National Conference on Prostate Cancer

The National Conference on Prostate Cancer was recently held in Los Angeles, California, from September 7-10, 2007. Paul Zatz, facilitator for the Sarasota Man to Man group attended the conference. The following is a synopsis of the meetings and is sent to you to further your knowledge of Prostate Cancer.

The topics covered over the three days by a variety of national experts, included a demonstration of a color flow biopsy, information on Prostate pathology and staging, Active Surveillance, Magnetic imaging, Combidex, use of low-impact pharmaceuticals, robotic surgery, IMRT/Brach therapy, focal Cryotherapy, and use of hormones. Other topics included related cardiac issues, monotherapy, research, and navigating Medicare.

The presenters were a Who’s Who of PC experts from the USA. They included Dr. Charles Myers, Dr. Stephen Strum, Dr. David Bostwick, Dr. Mark Scholz, Dr. Donald Coffey, Dr. Duke Bahn, Dr. Fred Lee and numerous others.

It is not possible in this format to present all the information offered during the three intensive days of the conference. Sarasota MTM has had speakers on a number of the topics; therefore all the areas covered at the conference will not be presented in this report.

The overall impression gathered from the meetings, was that all the modalities of treatment have significantly improved, and are being constantly upgraded to provide more effective treatment with fewer side effects .Along with the improvement in treatments, the diagnostic tools are better able to have an impact on projected outcomes. This information along with significant successes in chemotherapy, led some of the presenters to feel that within ten years, most of the treatments for PC will be with drugs and vaccines. However, we are not at this point yet. There is still no pill or injection that will cure PC.

An emphasis was placed on diet, supplements and exercise. Some of the supplements discussed were Lycopene, Selenium, Vitamin E and D and Pomegranate. A caution should be noted that your doctor should be consulted before anyone takes any vitamin or supplement, so that they do not harm you, or decrease the efficacy of any existing prescription medicines you might be taking for cardiac, diabetes, or any other health conditions.

The use of low- impact drugs that are prescribed by doctors was discussed. Some of these are: Avodart, Calcitrol, Avandia, Atacand, Dostinex, Proscar, Trental and Celebrex. Some of these are used together for a synergistic impact. These prescription medications are usually prescribed by a medical oncologist, who would know your case, and can supervise the drug’s dosage and effectiveness.

Dr. Mark Scholz made a presentation on staging of newly diagnosed patients and the use of Active Surveillance. This is the new term for Watchful Waiting. Dr. Scholz pointed out that all treatments have side effects but Active Surveillance has none. He noted that immediate treatment is to be avoided if the tumor growth is closely monitored. Existing treatments should only be used if necessary. Dr. Scholz cited the work of Dr. Laurence Klotz from the University of Toronto in Canada. Dr. Klotz was a speaker last year at one of our meetings

Dr. Colin Campbell from Cornell University emphasized the importance of diet and nutrition. His research indicates that a diet low in animal protein, but high in plant protein prevents the development of cancer, and also suggests that this diet can even reverse cancer growth in its late stages. A low animal protein diet also helps to ward off a plethora of chronic illnesses.

In the field of diagnostic tools, a presentation was made on MRI, Combidex, Spectroscopy, and Bone Marrow imaging. Though advances have been made in locating the cancer, determining the spread outside the capsule, and estimating the aggressiveness of the tumor, it appears ultimately, as the new technologies are refined and commercialized, the most accurate detection and characterization of PC will occur when the techniques are combined into a single imaging exam. It is still difficult to see the spread of the cancer, but the information can be used for Active Surveillance in both newly diagnosed and recurrent cancers.

Androgen Deprivation Therapy was presented as a primary treatment for PC. Dr. Strum noted that the New England Journal Medicine has reported that surgery (presumably radiation) only improves survival rate by 5% over a ten year period. ADT is the only treatment that has a therapeutic effect on microscopic metastasis outside the prostate and its side effects are generally reversible. Dr. Strum noted that starting treatment with ADT suppresses cancer growth and opens up the possibility of future yet-to-be discovered treatments .The use of intermittent ADT was touted as the best approach, with supportive measures to minimize side effects.

A number of chemotherapy treatments were discussed by Dr. Richard Lam. The many agents being used today include, but not limited to, Taxotere combinations, Carboplatin, Avastin activated with Rocaltrol, Thalidomide and Quadramet. He said that combinations of these drugs along with ADT are seeing new and improved effectiveness.

Oral agents such as Satraplatin, Thalidomide, Nilutamide, Phenylbutyrate, Estrogens and Ketocanozole are being used alone, or in combination with other agents. The areas that these drugs are showing promise are in antiagiogenesis, differentiation inducers, immune modulators, second line hormonal therapy, and as oral chemotherapy.

These approaches are being tested in various stages of clinical trials. As with most oral agents, they have side effects to various degrees. Therefore, dosage and effectiveness are being closely monitored.

The last speaker, prior to the round table wrap up dealt with research in the field of PC. The Prostate Cancer Foundation along with many other groups is funding research around the world by universities and pharmaceutical companies. The activities of these researchers range from pre-clinical trials to large randomized studies. Optimism was evident that research would find a cure, but that more money and time was needed.