Choosing the Right Path

Longer lives, fewer side effects, less overall toxicity: These are the treatment goals that men tend to share after being diagnosed with prostate cancer.

Although there are still mysteries to resolve, continual advances in treatment mean that these benchmarks are being met more and more effectively over time.

In this special issue of CURE, we bring you a comprehensive overview of the latest techniques in prostate cancer treatment, from the strategies appropriate for the earliest phases of the disease to those applied in the latest stages. In a detailed timeline spanning back to the year 1904, we also offer a sense of just how far prostate cancer treatment has come.

For instance, in slow-growing localized disease, when active surveillance is an option, state-of-the-art imaging in the form of the highly accurate multiparametric MRI is becoming more available. In addition, there’s a growing understanding of biomarkers that can signal the presence of prostate cancer or its aggressiveness, helping to determine when the disease should be actively treated instead of carefully watched.

When men do step into the treatment arena, a prime concern is often finding a way to effectively fight the cancer without incurring the common side effects of urinary incontinence or sexual dysfunction.

For one man featured in these pages, that became possible through highdose- rate brachytherapy; in fact, shorter, higher-dose courses of therapy are being explored throughout the radiation realm. In the surgical suite, more and more doctors are turning to laparoscopic prostatectomy (in some cases robotic) as a less invasive alternative to open prostatectomy, and we also discuss surgical techniques on the horizon that may do more to prevent side effects by avoiding damage to the structures surrounding the prostate.

Perhaps the most notable recent advances in prostate cancer treatment are the six new medical agents approved since 2010, five of them based on their ability to improve patient survival. In addition to presenting information on these cutting-edge treatments, we discuss a variety of investigational drugs, including hormonal treatments galeterone (TOK-001) and ARN-509 and the immunotherapy Prostvac.

In keeping with CURE’s mission to provide both education and inspiration for patients, survivors and caregivers during the cancer journey, we’ve filled this issue with facts and advice about every aspect of prostate cancer screening, diagnosis, treatment and research — and even some thoughts on living with side effects. Through guidance from leading oncologists and other decision-making tools, we hope to leave you better prepared to make choices about your own care – or at least to ask the questions that will help you determine the path that is right for you. As always, thank you for reading.

Mike Hennessy, Sr.Chairman and CEO