Prostate Cancer Therapy

Prostate cancer is the second most common cancer in men, affecting millions worldwide. Over the past few years, significant advancements have been made in understanding the disease’s biology, leading to improved diagnostic methods and more effective therapies. This article provides an overview of the current state of prostate cancer therapy, touching on both traditional and emerging treatments and the challenges faced in providing personalised care for patients.

Conventional Treatments

  • Surgery: Radical prostatectomy is a common surgical treatment for prostate cancer involving the removal of the entire prostate gland and surrounding tissues. While this approach has been effective in many cases, it can lead to complications such as urinary incontinence and erectile dysfunction.
  • Radiation Therapy: External beam radiation therapy (EBRT) and brachytherapy are widely used radiation treatments. EBRT targets the prostate gland with high-energy X-rays, while brachytherapy involves the placement of radioactive seeds directly into the prostate tissue. Unfortunately, both methods can cause side effects, including bowel and urinary problems.
  • Hormone Therapy: Androgen deprivation therapy (ADT) is used to lower the levels of male hormones (androgens) that stimulate prostate cancer growth. ADT can be administered through injections, oral medications, or surgical castration. Side effects may include hot flashes, fatigue, and loss of libido.

Emerging Treatments

  • Immunotherapy is a promising treatment modality that uses the patient’s immune system to fight cancer cells. Checkpoint inhibitors, such as pembrolizumab and nivolumab, have shown promising results in clinical trials, extending survival rates in certain cases. Another approach is the use of therapeutic cancer vaccines, which stimulate the immune system to recognise and attack cancer cells.
  • Targeted Therapy results from advances in genomic profiling identifying specific genetic mutations driving prostate cancer. Targeted therapies, such as PARP and PI3K inhibitors, are designed to exploit these genetic vulnerabilities and disrupt cancer cell growth.
  • Focal therapy aims to target and destroy only the cancerous tissue within the prostate, preserving the healthy surrounding tissue. High-intensity focused ultrasound (HIFU) and cryotherapy are examples of focal therapy methods that minimise the risk of side effects like incontinence and erectile dysfunction.

Challenges in Personalised Care

Despite the advancements in prostate cancer therapy, challenges remain in providing personalised care for patients. The heterogeneity of the disease, variable treatment responses, and resistance mechanisms complicate the selection of optimal therapies. Moreover, access to cutting-edge treatments can be limited due to high costs and availability in certain regions.

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