A Publication of the Patrick C. Walsh Prostate Cancer Research Fund
As part of The Patrick C. Walsh Hereditary Prostate Cancer Program , “in an effort to find additional genes that can predict prostate cancer risk, we have begun a large study, sequencing each of the over 20,000 inherited genes from different sets of prostate cancer patients: men with highly aggressive or lethal disease, men with more indolent or benign disease, and men with multiple affected family members.”
Good news for some men with very aggressive prostate cancer: in a small study at Hopkins, a combination of two immunotherapy drugs has made a significant difference – shrinking tumors partially or completely – and two of 15 men have shown exceptional responses.
HOXB13, a mutated gene that greatly raises a man’s risk of getting prostate cancer, was discovered in 2012 by William Isaacs, Ph.D., the William Thomas Gerrard, Mario Anthony Duhon and Jennifer and John Chalsty Professor of Urology, and colleagues in a seminal study published in the New England Journal of Medicine.
Prostate cancer steals the kindling from the neighbor’s woodpile – and this may help explain why androgen deprivation therapy stops working: the cancer bypasses it, and makes its own supply of male hormones.
A blood test for key genetic mutations could help doctors get the jump on the most aggressive cancer sooner, with more aggressive or gene-specific treatment.
“Our findings suggest that a man who carries one of these mutations may be better off with treatment rather than surveillance.”
The downside of active surveillance (AS) for prostate cancer is the follow- up needle biopsies. Nobody likes them: not the men who feel like pincushions, and not the surgeons who do the repeated biopsies, sometimes for years. But everyone has agreed – because there hasn’t been a better approach – that it would be far worse to miss the presence of more aggressive cancer that needs to be treated.
“This is a four- to five-times higher risk than for men with low- and very low-risk prostate cancer.”
Determining factors included seminal vesicle invasion, a Gleason score of 9 or greater, having three or more positive lymph nodes, and having positive surgical margins. Men with one or more of these findings would benefit from ADT plus radiation.
It may be that targeting the gut microbiome – in the form of prebiotics, probiotics, or even fecal transplant – may make ADT and other forms of treatment much more effective.
“There are patients with favorable and unfavorable intermediate- risk prostate cancer.”
It’s a cellular version of “no man left behind.” Recovery of CTCs is 100 percent.
The most aggressive localized prostate cancer has a Gleason score of 9-10. What’s the best way to treat it? Radiation oncologist Phuoc Tran, M.D., Ph.D., and colleagues recently took part in a multi-institutional study to find out.
Among the many changes that happen when prostate cancer becomes metastatic is a weird kind of freeze-tag, played at the protein level between cancer cells and cells of the immune system.
Often in the microenvironment of prostate cancer are immune system cells, just sitting nearby and not doing anything. These cells need to wake up.
“Every man has a prostate of a different size and shape.”
“Given the higher prevalence of hepatitis C virus in Baby Boomers and rising prevalence of non- alcoholic fatty liver disease, our work has implications for prostate cancer screening.”
Radical prostatectomy patients needed less than a quarter of the pain medications they were prescribed.
What can experts from other fields show us about how cancer works?
Making a mini-organ using the patient’s own tissue can spare time, money, and disappointment by predicting drug sensitivity and resistance – avoiding weeks or months of trial and error.
The way we think about bladder cancer has been transformed. The revolution in thought, led by Greenberg Bladder Cancer Institute scientists David McConkey, Ph.D., and Woonyoung Choi, M.S., Ph.D., Director of Genomics, is this: there are different molecular subtypes of bladder cancer – each with distinct biological and clinical characteristics. Not only may they behave in significantly different ways; they may respond better to different forms of treatment.
“These new tests are so sensitive, they can detect just one single cancer cell!”
“Patients who received neoadjuvant chemotherapy were more likely to have non-invasive disease at surgery – meaning their invasive disease had been eradicated.
The ADAPT-BLADDER trial will combine immune checkpoint-inhibitor therapy, BCG, and radiation therapy.
“We don’t know if these are benign lesions that just disappear on their own, or if they are small cancers that the body fights off.”
“The risk of death from cancer is incredibly low in these patients, and choosing the right management strategy is highly patient-specific.”
They call themselves the Go Team.” As in, “when you get the phone call, you go!”
Read About the Research You Have Helped Make Possible.
We’re curing cancers that used to be incurable.
Partnerships with donors make discoveries possible. Thank you to those who have contributed $500,000 or more to The Patrick C. Walsh Prostate Cancer Research Fund.
He was “the father of modern science in prostate disease.” More than this, he was a great man.
