Breaking Down A Breakthrough: Pros & Cons Of Provenge
CLEVELAND (Ivanhoe Newswire) - Four months. It may not seem like a long time to many people, but for those with cancer, it's 120 days they might not have. A breakthrough treatment for prostate cancer patients is changing that for some, but people who've gone through the process have mixed emotions about it.
Ray Schmidlin and Robert Obin are two men with prostate cancer who know the disease will kill them.
"I expect to die of prostate cancer. It's a matter of when," Ray Schmidlin, told Ivanhoe.
They have both been treated with Provenge, a therapeutic vaccine using their own blood to slow down the cancer. Certain cells are harvested, altered and infused back into the body to help the immune system attack the cancer. Studies show it can improve a patient's median survival rate by four months, and it reduced patients' risk of death by 22 percent. Robert believes it's the reason he's still around.
"It's not going to cure me, but that will help me to give me, I don't know, more days?" Robert Obin said.
Ray said the immunotherapy took a toll on him. The active grandfather told Ivanhoe he was strapped down for several hours at a time during six weeks of treatment.
"And that was pretty stressful, because you couldn't, you couldn't move," Ray said.
He's not sure the discomfort and confinement was worth it.
"If I'm going to live 60 months, I don't want to spend the money and the time to live 64 months," Ray said.
"I think it's a controversial topic," Jorge A. Garcia, M.D., a director advanced prostate cancer program at the Cleveland Clinic, said.
Ray's physician doctor Jorge Garcia of the Cleveland clinic said there are misconceptions about Provenge.
"The patient automatically believes if I get the treatment, I'm going to live four months more, and that's inaccurate," Dr. Garcia said.
Garcia said some live longer but some don't make it to four months, and it's not for all prostate cancer patients. It's designed for those who show few or no symptoms, but have a form of the disease that has spread and is resistant to hormonal therapy.
"I think that there's a selective group of patients who should actually consider getting it," Dr. Garcia said.
Garcia said it doesn't lower PSA levels, shrink tumors, or reduce symptoms like bone pain.
"But yet, you're likely to live longer," Dr. Garcia said.
While the doctor believes Provenge is a breakthrough, he says it's important for patients like Ray and Robert know it may or may not be the right option for them.
Provenge costs $93,000. It's now covered by Medicare, but the time it takes for the treatment seems to be driving some doctors and patients away. Recent reports show Zytiga, a newly approved pill for advanced prostate cancer that's also been shown to prolong life by four months in clinical trials is gaining in popularity. It costs $5,000 a month and usually takes eight months to complete the drug cycle.
PROSTATE CANCER: Aside from non-melanoma skin cancer, prostate cancer is the most common cancer among men in the United States. There were 240,000 estimated new cases and deaths from prostate cancer just in 2011. (Source: CDC)
PROVENGE: Provenge is a cell therapy that aims to train the immune system to attack tumor cells. It's made using cells from a patient's own immune system, so it cannot be warehoused like many other drugs. The process of making Provenge involves the exposure of a patient's immune cells to a protein that functions as a prostate cancer-associated antigen. An antigen is a substance that causes the body to react with an immune response. This process activates the patient's immune cells against prostate cancer to help the immune system better fight the disease. The most common side effects reported with PROVENGE are chills, fatigue, fever, back pain, nausea, joint ache, and headache. These are not all the possible side effects of Provenge treatment. (Source: Dendreon.com, Provenge.com)
THE DRUG DEBATE: A new survey of cancer doctors is found the miracle drug has some cons as well. The percentage of patients who are deemed eligible for Provenge seems to be going down, declining from 37% to 24%. Of the 67% of total responders who did not have access to Provenge at the time of the survey, just 50% indicate they will prescribe Provenge once it becomes available. (Source: Forbes.com)
A NEW MIRACLE? A new study published in the New England Journal of Medicine shows, the newly approved prostate cancer pill Zytiga may extend life by up to four months in men with spreading cancer who have already been treated with chemotherapy. It inhibits a protein that helps form male hormones. Men who took the new pill also saw greater responses in levels of prostate-specific antigen (PSA) than men who received placebo. This survival edge was considered so significant that men who received the placebo were permitted to switch to the new drug before the study was completed.
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