INa's declaration of his personal office on May 18, former president Joe Biden revealed that he had an aggressive form of prostate cancer which has spread to his bones. “Although this represents a more aggressive form of the disease, cancer seems to be sensitive to hormones that allows effective management,” said its office in a press release. “The president and his family examine the processing options with his doctors.”
Recent studies Show that the survival for men with prostate cancer which has spread to the bone is just under two years old. But this form of cancer, although aggressive, can sometimes be controlled. Here is what oncologists who treat prostate cancer say they are the most common strategies to treat cancer like that of Biden and some of the challenges.
The latest ways to brake the aggressive prostate cancer
“The good news is the following: we have now entered an era of different treatments that I call an intensification of therapy where we are trying to attack cancer with a multimodality approach”, explains Dr. Maha Hussain, deputy director of the Robert H. Lurie CONCERNSIVE CANCER Center of the Northwestern University Feinberg Schicine. “We can find a significant extension of life compared to the moment when I entered the field.” She saw patients with prostate cancer who have spread to survive and “live for many years”.
Most prostate cancer are powered by male hormonal testosterone, so the most effective strategies to control it to starve cancer by cutting its supply, according to experts. Historically, doctors have removed the testicles – the main source of the hormone, but today, pills and injections can remove testosterone not only in testicles but also in other organs which also produce small quantities, such as adrenal glands. Doctors are now adding chemotherapy to hormonal abolition to better control cancer growth.
Treatment combinations are correct for Biden will depend on whether your cancer is new or if it has been diagnosed previously and recently reappeared. According to experts, one or the other scenario is possible.
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Regarding prostate cancer initially diagnosed in such an aggressive state, after it has already spread: “I do not think there is a reason to think that this could not be the natural history of prostate cancer in an elderly person,” explains Dr. Robert Figlin, director of Cancer Center at Cedars-Sinai Cancer. “And it wouldn't be [indicate] Something that has been missed or poorly managed in recent years. This is certainly something that can happen during the life of a man – it is not unusual to present in this way. Many older men receive a diagnosis of aggressive illness, with studies showing that around 20% of prostate cancer cases are diagnosed in men aged 75 and over, and that men aged 70 and over tended to have higher Gleason scores, an indicator of the aggressiveness of cancer, at diagnosis. (Gleason de Biden's score is 9, said his office in the statement, indicating more aggressive cancer.) “Prostate cancer can stay dormant for years and suddenly decide to wake up,” said Hussain. “I saw all kinds of cases – all the shades of gray.”
Treatment options also depend on the overall health of a patient. Other conditions that a person may have can affect their ability to tolerate therapies and side effects. “We must take into account other diseases than a man may have, other medical conditions which can be limited for life, objectives that man has in terms of longevity and quality of life, and other drugs he can take,” explains Dr. Michael Morris, head of the prostate cancer section at the Memorial Sloan Kettering Cancer.
What about immunotherapy?
Immunotherapy – An exciting new treatment that exploits the immune system to combat certain types of cancer – is so far not effective against prostate cancer. Although he has managed to slow down melanoma, breast cancer, lungs, kidneys and bladder and lymphoma, prostate cancer remains relatively hidden from the immune system, which does what doctors call “cold” cancer. “I prefer to call it sneaky cancer,” says Hussain. “Prostate cancer cells are literally found inside the bone marrow next to white blood cells”, which are immune cells. “White blood cells cannot see it, so unlike other cancers, prostate cancer has still not been sensitive to immunotherapy.”
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However, although current immunotherapy strategies may not be as effective against prostate cancer, new immune interventions are explored, explains Morris. “For the moment, for a patient who today presents prostate cancer, there is no real role for immunotherapy,” he said. “But there are many ways to handle the immune system to activate prostate cancer. If you ask me in a few years, we will have a fairly different message.”
Doctors also explore whether the introduction of chemotherapy earlier, as well as hormonal abolition treatments, could improve their chances of controlling cancer and preventing it from spreading and becoming more aggressive. “One of the most important questions for patients with newly diagnosed metastatic disease should answer is whether they need Doctaxel chemotherapy in addition to [hormone suppressing] Therapy, ”explains Dr. Timothy Daskivich, associate professor of urology at Cedars-Sinai. “The data suggests that patients with higher volume metastases benefit the most from doctaxel. If these patients do not go up, this could be a missed opportunity.”
Prostate cancer screening
Prostate cancer screening – has made a blood test for the specific prostate antigen (PSA), a cancer cell marker – has helped reduce deaths due to the disease. But screening has been controversial, as prostate cancer generally increases slowly and the test can resume signs of benign prostate growth, which also occurs as men age.
However, the American Cancer Society currently recommends that men at an average risk of prostate cancer will be detected from the age of 50, if they should live at least 10 years more, and that men at higher risks, including African-American men and those with a father or a brother diagnosed with the disease, begin earlier, at 45. US preventive services working group Recommends that most men cease to detect at 70, because at that time, men can be more likely to die of causes other than prostate cancer, and the risks of exceeding slow growth cancers can prevail over benefits.
A legacy of advocacy for new cancer approaches
As Vice-President of President Barack Obama, Biden has led Moshot cancer to stimulate research on new treatments. As president in 2022, a national objective has set itself to reduce cancer mortality rates by 50% over 25 years. The quest was personal for Biden, whose son Beau died in 2015 from brain cancer at 46.
“Cancer touches us all,” he wrote in a Instagram post May 19. “Like many of you, Jill and I have learned that we are the strongest in broken places. Thank you for raising us with love and support.”
