Spinal Cancer: Types, Symptoms, Prognosis, and More



stage 4 prostate cancer remission :: Article Creator

Prostate Cancer Triple Therapy Offers Promise But Non Medical Treatment Also Emphasized For Success

LOS ANGELES (KABC) -- Stage 4 prostate cancer patients can benefit the most from a triple combination therapy, studies show. But doctors say the most essential part of treating men with this dire diagnosis isn't medical at all.

Steven Montgomery counts his blessings everyday.

"I'm just so grateful and just so humble to just to be here in 2024," the 68-year-old said.

In September 2022, doctors diagnosed this husband, father, grandfather and great grandfather with stage 4 prostate cancer. It had spread to his bones. Montgomery was emaciated and unable to walk.

"My wife looked at me and said 'Look, you have got to fight,'" he said.

His willingness to fight led him to oncologist John Shin at the Loma Linda University Cancer Center.

"He prayed with me and my wife and something sparked in me and it just gave me hope," Montgomery said.

Once prostate cancer spreads, survival rates fall. About a third of patients survive five years. Shin said the gold standard of treatment are two forms of hormone therapy. But the latest research shows combining a third course of medicine appeared to offer patients like him better odds at keeping the cancer at bay. Doctors added chemotherapy (docetaxel) to next-generation hormonal therapy (Prednisone and Abiraterone) and androgen deprivation therapy (Leuprolide).

"For people with aggressive disease or a lot of disease burden, a triple combination where you add chemo to the two hormonal agents can be more beneficial for these people," Shin said.

The triple therapy proved to be the right fit. But Shin warned Montgomery that the chemo side effects would be severe. But in his case, something unheard of happened.

"No side effects at all, none, which is incredible," said Montgomergy.

Shin credited Montgomergy's faith and an extremely positive mindset.

"How you live your life, especially how you think, and the attitude that you hold plays a huge role in unlocking the most powerful pharmacy in the world, which is the one located between your ears," he said.

"Never give up hope. Hold fast to your hope," Montgomery said.

MORE: Cancer deaths declining, but increase in some types for young adults

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Louisiana Marathon Runner Has Run Nearly 700 Marathons, Many While Battling Cancer

Setting and meeting goals is a driving force for Tom Perri, a Minnesota native who will run as a pacer in the 13th annual Louisiana Marathon staged this weekend in downtown Baton Rouge.

Perri, 62, has been running races for the past 47 years, and is nearing a career mark of 700 marathons. He has completed a United States marathon circuit — one completed marathon in each state — seven times, and was working on a sub-four hour circuit in 2018 when he was slowed down by fatigue.

After numerous visits with his doctor, Perri was diagnosed with Stage 4 prostate cancer. Amazingly, while the disease has sapped time off his finishing numbers, it has only put a small dent in his running schedule.

On Sunday, Perri will serve as a six-hour marathon pacer. Four-and-a-half years after his initial diagnosis, being a marathon pacer is a service he still provides at races stateside and abroad. He is no longer leading four-hour groups, but he is still working to help others finish races and improve their own times.

"I want people to know that just because you have a cancer diagnosis, whatever you're going through, you can still live a fairly normal life," Perri said. "I run every other day instead of every day, but I still put in 48-mile weeks."

Perry has run 177 marathons since receiving his Stage 4 diagnosis, but so far his only concession when running a race is that his times have gotten slower.

"I was running really well in 2022, but then, after my last round of treatment, it knocked me on my ass so I've been fighting ever since," Perri said. "There's going to be no remission for me so one of these days I'll be in the grave, but it won't be soon. I'm trying to fight it."

Besides running, a passion for Perri has been working on a book that details the spirit he has maintained during his cancer battle. It is still being written, and is expected to include the stories of more than 25 athletes who have also battled cancer.

Perri already has ideas about what the book will be named.

"The current thought is it will be something like 'Cancer' with the c-e-r crossed out," Perri said. "It's going to have the word 'can' in it, for sure, because I'm all about what you can do, not what you can't do. Cancer may tell me what I can't do, but, no way in hell it's going to tell me what I can do."

The Louisiana Marathon will be the third for Perri in 2024. He comes to Baton Rouge after running in the Brazos Bend marathon, about an hour west of Houston, last weekend. From there, his plans will take him to Hawaii for a couple of marathons. He is 10 states away from completing his eighth U.S. Circuit, and 21 away from a ninth.

After that, there is the goal of 750 career marathons.

Note

The marathon expo will be at the Raising Cane's River Center ballroom from 11 a.M.-6 p.M. Friday and 10 a.M.-5 p.M. Saturday. Saturday's schedule features quarter-marathon and 5K runs beginning at 8 a.M. Followed by the Blue Cross and Blue Shield kids marathon at 10:15 a.M. On Sunday, the Louisiana Marathon and half-marathon will begin at 7 a.M.


NICE Impact Prostate Cancer

Prostate cancer is the most commonly diagnosed cancer in the UK. In their lifetime 1 in 6 men will be diagnosed.

This report highlights progress made by the health and care system in implementing NICE guidance on prostate cancer.

Published November 2020

Why focus on prostate cancer?
  • 57,000 new UK diagnoses in 2018 - more than breast, lung and bowel cancer
  • 33% increase in hospital admissions between 2014 to 2015 and 2018 to 2019
  • 1 in 6 men will be diagnosed in their lifetime
  • 400,000 people living with or after the disease
  • What we've published on this topic Key findings from the report

    This page provides a summary of the findings from the report. It includes insight from Dr John Graham, consultant oncologist and cancer lead clinician at Taunton and Somerset NHS Foundation Trust, about NICE's role in improving outcomes for people with prostate cancer.

    This report looks at the impact of our guidance using data mostly collected before the COVID-19 pandemic. It highlights where new COVID-19 resources have been developed to help the NHS take action.

    There have been substantial improvements in the diagnosis and treatment of prostate cancer over the last 20 years and NICE guidance has been key to many of these.

    Dr John Graham, consultant oncologist and cancer lead clinician at Taunton and Somerset NHS Foundation Trust

    Recognition and diagnosis of prostate cancer Key points
  • Prostate cancer has a 5 year survival rate of over 95% when diagnosed at stage 1 to 3 compared with other cancers. Although, for the 1 in 5 people diagnosed with stage 4 prostate cancer (metastatic), the 5 year survival rate drops to just 49%.
  • Awareness has been raised by national campaigns. NHS Be clear on cancer has raised awareness. As has coverage of diagnoses. Media coverage of Stephen Fry and Bill Turnbull's cases resulted in a 250% increase in visits to the NHS prostate cancer advice webpage.
  • In April 2020, the number of people referred for investigations for any suspected cancer fell by more than half. This was due to the first COVID-19 lockdown. Numbers have since recovered and by August 2020, 88% had their first consultant appointment within 2 weeks. Despite the pandemic, the number of urgent GP referrals had returned to almost previous levels.
  • Testing is important to determine the stage of prostate cancer and to make sure the appropriate treatment is offered. Our guideline on prostate cancer says to offer multi-parametric MRI (mpMRI) first for people with suspected clinically localised prostate cancer. The proportion of mpMRIs performed before biopsy is increasing year on year. In 2017 only 37% were performed. This increased to 46% in 2018 and 87% in 2019.
  • Insight from Dr John Graham

    "Identifying significant prostate cancer remains the principal challenge. Many localised cancers may never impact on life expectancy, but it is essential that high risk cancers are identified at an early stage.

    Although the treatments for incurable prostate cancer continue to improve, it is imperative that we reduce the number of people being diagnosed with stage 4 of the disease.

    The impact of COVID-19 remains to be quantified, but it's encouraging to see referrals for cancer diagnostics improving following the initial reduction. However, the second wave of COVID-19 may impact on this."

    Key points
  • A range of prostate cancer treatment options are available depending on the stage of cancer. The Predict Prostate patient decision aid is endorsed by us and supports our guideline on prostate cancer. Produced by the University of Cambridge Academic Urology Group, it compares the potential outcomes of different treatment options for people with non-metastatic prostate cancer.
  • The robotic approach to surgery is increasing. In 2019, the proportion of prostatectomies performed robotically rose from 74% in 2017 to 85% in 2019. The benefits of robotic surgery include less blood loss, reduced pain and shorter hospital stays.
  • For people with metastatic hormone-relapsed prostate cancer, we recommended both abiraterone or enzalutamide before chemotherapy and following androgen deprivation therapy. The overall use of these drugs has increased since they were first recommended by us. The use of abiraterone and enzalutamide is measured in defined daily doses (DDDs). DDDs have risen from 350,000 in 2015 to almost 600,000 in 2020.
  • We published the COVID-19 rapid guideline: delivery of systemic anticancer treatments in line with advice from NHS England and NHS Improvement. This prioritises radiotherapy treatments if services become limited because of the COVID-19 pandemic. It maximises patient safety and makes the best use of resources while protecting staff from infection.
  • Insight from Dr John Graham

    "The steady increase in robotic radical prostatectomy is welcome and the 2014 NICE guidance was a key driver of this change in practice.

    The COVID-19 measures for newly diagnosed prostate cancer are welcome. However, I remain concerned that due to COVID-19 the incremental improvements seen in the management of advanced prostate cancer over the last 20 years may be undermined by clinicians' and patients' reluctance to consider chemotherapy.

    Even pre-COVID there were substantial variations in chemotherapy rates across the UK."

    Managing adverse effects of treatment Key points
  • Side effects after treatment for prostate cancer are common. After radiotherapy, 10% of people develop gastrointestinal complications, and after prostatectomy, 9% developed genitourinary complications. Both require further investigation or treatment 2 years after radical treatments.
  • After treatment for prostate cancer, most people will have an assessment for some of the key adverse events. These assessments allow decisions on further treatment. Our guideline on prostate cancer says that people with adverse effects should be offered care from an expert team of professionals and have access to specialist services for assessment, diagnosis and conservative treatment.
  • Insight from Dr John Graham

    "While the earlier use of novel hormone therapies has many advantages, there is a continuing need for improved investigation and management of the toxicities associated with long term androgen deprivation therapy."

    People's experience of care Key points
  • People should discuss their treatment options and possible adverse effects with a named nurse specialist. In 2019, 88% of people with prostate cancer in England were given the name of a nurse specialist to support them through their treatment. The support given helps people feel reassured that they are well informed and involved in decisions about their care.
  • Urology has the highest number of new cases per cancer nurse specialist. There are 145 urological cancer patients for every nurse, compared to 108 for lung cancer and 84 for breast cancer patients.
  • There is a substantial variation between cancer alliances in the ratio of urology specialist cancer nurses to newly diagnosed patients in their care. For every urology cancer nurse, there are 251 new patients. The fewest new patients for a nurse is 87.
  • Insight from Dr John Graham

    "The figures on cancer nurse specialists in urology compared to other cancers remain a concern. Prostate cancer treatment is complex and often extends over many years.

    NICE guidance has highlighted the need for additional nurse specialists for people with prostate cancer but a lot more needs to be done."

    More information

    This report highlights progress made by the health and care system in implementing NICE guidance. We recognise that change can sometimes be challenging and may require pathway reconfiguration. It may also require additional resources such as training and new equipment.

    We work with partners including NHS England and NHS Improvement, Public Health England and other relevant organisations to support changes. We also look for opportunities to make savings by reducing ineffective practice.






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