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Advanced prostate cancer: see news on treatment

Advanced prostate cancer: see news on treatment

Prostate cancer is the most common malignancy in men around the world. It is estimated that approximately 1.3 million men are diagnosed with the disease every year worldwide. In Brazil, we observed a higher proportion of cases diagnosed at advanced stages of the disease. In some regions of the country with the worst rates of health care, it can reach up to 40% of cases diagnosed with advanced or metastatic disease.

Difficulty in accessing the health system or even cultural issues may explain a good part of the diagnosed cases in more advanced stages.

Limitations to treatment of advanced prostate cancer

The development of new treatment strategies has been an area of ​​great interest in science in recent years. . In the last decade there has been an expansion of knowledge and a better understanding of alternative molecular pathways that trigger mechanisms of resistance from prostate cancer to chemotherapy and last generation hormonal blockers.

When advanced disease is detected, we commonly use blocking medications action of testosterone throughout the body - known to physicians as chemical castration. This is because prostate cancer uses testosterone as fuel to accelerate the rate of multiplication of your cells.

Over time the cancer can become resistant to this hormonal block, leading to the emergence of new cells with the ability to continue to multiply regardless of low testosterone levels. At this stage, we say that cancer has become resistant to chemical castration.

News to solve these problems

By 2011, when prostate cancer reached the stage of metastatic resistance to testosterone blockade, the only available treatment option was the use of chemotherapy.

Recent research has been enhancing the investigation of the mechanisms of escape of prostate cancer. With this we witnessed the appearance of numerous new molecules, both chemotherapy and last generation hormonal blockers, the latter being used only when the chemotherapy showed no results.

Next researchers demonstrated that the use of these new hormonal blockers could also bring

Two recent studies presented at the largest World Cancer Congress organized by the American Society of Clinical Oncology

(ASCO), which took place in June 2017 in Chicago, USA, bring positive results with the use of the drug abiraterone - a blocker of the latest generation of testosterone production. Studies have shown that the drug led to an increase in overall survival for men with locally advanced or metastatic prostate cancer who had not yet received any testosterone blocker or chemotherapy. In Brazil, the drug is not yet available in the system but it is already used in the private and complementary healthcare system (agreements) since 2015, for cases that have already been treated with chemotherapy. Its use is not yet released in the country for men who have not yet been treated with chemotherapy. Other fields of prostate cancer research also show encouraging results. The emergence of radioactive molecules that can be injected into the bloodstream and which have high affinity for prostate cancer cells, have also shown significant gains in increased survival.Other advances in the field of immunology (anti-bodies and vaccines) have also contributed to the increase in options in the arsenal of advanced and metastatic prostate cancer. These medications increase the immune system's ability to recognize abnormal prostate cancer cells. These new drugs have the advantage of having less severe side effects.

Advances are not restricted to the field of treatments alone. Improvements in diagnostic techniques bring greater power to early detection of advanced forms of the disease, such as high resolution magnetic resonance imaging, bone scintigraphy and molecules with high affinity to the cancer cell membrane, favor the generation of high precision images for a more accurate diagnosis

When all these advances are added together, we have an encouraging overview for the diagnosis, treatment and control of prostate cancer in its advanced and metastatic forms.

In the near future, what ideal form of use, association, or sequencing of these and other new treatment options will emerge.

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