In the first of these studies, a drug called abiraterone shrank tumors by 30% in one-fourth of 31 men whose prostate cancer did not respond to standard therapies and continued to grow. In 35% of the patients taking the experimental drug, their tumors stopped growing.

Standard PSA (prostate-specific antigen) measurements were able to give accurate indications of each response to the new treatment. PSA levels after 12 weeks of treatment with abiraterone lowered PSA levels by 50% or more in 71% of the patients. In two men, the PSA fell so dramatically, it was undetectable.

A leading medical authority at the Cedars-Sinai Medical Center in Los Angeles Radiation Oncology Department called abiraterone currently the most promising prostate cancer drug on the horizon. He explained that the new hormone therapy appears to be active in men not responsive to other hormone treatments.

Abiraterone works differently from other hormone treatments in wide use today. The new drug targets an enzyme called CYP17 that is needed to produce male hormones throughout the body. Current hormonal treatments can only prevent production of male hormones in the testes. Other parts of the body are still able to produce testosterone and related hormones called androgens that fuel the growth of prostate cancer.

The first study involved men who were initially treated surgically or medically to prevent testosterone production in the testes. None had received chemotherapy, sometimes administered when the cancer does not respond well to hormone therapy. Men in the study took abiraterone orally once a day and generally tolerated the drug without serious side effects.

In a second study, men who were given chemotherapy after their hormone treatment no longer worked showed similar encouraging results after taking the experimental drug. Cougar Biosciences is the manufacturer of abiraterone, and they funded this study.

Researchers have begun enrolling men in a larger and longer study. Patients will be randomly assigned to abiraterone or a placebo (sugar pill). If results continue to be promising, the company will apply to the FDA for approval of the drug. Unfortunately, these studies and the approval process can take several years.

In the U.S., prostate cancer was diagnosed in over 180,000 men and 28,000 men died of the disease in 2008. It is the second most common cause of cancer death in the U.S.

Source: WebMD Health News; 3/1/09 written by Charlene Laino and reviewed by Louise Chang, M.D. blog article by Anna Dabney

In recent studies of 385 men, those with elevated EPCA-2 test results were found to have cancer 94% of the time, compared with 19% of those showing elevated PSA results. Only 3% showed false positive results and about 6% of existing cancers were missed using the new EPCA-2 blood protein markers. These results compare more favorably than the PSA test, which misses about 15% of existing cancers and gives a high level of false positives.

Every year, about 1.6 million men have unnecessary biopsies because of elevated PSA scores, whereas only about 230,000 of them actually are shown to have cancer. The digital rectal exam (DRE) is also not definitive in detecting this common cancer of men.

Prostate cancer is diagnosed in 230,000 new cases annually, and about 27,000 men die of the disease. The current PSA and DRE detection procedures are also deficient in that they cannot distinguish between cancer’s aggressive form, which is frequently fatal, and a slow-growing variety where “watchful waiting” may be the best strategy.

The new test could revolutionize the treatment of prostate cancer. It could save many lives and spare men with the slow-growing form of cancer from having unnecessary treatments in the future. Its manufacturer Onconome Inc., a Seattle Biomedical company, is developing the EPCA-2 test and expects the FDA to approve it by early next year.

Source:  San Francisco Chronicle; Sunday, April 26, 2007; reporter Susan Brink of the Los Angeles Times

The variant gene was discovered in men in Iceland, Sweden, and in two populations in the U.S. The gene variant, carried by about 13% of men of European ancestry, raises the risk of getting prostate cancer by 60%, compared with a 13% risk in those who did not carry it. Men with this recently found gene were discovered to make up about 8% of all cases of prostate cancer.

The variant in African-American men is twice as common as in men of other ancestry. For this reason, prostate cancer may be more prevalent and have a higher mortality rate in black males in the U.S. than in white males. Early detection and aggressive treatment could lead to better outcomes for black males.

According to Dr. Kari Stefansson, DeCode’s chief executive, this was the first major gene in prostate cancer found in widespread populations.

Source:  Oakland Tribune, reprinted from New York Times writer Nicholas Wade’s article; May 8, 2006

Additional Resources:
What You Need to Know About Prostate Cancer

More than 2 million American men and many in Europe take the herb in an effort to ease their urinary symptoms — the frequent urge to go to the bathroom. In this new study, saw palmetto was no more effective than placebo pills (fake capsules). Findings were published in the New England Journal of Medicine (NEJM) in early February.

As men age, many develop benign (noncancerous) enlargement of the prostate, a walnut-sized gland that surrounds the urethra. The men recruited for this most recent study had moderate to severe symptoms. One group took 160 miligrams of saw palmetto twice a day.

Men in the second group swallowed a similar-looking, tasting and smelling dummy capsule. Participants in both groups filled out a symptoms survey and had urine flow measured. After a year, no significant difference was detected between the two groups, in symptom changes or other measurements.

An earlier, shorter study found that some men seemed to benefit from taking Saw Palmetto. Until this new research is confirmed by more studies, lead researcher Dr. Stephen Bent of San Francisco’s VA Medical Center advises that men who take the herb and feel it is helpful should probably keep using it.

Source: San Francisco Chronicle (2/9/06)  www.sfgate/chronicle.com

Further Research:
What You Need to Know About Prostate Cancer