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Prostate Problem Guide
Taking A Break From Advanced Prostate Cancer Treatment
Once prostate cancer has moved out of the prostate gland and spread into other areas of the body it is said to be advanced prostate cancer and treatment becomes far more difficult than when cancer is confined to the prostate gland.
As long as your cancer has not spread too far and is not too aggressive it is still possible not simply to treat the condition but in fact to cure it. However, in many cases where cancer has spread widely, or is particularly aggressive, treatment becomes a matter of simply slowing the progression of the disease and providing you with the best possible quality of life.
At present one of the main treatments for advanced prostate cancer is intravenous chemotherapy often using a drug known as docetaxal. This is a very effective drug for many patients and does indeed slow the progression of prostate cancer and extend life for many patients. However, it is not without its side effects which include such things as nausea, loss of appetite, hair loss and an increased risk of infection. It is here therefore that we meet one of the biggest problems in advanced cancer treatment.
If you are treating a condition which cannot be cured and which will eventually kill you, then extending your life by holding back the progress of the disease is fine as long as that treatment provides you with an acceptable quality of life and does not end up being worse than the disease itself.
For many prostate cancer sufferers, who are often in their 60s, 70s or even 80s, chemotherapy is not exactly pleasant but is a price worth paying to buy them some time when they first start their treatment. However, as time goes by and the side effects start to build the picture often changes and many patients soon begin to question whether or not it is all worth it. This of course is never an easy question to answer and must be the subject of a very personal discussion between the patient, his family and his physician.
Many of us will be familiar with this scenario either through our own personal experience of illness or from our experience of seeing a family member of close friend in this situation and will know only too well just how difficult a time it can be.
Now, however, there may be a little light at the end of this tunnel as studies involving a sizeable group of patients with metastatic, androgen-independent prostate cancer suggest that many patients may be able to take a 'chemotherapy holiday' without any significant detriment to their treatment. In other words, after several weeks of chemo, and when the side effects are really beginning to get you down, you may be able to simply stop your treatment for a while and give your body a chance to recover a bit before carrying on with your treatment.
Now it is of course early days yet and nobody is quite sure yet just how long your 'chemo holidays' might be or how often you can take them, but for many advanced prostate cancer sufferers this seemingly small advance in treatment may well make all the difference in the world.
CHT (COMBINED HORMONAL THERAPY): the use of more than one hormone in therapy; especially the use of LHRH analogs (e.g. Lupron®, Zoladex®) to block the production of testosterone by the testes, plus anti-androgens (e.g. Casodex® (bicalutamide), Eulexin® (flutamide), Anandron® (Nilutamide), or Androcur® (Cyproterone) to compete with DHT and with T (testosterone) for cell sites thereby depriving cancer cells of DHT and T needed for growth; also referred to as CHB, MAB, TAB; the preferred term is ADT.
DOWNSTAGING: the use of hormonal or other forms of management in the attempt to lower the clinical stage of prostate cancer prior to attempted curative treatment (e.g. from stage T3a to stage T2b); this technique is highly controversial
INCIDENTAL: insignificant or irrelevant; for example, incidental prostate cancer (also known as latent prostate cancer) is a form of prostate cancer which is of no clinical significance to the patient in whom it is discovered.
SIGN: physical changes which can be observed as a consequence of an illness or disease.
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