| Prostate Cancer |
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Prostate Cancer in FranceThe most common cancer in men aged over 50 40,000 new cases in 2005 (25% of the new cases of cancers in men) 1 in 8 Frenchmen will have a cancer of the prostate during their lives It is a cancer of the elderly, and very rare under 50 years of age Second cause of death from cancer in men 9,000 deaths from prostate cancer in 2005 (10% of deaths from cancer in men) The prostate cancer rate increases every year |
Classification and prognostic
The prognostic for prostate cancer will depend on the size of the tumor and its stage of extension (TNM), but also on its aggressiveness which is determined using the Gleason Score.
| Gleason score: In 1966, Gleason defined five different histological aspects graded from 1 to 5 from the most differentiated form to the least differentiated form. The benefit of this score is that it takes the heterogeneous nature of the tumor into account. It is the sum of the 2 predominant malignant cellular contingents (for example, a contingent of Gleason 3 cells with a more undifferentiated contingent of Gleason 4 will give a result of 3+4=7). |
Treating prostate cancer
If the cancer is diagnosed at a localized stage (T1/T2 ), potentially curative treatment can be applied. The radical prostatectomy is the usual treatment. The radiations can be used instead of or after surgery. Hormone therapy is used in patients with cancer which has spread beyond the limits of the prostate or has returned after initial treatment. The purpose of “hormone” treatment is to counter the action of male hormones (androgens) which stimulate the prostate, either by an orchiectomy or by the administration of LHRH agonists or by using an anti-androgen. Hormone therapy is effective in 80% of cases, but it stops the cancer spreading without curing it. However, hormone therapy only has a transitory effect of a variable duration.
| LH-RH (luteinising hormone - releasing hormone or gonadorline) This is a protein produced by the hypothalamus gland located behind the base of the brain which stimulates the production of the luteotrope hormone (lh) which in turn stimulates the testicles and the synthesis of male hormones (androgens) |
Hormone resistant prostate cancer
A certain number of prostate cancers become capable of growing with few or no male hormones. This stage is called the ‘hormonal escape phase’ characterized by the disease changing under hormone therapy. It occurs within 18 to 36 months after the start of hormonal therapy. The cancer is called hormone-resistant.
Treatment of hormone resistant prostate cancer
Chemotherapy treatment is the current therapeutic option for treating hormone resistant prostate cancer. The role of chemotherapy at the hormone resistant stage was confidential for a long time until the results of two large international studies were published, which, for the first time, showed an increase in the global survival of a group of patients treated with chemotherapy combining Taxotere® and prednisone. Taxotere® has become the standard treatment for hormone resistant prostate cancer since these two studies were published and has obtained marketing authorization (MA.) in Europe and the United States, in this indication for a 75 mg/m2 dose every 21 days, combined with prednisone at a dose of 5mg morning and evening.
Numerous products are being tested with Taxotere®, including inecalcitol with the hope of increasing the survival rate for these patients.