A 'miracle year' in treatment of prostate cancer


Sometimes breakthroughs in science or medicine occur all together, in conjunction. When they do, they create what might be termed a “miracle year” giving rise to hope for real progress and optimism, particularly for difficult-to-treat diseases.

So it has been over this past year in the world of prostate cancer.

After years of what had once been regarded as a neglected area of medical research, there is now an explosion of new technologies and treatments for men faced with a prostate cancer diagnosis.

To explore these developments, the Providence St. Mary Regional Cancer Center is hosting a free community town hall meeting Oct. 16 at 7 p.m. in the Providence Room. It is designed to share with the public some of these breakthroughs which are available in Walla Walla. Dr. Spencer Ashton, Dr. David Hutton, Dr. John Sislow, and clinical trials coordinator Kathleen O’Connor, also will answer questions from the audience.

Examples of these areas of progress come first from the development of more efficient means of screening for cancer. The adoption of the prostate cancer health index, an improvement over previous prostate specific antigen determinations, acts to better delineate a man’s risk of developing this cancer. This allows urologists a means of focusing attention on those individuals found to be at highest risk for harboring disease to recommend prostate biopsy.

A major benefit from achieving an early diagnosis of prostate cancer has been to help urologists differentiate cases based on newly developed risk stratification techniques into low risk cases for which active surveillance is appropriate, compared to high risk cases for which aggressive early intervention is warranted.

The Cancer Center believes all men found to have prostate cancer benefit from access to this risk stratification approach, which is afforded by prostate cancer screening. Many individuals with slow progressing disease may now safely postpone any form of cancer treatment, often for extended periods.

This fall the Cancer Center will become one of just a handful of sites in the Northwest that are able to offer active cellular immunotherapy to treat prostate cancer.

Harnessing the power of the immune system has been a dream of oncologists over the past century. That dream is being realized by the development of a technique of vaccinating the immune system against prostate cancer, termed sipuleucel-T (Provenge). This in turn allows the recruitment of an effective immune-mediated response directed solely against the tumor.

Achievement of such a high specificity involves harvesting from patients a special cellular competent from the circulation, termed the dendritic cell, using a safe procedure of leukophoresis that separates blood cells based on their density in a high speed centrifuge. Dendritic cells have the unique capacity to absorb and process prostate cancer-related antigens to which they are exposed and then to “share” this newly acquired information within strategic areas of the immune system to help coordinate an anti-prostate cancer response.

Dendritic cells can be thought of as scouts on patrol, reporting back to the command center with hard-to-gain intelligence concerning an invading foe and thus serving to alert and mobilize our immune resistance against such an invasion.

The Cancer Center also is participating with the National Cancer Institute Clinical Trials Group Cooperative to make prostate cancer clinical trials available in Walla Walla. These trials are now open for patients. They are designed to help patients and oncologists test new prostate cancer treatments that have shown promise but are still under development.

These studies also assess the importance of dietary modifications that patients may make to help control early stages of prostate cancer, before the development of dissemination, when cells are still potentially sensitive to such restraining influence.

On hand at the town hall meeting to explain these programs will be O’Connor, the coordinator of clinical trials. Participation in cancer research is, of course, purely voluntary. However, patients invariably benefit from such participation. They receive early access to promising new treatments, gain knowledge about their condition, and often experience a sense of altruism because their participation is advancing cancer research.

This autumn the Cancer Center will acquire highly sophisticated prostate gland imaging equipment and accompanying software that will further advance treatment of prostate cancer. The team at the Cancer Center is working in conjunction with specialists from the Seattle Prostate Institute.

At the town hall meeting, Ashton, Hutton and Sislow will discuss new developments in prostate cancer brachytherapy and other techniques relevant to the control of disease within the gland itself, and the approaches they use to retain urologic functioning.

Dr. James Cunningham is a cancer specialist and the medical director of the Providence St. Mary Regional Cancer Center.


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