December 2005

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There will not be a regular meeting held in December but our next meeting will be held on January 31st 2006.

At our January meeting Maren Martin has agreed to to return to speak to our group. The subject will be "intimacy" especially as it relates to prostate cancer

Maren Martin is a Licensed Clinical Social Worker with a psychotherapy practice in Pacific Grove as well as a Certified Sex Therapist and specializes in sex and couple therapy. She has a special interest in helping cancer survivors have emotional intimacy and fulfilling sexual relationships.

This group will be for men that have been diagnosed with prostate cancer which has spread outside the prostate or who have experienced a recurrence after primary treatment. Typically, these men are receiving hormone blockade, are participating in a clinical trial or are receiving some other form of advanced treatment. The sub-Group will meet every TWO months at the Katz Cancer Resource Center of Dominican Hospital. The sub-group will meet on the 2nd MONDAY OF THE MONTH. Next Meeting Date: …… February 13^th, 2006, 5 – 7 pm.

The purpose of this group will be to better address the special problems and issues of men with advanced prostate cancer. In addition, at some meetings, we will invite local medical oncologists to discuss their approach and treatments

Men with advanced prostate cancer will continue to be welcomed at the regular monthly meetings on the last Tuesday of the month. Tony Calvo has agreed to coordinate the sub-group. If you have any suggestions or questions, contact Tony Calvo at 684-0940.

SUPPORT SUB-GROUP MEETING FOR WIVES and PARTNERS OF MEN LIVING WITH PROSTATE CANCER

This group is for women to share information with each other, learn more about prostate cancer, and how to cope with the impact of the disease individually and within the family in a supportive, caring and confidential environment. The meeting will be held every two months, the 2nd Monday of the month, 5 – 7pm (same time and same building as the men’s Advanced Prostate Cancer Meeting). For more information, contact Julie Batz at 724-2701

Next Meeting Date: February 13^th, 2006, 5 – 7 pm, Rm. B-2 (upstairs from the Katz Cancer Resource Center)

11/23/2005 - One in six men will develop prostate cancer at some point in their lives. That's according to the American Cancer Society. Now, doctors are testing a vaccine that may some day offer hope to patients whose prostate cancer has spread. 7Healthcast reporter Dr. Deanna Lites has more.

13 years ago, James Wilson says he didn't even know what a prostate was, but he got a fast education. He was diagnosed with prostate cancer in 1992. Since then, he's been through all kinds of treatments including hormone therapy, one of the most common treatments for advanced prostate cancer. Still, his cancer has spread, which is not uncommon.

Oncologist Dr. Gregory Rausch says "But virtually 100% of those men eventually develop progression of the disease. When that occurs and they become resistant to hormone treatment. There are few alternatives. The only real alternative right now is chemotherapy."

Now a vaccine designed to stimulate the patient's immune system to fight prostate cancer is being studied. It's different from other cancer vaccines that are made from the patient's own cells. "Prostate cancer cells are so similar from patient to patient, you can use sort of a standard cell line to develop the vaccine," says Dr. Rausch.

If the vaccine is effective, it could help prostate cancer patients survive longer. So far, patients have reported few side effects. Results from initial studies of the vaccine are promising. Now it's being tested to see how effective it is compared to chemotherapy. James has signed up for the latest study. He says, " If I can help one person, me first, and then someone else, you or whoever, I'm glad to do it."

This news story is about the GVAX® Vaccine for Prostate Cancer Clinical Trial. GVAX® vaccine for prostate cancer is a product currently in Phase 3 clinical development for patients with advanced-stage, hormone-refractory prostate cancer. The vaccine is comprised of two prostate cancer cell lines that have been genetically modified to secrete granulocyte-macrophage colony stimulating factor (GM-CSF), a hormone which plays a key role in stimulating the body's immune response to vaccines, and then irradiated for safety. GVAX® vaccine for prostate cancer is an “off-the-shelf” product designed to stimulate a systemic immune response against the patient's prostate cancer, destroying prostate cancer cells that persist or recur following surgery, hormone or radiation therapy. The vaccine has demonstrated a favorable safety profile in each trial it has been evaluated in to date.

Cancer Research & Treatment Center, Soquel, California; Recruiting Cecilia Rivas 831-462-8750

NEW YORK (Reuters Health) Nov 29, 2005- Men with high-risk prostate cancer fare better when they are treated with at least 12 months of hormone reduction therapy rather than with a shorter duration of treatment, new research suggests. This holds true regardless of how fast growing or advanced the cancer is.

Androgen deprivation therapy involves lowering levels of male hormones, such as testosterone, in the body in an effort to block or slow the growth of prostate cancer. Androgen deprivation therapy is most commonly achieved with medications, but it can also be produced by removing the testes.

Previous reports have suggested a survival benefit with long-term androgen deprivation therapy, but it was unclear if this applied to all patients or only those with fast-growing cancers, lead author Dr. Eric Berthelet, from the British Columbia Cancer Agency (BCCA) in Victoria, Canada, and colleagues note in the International Journal of Radiation Oncology, Biology, Physics.

The study involved 307 patients who were treated with radiation therapy and entered in the Prostate Cancer Outcomes Initiative database of the BCCA. Roughly half of the patients received short-term androgen deprivation therapy, defined as less than 12 months, and half received therapy for longer durations. The groups were comparable in terms of tumor aggressiveness and disease stage, the authors note.

The patients were followed for around 47 months. The typical duration of treatment in the short-term group was 6 months, whereas the duration in the long-term group was 26 months. On follow-up, 63 percent of long-term therapy patients had no apparent disease compared with just 37 percent of short-term therapy patients. Moreover, the 5-year survival rate in the long-term group was 88 percent, significantly higher than the 75 percent rate seen in the short-term group.

The study shows that long-term androgen deprivation therapy used along with radiation treatment improves survival rates for high-risk patients, regardless of the cancer's aggressiveness or disease stage, Berthelet concluded.

SOURCE: International Journal of Radiation Oncology, Biology, Physics. November 1, 2005.

NEW YORK (Reuters Health) Nov 28, 2005 - Even if patients have relatively low prostate specific antigen (PSA) levels, a biological marker for the disease, abnormalities detected by digital rectal examination (DRE) can help identify prostate cancer, re-enforcing the importance of this procedure, new study findings suggest. Some doctors believe the use of DRE in patients with low serum PSA levels - lower than 4 ng/mL - is not necessary.

To further investigate, Dr. Caleb B. Bozeman and colleagues at Louisiana State University Health Sciences Center in Shreveport identified 916 patients with abnormal DRE findings and a PSA level lower than 4.0 ng/mL. Most patients underwent standard rectal biopsies.

According to the team's paper, published in the medical journal Urology, prostate cancer was diagnosed in 81 men, or 8.8 percent. The investigators found that the predictive value of the DRE increased as PSA levels increased, with cancer detected in 1.8 percent of those with levels between 0.0 and 0.9 ng/mL, versus 21 percent among those with levels between 3.0 and 3.9 ng/mL.

Age was also a significant predictor, with cancer diagnosed among 5.4 percent of those younger than 50 years and among 11.3 percent older than 70 years.

The authors also noted that during surgery, 19 percent of the prostate cancers were diagnosed on the side opposite the original abnormality, defined as "serendipitous detection."

"Our study found that the abnormality on the DRE in patients diagnosed with prostate cancer was most likely to represent cancer and thus, in most patients, cancer was not diagnosed serendipitously," Bozeman and his associates write. However, they add, "one could argue that patients with abnormal DRE findings and a serum PSA less than 2.0 ng/mL could simply be followed up closely and do not require a prostate biopsy."

NEW YORK - REUTERS - An olive-oil based herbal extract preparation called Zyflamend suppresses the growth of prostate cancer cells and induces prostate cancer cells to self-destruct, according to a new study. A Columbia University study has reportedly demonstrated Zyflamend, an proprietary herbal extract preparation, suppresses prostate cancer cell growth

Zyflamend has the ability, in culture at least, to reduce prostate cancer cell growth by as much as 78 percent and induce cancer cell death or "apoptosis," scientists report in the journal Nutrition and Cancer.

"Together, these results suggest that Zyflamend might have some chemopreventive utility against prostate cancer in men," lead investigator Dr. Debra L. Bemis of Columbia University College of Physicians and Surgeons, New York told Reuters Health.

Zyflamend has both COX-1 and COX-2 anti-inflammatory effects, although its anti-cancer effects against prostate cancer are independent of COX-2 inhibition. COX inhibitors have shown value for prostate cancer patients, but data from recent trials of selective COX-2 inhibitors suggest that use of these drugs might have adverse effects on the heart.

Aspirin, a non-selective COX inhibitor, is not associated with these side effects and, instead, has well established benefits in people with heart disease. Zyflamend has a biochemical action profile similar to aspirin.

In the laboratory, Bemis and colleagues observed that treatment of prostate cancer cells with Zyflamend dramatically decreased COX-1 and COX-2 enzyme activity and attenuated cancer cell growth. Bemis said "we are currently conducting a Phase I clinical trial for men with a pre-cancerous lesion of the prostate -- prostatic intraepithelial neoplasia -- to gain some information as to Zyflamend's potential to prevent or slow... progression to prostate cancer." SOURCE: Nutrition and Cancer, October 2005.

Phenoxodiol, a drug derived from genistein, the isoflavone found in soy, has been successful in slowing the progress of hormone refractory prostate cancer, resulting in an increase in the average time before the disease progresses, from 15 to 47 weeks, and extending the average PSA doubling time from 18 to 43 weeks. In this study the drug was used alone, but in other studies, phenoxodiol has been shown to increase the effectiveness of other chemotherapy drugs by as much as 100 times. Further studies are planned. The full news article:

Newswise - Nov. 17, 2005 — A new study presented today at the International Conference on Molecular Targets and Cancer Therapeutics in Philadelphia shows that phenoxodiol significantly delays tumor progression in men suffering from late-stage hormone refractory prostate cancer. The meeting is sponsored by the American Association of Cancer Researchers (AACR), the National Cancer Institute (NCI), and the European Organization for Research and Treatment of Cancer (EORTC).

The anti-tumor effect in this Phase Ib/IIa trial was dose-dependent. The trial was designed to end after 24 weeks of treatment, but had to be extended to the current 90 weeks because of the unexpected extended survival in some patients. Patients have been able to remain on phenoxodiol for this extended time without any evidence of toxicity.

Researchers administered various doses (20, 80, 200 and 400 mg) of phenoxodiol to men with metastatic, hormone-refractory prostate cancer to establish what level of anti-cancer effect the oral dosage form of this drug would provide and whether there was a dose-dependent effect. The phenoxodiol was administered in monthly treatment cycles comprised of 3 doses daily for 21 consecutive days followed by 7 days without treatment. The original plan was to treat patients for a maximum of 6 treatment cycles. Except for anti-androgen therapy being continued in those who were receiving it pre-trial, phenoxodiol was the only treatment. The age of the 26 subjects studied ranged from 55 to 85, the Gleason score was mean 8.04 (range 6-9), and the mean baseline PSA level was 56.3 pg/ml.

Response to therapy in these patients was determined on the basis of PSA response (a decline in PSA level compared to baseline of at least 50 percent), PSA doubling time (time for the baseline PSA level to double), and time to progression (length of time that patients remained on phenoxodiol based on PSA levels and clinical assessment).

"The two highest dosages of phenoxodiol provided a significant anti-tumor response in a disease that is normally unresponsive to treatment in its late stages," says Robert Davies, MD, lead investigator of the study and urologist at Sir Charles Gairdner Hospital in Perth, Australia. "We found that the PSA level, an indicator of the level of cancer, decreased. We also saw a clinical response that was prolonged in some patients."

Combining the data from the two lowest dosages (12 patients) and the two highest dosages (14 patients), the number of patients still on therapy after 6 months increased from 1 out of 12 (8.5 percent) to 10 out of 14 (71.4 percent), and the mean time to progression (length of time patients were deemed to be deriving a benefit from therapy) increased from 15 weeks to 47 weeks. This latter figure does not take into account four patients who remain on therapy after 42, 74, 82 and 90 weeks.

In terms of PSA levels, there were no PSA responses in the two lowest dosage groups, but 3 of the 14 in the two highest dosage groups experienced a PSA level reduction of 50 percent or greater from baseline. The PSA doubling time increased from a mean 18 weeks to 43 weeks, not including the 3 of 14 patients who remain on phenoxodiol therapy and whose PSA levels have yet to double. While it was not possible to measure tumor size in this study, an increase in PSA doubling time is generally regarded as reflecting a tumor response.

"The long-term anti-tumor effects and safety demonstrated in this study are very encouraging developments," said Graham Kelly, Ph.D, Chairman of Marshall Edwards, Inc. Professor Kelly presented the data on behalf of the investigators in the 12:30 - 2:30 pm poster session on Thursday, November 17, at the AACR-NCI-EORTC meeting.

A Californian oncologist who referred two patients to the trial agrees that the results are good news, and may impact the way prostate cancer is treated. "Phenoxodiol represents a unique new class drugs for men with prostate cancer," says Steven Tucker, MD, Director of Prostate and Genitourinary Oncology at The Angeles Clinic & Research Institute in Los Angeles. "If the clinical benefit seen in these refractory patients can be extended into an earlier disease state, we may be looking at a paradigm shift in the management of advanced prostate cancer,” says Dr. Tucker, who is also an Assistant Clinical Professor of Medicine at the UCLA School of Medicine.

Professor Kelly said that the next stage of development of phenoxodiol for prostate cancer would be to use it in patients who have failed to respond to both hormone therapy and docetaxel therapy. “On the basis of this data, we would expect that phenoxodiol alone would offer these patients a significant survival benefit, but we also will be interested in testing the ability of phenoxodiol to restore sensitivity to docetaxel in these end-stage patients,” Professor Kelly added.

This next study will be conducted in the U.S. and is planned to commence enrollment in 2006.

Combination of Two Existing Drugs Offers Potential Alternative for Prostate Cancer: Presented at AACR-NCI-EORTC

By Maggie Schwarz PHILADELPHIA, PA -- November 22, 2005 -- A combination of two drugs already in use to treat certain cancers offers a potential strategy to treat prostate cancer without subjecting men to treatments that squelch the production of testosterone. The two drugs are granulocyte macrophage colony-stimulating factor (GM-CSF) and thalidomide. Lead investigator Robert J. Amato, DO, Director of the Genitourinary Oncology Center, Methodist Hospital Research Institute, Houston, Texas, United States, presented the phase 2 findings here on November 16[th at the International Conference on Molecular Targets and Cancer Therapeutics.

The conference is organized jointly by the American Association for Cancer Research, the National Cancer Institute, and the European Organisation for Research and Treatment of Cancer (AACR-NCI-EORTC).

The protein GM-CSF stimulates immune system blood cell proliferation. It has been studied for its effects on colon,,ovarian and prostate cancer, and in myeloma, as well as other non-cancerous conditions such as Crohn's disease.

Thalidomide was prescribed in the 1950s and 1960s as treatment for morning sickness, but was banned from use when it became clear that it caused severe birth defects. Much of its deleterious effects on development in early body formation in babies were related to its function in thwarting angiogenesis. In addition to inhibiting angiogenesis, thalidomide contributes to enhanced immune response.

In their phase 2 trial, Dr. Amato and colleagues evaluated the combination of GM-CSF and thalidomide in prostate cancer patients; seven had undergone radical prostatectomy, six had radiation therapy and five had both. None had received previous hormone ablation therapy.

Treatment consisted of three weekly doses of GM-CSF and thalidomide once daily at bedtime. Doses were scaled to determine maximum tolerable levels of thalidomide. The researchers monitored prostate-specific antigen (PSA) levels at 6-week intervals. "All of the men in the study had a 26% or greater reduction of PSA blood levels," Dr. Amato observed. "The median response was 59%."

Toxic events were all grade 1 or 2 in severity and manifested predominantly as transient skin rash, fatigue, peripheral neuropathy and constipation. However, one patient developed deep vein thrombosis and pulmonary embolism.

"GSM-CSF plus thalidomide can be used successfully with encouraging anti-tumor activity," Dr. Amato concluded. "The combination of GM-CSF plus thalidomide may constitute a significant improvement over current therapies."

Long-term androgen suppression therapy (more than 1 year) can lead to significant adverse effects, including bone density loss, anemia, breast enlargement, hot flashes, impaired memory and impotence in some patients, especially among elderly men.

"Existing hormone ablation therapy is effective and palliative," Dr. Amato asserted. "Many patients, however, hesitate to begin hormonal therapy due to the adverse effects."

Cellular molecule spurs growth of prostate cancer - May provide target for treatment

Dec 1, 2005 - University of North Carolina at Chapel Hill scientists have identified a molecule that stimulates the aggressive growth of prostate cancer. The molecule, Ack1, a member of the growth-promoting tyrosine kinase gene family, stimulates tumor formation in part by signaling prostate cells to rid themselves of a tumor-suppressor protein. Normally, this suppressor protein would inhibit rapid cell growth by signaling the cell to destroy itself.

A report on the study, which appeared Nov. 15 in the journal Cancer Research, also points to Ack1 as a potential target for developing novel drugs against prostate cancer.

The study's senior author, Dr. Shelton Earp, directs the UNC Lineberger Comprehensive Cancer Center and is Lineberger professor of cancer research and a professor of pharmacology and medicine. Tests of Ack1 demonstrate a profound effect on tumor growth in experimental systems, Earp said. "It's a remarkable effect. Tumors grew more rapidly and invaded as if they were converted to advanced prostate cancer."

Another major finding of the study involved an experimental drug developed by the National Cancer Institute, called geldanamycin. In laboratory tests, the UNC Lineberger group found Ack1 activity could be inhibited through interference with its molecular interactions, thus offering a target for treatment. First, the group discovered that Ack1 bound to a protein called Hsp90 (heat shock protein 90), which associated with many oncogenic, or cancer-causing, signaling proteins. "If you add geldanamycin to the prostate cancer cell, the drug knocks Hsp90 off oncogenic signaling molecules. This dramatically decreases Ack1 activity and slows tumor formation," Earp said.

In addition, the team compared Ack1 activation in advanced prostate cancer tissue from patients with that found in benign prostatic hypertrophy, or non-cancerous prostate enlargement. The team showed the levels of the activated Ack1 to be much higher in the advanced tumors. "Because we found Ack1 is more active in advanced prostate tumors, and its inhibition blocks experimental tumor growth, we believe Ack1 should be a target for novel drug development."

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The Santa Cruz County Prostate Cancer Support Group does not endorse any provider, organization, product or individual. All medical decisions should be made with the advice and consultation of medical professionals.

Our newsletter serves over 200 members. Many THANKS to the American Cancer Society for assisting with the printing and mailing of this newsletter and the Katz Cancer Resource Center for allowing us to use their facility.