The news that the former US president, Joe Bidenis suffering from aggressive prostate cancer It brings to the forefront that affects 1.4 million men each year.
Publicity that emerged after the news that Joe Biden is suffering from prostate cancer is a reason to raise public awareness of the disease and understanding the potential for early diagnosis and treatment of the disease, reported by the doctors of therapeutic clinic. Oncology), Dr. Maria Kaparelou (Pathologist-Oncologist), Theodora Psaltopoulou (Pathologist, Professor of Therapeutic-Epidiology-Private Medicine) and Thanos Dimopoulos (T. Rector of EKPA, Professor of Therapeutic-Oncology
They add that the vast majority of patients with prostate cancer will be diagnosed with local disease and their prognosis is usually quite good. A series of features, such as the morphology of the disease in biopsy (degree of differentiation), the extent of the disease as demonstrated by imaging tests (magnetic prostate, axial, bone scintigraphy, PET-PSMA), the price of PSA in the blood and as it was recently seen by the clinic and determine the proposed therapeutic plan.
Traditionally, the radical prostatectomy or external radiotherapy They are the key therapeutic pillars in the treatment of local localized prostate cancer. Recent data, however, have shown that patients with localized prostate cancer and low risk of relapse have a higher than 90% chance of survival from the disease to 15 years, regardless of whether they will be treated immediately after diagnosis or put on active monitoring. In this way, a significant proportion of patients will avoid the morbidity of surgery or radiotherapy without increasing the risk of their disease.
For patients, of course, the disease is locally advanced during diagnosis (aggressive histology, prostate expansion, lymph node expansion) the treatment should be immediate and multifactorial. Now, modern imaging methods such as PET-PSMA They highlight the extent of the disease with great sensitivity and specialty and help to make the appropriate therapeutic decisions.
For patients with local advanced disease or metastatic disease, in recent years it has been evident through clinical studies that the most aggressive treatment of the disease and the use of new therapies can increase the survival of patients. Androgenic exclusion, that is The suppression of testosterone levels It supplies the proliferation of prostate cancer cells has been the basic treatment at this stage of the disease for decades. We now know that the combined treatment of androgenic blockade with newer hormonal drugs such as amparaterone and Use of external radiation in prostate They greatly benefit men who will be diagnosed by extension of the disease to the lymph nodes. Similarly a significant delay in the progression of the disease is achieved by the use of the newest antiandrogen enzalutamide along with androgenic exclusion in patients who show an increase in PSA (biochemical recurrence) after radical treatment of local disease.
The intensification of treatment has also brought about a significant benefit of survival in metastatic disease. The combination of androgenic exclusion and newer hormonal drugs is now the established treatment for men who will be diagnosed with metastatic disease. In fact, a percentage of them with a higher load of disease are used triple combinations with the addition of chemotherapy, bringing a significant delay in developing the disease in its next stage, that of it. faithful where the sensitivity of cancer cells to hormonal manipulations is now limited. Clinical studies and daily clinical practice now show that these combinations can lead to a long -term recession of the disease, without particularly affecting the quality of life of patients.
Finally, for patients who will have a favorable disease, understanding molecular biology of the disease has led to therapeutic developments and a series of clinical studies presented at international conferences demonstrate the role of targeted therapies at this stage of the disease. The recent conference on neooplasms of the Urinary System of the American Society of Oncology (ASCO GU) presented the results of overall survival from the combination of targeted treatment – the PARP Talazoparib Inhibitor – with Enzalutamide in patients with a favorable disease.
The combination has shown that it increases survival both in those who have mutations in the genes involved in the DNA repair mechanism of the counterpart of recombinant (about 20% of patients who are considered more sensitive to the action of PARP inhibitors) and the rest of the population. These combinations are now approved in our country as the initial treatment of the favorable prostate cancer. For this stage of the disease, there is an intensive research on the use of radiopharmacies. Already the LU-PSMA radio biscuit binding to the PSMA, a molecule expressed almost selectively, prostate cancer cells is a particularly effective treatment for patients with a favorable disease and the percentage of patients receiving this treatment increases significantly in recent years in our country.
From the above it is evident that prostate cancer is a common disease in men with several Available therapeutic options Even for patients with metastatic disease they usually provide Long -term survival with good quality of life. The interest of the scientific community focuses both on the recognition and more radical treatment of the most aggressive forms of the disease related to the development of metastases and on the other hand, the treatment of the treatment for low -risk disease to avoid morbidity from treatments.
Source: RES-EIA