importantly, the hope has been to establish treatments before resorting to chemotherapy. Both radio- and chemotherapy have a serious effect on the body and, with earlier intervention, either or both may be avoided in the short term. Now the New England Journal of Medicine is reporting a successful trial of two drugs in combination. The first is abiraterone acetate, the second our favorite corticosteroid, Prednisone.

The first point is the number of people involved in the trial which, at more than 1,075 produces a result that can be generalized with reasonable confidence. The point of the trial was to measure how quickly the pain management regime had to be increased to the use of opioids and longer term survival trends after the use of chemotherapy. All the results show a positive improvement in the quality of life, and extended periods of survival. This is not to say that survival was without problems. The combination of drugs produced a number of side effects. Most participants felt more tired, there were increased levels of pain in the joints, and some increased swelling in the legs and ankles. Even though this reduced mobility, the majority of participants accepted the discomfort and incapacity as the price of a more general sense of wellbeing. The importance of these findings cannot be overstated. Prednisone has been proved effective in helping to control cancer and more generally to keep problems of inflammation under control. The publication of this research also coincides with the formal FDA approval for the use of Prednisone in this context. This is reassuring. Not everyone feels confidence hen invited to take a drug off-label.

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