BOSTON, Mass. (Ivanhoe Newswire) — For patients with aggressive prostate cancer, there are limited treatment options. Once cancer has spread, most doctors rule out surgery and radiation, the standard treatments for early stage prostate cancer. But now, new advances in testing are helping doctors zero in on therapies besides hormones and chemo to stop advanced cancer in its tracks.
For John C. White III, this is the perfect way to spend an evening.
John said, “My wife and I like to go out in it on a hot night and cruise around in it.”
Classic cars like his 1923 Ford T-Bucket Roadster are a passion. Just four years ago John wasn’t sure he and Joanne would have too many more nights like this left. John’s doctors diagnosed him with aggressive prostate cancer that had spread.
“I started a year and a half of chemotherapy, four different drugs, with the hope that would eradicate it,” John shared.
Nothing doctors tried stopped the cancer.
Paul Mathew, MD, a Genitourinary Oncologist at Tufts Medical Center, Boston said, “His life was in danger. I would have estimated a life expectancy of under a year if not six months.”
That’s when Dr. Mathew tried something cutting-edge for prostate cancer, he removed John’s tumor and sent it to a Boston biotech lab. Technicians analyzed the genes known to drive tumor growth.
Dr. Mathew said, “In John’s case he had very rare mutation found in .1 percent of all prostate cancers.”
The lab was also able to match John’s profile with treatment options and one was the immunotherapy drug Keytruda, FDA-approved for melanoma and bladder and lung cancer but so far, not prostate. John had infusions for three years, and it worked!
“His scans are pristine. His PSA is undetectable,” said Dr. Mathew.
“He had a hunch that I might respond to this, and he was absolutely right. I’m just thankful for every single day I have,” John told Ivanhoe.
Despite John’s treatment success, Dr. Mathew cautions patients that genomic profiling is not a magic bullet for everyone. Sometimes there will be no existing therapies that will be a match. John says in his case, he’s thankful that when all other treatments failed, the testing delivered a life-saving option.
Contributors to this news report include: Cyndy McGrath, Field Producer; Roque Correa, Editor and Videographer.
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BACKGROUND: Patients diagnosed with stage IV prostate cancer can be broadly divided into two groups. Patients with cancer locally confined to the pelvis but involving adjacent organs or lymph nodes have localized stage IV or D1 prostate cancer. Patients with disease that has spread to distant organs, most commonly the spine, ribs, pelvis and other bones have metastatic stage IV or D2 prostate cancer. Prostate cancer diagnosed in this stage is often difficult to cure, although patients may live for several years with effective treatment. Recent advances in treatment have resulted in new treatment options that reduce symptoms and improve survival. Each person with prostate cancer is different, and the specific characteristics of the condition will determine how it is managed.
TREATMENT: Advanced genomic testing is designed to help identify the DNA alterations that may be driving the growth of a specific tumor. Information about genomic mutations that are unique to your individual cancer may help doctors identify treatments designed to target those mutations. The roots of advanced genomic testing can be traced to the completion of the Human Genome Project in 2003. Researchers mapped the entire human genetic code, discovering that every human cell is packed with an estimated 20,000 to 30,000 genes. This marked a dramatic shift in the understanding of cancer and other diseases. Researchers have used the discoveries to link dozens of diseases, such as Alzheimer’s disease and inherited colon cancer, to specific genes. In recent years, researchers have taken the advancements one step further, with genomic tests of the cancer itself.
NEW RESEARCH: Paul Mathew, MD, a Genitourinary Oncologist at Tufts Medical Center said, “I think every physician should learn how to counsel patients on the implications of genetic testing. It can cause a lot of fear and anxiety about the impact on, for example, health insurance or life insurance and so forth. So I think those are the questions that people would have in their mind. And that’s why clinical geneticists play such an important role. And it would be my preference if they could get access to a clinical geneticists to avail themselves of that resource even if it meant some travel.”
(Source: Paul Mathew, MD)
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