Hope for Filipinos with advanced prostate cancer

Dr. Antonio Villalon is facing a very interesting dilemma. As one of the country’s preeminent medical oncologists, he now has a very potent treatment option for patients suffering from the most advanced stage of prostate cancer.

In fact, the new chemotherapy drug is proving extremely effective for the five Filipino patients Villalon is currently treating. The intravenous drug has helped his patients keep their cancer in check without debilitating side effects.

Advanced prostate cancer occurs when the cancer has spread to the bones and or the lymph nodes. Currently there is little doctors can do to help prostate cancer patients who progress to this stage as these men, who may already suffer from “refractory” or “castration resistant” cancer, no longer respond to the usual hormone therapy.

But despite the obvious proof that it could prolong the lives and relieve the symptoms associated to advanced prostate cancer, Villalon cannot immediately offer Jevtana (cabazitaxel) to the rest of his patients as the drug will not be available until August.

Moreover, the number of vials that he has are limited to the five patients who are study volunteers for the drug’s global clinical trial.

“Access to a greater range of effective treatment options at all stages of prostate cancer is of great importance to prostate cancer patients. And the imminent arrival of the Jevtana (cabazitaxel) here is most welcome as it would improve survival rate of Filipinos with advanced prostate cancer as well as improve the lives of their families also affected by this disease,” said Villalon, who is also the director of St. Luke’s Medical Center’s Cancer Institute in Global City, Taguig.

Prostate cancer is a disease that affects men from around the age of 50 years (in the Philippines, it develops in 19.3 out of every 100,000 Filipinos). It involves the prostate gland, which is a small gland about the size of a walnut, positioned just beneath the bladder, and is responsible for producing fluids that nourish and protect sperm.

The disease is mostly detected among senior citizens because the disease develops slowly and may cause few, if any, symptoms.

30% reduction

In a clinical study that has become the basis for the approval of both the United States and the Philippines Food and Drug Administration, Jevtana has been shown to reduce the risk of death by 30 percent when used in combination with anti-inflammatory drug prednisone.

The study, known as the Phase 3 Tropic (Treatment of Metastatic Hormone-Refractory Prostate Cancer Previously Treated with Taxotere-Containing Regimen), was conducted at 146 sites in 26 countries.

The Tropic study showed that Jevtana could significantly extend overall survival compared to mitoxantrone in men whose disease has progressed during or after treatment containing docetaxel.

“Jevtana represents a significant therapeutic advance considering that men with this stage of cancer typically have a poor prognosis and until recently there have been no licensed treatments available to extend life,” Villalon explained.

This means Jevtana will now become the first approved “second-line” treatment—after hormone therapy and chemotherapy—for men with advanced prostate cancer.

Improved quality of life

“What is also interesting is that the drug has been shown to significantly improve the quality of life of these patients not only in terms of pain relief but also in getting rid of their anxiety and depression as well as regaining self-confidence,” Villalon said.

It should be noted that although the early stages of prostate cancer may cause little or no pain, advanced prostate cancer that has spread to other parts of the body can be very painful. These cancer cells tend to affect the nearest areas—usually the bones in the pelvis, the tops of the thighbones and the lower part of the spine (which may cause nerve problem that could bound a patient to a wheelchair or bed).

“Extending patients’ lives at this late stage of their prostate cancer is a primary consideration. But as doctors we should also assure that such treatment should provide better health-related quality of life. With Jevtana, we may now have a much better choice,” the doctor said.