Can I Take Provenge after Prostate Surgery?


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Many men will experience a relapse or progression of a prostate cancer, in which case a physician may recommend Provenge after prostate surgery.

According to the National Cancer Institute there will be over 230,000 new cases of prostate cancer in 2013 and nearly 30,000 deaths.  Your treatment will depend on both the stage and grade of your cancer in addition to any other medical conditions you may have.

What is prostate cancer staging?

Staging helps your doctor determine the extent to which your cancer has spread to other parts of your body. When prostate cancer spreads, the abnormal cancer cells are commonly found in lymph nodes near the prostate but may also spread to bones or other organs.

In order to help determine the stage of your prostate cancer, your doctor may order the following tests:

  • Bone scan: a nuclear medicine test to see if your prostate cancer has spread to the bones.
  • CT scan or MRI:  special x-ray tests that can show more detailed pictures of your organs to determine if the prostate cancer has spread to other areas of your body like the lymph nodes.

Provenge after prostatectomy—treatment

While there are general, recommended treatment plans for prostate cancer, the best treatment for you should be made in consultation with a doctor knowledgeable about you and prostate cancer. The following factors will all impact your best treatment:

  •   Your age
  •   Gleason score (grade) of the tumor
  •   Stage of prostate cancer
  •   Your symptoms
  •   Your general health

For example, if you have a very slow-growing or nonaggressive prostate cancer, you are older, or have serious health conditions, you may never need treatment for your prostate cancer. In this case your doctor may recommend observation. You and your doctor will look at all factors that may affect your treatment and come up with a plan.

Surgery is a common, curative treatment option if your cancer has not spread outside of the prostate. The most common surgery is a radical prostatectomy. Your surgeon removes the entire prostate gland plus some of the surrounding tissue. There are several different ways the procedure can be preformed and you should discuss the best one for you with your surgeon.

Hormone therapy or androgen deprivation therapy prevents the male hormone called androgen from reaching the prostate cancer cells and lowers the overall levels of androgens in the body. Androgens are produced by the testicles and can be thought of as fuel for your prostate cancer. Lowering androgen levels can cause prostate cancer to shrink or spread more slowly.

Androgen deprivation therapy may be used in the following situations:

  • If you are not a surgical candidate
  •  If the cancer has spread beyond the prostate gland
  • If your cancer does not respond to radiation
  • If your cancer recurs following surgery
  • If your doctor wants to try to shrink the cancer before surgery

Provenge after Prostatectomy

Over time patients treated with androgen deprivation therapy may develop disease progression—a rising PSA, metastasis or spread to distant sites, or worsening of the prostate cancer in sites where the cancer has already affected.

A number of options exist for the treatment of metastaic or castration-resistant prostate cancer. Unfortunately, the best treatment option for castration-resistant prostate cancer is not known and there are a number of different options. One option at this point is Provenge after prostatectomy when other medical treatments are not yielding the desired result.

Provenge is a novel therapy tailored to your specific cancer. Your body’s immune cells are removed through a process called pheresis (sort of like donating blood). Your immune cells are then specifically treated to develop your personalized Provenge infusion.

When infused, your treated immune cells find and attack the prostate cancer. This treatment does not usually cause PSA levels to decrease and may take months to work. As a result, Provenge is not optimal for patients needing a rapid response.

Who is a good candidate for Provenge?

You may benefit from Provenge if:

  •   You have a rising PSA level despite hormone therapy.
  •   Your prostate cancer has spread to other parts of the body
  •   You do not need narcotics for pain control

Does Provenge work?

In the study that led to the approval of Provenge, more men treated with Provenge were alive at 3 years after beginning the trial compared those not treated. Additionally, the risk of death in the Provenge group was 22% less than in the non treated group.

Read more in our Prostate Cancer Health Center.

References

Anassi E and Ndefo UA. Sipuleucel-T (Provenge) injection: the first immunotherapy agent (vaccine) for hormone-refractory prostate cancer. Pharmacy and Therapeutics 2011 Apr; 36(4)

Hall SJ et al. Integrated safety data from 4 randomized, double-blind, controlled trials of autologous cellular immunotherapy with sipuleucel-T in patients with prostate cancer. J Urol 2011; 186(3):877.

Kantoff PW et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med 2010; 363:411-422.