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    Prostate Cancer Therapy - What You Must Know
    Prostate Cancer Therapy - What You Must Know
    Prostate Cancer Therapy - What You Must Know
    Ebook255 pages2 hours

    Prostate Cancer Therapy - What You Must Know

    By Dr Kevin W Wellington

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    About this ebook

    Prostate cancer is one of the most widespread cancers in men globally which accounts for 1,276,106 new cases and caused 358,989 deaths (3.8% of all deaths caused by cancer in men) in 2018. Prostate cancer is also more common in developed countries. It has been projected that there will be 2,293,818 new cases by 2040 and that there will be a minor difference in mortality (a rise of 1.05%).

    The incidence rates are elevated in African-American men when compared to White men, with 158.3 new cases diagnosed per 100,000 men. The kind of prostate cancer encountered in African-American men is also more aggressive. Furthermore, the mortality in African-American men is double that of White men and has been attributed to disparities in environmental, genetic and social aspects. The purpose of this book is to increase awareness about prostate cancer and to educate men about it. By doing so the disease would be detected early, treated and fatalities reduced.

    This book will be of benefit to you if you who want to know more about prostate cancer and also if you have been diagnosed with it. By reading this book you will acquire an understanding of prostate cancer and the current therapies available to treat it. You will get to know about the advantages and disadvantages of the different treatments as well as their side effects.

    I have personally experienced the impact of cancer in my family. My father was diagnosed with colon cancer in 2008, fortunately the polyps were successfully removed though surgery and he is still alive today.

    I am a PhD research scientist trained in the area of synthetic organic chemistry and coordination chemistry. I have led and managed research projects particularly focused on human and animal health. My experience of the impact of cancer while growing up led me to pursue research to discover novel medicinal agents that can be used to treat cancer. I have published several research articles in international journals in the field of cancer drug discovery. I have a very strong interest in this devastating disease and my aim is to increase awareness and educate the general public about it.

    LanguageEnglish
    PublisherDr Kevin W Wellington
    Release dateJul 11, 2020
    ISBN9781393690962
    Prostate Cancer Therapy - What You Must Know
    Author

    Dr Kevin W Wellington

    Dr Kevin Wellington is a research scientist who has more than a decade's research experience in the discovery of medicinal agents for application in human and animal health. While working at the Biosciences unit at the Council for Scientific and Industrial Research in South Africa he lead and managed research projects focused on human and animal health. He has a special interest in the discovery of novel medicinal agents that can be used to treat cancer and microbial infections. Linkedin profile https://www.linkedin.com/in/kevin-w-wellington-phd-b854928/ E-mail: [email protected]

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      Book preview

      Prostate Cancer Therapy - What You Must Know - Dr Kevin W Wellington

      PROSTATE CANCER THERAPY

      What You Must Know

      By

      Dr. Kevin W. Wellington

      Copyright © 2020

      Introduction

      Prostate cancer is one of the most widespread cancers in men globally which accounts for 1,276,106 new cases and caused 358,989 deaths (3.8% of all deaths caused by cancer in men) in 2018. Prostate cancer is also more common in developed countries. It has been projected that there will be 2,293,818 new cases by 2040 and that there will be a minor difference in mortality (a rise of 1.05%).

      The incidence rates are elevated in African-American men when compared to White men, with 158.3 new cases diagnosed per 100,000 men. The kind of prostate cancer encountered in African-American men is also more aggressive. Furthermore,  the mortality in African-American men is double that of White men  and has been attributed to disparities in environmental, genetic and social aspects. The purpose of this book is to increase awareness about prostate cancer and to educate men about it. By doing so the disease would be detected early, treated and fatalities reduced.

      This book will be of benefit to you if you who want to know more about prostate cancer and also if you have been diagnosed with it. By reading this book you will acquire an understanding of prostate cancer and the current therapies available to treat it. You will get to know about the advantages and disadvantages of the different treatments as well as their side effects.

      I have personally experienced the impact of cancer in my family. My father was diagnosed with colon cancer in 2008, fortunately the polyps were successfully removed though surgery and he is still alive today. 

      I am a PhD research scientist trained in the area of synthetic organic chemistry and coordination chemistry. I have led and managed research projects particularly focused on human and animal health. My experience of the impact of cancer while growing up led me to pursue research to discover novel medicinal agents that can be used to treat cancer. I have published several research articles in international journals in the field of cancer drug discovery. I have a very strong interest in this devastating disease and my aim is to increase awareness and educate the general public about it.

      DEDICATION

      ––––––––

      This is specifically dedicated to men who have been affected by prostate cancer. I also dedicate this to my wife Annabel and my daughters, Sarah and Hannah, who supported me in writing this book.

      TABLE OF CONTENTS

      CHAPTER 1: PROSTATE CANCER

      1.1 Background

      1.2 What is Prostate Cancer?

      1.3 Types of Prostate Cancer

      1.3.1 Common prostate cancer

      1.3.2 Rare prostate cancers

      1.4 Prostate Cancer Signs and Symptoms

      1.5 The Stages and Grades of Prostate Cancer

      1.5.1 TNM staging system

      1.5.2 Gleason score for grading prostate cancer

      1.5.3 Cancer stage grouping

      1.6 Treatment Outline

      1.7 Management of Prostate Cancer

      References

      CHAPTER 2: ACTIVE SURVEILLANCE AND WATCHFUL WAITING

      2.1 Background

      2.2 Active Surveillance

      2.2.1 Background

      2.2.2 Advantages and disadvantages of active surveillance

      2.3 Watchful Waiting

      2.3.1 Background

      2.3.2 Advantages and  disadvantages of watchful waiting

      2.3.3 Distinctions between active surveillance and watchful waiting

      References

      CHAPTER 3: SURGERY

      3.1 Background

      3.2 Simple Prostatectomy

      3.3 Radical Prostatectomy

      3.3.1 Keyhole surgery

      3.3.2 Open prostatectomy

      3.4 Advantages and Disadvantages of Surgery

      3.5 Side Effects of Surgery

      3.5.1 Urinary complications after surgery

      3.5.2 Erection challenges after surgery

      3.6 Risks of Surgery

      3.7 Therapies for Erectile Dysfunction

      References

      CHAPTER 4: RADIATION THERAPY

      4.1 Background

      4.2 External Beam Radiation Therapy (EBRT)

      4.2.1 Treatment

      4.2.2 Types of EBRT

      4.2.3 Advantages and disadvantages of EBRT

      4.2.4 Side effects of EBRT

      4.3 Brachytherapy

      4.3.1 Low-dose rate (LDR) implants

      4.3.2 High-dose rate (HDR) implants

      4.3.3 Advantages and disadvantages of HDR

      4.3.4 Permanent implants

      4.3.5 Side effects of brachytherapy

      References

      CHAPTER 5: HORMONE THERAPY

      5.1 Background

      5.2 The Androgen Hormones and Their Relation to Cancer

      5.3 Androgen Deprivation Therapy

      5.4 Strategies for Treating Prostate Cancer

      5.4.1 Androgen Reduction

      5.4.2 Androgen inhibitors

      5.4.3 Inhibitors of androgen generation

      5.5 Applications of Hormone Therapy

      5.5.1 Adjuvant hormone therapy

      5.5.2 Neoadjuvant hormone therapy

      5.5.3 Hormone therapy alone

      5.6 Advantages and Disadvantages of Hormone Therapy

      5.7 Side Effects of Hormone Therapy

      5.8 Management of the Side Effects of Hormone Therapy

      References

      CHAPTER 6: CHEMOTHERAPY

      6.1 Background

      6.2 The Advantages and Disadvantages of Chemotherapy

      6.3 Side Effects of Chemotherapy

      6.4 Preparation and Requirements for Chemotherapy

      6.4.1 Before treatment

      6.4.2 Treatment

      6.5 Treatment for Managing the Side Effects of Chemotherapy

      6.5.1  Steroids

      6.5.2  Antibiotics

      6.5.3 Anti-sickness medicines (anti-emetics)

      6.5.4 Granulocyte-colony stimulating factor (GCSF)

      6.6 Chemotherapy Drugs for Prostate Cancer

      6.6.1 Docetaxel (Taxotere®)

      6.6.2 Cabazitaxel (Jevtana®)

      6.6.3 Mitoxantrone (Novantrone®)

      6.6.4 Estramustine (Emcyt®)

      References

      CHAPTER 7: TREATMENT FOR PROSTATE CANCER IN BONES

      7.1 Radiopharmaceutical Drugs

      7.1.1 Radium-223 (Xofigo®)

      7.1.2 Side effects of radium-223

      7.2 Bisphosphonates

      7.3 Denosumab (Xgeva®)

      7.4 Corticosteroids

      7.5 External Radiation Therapy

      7.6 Kyphoplasty Surgery

      7.7 Pain Medicines

      References

      CHAPTER 8: OTHER THERAPIES

      8.1 Immunotherapy

      8.1.1 Cancer Vaccines

      8.1.2 Immune checkpoint inhibitors

      8.2 High Intensity Focused Ultrasound (HIFU)

      8.3 Cryotherapy

      8.4 New Treatments and Clinical Trials

      References

      CHAPTER 9: A SUMMARY

      9.1 Prostate Cancer Treatments

      9.1.1 Active Surveillance

      9.1.2 Watchful Waiting

      9.1.3 Surgery

      9.1.4 Radiation Therapy

      9.1.5 Hormone Therapy

      9.1.6 Chemotherapy

      9.1.7 Immunotherapy

      9.1.8 Immune Checkpoint Inhibitors

      9.1.9 High Intensity Focused Ultrasound

      9.1.10 Cryotherapy

      9.2 Prostate Cancer Treatment by Stage

      9.2.1 Stage I

      9.2.2 Stage II

      9.2.3 Stage III

      9.2.4 Stage IV

      9.2.5 Biochemical or PSA recurrence

      9.2.9 Recurrent cancer

      9.2.10 Unsuccessful Treatment

      9.2.11 Remission

      References

      GLOSSARY

      About The Author

      CHAPTER 1: PROSTATE CANCER

      1.1 Background

      One of the most widespread cancers in men globally is prostate cancer (after lung cancer) which accounts for 1,276,106 new cases and caused 358,989 deaths (3.8% of all deaths caused by cancer in men) in 2018 (Bray et al. 2018; Cancer Today). Prostate cancer is also more common in developed countries. It has been projected that there will be 2,293,818 new cases by 2040 and that there will be a minor difference in mortality (a rise of 1.05%) (Cancer Tomorrow).

      The incidence rates are elevated in African-American men when compared to White men, with 158.3 new cases diagnosed per 100,000 men. The kind of prostate cancer encountered in African-American men is also more aggressive. Furthermore,  the mortality in African-American men is double that of White men  and has been attributed to disparities in environmental, genetic and social aspects (Panigrahi et al. 2019).

      The incidence and mortality of prostate cancer globally correspond with an increasing age. This cancer is generally diagnosed at the age of 66 years in about 60% of cases and seldom occur earlier than age 40 (NCI). When prostate cancers (90%) are discovered, it is usually only in the prostate and surrounding organs. Prostate cancer may be cured when limited to the prostate (localized), and often reacts to treatment even when it has dispersed throughout the body (metastasized).

      The rate at which prostate cancer develops fluctuates from very slow to moderately fast. Certain men may have an extended life span even after the cancer has metastasized to remote parts like the bone. Numerous men, like those with localized tumors, may succumb to other diseases without ever having experienced incapacity from prostate cancer (Albertsen et al. 2011; Lu-Yao et al. 2009). To date there is no proof on how to avoid prostate cancer, but the risk can be reduced by:

      Restricting high-fat foods

      Escalating the consumption of vegetables and fruits

      Doing more exercise

      Men with a family history of prostate cancer and African-American men should begin screening for prostate cancer at age 45 (Rawla 2019). The majority of men with local or advanced (regional) prostate cancer have a 5-year survival rate of almost 100%. The 5-year survival rate is only 30% for men diagnosed with metastatic prostate cancer (Cancer).

      1.2 What is Prostate Cancer?

      Prostate cancer is defined as the uncontrolled growth of cells in the prostate gland which produces a specific fluid that occurs in semen. The prostate gland is roughly the size of a walnut in young men, but in older men it can be significantly bigger (ACS). Prostate cancer normally arises in older men. They are slow growing, but several grow quite rapidly. The cancer cells may disperse from the prostate to other body parts, predominantly the lymph nodes and bones (Ruddon 2007). 

      Figure 1. Prostate cancer on the right side in the prostate (Blaus).

      Figure 2. Prostate cancer pressing on the urethra which may trigger symptoms (CRUK).

      1.3 Types of Prostate Cancer

      There are both common and rare types of prostate cancer. Men can develop a common as well as a rare prostate cancer (Prostate Cancer UK).

      1.3.1 Common prostate cancer

      Adenocarcinoma or acinar adenocarcinoma is the most common prostate cancer and is accountable for more than 95% of prostate cancer cases. This cancer originates  from the gland cells which produce the prostate fluid that is added to the semen (Nelsen et al. 2003; Prostate Cancer UK).

      1.3.2 Rare prostate cancers

      These rare variants account for the remaining cancer cases that start in the prostate. There are several types of rare prostate cancers that are as follows (Prostate Cancer UK; Zelefsky et al. 2011):

      •  Neuroendocrine prostate cancers

      ❍  Small-cell neuroendocrine carcinoma of the prostate (SCNCP)

      ❍  Treatment-emergent small-cell neuroendocrine carcinoma of the prostate (t-SCNC)

      ❍  Large-cell neuroendocrine carcinoma of the prostate (LCNCP)

      •  Glandular prostate cancers

      ❍  Ductal adenocarcinoma (DA)

      ❍  Mucinous (colloid) prostate cancer

      ❍  Signet ring cell carcinoma (SRCC)

      •  Basal cell prostate cancer

      •  Transitional cell prostate cancer

      •  Prostate sarcomas

      ❍  Leiomyosarcoma

      ❍  Rhabdomyosarcoma (RMS)

      Generally, they are aggressive tumors with poor prognoses. Several develop from acinar adenocarcinoma following hormonal or radiation therapy (Mazzucchelli et al. 2008).

      Treatment can be reliant

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