Medivizor

prostate cancer | Research | Treatment | 11 pages | source: Lancet oncology | Added Feb 13, 2019

Phase 2 clinical trial evaluating the cardiovascular complications of hormone therapy in patients with advanced prostate cancer

This phase 2 clinical trial investigated whether transdermal estrogen or TE (estrogen absorbed through the skin) could be used as an effective treatment in patients with advanced prostate cancer (PCa), while also avoiding the long-term cardiovascular or CV (heart and blood vessels) complications associated with luteinizing hormone-releasing hormone agonists (LHRHa).

prostate cancer | Expertise | 0 pages | source: Patient Power | Added Jan 26, 2019

When Should Prostate Cancer Patients Consider Participating in a Clinical Trial? (VIDEO)

Recorded on July 12, 2015

Sumit K. Subudhi, MD, PhD

Assistant Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeri Kim, MD

Associate Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeff Folloder:

So we’ve been talking about cutting-edge investigations. That falls under the big giant heading of clinical trials. And I know that MD Anderson is a center for clinical trials. But let’s be realistic. A lot of people sitting out there in the audience right now, they hear the words “clinical trial,” and they think guinea pig.

I’m gonna be a lab rat. I’m gonna be experimented on. Is that what happens? I’m asking you straight up.

Dr. Subudhi:

That’s a great question. So the answer—from a literal answer, the answer is yes. But all those drugs that are FDA- approved right now, everyone was a guinea pig at some point, and that’s where we’ve come to.

I think it’s—so just to combine the next question, when should patients consider a clinical trial? I think when you’re coming to a place like MD Anderson, you’re coming because you’re looking for other options besides the standard of care. Because we know the standard of care for advanced prostate cancer is, right now, we cannot cure it. So MD Anderson is looking for ways to cure or even allow our patients to live longer. We’ve talked about there [are] only six drugs that are FDA- approved that improve survival.

On average, these drugs work for approximately six months. So six drugs times six is 36 months, or three years. If I told you or your loved ones that you’ve got three years, you’d probably punch me in the face, as I would to my doctor if they said that to my father. And so, we have to push the envelope. And I think clinical trials allow us to do that. I think it’s very important for every one of you to ask, what is the current standard of care that I qualify for?

And how does this clinical trial change that, and why would you recommend it now as opposed to later?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jeff Folloder:

That’s a question I’m gonna play to you, that when. We have the standard of care. Some people will call it the gold standard of care. When should a patient consider that the gold standard might not be the right thing? When is it a good time to consider a clinical trial?

Dr. Kim:

Well, I think if you’re coming to a big research hospital like ours, I think most patients come in having in mind clinical trials. And I think actually anytime in your cancer management; I think participating in a clinical trial is a good time, or the right time. And I think that I really encourage patients to participate in clinical trials, and because this is how we make advances in science and also improving patient care.

And from a patient’s perspective, by participating in clinical trials, you can get access to new drugs. And really, you’ll be really getting access to the cutting edge, the science and the new drug development. So I would really encourage that to our patients.

Jeff Folloder:

Dr. Subudhi, is there a downside to participating in a clinical trial?

Dr. Subudhi:

I think the only downside that I see from a patient perspective, if I was a patient, is the time commitment—meaning that the visits, they’re usually more frequent visits to MD Anderson when you’re on a clinical trial. But I believe the upside is similar to what you experience yourself on a clinical trial, and I believe a lot of my patients that have been on clinical trials feel like they’re getting the next emerging drugs, or the drugs of the future early on, and hopefully seeing a benefit.

Jeff Folloder:

How many people have participated in a clinical trial here? Raise your hand. That’s more than I expected. I expected just a few hands up. When MD Anderson recommended to me that it was a good idea to consider a clinical trial, I asked the question that I kind of sort of asked here. Why?

Doctor looked me straight in the eyes, and he said, “Because I believe that the clinical trial is going to provide you with the best outcome with the least amount of damage to your body. It’s as good as we can hope for with the least amount of side effects. If this was me, this is what I’d be doing.” And then he went to great lengths to let me know, “And I will not be your doctor during the process so that I can maintain arm’s length.”

This is not just about doctors pushing their research goals. This is about MD Anderson or any research hospital providing the best possible route to a great outcome for you. So always ask about clinical trials, right?

Dr. Kim:

Yes.

Jeff Folloder:

Always.

Dr. Kim:

Yes.

Dr. Subudhi:

Some of our patients that come to see us, and you guys probably interact with other patients outside of MD Anderson, and maybe you can pass the message. They come to see us after they’ve used all of the FDA-approved drugs, and then they’re expecting a clinical trial or a miracle. And at that point, it becomes a lot more difficult, because there [are] clinical trials that are pretty much designed for every aspect of prostate cancer.

But they may not be designed, or there may not be one available when the patient comes to see us. And that’s why I think day one that you come to MD Anderson, you should be asking about clinical trials, and we should be talking about it.

Recorded on July 12, 2015

Sumit K. Subudhi, MD, PhD

Assistant Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeri Kim, MD

Associate Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeff Folloder:

So we’ve been talking about cutting-edge investigations. That falls under the big giant heading of clinical trials. And I know that MD Anderson is a center for clinical trials. But let’s be realistic. A lot of people sitting out there in the audience right now, they hear the words “clinical trial,” and they think guinea pig.

I’m gonna be a lab rat. I’m gonna be experimented on. Is that what happens? I’m asking you straight up.

Dr. Subudhi:

That’s a great question. So the answer—from a literal answer, the answer is yes. But all those drugs that are FDA- approved right now, everyone was a guinea pig at some point, and that’s where we’ve come to.

I think it’s—so just to combine the next question, when should patients consider a clinical trial? I think when you’re coming to a place like MD Anderson, you’re coming because you’re looking for other options besides the standard of care. Because we know the standard of care for advanced prostate cancer is, right now, we cannot cure it. So MD Anderson is looking for ways to cure or even allow our patients to live longer. We’ve talked about there [are] only six drugs that are FDA- approved that improve survival.

On average, these drugs work for approximately six months. So six drugs times six is 36 months, or three years. If I told you or your loved ones that you’ve got three years, you’d probably punch me in the face, as I would to my doctor if they said that to my father. And so, we have to push the envelope. And I think clinical trials allow us to do that. I think it’s very important for every one of you to ask, what is the current standard of care that I qualify for?

And how does this clinical trial change that, and why would you recommend it now as opposed to later?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jeff Folloder:

That’s a question I’m gonna play to you, that when. We have the standard of care. Some people will call it the gold standard of care. When should a patient consider that the gold standard might not be the right thing? When is it a good time to consider a clinical trial?

Dr. Kim:

Well, I think if you’re coming to a big research hospital like ours, I think most patients come in having in mind clinical trials. And I think actually anytime in your cancer management; I think participating in a clinical trial is a good time, or the right time. And I think that I really encourage patients to participate in clinical trials, and because this is how we make advances in science and also improving patient care.

And from a patient’s perspective, by participating in clinical trials, you can get access to new drugs. And really, you’ll be really getting access to the cutting edge, the science and the new drug development. So I would really encourage that to our patients.

Jeff Folloder:

Dr. Subudhi, is there a downside to participating in a clinical trial?

Dr. Subudhi:

I think the only downside that I see from a patient perspective, if I was a patient, is the time commitment—meaning that the visits, they’re usually more frequent visits to MD Anderson when you’re on a clinical trial. But I believe the upside is similar to what you experience yourself on a clinical trial, and I believe a lot of my patients that have been on clinical trials feel like they’re getting the next emerging drugs, or the drugs of the future early on, and hopefully seeing a benefit.

Jeff Folloder:

How many people have participated in a clinical trial here? Raise your hand. That’s more than I expected. I expected just a few hands up. When MD Anderson recommended to me that it was a good idea to consider a clinical trial, I asked the question that I kind of sort of asked here. Why?

Doctor looked me straight in the eyes, and he said, “Because I believe that the clinical trial is going to provide you with the best outcome with the least amount of damage to your body. It’s as good as we can hope for with the least amount of side effects. If this was me, this is what I’d be doing.” And then he went to great lengths to let me know, “And I will not be your doctor during the process so that I can maintain arm’s length.”

This is not just about doctors pushing their research goals. This is about MD Anderson or any research hospital providing the best possible route to a great outcome for you. So always ask about clinical trials, right?

Dr. Kim:

Yes.

Jeff Folloder:

Always.

Dr. Kim:

Yes.

Dr. Subudhi:

Some of our patients that come to see us, and you guys probably interact with other patients outside of MD Anderson, and maybe you can pass the message. They come to see us after they’ve used all of the FDA-approved drugs, and then they’re expecting a clinical trial or a miracle. And at that point, it becomes a lot more difficult, because there [are] clinical trials that are pretty much designed for every aspect of prostate cancer.

But they may not be designed, or there may not be one available when the patient comes to see us. And that’s why I think day one that you come to MD Anderson, you should be asking about clinical trials, and we should be talking about it.

Recorded on July 12, 2015

Sumit K. Subudhi, MD, PhD

Assistant Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeri Kim, MD

Associate Professor, Department of Genitourinary Medical Oncology, Division of Cancer Medicine The University of Texas MD Anderson Cancer Center

Jeff Folloder:

So we’ve been talking about cutting-edge investigations. That falls under the big giant heading of clinical trials. And I know that MD Anderson is a center for clinical trials. But let’s be realistic. A lot of people sitting out there in the audience right now, they hear the words “clinical trial,” and they think guinea pig.

I’m gonna be a lab rat. I’m gonna be experimented on. Is that what happens? I’m asking you straight up.

Dr. Subudhi:

That’s a great question. So the answer—from a literal answer, the answer is yes. But all those drugs that are FDA- approved right now, everyone was a guinea pig at some point, and that’s where we’ve come to.

I think it’s—so just to combine the next question, when should patients consider a clinical trial? I think when you’re coming to a place like MD Anderson, you’re coming because you’re looking for other options besides the standard of care. Because we know the standard of care for advanced prostate cancer is, right now, we cannot cure it. So MD Anderson is looking for ways to cure or even allow our patients to live longer. We’ve talked about there [are] only six drugs that are FDA- approved that improve survival.

On average, these drugs work for approximately six months. So six drugs times six is 36 months, or three years. If I told you or your loved ones that you’ve got three years, you’d probably punch me in the face, as I would to my doctor if they said that to my father. And so, we have to push the envelope. And I think clinical trials allow us to do that. I think it’s very important for every one of you to ask, what is the current standard of care that I qualify for?

And how does this clinical trial change that, and why would you recommend it now as opposed to later?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Jeff Folloder:

That’s a question I’m gonna play to you, that when. We have the standard of care. Some people will call it the gold standard of care. When should a patient consider that the gold standard might not be the right thing? When is it a good time to consider a clinical trial?

Dr. Kim:

Well, I think if you’re coming to a big research hospital like ours, I think most patients come in having in mind clinical trials. And I think actually anytime in your cancer management; I think participating in a clinical trial is a good time, or the right time. And I think that I really encourage patients to participate in clinical trials, and because this is how we make advances in science and also improving patient care.

And from a patient’s perspective, by participating in clinical trials, you can get access to new drugs. And really, you’ll be really getting access to the cutting edge, the science and the new drug development. So I would really encourage that to our patients.

Jeff Folloder:

Dr. Subudhi, is there a downside to participating in a clinical trial?

Dr. Subudhi:

I think the only downside that I see from a patient perspective, if I was a patient, is the time commitment—meaning that the visits, they’re usually more frequent visits to MD Anderson when you’re on a clinical trial. But I believe the upside is similar to what you experience yourself on a clinical trial, and I believe a lot of my patients that have been on clinical trials feel like they’re getting the next emerging drugs, or the drugs of the future early on, and hopefully seeing a benefit.

Jeff Folloder:

How many people have participated in a clinical trial here? Raise your hand. That’s more than I expected. I expected just a few hands up. When MD Anderson recommended to me that it was a good idea to consider a clinical trial, I asked the question that I kind of sort of asked here. Why?

Doctor looked me straight in the eyes, and he said, “Because I believe that the clinical trial is going to provide you with the best outcome with the least amount of damage to your body. It’s as good as we can hope for with the least amount of side effects. If this was me, this is what I’d be doing.” And then he went to great lengths to let me know, “And I will not be your doctor during the process so that I can maintain arm’s length.”

This is not just about doctors pushing their research goals. This is about MD Anderson or any research hospital providing the best possible route to a great outcome for you. So always ask about clinical trials, right?

Dr. Kim:

Yes.

Jeff Folloder:

Always.

Dr. Kim:

Yes.

Dr. Subudhi:

Some of our patients that come to see us, and you guys probably interact with other patients outside of MD Anderson, and maybe you can pass the message. They come to see us after they’ve used all of the FDA-approved drugs, and then they’re expecting a clinical trial or a miracle. And at that point, it becomes a lot more difficult, because there [are] clinical trials that are pretty much designed for every aspect of prostate cancer.

But they may not be designed, or there may not be one available when the patient comes to see us. And that’s why I think day one that you come to MD Anderson, you should be asking about clinical trials, and we should be talking about it.

3

prostate cancer | Research | Treatment | 10 pages | source: Journal of nuclear medicine: official publication of the Society of Nuclear Medicine | Added Jan 02, 2019

Can PET/CT scanning guide radiotherapy treatment in prostate cancer?

This paper studied if a targeted form of radiotherapy could be effective in improving patient outcomes after surgical treatment of prostate cancer. The main finding was that a specific type of radiotherapy using PET scans improved outcomes in these patients.

23

prostate cancer | Expertise | 0 pages | source: NutritionFacts.org | Added Dec 28, 2018

Can aloe help patients with cancer?

For a half-century, aloe vera “[g]el processors and distributors armed with biblical quotes and anecdotal testimonials” have sought “recognition for their products”—too often “accompanied” however, by “misinformation,” none of which were more elaborate than promoting aloe vera for the treatment of cancer. But, check out this recent case report. A 64-year-old Hispanic woman with a tumor on her eyeball, which looked like a classic case of ocular surface squamous neoplasia, a type of eye cancer. And, therefore, surgery was recommended to remove it. “[B]ut the patient declined [the surgery], and instead initiated the use of concentrated [aloe] vera eye drops 3 times [a day] based on a friend’s suggestion.” Just some off-the-shelf aloe vera gel product, and to the doctor’s surprise, the lesion showed significant improvement after just one month. And, two months later, it went from this to gone completely. At the time of writing, it was six years later, and it appeared the cancer was gone, and had stayed gone.

Now, normally, you’d go in and cut out the cancer “with wide margins” to make sure you get it all, because “[d]espite the best efforts of the ocular surgeon, recurrence rates as high as [worse-than-a-flip-of-a-coin] have been reported,” because there’s little bits of cancer you miss on surgery. And, here, there’s this tumor that disappeared without surgery.

Are we sure it was cancerous, though? Well, she “refused [a] biopsy.” So, we don’t know for certain. However, it did have all the defining characteristics. And so, to see it disappear without any side effects, and stay gone, is pretty extraordinary. “Surgical resection” still remains the recommended treatment, but at least there’s an option for patients to try if they don’t want to go down that route.

Of course, this was just a single case report, no control group. It’s not like she had tumors in both eyes, and just tried the aloe on one. There was a controlled study suggesting aloe could prolong survival in those with advanced untreatable cancer, but it wasn’t a randomized controlled study, but a decade later, there was.

Hundreds of patients with metastatic cancer “randomized to receive chemotherapy with or without Aloe,” and the aloe group had three times the number of complete responses, significantly greater objective tumor responses, and two-thirds had some level of disease control, compared to only half in the non-aloe group. But, does that translate out into improved survival? Yes. For example, at one year, 70% of the aloe group was still alive, whereas most in the non-aloe group were dead.

And, as a bonus, the chemo was “better tolerated” in the aloe group, with less fatigue, for example, and better maintenance of their immune system. So, given the better disease control, given the better survival, “This study seems to suggest that aloe may be” a successful add-on therapy in terms of both tumor regression rate and survival time.

Now, this was a randomized controlled study, but not a randomized placebo-controlled study. It’s not like the control group was getting like some fake aloe drink. So, some of the tumor response may have been like a mind-over-matter placebo effect.

Now, there are potential downsides. As I explained in a previous video, swallowing aloe can, in rare cases, trigger liver inflammation, and cause electrolyte imbalances, due to diarrhea or vomiting. For example, there was a case reported of “aloe-induced [low potassium] in a patient with breast cancer,” which rapidly resolved once she stopped the aloe—thought to be due to the laxative effect aloe can have.

If you want to talk to your doctor about giving it a try, note this was not aloe vera, but aloe arborescens, a tree-like aloe that can grow to be like 10 feet tall. The concoction they made was a mixture of about two-thirds of a pound of fresh aloe leaves to a pound of honey, plus about three tablespoons of 40% alcohol, given orally at a dose of two teaspoons, three times a day, “starting 6 days prior to the onset of chemo[therapy].