According to the National Cancer Institute, more than 3 million men in the United States live with prostate cancer. Among them, the survival rate after 5 years is 97%.

As patients live longer and doctors see younger patients with this type of cancer, learning how best to treat them and provide them with a better quality of life is key to UT Health San Antonio. It is the focus of a national clinical trial involving participants at its home base, Mays Cancer Center. MD Anderson Cancer Center.

“There are aspects of prostate cancer that are very long-term problems, and doing anything now just puts patients at risk of side effects,” says Christian Kluwe, a radiation oncologist at the Mays Cancer Center. says the medical doctor.

At the other end of the spectrum, Kluwe said, are patients with more aggressive cancers who require a variety of treatments to fight the tumor to improve their chances of survival.

“That’s one of the big challenges: How do you differentiate between people who have low-risk tumors and don’t need treatment and those who have high-risk tumors and have to throw the kitchen sink at them?” ?” He said.

Clinical trial description

Researchers hope the phase 3 NRG-GU010 randomized clinical trial will answer the question of how much treatment is needed for patients with intermediate-risk prostate cancer who have a poor prognosis. As part of the trial, biopsies taken from participants’ tumors will be tested for various genes that can predict the risk of cancer spreading.

Based on the results, patients are given a score from 0 to 1. A low risk score is less than .45, a moderate risk score is between .45 and .60, and a high risk score is greater than .60.

Kluwe said the standard treatment for unfavorable intermediate-risk patients is radiation therapy and hormone therapy based on the results of a physical exam, biopsy, and blood tests. This hormone therapy, called androgen deprivation therapy, reduces the levels of testosterone and dihydrotestosterone in the body. Kluwe compares it to a woman going through menopause.

“The entire body is affected. Patients may experience fatigue, weight gain, arthritis, pain in strange places, mood changes, hot flashes, etc.,” Kluwe said. “But we also know that this hormone therapy puts stress on the heart. Taking someone’s testosterone away actually increases their risk of adverse cardiac events, including stroke and heart attack.”

Kluwe said patients’ longer lifespans mean treatments need to change to improve patients’ quality of life as they get older. He recalled a time in his youth when he met a colleague of his father’s who had retired.

“He was 65 years old, limping with a cane and showing signs of age. Today, that’s how I see a typical 85-year-old,” he said. “So when I look at a 70-year-old man, I think we have to get rid of this disease, because he’s going to live to be 85. These men are healthier and live longer. So the competing risk of death is It’s low.’ It’s not there anymore. ”

He said the same is true for the increasing number of younger patients he is starting to see.

“When I look at a 50-year-old guy, I say to myself, we really have to know what’s best for him,” he said. “I expect him to live another 35 years.”

help others

Milton Menjivar, an outgoing 78-year-old, said he had never been sick except for a bout with pneumonia 20 years ago.

Every year, in the month of his birthday, he schedules his annual checkup with a doctor, a holdover from his military days. In June 2023, the military veteran and businessman was told that his blood test results were abnormal, and after seeing a urologist, he was diagnosed with prostate cancer.

Faced with the diagnosis, Menjivar thoroughly researched the disease and all treatments. He learned that his prostate was too enlarged for surgery and wanted to avoid his radiation therapy.

“We now know that radiation therapy is like a flashlight, shining a broad beam that can damage healthy tissue around tumors,” he says.

He consulted a nurse friend who arranged a meeting with Kluwe.

Menjivar has remained independent throughout his life, and despite his difficult upbringing and multiple injuries sustained while stationed in Vietnam, he maintains a positive attitude that he generously shares with the world.

“Overall, I’m a happy camper,” he said. “I’m the guy who talks to you at the grocery store.”

When Kluwe asked if he wanted to participate in the trial, Menjivar said, “Yes.”

“I’m a giver,” he said.

As part of his treatment during the trial, Menjivar underwent radiation therapy. But it wasn’t the broad beam treatment he had previously heard of. Several grain-sized pellets were placed near the tumor in the prostate.

The pellets will help make his radiation treatment more precise and ensure that healthy tissue is not affected. This treatment is known as stereotactic radiation therapy (SBRT). The advantage of SBRT is that the treatment is completed in just five sessions, whereas other treatments are given daily for over a month.

Study patients were divided into two categories: those who received hormone therapy and those who did not. Menjivar did not receive hormone therapy.

Kluwe said patients like Menjivar are having a global impact on prostate cancer treatment.

“There’s a certain sense of selflessness that comes with being involved,” Kluwe said. “He gave a part of himself so that others could get the data and learn from his experience.”

Menjivar, who completed the radiation treatment without any side effects and no disruption to his daily life, said he is in good condition.

“I feel great and I still have a lot of life left in me,” he said.

If you would like to learn more about clinical trials at Mays Cancer Center, please give us a call. 210-450-5798 or go to MaysCancerCenter.org/clinicaltrials.