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Your prostate cancer diagnosis is just a starting point. Even though the path ahead may seem unclear or even insurmountable, armed with knowledge you can take control.

Let us help you become empowered to understand your diagnosis, to confidently ask questions, and to identify providers that are the best fit for you.

More resources for Prostate Cancer Newly Diagnosed from Patient Empowerment Network.

How Do Genetic Mutations Impact Prostate Cancer Treatment Options?

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How Do Genetic Mutations Impact Prostate Cancer Treatment Options? from Patient Empowerment Network on Vimeo.

 How do genetic mutations impact prostate cancer treatment options? Dr. Himisha Beltran shares how information about genetic mutations play into treatment decisions and discusses the role of PARP inhibitor therapies and immunotherapies.

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

See More From INSIST! Prostate Cancer

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What Is a Prostate Cancer Genetic Mutation?

What Is a Prostate Cancer Biomarker?

 

Transcript:

Katherine Banwell:

Dr. Beltran, are there gene mutations that affect prostate cancer treatment choices?

Dr. Beltran:

Yeah. So, we’re still really in the infancy of precision medicine in prostate cancer, but we’ve come a very long way. The field has identified several classes of mutations that have treatment implications for men with advanced prostate cancer. One class of mutations is in a pathway we call homologous recombination DNA repair. So, what this really is, is a pathway that consists of multiple genes. BRCA2 is the most common, but there are many within this gene family. And this pathway is important in maintaining DNA repair in a cancer.

There are specific types of mutations that can affect treatment choices for advanced prostate cancer. And there are drugs that specifically target these mutations. So, testing for them in is important in the clinic. The drugs that approved today fall into two classes of medications. One is a class of medicines called PARP inhibitors. These drugs specifically are geared towards patients whose cancers harbor mutations in a pathway called homologous recombination.

So, how these mutations impact the cancer is that they work to repair the DNA of a cell. And if a cancer cell has a mutation or a loss of function of one of these genes, they can still survive because there’s another pathway that can come in and take over. If you can now come in what a drug called a PARP inhibitor, and you block that other pathway, those cells are particularly vulnerable. And they die through a process we call synthetic lethality. And so, this is really the rationale for using a PARP inhibitor specifically for patients whose cancer have an alteration in this pathway.

And I mentioned there are a number of genes that are involved. And so, typically, the way they’re tested for is looking at either the primary cancer or a metastatic biopsy or a liquid biopsy. There’s a number of tests that are available to try to look for these mutations. There is a second class of drugs that is approved for prostate cancer patients based on genetic mutations. And that is a class of drug called immunotherapy. But the drug that’s approved is pembrolizumab. The way this drug works is it’s immunotherapy, meaning that it stimulates the patient’s own immune system to fight the cancer.

And this drug does not work in every patient with prostate cancer. We know it only works in a minority of patients whose tumors have specific vulnerabilities that make them amenable to this. And there a number of ways we test for it. There is something called hypermutation where there’s a lot of mutations in the cancer, mismatch repair deficiency which can be detected by DNA sequencing as well as protein expression. And there’s something called microsatellite instability. And so, these are tests that we are also commonly doing. It’s rare in prostate cancer, less than five percent, but it important because there a class of drugs that approved that can specifically target this.

And then, beyond these two pathways that I refer to, there are a number of emerging therapies that are specifically geared towards mutations in the DNA. So, as we do sequencing, we commonly get more information than just this. There are other common mutations in prostate cancer with clinical trials really geared towards individualizing care based on those mutations, whether it be through targeted therapies or immunotherapies or other approaches. So, the field is really moving very quickly. And so, it’s now quite relevant to test to for mutations where it wasn’t the case really not that long ago.

What Is a Prostate Cancer Genetic Mutation?

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What Is a Prostate Cancer Genetic Mutation? from Patient Empowerment Network on Vimeo.

 What is a prostate cancer genetic mutation? Dr. Himisha Beltran defines genetic mutations, where they may occur, and how identification of mutations can assist in prostate cancer detection and care.

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

See More From INSIST! Prostate Cancer

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How to Engage in Your Prostate Cancer Treatment Decisions

How Do Genetic Mutations Impact Prostate Cancer Treatment Options?

What Is a Prostate Cancer Biomarker?

 

Transcript:

Dr. Beltran:

So, genetic mutation refers to changes in the DNA sequence of an individual or their cancer. And so, we know that normal individuals have variations in their inherited or normal DNA that drive diversity. And some of these changes actually in your inherited DNA can predispose to future development of cancer. So, those are important to identify as those are mutations that may help us guide early detection and screening strategies for people at high risk for cancer.

There are also genetic mutations in cancers themselves. And each cancer type is characterized by different patterns of mutations that can sometimes help us in the clinic figure out, where did a cancer come from? Did it come from the prostate, or did it come from somewhere else? Some of these mutations in the cancer can also be targeted with drugs. And there are drug approaches that are developed that specifically target an individual’s mutation in their cancer. And every individual, even within prostate cancer, may be different. And so, this is something that we’re commonly testing for in the cancer itself by doing DNA sequencing to look for letter changes in the DNA.

What Is a Prostate Cancer Biomarker?

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What Is a Prostate Cancer Biomarker? from Patient Empowerment Network on Vimeo.

What is a prostate cancer biomarker exactly? Dr. Himisha Beltran defines biomarkers and breaks down three types of biomarkers that help guide optimal care for prostate cancer patients.

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

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How Do Genetic Mutations Impact Prostate Cancer Treatment Options?

 

Transcript:

Dr. Beltran:

So, the word, ‘biomarker’ is a term that we often use that refers to a set of information or a test that provides insights into a particular diseased state. And in prostate cancer, there are several different types of biomarkers that we use. There are diagnostic, prognostic, and predictive biomarkers. And each of them provide different sets of information. A diagnostic biomarker is a test that improves the diagnosis of prostate cancer, and one that we are very familiar with is PSA test. This is a test that’s commonly done that may lead a suspicion of cancer. That leads to an additional work-up for prostate cancer. And there are other tests, urine, blood, and tissue-based, that can improve the detection of prostate cancer as well as specific types of prostate cancer.

Then there are prognostic biomarkers. A prognostic biomarker is a biomarker that provides insight into how indolent or aggressive a cancer is. And this can inform treatment decisions for newly diagnosed patients in trying to consider whether you should do active surveillance or get local therapy. In the more advanced disease setting, a prognostic biomarker can help us think about treatment intensification strategies for patients that are predicted to not respond as well to traditional approaches. And these are often molecular tests.

And then there are predictive biomarkers, which in opinion, are quite informative in trying to make a prediction as to how likely will respond to a specific treatment. And this is a really emerging field. And in an advanced prostate cancer, one example of a predictive biomarker is a mutation in a gene called BRCA2, which can identify patients more likely to respond to a PARP inhibitor versus those that do not. That’s just one example of how we may be able to use molecular features of a cancer to provide insights into what therapy that patient might benefit from most.

There are no perfect biomarkers. All of these types of biomarkers are just tools that we use to help guide treatment decisions at different stages of prostate cancer.

COVID Vaccines: What Do Prostate Cancer Patients Need to Know?

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COVID Vaccines: What Do Prostate Cancer Patients Need to Know? from Patient Empowerment Network on Vimeo.

What do prostate cancer patients need to know about COVID-19 vaccines? Dr. Himisha Beltran shares information about safety, effectiveness, and recommendations for prostate cancer patients in active treatment. 

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

See More From Engage Prostate Cancer

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What Is a Prostate Cancer Biomarker?

 

Transcript:

Katherine:

Is the COVID vaccine safe and effective for patients with prostate cancer?

Dr. Beltran:

Absolutely. There really are no contraindications to getting the COIVD vaccine, unless there is some component of the vaccine that a patient cannot tolerate. And prostate cancer patients tend to be older. They can have their lower immune system if they’re getting chemotherapy. So, they’re at higher risk for having complications from COVID itself. So, I do think that it’s something to consider. There are even patients that are undergoing active therapy. They should, I think, consider getting the vaccine.

Katherine:

How does the vaccine effect treatment?

Dr. Beltran:

There should not be any delays or changes in therapy based on getting the vaccine.

An Update on Prostate Cancer Treatment and Research

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An Update on Prostate Cancer Treatment and Research from Patient Empowerment Network on Vimeo.

What’s the latest in prostate cancer treatment and research? Dr. Himisha Beltran shares developments in precision medicine and clinical trials, including how prostate-specific membrane antigen (PSMA) imaging can help provide targeted care.

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

See More From Engage Prostate Cancer

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What Is a Prostate Cancer Genetic Mutation?

 

Transcript:

Katherine:

Dr. Beltran, when it comes to prostate cancer research and emerging treatment options, what are you excited about specifically?

Dr. Beltran:

Well, there’s so much I’m excited about. There’s a lot happening in prostate cancer research. When it comes to precision medicine, we are still at the beginning. We are developing new trials and treatment strategies to target other mutations with drugs that have not yet been approved. We have the capability to interrogate treatment resistance, recognizing that tumors can evolve, and the technologies are such where we can start to understand why different people respond differently to the different treatments that we have, and now come in to try to prevent of bypass that treatment-resistant pathway, which is still a very new field.

I’m also very excited about even our understanding about the inherited mutations that predispose to prostate cancer because that has implications for family members, and one could envision a future where we have better detection and prevention for prostate cancer for high-risk individuals. And then, finally, one class of drugs that we didn’t talk about that is really precision medicine’s strategy is a class of drugs targeting PSMA – prostate-specific membrane antigen.

So, that is a molecular feature of the cancer. It is a protein that is expressed on the cell surface of prostate cancer. It’s not a genetic mutation that we test through genetic sequencing, but we have something called PSMA imaging where we can do molecular imaging to figure out if the prostate cancer expresses this protein. And there are a number of drug approaches that are coming in to target this very specific protein on the cell surface.

And so, I’m very excited about that. I do think that does represent precision medicine, and these are treatments in clinical trials that we’ll hear much more about later this year. And so, I think in general, as we start thinking about how we start treating prostate cancers, we’re moving beyond, “Treat everyone the same,” and really trying to figure out, “Can we really understand, who are the patients? And develop strategies that are more specific for that individual.”

How to Engage in Your Prostate Cancer Treatment Decisions

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How to Engage in Your Prostate Cancer Treatment Decisions from Patient Empowerment Network on Vimeo.

What factors are important to consider when deciding on a prostate cancer treatment approach? Dr. Himisha Beltran reviews key considerations and highlights the important role patients play in their care.

Dr. Himisha Beltran is Director of Translational Research in the Department of Medical Oncology at Dana-Farber Cancer Institute. Learn more about Dr. Beltran, here.

See More From Engage Prostate Cancer

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How Do Genetic Mutations Impact Prostate Cancer Treatment Options?

 

Transcript:

Katherine:

What are the considerations when choosing treatment for prostate cancer?

Dr. Beltran:

Yeah, so there are many considerations when thinking about a therapy choice for a patient with prostate cancer. Oftentimes, we use clinical features, radiology, blood tests, and now molecular features incorporating into that to really guide care based on how indolent or aggressive the cancer is. There are some cancers that don’t need to be treated that we follow on active surveillance. There are different states where we may do intermittent treatment, weighing the risks and benefits of the therapy.

And then, in the more advanced setting where you need continuous treatment – and there is now many choices of different drugs that are approved for prostate cancer – we often make these choices with our patients based on not just the trajectory of the cancer but also weighing the side effects and quality of life and other issues for those different treatment modalities. And I see precision medicine as providing one extra layer of information to help guide those conversations.

Katherine:

What’s the patient’s role in making treatment decisions?

Dr. Beltran:

The patient is the center. It’s really our role to help inform and partner with them because now we have a lot of choice. And one choice might not be the same for each individual. And so, we use clinical features and features of the cancer, but the other features factor, such as quality of life. It factors cost considerations – the logistics of it all. These can vary across the different treatments. And so, it really requires really going through everything with the patient. And the patient really does have a voice and really should be the center of that treatment decision.

Prostate cancer treatment is complex, and sometimes there are questions there are questions that a patient might have that their physician did not answer adequately. And they really should speak up because it’s important to know what all the options are. There are even things like the DNA sequencing. It can be difficult to interpret. And you may not know what available treatments are there unless you ask the questions.

Prostate Cancer Survivor Thrives After Unexpected Diagnosis

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Prostate Cancer Survivor Thrives After Unexpected Diagnosis from Patient Empowerment Network on Vimeo.

Prostate cancer patient Theo received a shocking prostate cancer diagnosis six years after a biopsy following a high PSA. Watch as he shares his cancer journey and advice to other prostate cancer patients.

See More From Best Prostate Cancer Care No Matter Where You Live

Transcript:

My name is Theo, and I live in Akron, Ohio. In 2009, I was diagnosed with prostate cancer. At 52 years old, this came as a shock as I took good care of myself and worked out regularly. Prior to that, I had a biopsy in 2003 following a high PSA diagnosed by my primary physician.

After the biopsy, no follow-up with care was recommended. I was not asked to return or contacted again by the urologist’s office. When I met with a urologist in 2009, the biopsy showed cancer with a Gleason score of 7. The doctor showed me a chart that revealed I had eleven years to live. I immediately thought of my oldest grandchild, and wondered if I’d be around to see him grow up. I was in disbelief and stunned.

I opted to have surgery following my diagnosis, and though my PSA was then down below one, it began to climb. I followed up with radiation for seven weeks, but my PSA started to climb after completing radiation. Ever since, I have been seeing my medical oncologist every 3 months since 2010.

Since 2019, my PSA has gone up and down but has gone from 53 in May of 2019 to 57 in December of 2020. My doctor has advised not starting hormone treatments until metastasis is found. Confident in my care, I agreed with that advice. I soon discovered that I was not alone. After speaking with members of my church, I discovered other men faced the same diagnosis and varied experiences.

Soon, time became more precious. I was fortunate to have my family with me every step of the way. Seven grandchildren later, that eleven years has now turned into 12 years.

My advice for other prostate cancer patients:

  • Be aware that your care team members may have biased opinions based on their fields of expertise.
  • Discuss all options with each treatment specialist prior to deciding which course of action to take.
  • Connect with others, it can be comforting to know that you share the same experience.

These actions are key to staying on your path to empowerment.

How Does Stress Correlate With Your Prostate Cancer Diagnosis?

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How Does Stress Correlate With Your Prostate Cancer Diagnosis? from Patient Empowerment Network on Vimeo. 

How do stress and cortisol levels contribute to prostate cancer incidence and aggressiveness in Black men? Dr. Leanne Burnham explains her research studies where they looked specifically at the role of stress in prostate cancer, tumor aggressiveness, and Black men — and also shares research about cortisol levels in African American children.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

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What Are Some Hereditary Factors Impacting Prostate Cancer Patients?

Top Tips and Advice for Prostate Cancer Patients and Caregivers Navigating Treatment

Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations?
 

Transcript:

Dr. Leanne Burnham

I have a few publications that look at the role of stress and prostate cancer, tumor aggressiveness, and Black men. And so, I looked at Black men specifically, because I have wondered if Black men who maybe were exposed to more stressors in their lifetime if that had any correlation to Black men getting prostate cancer earlier in their life and getting a more aggressive disease. And so, there were very realistic ways that we were able to look at that in the lab and then also in collaboration with public health colleagues that I have. Because what we know there are studies that show that African American children experience more stress, and their cortisol levels in their bodies are effective much earlier than any other race, and their studies that show the distress begins in the daycare setting based on discrimination that they may have from the adults that are taking care of them in that setting. And so, imagine cumulatively how that looks, and so we have ways that there are validated scales to assess levels of stressors that people have been exposed to. So that could be…what are your finances looking like? Have you been affected by incarceration yourself or anyone in your family? Have you experienced the death of a loved one? Has your home been broken into recently?

There are all kinds of, there are hundreds and hundreds of questions, and we can get to the root of how much stress has somebody been exposed to. And we know that unfortunately, African Americans in this country are exposed to more of these stressors than other demographics, and so what we did was look at the elevated stress, we could look at the cellular level and see, now if we’re growing prostate cancer cells, so that’s what I did. I was growing cancer cells in the lab that were from Black patients and white patients, and I would expose them to stress hormones in the flask, or maybe you like to think of it as kind of like a petri dish, but in the flask where the prostate cancer cells were growing. I would treat them with stress hormones, and then I would look and see do the cells grow differently, do they express genes and proteins differently based on race? And what I found very surprisingly, disturbingly, whichever adverb you want to use, that the African American prostate cancer cells, when they were exposed to stress hormones, the tumor cells became more aggressive, and they up-regulated genes that we know prime a patient to resist therapy.

So, the genes that were up-regulated in these prostate cancer cells are genes that we know, let’s say if a patient were to get chemotherapy, that patient would be more likely to fail that chemotherapy early, which is a terminology we call chemo resistance. And so those are studies right now that have just sort of, they’re newer to the forefront looking at stress and tumor aggressiveness. But there are studies going on nationwide right now involving thousands of African American men participants, where we are looking at the role of stress and what that does in terms of prostate cancer, aggressiveness in Black men specifically, and seeing what we can do to address it. But first we have to acknowledge that the problem is even there, a lot of people don’t think the problem is there, but we are scientists, we think the problem is there. So, we have to get the data to show the public that the problem is there, and then we need to really address the systemic racism that leads to this elevated and chronic stress that other demographics don’t have to deal with, because it’s literally leading to increased disease and increased health disparities. And if that’s something that we can change at some very basic levels, then that will improve health overall.

Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations?

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Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations? from Patient Empowerment Network on Vimeo. 

Should prostate cancer screening be done sooner for some men? Expert Dr. Leanne Burnham details screening guidelines from the American Cancer Society and the U.S. Preventive Services Task Force, how guidelines differ for Black men, and when to advocate for earlier screening.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

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What Are Some Hereditary Factors Impacting Prostate Cancer Patients?

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Transcript:

Dr. Leanne Burnham

In terms of prostate cancer screening, the current recommendation by the U.S. Preventive Services Task Force is that men between the ages of 55 to 69 have a discussion with their physician about whether or not they should be screened. Okay, now the U.S. Preventive Services Task Force base this decision on studies, as I mentioned earlier, in predominantly white men, if you look at American Cancer Society, the recommendation is that African American men are screened at age 45 and African American men who are 40, but have a family history of prostate cancer should be screened at age 40. So the issue is most physicians follow the U.S. Preventive Services Task Force recommendation for white men. And so, if you have a family history, or if you’re just 45 and you want to know, do you have prostate cancer, you have the right to ask your physician and let them know. Show them on your phone, American Cancer Society recommends this for me because of my race, because of my family history, and your insurance will cover that. Now, these recommendations for Black men in their 40s are not just for no reason, it’s because we see prostate cancer in men at this age, like I said before, my dad being diagnosed at 50 with a PSA score of 64 means that he was growing prostate cancer in his 40s, and who knows how early in his 40s if that was happening. At City of Hope, we provide free prostate cancer screening in the community, and there’s thousands of men that are eligible to be screened, and what we see is there are men in their 40s that have elevated PSA, and if we can catch that early enough, that’s a game changer for them in terms of the length of their life and the quality of their life that they’ll have moving forward.

So, one thing that we see in the community, and I talk to a lot of men about, is not even just men, people in general, trust their doctor, right, they trust to speak to their physician. If the physician says, “It’s your annual visit, you need to have A, B, and C done.” A lot of the men, they’ll say, “Oh, I went to the doctor, I had everything done,” and we really have to let them know your doctor may not have included that with everything else. Yes, you’ve got your blood pressure checked, your blood sugar, and they checked your weight and all this, but go through your record, and a lot of these records are electronically available in apps now and see. Just look at your app and see, did they test for PSA? And if they didn’t and you’re 45 and you’re African American or you’re 40 and you have family members, then that’s something you can shoot your doctor an email and request and just say, “You know, I’m concerned about this, and I would really like to have this test done based on American Cancer Society’s recommendations.” And what we see a lot of times too in the community, is men will say, “Well, I feel fine.”

Well, what you need to understand about prostate cancer is, men do not have symptoms unfortunately until it is beyond early stages is how it works, and so as men get older, the prostate enlarges, whether or not they have prostate cancer or not, and it causes a frequency in urination especially at nighttime. So, if you have a frequency in urination, it will occur as you get older, that’s something you need to let your doctor know. It may not be prostate cancer, so don’t freak out, but it very well may be other symptoms as prostate cancer progresses include back pain, sometimes sexual dysfunction, things like that start to occur, and back pain can be anything. So that’s why it’s important to get your PSA tested even if you don’t have symptoms, because I can tell you that, my dad did not have any symptoms with a PSA of 64, and the only reason I found that was on accident in an emergency room, he went to the ER after having a colonoscopy. And my dad never got sick for anything that he didn’t even understand what physical discomfort means, and he had a colonoscopy, and you know, when you get a colonoscopy, they tell you afterwards, you may have some gas pain, he never had gas pain. So, he didn’t know when his stomach was hurting so bad afterwards, he just thought, this is not okay, this is not okay, he goes to emergency room, they say, Listen, sir, it’s just gas from your colonoscopy, by the way, we ran your blood work, your PSA is extremely elevated. He found out on accident. Who knows how much longer that would have been growing after that, and so I say all that to say, do not expect, do not wait for symptoms to come, and that Black men do get prostate cancer young and that you wanna catch it early because then you have a 100 percent cure rate when you catch it early, so it just makes the most sense to stay on top of it.

Top Tips and Advice for Prostate Cancer Patients and Caregivers Navigating Treatment

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Top Tips and Advice for Prostate Cancer Patients and Caregivers Navigating Treatment from Patient Empowerment Network on Vimeo. 

What should prostate cancer patients and caregivers know about prostate cancer treatment? Dr. Leanne Burnham shares advice for patients with concerns about treatment side effects, information about active surveillance, and some specific advice for Black men with prostate cancer.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

Related Resources:

 

What Are Some Hereditary Factors Impacting Prostate Cancer Patients?

Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations?

How Does Stress Correlate With Your Prostate Cancer Diagnosis?
 

Transcript:

Dr. Leanne Burnham

Yes, so it is a couples’ disease for sure, and you want to make sure to do a little bit of your own research. Make sure that your doctor knows how this disease affects Black men differently, because what I see a lot of time, even in my own family, my husband’s family members that get prostate cancer and they come to me, a lot of times, their doctor will recommend active surveillance. And it may not be appropriate for African American men if you look at the research and you look at the studies. And so, it may benefit you to just ask your doctor, “Do you treat a lot of Black patients, or do you see any difference in their survival rates versus your other patients?” And really consider that when you’re thinking about whether to do active surveillance or not. Once it gets time for treatments, one thing when I — because I talk to a lot of men and support groups, and men are scared, they don’t want to lose their urinary function, they don’t want to lose their sexual function. And so, they’re nervous about certain diseases and in terms of surgeries and radical prostatectomy, there are nerve-sparing surgeries now to really protect that function afterwards, and there are exercises that can be done afterwards to also help improve, and so ask the nurses in your setting, “What are some of those exercises that can be done?” But one thing to keep in mind is every treatment comes with its sort of risk, right?

So, no matter whether you choose radiation or surgery, there’s always a risk that you may lose some of that function, what I tell men, and not to sound not sensitive to the matter, but a lot of men, they’ll say, you know, “Oh, if I get this treatment and what if I can’t have sex anymore?” You’re not going to have sex when you’re buried 6 feet underground either. And so, you want to be able to get those treatments, the ones that you and your physician have a shared decision in and in deciding what’s best as a couple. But you don’t want to be naive if you’re at the doctor and you have a really elevated PSA and you have a Gleason score of 8, and your doctor is telling you, “We really need to treat this,” you don’t want to shy away from that, because you’re scared of the side of the side effects in that setting. You can look for where the best surgery center is if they have the nerve-sparing surgery, as I said, and explore your options that way. But don’t put it off so long, because you’re worried about the side effects. And if you don’t get treatment and your doctor wants you to, as time goes on, you’ll lose the urinary function and the sexual function anyways.

So yeah, it’s not something that you want to put off because you’re scared about the side effects. And a lot of men do have side effects temporarily, and then they regain their function, and I really encourage to join support groups virtually now because of how the role is set up. But just talk to some other men that have had some of these procedures and see how they’re doing. And I personally haven’t met a man that felt like, “Oh, I have been cured from prostate cancer, and now I have the side effects, and I wish I wouldn’t have had the procedure,” I haven’t met one. And I know in those who have side effects and they had surgeries and 10, 15 years ago, and they have side effects, I’m not going to act like that doesn’t happen. But none of them have ever expressed to me that they wish they could go back in time and not do that, because, at the end of the day, they’re grateful that they are still here with their loved ones.

What Are Some Hereditary Factors Impacting Prostate Cancer Patients?

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What Are Some Hereditary Factors Impacting Prostate Cancer Patients? from Patient Empowerment Network on Vimeo.

Along with aging, hereditary factors also contribute to prostate cancer incidence. Expert Dr. Leanne Burnham details some of the hereditary factors, their mechanism of action, and some treatments under study in prostate cancer clinical trials for African American men.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

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Top Tips and Advice for Prostate Cancer Patients and Caregivers Navigating Treatment

Should Prostate Cancer Screening Happen at an Earlier Age for Certain Patient Populations?

How Does Stress Correlate With Your Prostate Cancer Diagnosis?
 

Transcript:

Dr. Leanne Burnham

So, cancer is a disease of aging, and cancer is a hereditary disease for a lot of different kinds of cancers, not all, but for a lot of them. And so prostate cancer is one of those that we know for sure that there are some genetic variations that are passed down from our parents that would make men either predisposed or not to get prostate cancer and also would predispose them to get aggressive prostate cancer.

And so, for example, if you have a father, an uncle, grandfather, if you have family members that have had prostate cancer, and beyond that, if you had women in your family that have had breast cancer, then that increases your chance as a man to get prostate cancer and to get it even younger than other races would. And so certain things that we look at in the lab and in the clinic at City of Hope are really trying to understand what those hereditary factors are, and then how you can target them with drug treatments specifically.

So, for example, we have a clinical trial that a team of us developed, and we are looking at the ability of something called PARP inhibitor not to get too technical with you, but PARP inhibitors, if you want to Google it, they are at the forefront of prostate cancer treatments right now, and especially a few running in clinical trials. And so there is a hereditary disposition, there is a mutation on the BRCA gene that leads to PARP inhibitors benefiting any person that would have that BRCA mutation.

What we’re doing in our clinical trial is we are using a PARP inhibitor called talazoparib (Talzenna), and we are not only providing that to patients that have the spark commutation, but we are extending it to patients that may not have that mutation, and the reason for is because, and I definitely don’t want to get crazy technical, but the reason for it in a nutshell, as we know in cancer there is an interaction between PARP inhibition and androgen receptor function and reaction to treatments. And so, you may have heard of androgen and androgen receptor when it comes to prostate cancer, it’s really the fancy way of saying testosterone, and prostate cancer needs testosterone, or it needs androgen and androgen receptor to function and to grow. And so, what we want to see in this clinical trial is if we target, if we use PARP inhibitors in combination with hormone therapy that’s targeting androgen production androgen receptor, will we see better treatment and better response to the drugs in those patients. And the extra cool part to me is we know that there are variations in DNA segments that affect androgen receptor function in African American men. And so, for a specific mechanism that I won’t dive into, it involves trinucleotide repeats and link, segments links and all this, but because of these variations and androgen receptor in African American men that we know was associated with their ancestry and what they’ve inherited in their own DNA, this drug should work better in African American men. And we will be able to tease that out in this clinical trial. So, it’s an opportunity for African American men who have prostate cancer who have not developed castration resistance yet, but who do have metastatic prostate cancer so, at that point, there is not a cure, right, and so you can go to your physician, and you can get a standard of care therapy, or you may want to consider this clinical trial where you would receive standard care therapy. And then also, as I said before this VIP access to this new drug, this PARP inhibitor that we think may improve outcomes in men.

What You Need to Know Before Choosing a Cancer Treatment

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What You Need to Know Before Choosing a Cancer Treatment from Patient Empowerment Network on Vimeo.

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What steps could help you and your doctor decide on the best treatment path for your specific cancer? This animated video explains how identification of unique features of a specific cancer through biomarker testing could impact prognosis, treatment decisions and enable patients to get the best, most personalized cancer care.

If you are viewing this from outside of the US, please be aware that availability of personalized care and therapy may differ in each country. Please consult with your local healthcare provider for more information.

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TRANSCRIPT:

Dr. Jones:

Hi! I’m Dr. Jones and I’m an oncologist and researcher. I specialize in the care and treatment of patients with cancer. 

Today we’re going to talk about the steps to accessing personalized care and the best therapy for YOUR specific cancer. And that begins with something called biomarker testing.

Before we start, I want to remind you that this video is intended to help educate cancer patients and their loved ones and shouldn’t be a replacement for advice from your doctor.

Let’s start with the basics–just like no two fingerprints are exactly alike, no two patients’ cancers are exactly the same. For instance, let’s meet Louis and another patient of mine, Ben. They both have the same type of cancer and were diagnosed around the same time–but when looked at up close, their cancers look very different.  And, therefore, should be treated differently.

We can look more closely at the cancer type using biomarker testing, which checks for specific gene mutations, proteins, chromosomal abnormalities and/or other molecular changes that are unique to an individual’s disease.

Sometimes called molecular testing or genomic testing, biomarker testing can be administered in a number of ways, such as via a blood test or biopsy. The way testing is administered will depend on YOUR specific situation.

The results could help your healthcare team understand how your cancer may behave and to help plan treatment. And, it may indicate whether targeted therapy might be right for you. When deciding whether biomarker testing is necessary, your doctor will also take into consideration the stage of your cancer at diagnosis.

Louis:

Right! My biomarker testing results showed that I had a specific gene mutation and that my cancer may respond well to targeted therapy.

Dr. Jones, Can you explain how targeted therapy is different than chemo?

Dr. Jones:

Great question! Over the past several years, research has advanced quickly in developing targeted therapies, which has led to more effective options and better outcomes for patients.

Chemotherapy is still an important tool for cancer treatment, and it works by affecting a cancer cell’s ability to divide and grow. And, since cancer cells typically grow faster than normal cells, chemotherapy is more likely to kill cancer cells.

Targeted therapy, on the other hand, works by blocking specific mutations and preventing cancer cells from growing and dividing.

These newer therapies are currently being used to treat many blood cancers as well as solid tumor cancers.  As you consider treatments, it’s important to have all of the information about your diagnosis, including biomarker testing results, so that you can discuss your treatment options and goals WITH your healthcare team.

Louis:

Exactly–Dr. Jones made me feel that I had a voice in my treatment decision. We discussed things like potential side effects, what the course of treatment looks like and how it may affect my lifestyle.

When meeting with your healthcare team, insist that all of your questions are answered. Remember, this is YOUR life and it’s important that you feel comfortable and included when making care decisions. 

Dr. Jones:

And, if you don’t feel your voice is being heard, it may be time to consider a second—or third—opinion from a doctor who specializes in the type of cancer you have. 

So how can you use this information to access personalized treatment?

First, remember, no two cancers are the same. What might be right for someone else’s cancer may not work for you.

Next! Be sure to ask if biomarker testing is appropriate for your diagnosis. Then, discuss all test results with your provider before making a treatment decision. And ask whether testing will need to be repeated over time to identify additional biomarkers.

Your treatment choice should be a shared decision with your healthcare team. Discuss what your options and treatment goals are with your doctor.

And, last, but not least, it’s important to inquire about whether a targeted therapy, or a clinical trial, might be appropriate for you. Clinical trials may provide access to promising new treatments.

Louis:

All great points, Dr. Jones! We hope you can put this information to work for you. Visit powerfulpatients.org to learn more tips for advocating for yourself.

Dr. Jones:

Thanks for joining us today. 

This program is supported by Blueprint Medicines, and through generous donations from people like you.

Telemedicine Tips and Facts for Prostate Cancer Patients

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Dr. Leanne Burnham’s Top Tips for Your Prostate Cancer Telemedicine Visit

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Dr. Leanne Burnham’s Top Tips for Your Prostate Cancer Telemedicine Visit from Patient Empowerment Network on Vimeo. 

What are some ways that prostate cancer patients can prepare for telemedicine visits? Dr. Leanne Burnham shares her top tips for ensuring success and for getting the most out of televisit appointments.

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

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What Prostate Cancer Populations Will Benefit Most From Telemedicine?

How Will Telemedicine Impact Prostate Cancer Clinical Trials?

What Are the Benefits of Telemedicine for Prostate Cancer Patients?
 

Transcript:

Dr. Leanne Burnham

Okay, my top three tips to prepare for a telemedicine visit is if you would usually have an advocate come with you to your in-person doctor’s appointment, try to make that happen for your televisit appointment as well. And explain to your physician when you get on the call say, “Hey, this is my wife, this is my husband, and they’re going to be joining the call if they have a few questions too, and I would like to have them be involved as part of the conversation.” The other thing is to have your questions prepared ahead of time, you know, and a lot of people have questions prepared ahead of time for in-person visits, but they might be nervous, they might keep their questions tucked away, well, this way your questions can be on the table next to you. Your doctor doesn’t even know, you still get to ask those questions though, and then the third tip that I would have is to allow for technology to mess up. So, for your visits, a lot of times your physician may give you a window where they say, “We’re going to call you between such and such time,” such as such time, you just sitting there waiting for them to call. But I say give yourself even more time than that in case you know something’s going on with your Internet or you are just not able to log into the app well, because I did have that happen to me personally, one time with the physician, and they were trying to get ahold of me, and I was having trouble connecting, and then he emailed me later saying, “You missed our appointment.”

I really wasn’t trying to miss the appointment, so just give yourself that extra time to get your technology together.

How Will Telemedicine Impact Prostate Cancer Clinical Trials?

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How Will Telemedicine Impact Prostate Cancer Clinical Trials? from Patient Empowerment Network on Vimeo. 

How will prostate cancer clinical trials be changed by the addition of telemedicine to the treatment toolbox? Expert Dr. Leanne Burnham details patients who can benefit from telemedicine visits — and explains some of the history of discrimination in medical care for BIPOC patients and treatment response of African American men with prostate cancer

See More From the Prostate Cancer TelemEDucation Empowerment Resource Center

Related Resources:

 

Will Telemedicine Mitigate Financial Toxicity for Prostate Cancer Patients?

What Are the Limitations of Telemedicine for Prostate Cancer Patients?

Dr. Leanne Burnham’s Top Tips for Your Prostate Cancer Telemedicine Visit
 

Transcript:

Dr. Leanne Burnham

So clinical trials, the whole concept of clinical trials has really come to the forefront of the media right now with everything that’s happened in 2020 and currently with COVID.

And so a lot of people, if they were not aware of discrimination in medical care or clinical trials in the history of the U.S., then now they’re starting to become well-versed in it. So now people are hearing, “Oh, Tuskegee syphilis experiment,” where those of us who are in science, in medicine study health series research is, this is not new to us, so we’re grateful that it’s coming to the forefront. People are learning about it, but there is a justifiable medical mistrust by many Black and Brown people, but African Americans in particular, because of what has been done and not done in terms of medical treatment in the past 400 years. And so, because of this medical mistrust, that leads to sometimes a hesitancy to participate in clinical trials, because there’s an idea of, I don’t want to be a guinea pig, so that’s just one aspect that leads to less enrollment in clinical trials. There’s the whole other side of things, right? There’s the fact that a lot of African American patients are not asked to be in a clinical trial, they’re not explained what the clinical trial entails, a lot of people don’t realize that clinical trial patients have access to what I call what I consider to be VIP access to what is cutting-edge, and it doesn’t mean that it’s not new, that it hasn’t been tested extensively. It’s just now that it’s available to a patient at a particular disease stage that we might be looking at, and we have a lot of reason to believe that it will help that patient.

So a patient that’s enrolling in a clinical trial has access to the VIP treatment. And then as an added bonus, they actually have extra engagement with providers, extra touchpoints with their providers that patients that are receiving standard of care and not enrolled in a clinical trial don’t have as much access to. That being said, in addition to that, for us to really forward medicine in what we call precision medicine, which is able to have medication that’s tailored to an individual person based on their DNA makeup, based on how their body would individually respond to a drug. It’s super important, highly important that we have diversity in patients that are enrolled in clinical trials. For example, if you don’t have enough African American men enrolled in the clinical trial for prostate cancer, then you don’t really know if that medication would work worse or even better in that patient. And what we’re actually seeing is there has been a development of race-stratified clinical trials in the past less than 10 years, really around five years, where we’ve looked at chemotherapy, we looked at hormone therapy, and we looked at immunotherapy, where we include enough African American men in the trials, and we look at how the drug responds in African American men versus other men. And we see that African American men actually have a better treatment response than other races, so how amazing is that? Where you have a demographic that is more likely to get aggressive prostate cancer and die much younger, and we’re seeing that if they’re given the new treatments that are really tailored to target the disease in ways that we weren’t able to do it before, that they’re responding better and having longer survival and better outcomes. And so it’s really important for all those reasons I described to increase African American participation in clinical trials.

Now, I say all that to get to this point, which is, enrollment is not easy when you don’t live near a clinical trial center or a hospital that’s offering whatever treatment you’re interested in trying out as part of a trial. And so we know that race in this country is tied to geographic location, it’s tied to socio-economic status, and so what telemedicine provides is in previous instances where maybe a patient lives out the way 60 miles or more from an institution that has a clinical trial that they would want to be involved in, now they don’t have to drive to that center. They can have a telemedicine visit, they can conduct labs where they’re at near their home, see if they qualify to participate in the clinical trial based on their own body’s physiology and how their blood work comes out and how their imaging comes out, see if they qualify. And then they can enroll in that clinical trial, and so telemedicine in that aspect really opens the door to people who may have been interested who live out of the way, maybe even in a rural setting where the institutions that they have nearby, don’t have what they are interested in using or what may be best for their treatment plan personally, and so telemedicine opens a whole new world to patients such as those.