PCRI’s Executive Director, Mark Scholz, MD, gives an overview of unorthodox treatments for High-Azure (unfavorable high-risk) prostate cancer. He discusses the risks and benefits of each treatment and describes the situations in which a man with High-Azure prostate cancer might want to consider one of these unorthodox forms of therapy.

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0:20 High-Azure (unfavorable high-risk) prostate cancer is characterized by a recent diagnosis, a high Gleason score (9 or 10), and possible lymph node spread in the pelvic region. It’s a form of prostate cancer that is relatively difficult to treat, and so it’s reasonable to consider pushing the envelope when treating it.

0:43 Standard protocol for High-Azure prostate cancer is 18 months of hormone therapy, some form of beam radiation therapy to both the prostate and pelvic lymph nodes, and a seed implant boost.

0:55 Studies have shown that adding 4-6 cycles of Taxotere (a form of chemotherapy) to the standard protocol for High-Azure improves cure rates. Studies have also shown that adding Zytiga to the standard protocol improves cure rates. There are no studies, however (up to this point), on the effect of adding both Taxotere and Zytiga to the standard protocol so this would be an unorthodox course of treatment.

2:00 A combination of Taxotere and Zytiga is most promising for two types of patient: younger patients who can better tolerate the side effects Taxotere and who have more years at risk, and patients who have extensive lymph node spread or a very high PSA (greater than 50).

2:47 Using surgery alone as a treatment for High-Azure is largely ineffective (with cure rates around 20%) because by this stage the cancer has likely spread beyond the prostate gland. It is considered unorthodox undergo hormone therapy (Lupron, Zytiga) after surgery, but doing might increase a person’s chance of survival by attacking cancer that has spread beyond the prostate gland.

3:49 The addition of non-cancer medicines Aspirin, Metformin, and Statins have all been shown to improve cure rates with little risk to the patient; however, there have been no intensive clinical trials concerning their use as anti-cancer drugs, and so their use is considered unorthodox.

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