Prostate Cancer Canada Network

In The News

Well-Done Meat Consumption May Increase Prostate Cancer Risk
Research into the dietary habits of about a thousand men from the Cleveland area has found that a high consumption of meats, especially of red meat prepared by grilling, is positively associated with an increased risk of developing aggressive prostate cancer. This particular study, which was led by Dr. John Witte of the University of California, San Francisco (UCSF), has a number of limitations, but it does add support to other investigations connecting meat consumption with cancer risk.

Toronto researchers speculate regarding a link between prostate cancer and oral contraceptive use
Very preliminary and speculative research, designed to spark further inquires, suggests that there may be a connection between oral contraceptive use and rising rates of prostate cancer. One theory is that the widespread use of birth-control pills in various populations may result in a higher level of estrogen in the environment, which might, in turn, increase prostate cancer risk.

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A ray of hope for men with hormone refractory prostate cancer

August 2004

The following article was prepared for the PCCN (then called the CPCN) by Dr. Kim Chi, Medical Oncologist, BC Cancer Agency, Vancouver, BC:

Currently, the primary goal of treatment for men with metastatic hormone refractory prostate cancer (HRPC) has been that of symptom control, with the use of pain medications like morphine, radiation to the bone, and in some cases bisphosphonates. Previously, chemotherapy has been regarded as largely ineffective for men with prostate cancer. The standard chemotherapy currently in use is mitoxantrone. This well tolerated chemotherapy drug has been shown to help men with pain symptoms from metastatic HRPC, but has not been shown to improve overall survival.

Recently, the results of two clinical trials were reported at the 2004 American Society of Clinical Oncology Annual Meeting. The first trial, referred to as TAX-327, looked at over 1000 men from Europe and North America with metastatic HRPC. Approximately one-third of the men received standard therapy with mitoxantrone chemotherapy, one-third received docetaxel (Taxotere®) given once every three weeks, and one-third received docetaxel once a week. Treatment on all three arms was generally well tolerated with a relatively low incidence of serious side effects. The men treated with docetaxel every three weeks had a better response to treatment in terms of PSA decreases, better pain control, and improvement in quality of life. Importantly, men treated with docetaxel every three weeks also had a better survival overall. At any one point in time, there was a 24% decrease in the risk of dying in those men treated with docetaxel compared to those men treated with mitoxantrone. On average, men treated with docetaxel lived 18.9 months, while those men treated with mitoxantrone on average lived 16.4 months.

The second trial confirms the results of TAX-327. This trial was run in the United States by the Southwest Oncology Group (SWOG). In this trial, 770 men with metastatic HRPC were randomized to receive either standard chemotherapy with mitoxantrone or to treatment with docetaxel in combination with estramustine, another type of chemotherapy drug. Similarly, the men treated with the docetaxel combination had a better PSA response rate and a better overall survival than those men treated with mitoxantrone. For men treated with the docetaxel combination, median duration of survival was 18 months, and 16 months for those men treated with mitoxantrone, which translates into a 20% reduction in the risk of death for those men treated with docetaxel. Unfortunately however, there were some serious side effects associated with the estramustine including nausea, vomiting, and blood clots.

Thus the two trials both show the benefits of docetaxel chemotherapy with very similar results. However, given the additional side effects associated with the docetaxel-estramustine combination in the SWOG trial, the use of estramustine with docetaxel does not seem justified at this time.

The results from these two trials add docetaxel as a new chemotherapy treatment option for men with metastatic HRPC. We now have for the first time a treatment, in the form of docetaxel chemotherapy, which can improve overall survival for men with metastatic HRPC. Additionally, and probably just as importantly, benefits on pain control and to quality of life were also seen with docetaxel treatment. Although docetaxel may not be suitable for every patient with metastatic HRPC, docetaxel has now become the new treatment standard and other studies are looking at the value of treating men with docetaxel with earlier stages of disease.