Health Care Quarterly:

Something promising arrives in fight against stage 4 prostate cancer

One in six men will face prostate cancer in his lifetime.

According to the American Cancer Society’s 2019 Facts & Figures report, 1,180 Nevadans will be diagnosed with prostate cancer this year. This marks a slight decline compared to last year’s projection of 1,190 diagnoses in the Silver State, but it’s still important to recognize the significance of the disease.

Prostate cancer is more likely to be cured when detected or treated early via recommended screenings. The five-year survival rate, encompassing all stages, is 99 percent and the 15-year survival rate is 96 percent. ACS recommends men with an average risk of prostate cancer begin screenings at age 50. Those at higher risk, including those having a family history or who are of African-American descent, are advised to start screenings as early as 40 years-old.

While the statistics surrounding a stage 4 diagnosis are not quite as promising, it is treatable. According to the National Cancer Institute, those whose prostate cancer metastasizes regionally to nearby lymph nodes have a 5-year survival rate of 99 percent. For those whose metastasizes to distant parts of the body, the rate is 28 percent.

A promising new therapy for those with advanced stage prostate cancer – a radionuclide treatment known as 177Lu-PSMA-617 – is currently in Phase III of testing. The intravenous therapy acts like a lightning bolt – it kills a cancer that is dividing by destroying its machinery for cell division. And, with the small handful of patients that have received the treatment thus far, 30 to 40 percent have had a positive response.

On December 6, 2018, local grandfather and Comprehensive Cancer Center patient William Cooley became the very first in Nevada to receive the treatment.

Leading up to the treatment, Cooley had exhausted all of his options. With a stage 4 diagnosis, he had undergone chemotherapy, radiation and testosterone deprivation therapy, among other measures. Nothing was having a lasting impact, and he was given one to two years to live. After being screened by Comprehensive’s research team, Cooley was found to be a genetic fit for the trial.

Thus far, the treatment has worked well for Cooley. His Prostate-Specific Antigen Test (PSA) figures, which were rising rapidly pre-treatment, have been reduced dramatically. His PSA at the start of the 177Lu-PSMA-617 treatment was 33ng/mL and is now at 5ng/mL (with 4ng/mL or less being normal).

Given the targeted nature of the therapy, he has also had no side effects and is incredibly optimistic about his journey moving forward. “I feel great and everyone can tell a difference,” Cooley said, “I am gaining weight back and I have so much energy now. I can spend time with my wife and family again without getting tired. I am at the top of my game. It is such a blessing.”

Cooley’s treatment calls for six visits with the Comprehensive team.

Given the positive impact that 177Lu-PSMA-617 has had on patients like Cooley, the Food and Drug Administration is expected to fully approve the drug in one to two years. Simultaneously, other radionuclides (including Actinium-225) are currently being explored that may very well have a similar or even greater results.

An affiliate of the U.S. Oncology Network, Comprehensive participates in more than 170 Phase I, Phase II and Phase III clinical research studies each year and has played a role in developing more than 70 FDA-approved cancer therapies. With these clinical trials, there have been incredible successes, some of which have ultimately impacted patients throughout the world.

And for so many, just like Cooley, these trials mark another path forward and an unwillingness to give up hope.