After a long road to approval, Provenge, a vaccine that uses a patient’s own immune system to fight advance prostate cancer has been approved by the Food and Drug Administration (FDA). The vaccine suggests that people may be able to stimulate their own defense systems in order to help themselves fight against cancer.

Provenge, a product of the Dendreon Corporation, will be used to help men with prostate cancer who are no longer responding to hormone therapy. It is made by activating the patient’s white blood cells by exposing them to a protein found on prostate cancer cells. The cells are given back to the patient about three days later, a process similar to blood transfusion. This is done three times, with two weeks in between each dose.

In 2007, the FDA refused to approve Provenge, on the lack of information on whether the drug prolongs survival. In 2009, Dendreon re-submitted the drug with more information. Provenge was tested in a study that showed that men who received Provenge lived an average of about four months longer than those who received the placebo. Patients receiving the vaccine reported side effects of chills, fever, headache, fatigue, nausea, joint aches and back pain. All side effects usually went away within a few days.

There are also a few concerns with the vaccine. It is not for all men with prostate cancer, only a particular group. Because men with advanced prostate cancer have had long-term damage to the body, there is a risk of the cancer eventually stopping response to drugs that affect the body’s hormone levels. Another concern is that the drug does not show evidence of slowing the progression of the disease.

According to an article from The Washington Post, a recent study found that the use of high-tech imaging scans such as CT and PET, has substantially increased in recent years, raising costs and concerns about radiation exposure in cancer patients.

In 2006, lung cancer patients received almost six CT (computerized tomography) scans within two years, compared with four scans for patients in 1999. During this time, they had also received the highest imaging scan costs, exceeding an average of $3,000 per patient. But cancer patients are not the only ones affected by the increased use of these scans. CT and PET (positron emission tomography) scans are also used to detect injuries and for many other illnesses.

Although it is uncertain whether imaging scans are being misused, it is known that Medicare reimburses doctors more for analyzing these scans. Hospitals and clinics who have the scanning technology also receive heavy reimbursements for using it.

For patients, the costs of these scans have increased at a rate far past total cancer costs. According to a researcher of the study, the cause is that the tests are getting more expensive and are done more frequently.

The radiation from imaging scans has a chance of causing cancer many years after they are performed. However, others argue that imaging scans improve longevity and have greatly contributed to the declining national death rate due to cancer.

There is no doubt that high-tech imaging scans provide very valuable information regarding a patient’s health. CT scans pinpoint tumor locations and monitor diseases, while PET scans can show, for example, whether a swollen lymph node is due to infection or cancer.

According to a recent study by Victor Vogel of the American Association of Cancer Research, a common osteoporosis drug called Raloxifene, also known as Evista, reduces breast cancer risk by 38% in high risk women. The drug does so without causing the serious side effects of similar drugs.

According to Vogel, although Raloxifene is not a cure, it is an important protection. His findings arise from a study of nearly 20,000 high-risk, postmenopausal women over the course of almost seven years.

Raloxifene is already approved to prevent breast cancer in high-risk women. However, few women take it and few doctors prescribe it for prevention because of the concern about serious side affects.

A typical American woman has a 12% chance of getting breast cancer sometime in her life time. Her risk increases to 18% if her mother or sister has had breast cancer, and to 30% if she has had a breast lesion called atypical hyperplasia.

Raloxifene costs about $130 a month. Tamoxifen, a similar drug, is available as a generic and can be found for as little as $22 a month online.

According to a recent prostate cancer study, men who undergo hormone therapy for prostate cancer are at a greater risk of developing blood clots. In fact, men taking hormone therapy had a 2.48% increased risk of developing a blood clot and almost double the chance of a pulmonary embolism (when the clot travels to the lung), compared to men without prostate cancer.

For this reason, it is very important to consider blood-clotting side effects, especially for patients who undergo endocrine treatment.
These findings do not change the way men with prostate are treated, only the way they are monitored. Endocrine treatment is the main therapy with locally advanced or metastatic disease. It is therefore impossible to change the treatment; however, doctors can and should be more aware of blood-clotting diseases and check for symptoms when following up with their patients.

Although the general risk of blood clots for cancer patients has been known for decades, this new study sheds new light on the prostate cancer population. According to Dr. Steven Clinton of the Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute in Columbus, “for the first time, this puts some numbers on the risk in that population. It’s an enormous study, and it does give us some numbers to work with.”

Advancing age and other cancer treatments, such as prostatectomy (removal of the prostate gland) may further elevate the risk of blood clots. Those in the prostatectomy group had a 73 percent increased risk of blood clots and double the risk of a pulmonary embolism. Those under the age of 65 and those with more advanced disease had even more risk. Given that men in the no-treatment-yet group also had more blood clots, much of the risk was likely from the cancer itself.

These findings imply a link between the cancer and its biology’s impact on coagulation. However, the type of treatment used also plays a role.

The absolute number of blood clots seen in the study was relatively low — about four per 1,000 person-years, up from 2.

Men with prostate cancer should be aware of the increased risk of blood clots and make sure that that they are carefully being monitored for symptoms.

HealthDay reports that many breast cancer patients have lower levels of vitamin D, which could lead to weaker bones and increased risk of fractures. Women with breast cancer have accelerated bone loss due to the nature of hormone therapy and chemotherapy.

According to a study performed by U.S. researchers, in “166 women undergoing treatment for breast cancer and found that nearly 70 percent had low levels of vitamin D in their blood… The researchers found that weekly supplementation with high doses of vitamin D (50,000 IU or more) boosted the levels of the vitamin among all the women”. How else does vitamin D benefit cancer patients? vitamin D plays an important role in cell growth and keeping the immune system strong.

Visit NorthShore University HealthSystem’s cancer treatment center for more information on treatment options for cancer survivors.

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