Advanced Prostate Cancer
What is advanced prostate cancer?
Advanced prostate cancer (APC) is diagnosed when cancerous cells have spread outside the prostate. It can be categorized as being locally advanced or metastatic cancer. Locally advanced prostate cancer is cancer found outside the gland that remains in tissue and lymph nodes within close proximity to the prostate. Metastatic cancer has moved beyond the prostate to distant parts of the body including tissue, lymph nodes, bone, and other organs.
At the Austin Center for Radiation Oncology (ACFRO), men are routinely treated with radiation therapy for advanced prostate cancer. In addition, Dr. Richard Garza, Radiation Oncologist, supervises immunotherapy (Provenge) and Xofigo injections for the treatment of APC.
Radiation for advanced prostate cancer
When cancer spreads beyond the prostate gland, it will frequently move into surrounding bone. Radiation therapy is a proven option for treating bone tissue to slow the spread of cancer, and to manage cancer symptoms such as bone pain. Radiation treatment plans for advanced prostate cancer will depend on variables such as location of the metastases, the patient’s current health status, the condition of bone, treatment options that the patient has already completed or is currently undergoing. Radiation therapy for advanced prostate cancer in the bone is delivered in high doses using Intensity Modulated Radiation Therapy (IMRT).
Immunotherapy for advanced prostate cancer
Immunotherapy is indicated for some men with metastatic prostate cancer. This therapy uses the patient’s own immune system to fight their cancer. The process begins by harvesting dendritic immune cells from the body, and exposing them to specific molecules that have been designed to target and attack cancer cells. This molecule and the resulting treatment option are called Provenge immunotherapy. Provenge is indicated for advanced prostate cancer patients whose cancer continues to spread after hormone deprivation therapy.
The process of creating Provenge immunotherapy involves the following steps:
- The patient is scheduled for a blood draw so that dendritic immune cells can be harvested.
- Their blood is shipped to Dendreon labs, the manufacturer of Provenge.
- While at the lab, the patient’s immune cells are exposed to Provenge molecules. After exposure, the resulting vaccine will be shipped back to ACFRO for prompt infusion into the patient.
Provenge immunotherapy is dispensed over three separate appointments during the course of several weeks.
Xofigo injections for advanced prostate cancer
At ACFRO, Dr. Garza also oversees the prescribing and dispensing of Xofigo for men with advanced prostate cancer. Xofigo is an injectable radiation that is given to patients who are no long responding to hormone deprivation therapy (to lower testosterone levels), whose cancer has spread into bone, and who are experiencing symptoms related to cancer in the bone. It is designed to destroy prostate cancer cells in the bone. Xofigo is not indicated for patients in which prostate cancer has metastasized to lymph nodes, tissue, or other organs.
There are several guidelines that the radiation oncologist must consider before prescribing Xofigo. If the patient qualifies for this injection, Dr. Garza will review treatment goals, expected outcomes, protocols for the patient while using Xofigo, and possible side effects. Common side effects may include nausea, vomiting, low blood cells counts, diarrhea, and swelling in the arms and legs.
Xofigo is administered in six injections four weeks apart. Blood will be drawn and analyzed before each injection to ensure that the patient’s blood counts are normal and that they are cleared for injection.
Contact the Austin Center for Radiation Oncology to schedule a consultation with Dr. Richard Garza.