Friday, July 18, 2014

The "Evolution" of Advanced Prostate Cancer Research

Ken Pienta, MD and Director of Research
at the Brady Urological Institute
Prostate cancer affects approximately 230k men per year in the US.  Fortunately, over 90% of men present with localized, treatable prostate cancer.  Unfortunately, approximately 30k men still die of the disease each year in the United States.[1]  Advanced prostate cancer is treated with hormonal therapy, chemotherapy or radiation treatment in combination or alone.  As prostate cancer is a male cancer and driven by testosterone, hormone therapies can shrink and limit the growth of cancer cells.  Chemotherapy and radiation kill rapidly dividing cancer cells -- and have some effect on prostate cancer cells.  In them men who die of prostate cancer, the cancer cells learn or "evolve" to escape these treatments.  

In this blog entry, Ken Pienta, MD and Director of Research at the Brady Urological Institute, discusses how our understanding of advanced prostate cancer has "Evolved" to meet this challenge.  Dr. Pienta was recently awarded a $1.5 million Challenge Award from Prostate Cancer Research Foundation and Movember organizations to investigate circulating tumor cells and disseminated tumor cells in men with metastatic prostate cancer.

"Our understanding of how advanced prostate cancer changes over time is rapidly evolving. Prostate cancer changes over time because it mutates as part of its innate instability of its DNA as well as mutations that develop as the cancer adapts to the therapy to which we subject it (therapeutic pressure). As our understanding of prostate cancer evolution during progression grows, the challenge is to effectively sequence and combine our growing armamentarium of therapeutic agents for maximal patient benefit -- the right drugs, in the right combinations, given at the right time.  

It is especially important to anticipatie the need for therapy before it is clinically apparent; i.e. to move beyond anatomically-based clinical decisions and prognostication to biologically (marker)-driven therapy prediction. Treatment with androgen deprivation therapy (castration therapy, hormonal therapy) inevitably leads to the development of castrate resistant prostate cancer. The second generation anti-androgen (supra-castration) therapies, while effective, are leading to the emergence of new types of prostate cancer. Three phenotypes/genotypes of CRPC after treatment with second-generation agents appear to be increasing in prevalence and remain resistant to treatment: NeuroEndocrine Prostate Cancer (NEPC), Persistent AR – Dependent Prostate Cancer (PADPC), and Androgen Receptor Pathway Independent Prostate Cancer (APIPC). 



It is clear that new treatment paradigms, taking into account cancer cell genetic and epigenetic pathways, contributing factors within the microenvironment, and the macroenvironment of the host / patient need to be developed for this diverse group of diseases."

10 comments:

  1. I would be very thankful if you continue with quality what you are serving right now with your blog. I really enjoyed it. and i really appreciate to you for this. Multi Speciality in Dombivali || Physician and Neurosurgeon in Dombivali || Multispeciality Hospitals in Dombivli

    ReplyDelete
  2. I like the valuable information you provide in your blog. I will bookmark your blog and check again here frequently. I'm quite certain I will learn many new stuff right here! Best of luck for the next! Cancer Surgeon in Dombivli || Urology Center in dombivli || Orthopedic Surgeon in Dombivli

    ReplyDelete
  3. i was just read your blog that was really superb got much pleasure to read that post. please keep sharing post like that.thanks for share with us for this post. Critical Care in Dombivali || Plastic Surgeon in dombivli || Orthopedic Hospital in Dombivli

    ReplyDelete
  4. Very informative and impressive post you have written, this is quite interesting and i have went through it completely, an upgraded information is shared, keep sharing such valuable information. Hospitals in Dombivli || Physiotherapy in Dombivli || Hospital in Dombivli

    ReplyDelete
  5. Thank you for sharing your valuable information. It is very useful for us, Plz visit us: Robotic Urologist in Delhi

    ReplyDelete
  6. Thank you for sharing your valuable information. It is very useful for us, Plz visit us: Best Urologist in Delhi

    ReplyDelete
  7. As a sign of gratitude i want to also reach out to others out there not lose all hope. 3 years ago I had a prostate cancer surgery. Since then I have not been able to have any erection to enable me have sex. Despite having taken various medications and supplements, I have not at all been successful. In my state of compliant i was opportune to speak to a cousin of mine because at first i was shy about the problem but this was almost tearing my marriage apart and my wife saw me as a half man who could not perform his duty as a man to satisfy her. He gave me the contact information on how to contact the doctor who sent this very powerful herbal medicine to his friend that had similar problem, i contacted him and he sent me the medication which i used too and that was all. In my life i never thought i would ever be able to have any erection not to talk about having sex again but i was proven all wrong and now i am so active like i am in my early 20's. Do not suffer in silence or be shy you can contact him too on joseherbals28@gmail. com He will surely be able to help you too.


    ReplyDelete
  8. This is such a great resource that you are providing and you it away for free. I love seeing blog that understand the value.Urologist in Delhi

    ReplyDelete