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Medicine Science

Mayo Clinic Reports Dramatic Outcomes In Prostate Cancer Treatment 122

Posted by Soulskill
from the turns-out-the-tumor-was-his-sled dept.
Zorglub writes "Two prostate cancer patients who had been told their condition was inoperable are now cancer-free as the result of an experimental therapy, the Mayo Clinic in Rochester announced Friday. 'Cancer has a propensity for turning off T cells. Dr. Allison hypothesized that if you block the off-switch, T cells will stay turned on and create a prolonged immune response. Dr. Kwon, then at NIH, demonstrated that CTLA-4 blockage could be used to treat aggressive forms of prostate cancer in mice. There was one limitation to that concept — the worry that by simply leaving all the T cells on there may not be enough response aimed at the tumor. Dr. Kwon called Dr. Allison and designed the trial together. The idea: use androgen ablation or hormone therapy to ignite an immune approach — a pilot light — and then, after a short interval of hormone therapy, introduce an anti-CTLA-4 antibody that acts like gasoline to this pilot light and overwhelms the cancer cells.' After the treatment, the patients' tumors shrunk to such a degree that they could be successfully removed."
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Mayo Clinic Reports Dramatic Outcomes In Prostate Cancer Treatment

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  • Hmmmm (Score:5, Insightful)

    by ZosX (517789) <zosxavius@gmai l . c om> on Sunday June 21, 2009 @11:32AM (#28411021) Homepage

    So the immune system will actually fight cancer, but the cancer negates this by turning off the T-cells. This is fascinating. The problem, from what I understand, is that cancer cells reproduce indefinitely as their DNA does not slowly break down. It seems like this could be a real breakthrough for lots of cancer patients.

    • Re:Hmmmm (Score:5, Insightful)

      by moon3 (1530265) on Sunday June 21, 2009 @11:43AM (#28411109)
      immune system will actually fight cancer

      You need to mark the cancer cells (in someway) so the immune system could recognize them as a threat. Many times big problems could have very simple solutions in biology.
      • Re:Hmmmm (Score:5, Insightful)

        by ColdWetDog (752185) on Sunday June 21, 2009 @11:52AM (#28411173) Homepage

        Many times big problems could have very simple solutions in biology.

        Simple

        I don't think that word means what you think it means. Just because something is conceptually simple, doesn't mean that it's simple to use as a medical therapy.

        Messing with the immune system is rarely "simple".

        • But think about it: What is the best, most integrative, and most sense-making therapy of a disease?
          Improving the own immune system, of course.

          Give it updates (immunization), improve its heuristics, give it all the resources it needs.

          It is funny and very telling of the real goal of pharma companies, that despite (or because of) all our "technology", the human immune system now is the weakest in the whole animal kingdom.
          But the main driver behind this weak immune system, is the crap that we call "food" (but r

          • Re:Hmmmm (Score:5, Insightful)

            by Daniel Dvorkin (106857) * on Sunday June 21, 2009 @12:38PM (#28411439) Homepage Journal

            the human immune system now is the weakest in the whole animal kingdom

            [citation needed]

            • Re: (Score:3, Funny)

              by MrNaz (730548) *

              You'll need to offer him some guidance on how to properly cite random bullshit pulled directly from the rectum.

              Perhaps like this?

              "The human immune system is now the weakest in the entire animal kingdom(1)."

              1. Dr Bhul Schitt "A Diverse Collection of Utter Nonsense." Published: Oxford, 2007. pp34-38.

            • Actually, our immune system changed a lot once we started living in cities. I don't know how good it is compared to other creatures, but it's improved a lot recently.
          • Re:Hmmmm (Score:5, Interesting)

            by TheLink (130905) on Sunday June 21, 2009 @02:16PM (#28412231) Journal
            If the human immune system was really the weakest in the whole animal kingdom we wouldn't be living to 70+ years.

            Even if you take real good care of mice, they tend to fall apart by 3 years - cancer etc.

            Just see what happens to a patient with AIDS - all sorts of rare cancers appearing, dying from common cold etc.

            The trouble with some of these tweaks is you could end up with an autoimmune response. Sure you might be able to get the immune system to blow away the cancer. But it might start to attack the normal cells as well.

            When you get old, the "normal" cells after years of abuse and damage aren't quite as normal as they were when you were 20. It could be like pouring some new fangled super rust remover on an old car to find that most of the old car is made of rust... ;).

            That's why there's reproduction - it's a bit like a reset. Start over from scratch with a sperm and egg.

            With unicellular creatures like bacteria and protozoa it's not as vital for huge colonies of them to mutually cooperate - they can drift genetically on every generation as long as they can keep reproducing successfully. That's not true for complex multicellular organisms like humans. A bunch of cells striking out on their own = cancer.
            • by 32771 (906153)

              > That's why there's reproduction - it's a bit like a reset. Start over from scratch with a sperm and egg.

              This has to be a geek friendly attempt at telling some of us to get out of the basement.

              > That's not true for complex multicellular organisms like humans. A bunch of cells striking out on their own = cancer.

              So the conclusion would be that we would never get as old as some much simpler tree that can get cancer but
              hardly has much in the way of organs that can fail. We would have to evolutionary outr

              • by TheLink (130905)
                You can graft a branch from a different tree to another tree and have it work fine. You can even graft different species of plants together :).

                Doesn't seem as easy to do that sort of stuff on animals that have a long lifespan.
            • by Zeio (325157)

              This rusty aging theory, that the reason people age is due to accumulated damage, is under serious scrutiny at this point.

              Its really simple: (1) Evolution has no reason to further improve on designs after successful reproduction, (2) lots of old people competing for the same food supply is not good for reproduction.

              There are clams that live to 400, turtles that are engaging in reproduction over 100 years old and trees that live for 5000 years.

              In fact, aging in humans is rapidly accelerated in the following

          • Re: (Score:2, Insightful)

            by assert(0) (913801)

            >But the main driver behind this weak immune system, is the crap that we call "food" (but really isn't).

            You really bought into the "health food" & supplements party line, didn't you?

            1. A stronger immune system is not always a good thing. See autoimmune syndrom, cytokine storms etc.

            2. We don't eat crap food! Yes, we have easy access to carbs, which is not always a good thing (depending on genetic and social factors). But we also have easy access to nutrients! We, in the west, can and do eat greens any

            • by dwywit (1109409)
              Your point 3 is superficial. Do you think your immune system isn't handling pre-cancerous cells or clusters all the time? Getting sick mostly comes down to one thing - your immune system becomes overwhelmed - either because it's weak (genetic and/or environmental reasons), or sheer mass of pathogens (i.e. some sick f#cker sneezes on you).

              You could be genetically "weak" with regard to certain cancer/s, or you could be chronically undernourished in important areas, i.e. low levels of zinc or selenium, for ex

          • by epine (68316)

            It is funny and very telling of the real goal of pharma companies, that despite (or because of) all our "technology", the human immune system now is the weakest in the whole animal kingdom.

            Wow. What we have here is a total collapse of the cognitive immune system responsible for thinking before typing.

            Over all I think the human brain is a remarkable organ, but some of its failure modes defy rational analysis. Six billion counter examples. Maybe it's hard to count to six billion with your fingers.

            Bonnie Bassler on how bacteria "talk" | Video on TED.com [ted.com]
            * 10 times more bacterial cells in or on a human than human cells
            * 100 times more bacterial genes in you or on you than human genes

            S

          • Ownz0red! [salon.com]

        • by sjames (1099)

          The thing is, the immune system dispatches cancerous cells all the time. A diagnosis of cancer means the immune system has already failed in that case and has been overwhelmed. That implies that it's harder than just provoking a response. It's already BEEN provoked and that didn't fix it.

          The key is to come up with a combination of immune boosters, better targeting of the immune system, radiation, chemo, and surgery that tips the game back in the immune system's favor without killing the patient in the proce

        • Messing with the immune system is rarely "simple".

          Bingo. The unintended consequence could be a tidal wave of autoimmune diseases from lupus to arthritis. Better than dying from cancer, but the cure may come at a the high cost of a low quality of life.

    • Re: (Score:2, Insightful)

      by Anonymous Coward
      It's not that their DNA doesn't slowly break down but that DNA in Humans is not fail-safe (intelligently designed? probably not). There are specific genes that suppress tumor growth, etc, when they fail you can get cancer.
      • Re: (Score:1, Insightful)

        by Anonymous Coward

        There are a lot of cellular and genetic causes of cancer. Telomerase is an generally an embryonic enzyme that is reactivated in cancer calls that prevents the 'breakdown' of DNA as cells replicate, leading to indefinite replecative capabilities. There are also tumor suppressor genes that when mutated or deactivated lose their ability to prevent cancerous cell growth. Examples of this include p53, which detects errors in the DNA and either stops the replicative cell cycle or promotes apoptosis (programed

    • Re:Hmmmm (Score:5, Informative)

      by ceoyoyo (59147) on Sunday June 21, 2009 @12:23PM (#28411343)

      The immune system is constantly fighting cancer. Whenever something goes wrong when one of your cells divides, which happens relatively frequently, if the built in suicide mechanisms don't work then the immune system deals with it. What we call "cancer" is just the result when the cancerous cells get too far ahead.

      • Re: (Score:1, Flamebait)

        by Hurricane78 (562437)

        The real reason behind this, is that this process of division goes wrong more and more often, because the whole system is already that damaged, from the trash we call "food" and our environment full of unhealthy materials. Which adds up to our already very weak immune system.

        • by maxume (22995)

          No. Just no. People used to die much more often because of stupid things like bacterial infections and savagery (people still die of those things today, but not at anything even resembling historical rates. Not even soldiers). Now that we (on average) live longer, we get subtler diseases.

          If we used human processes to create trillions of cells, most of the individuals would die of cancer before they were a year old (or something, take this as hyperbole, not as a fact). I'd say things are working pretty well.

          • Don't you get it? They would not die of most of those bacterial infections, if they had a real immune system, instead of that "spark-emitting, red-alarm-lights-blinking, and rotting" rest of an immune system.

            Same thing with cancer. Why do you thing the reproductive function of the cells starts to fail that early, and just at specific spots, instead of the whole body? This is no general thing of old age. It is all that trash fucking up the system.

            Same as allergies. I have living proof, that stopping to eat m

            • by maxume (22995)

              My allergies have attenuated as I have aged. Or so I figure. Maybe the fact that I am in (far) better cardiovascular condition than I was a decade ago has contributed, I don't really know, it could be lots of things. I don't think that I could prove either of those ideas using just my own experience as evidence though, and I never had asthma.

              Also, arthritis is often caused by too much immune activity, so maybe you should leave that one out when you are talking about our ruined immune systems (which I think

        • Re:Hmmmm (Score:5, Funny)

          by Sponge Bath (413667) on Sunday June 21, 2009 @12:58PM (#28411585)

          ...the trash we call "food"

          On the plus side, the contents of all those Hot Pockets, Cheetos, and Twinkies will help preserve my cancer ridden corpse for centuries.
          I just hope no joker poses me in an undignified position.

          • by maxume (22995)

            Hilariously, preservatives often work by preventing oxidation. Ya know, like antioxidants, those things that are supposed to keep you healthy and strong.

    • by infaustus (936456)
      Normal cells do not reproduce indefinitely not because their DNA is breaking down, but because of checkpoints in the cell cycle. In cancerous cells, these checkpoints fail because of problems such as the overexpression of oncogenes or the underexpression of tumor suppressors.
    • If you're wondering why it is cancer can gain the ability to turn off your T-cells, it's important to remember that overactive immunity can be just as dangerous as immune insufficiency. Mutations in the CTLA-4 gene that boost its activity are associated with autoimmune diseases like lupus (yes, sometimes it is lupus), type I diabetes, and rheumatoid arthritis. In fact, Bristol-Myers-Squibb, makers of the ipilimumab (anti-CTLA-4 antibody) investigational drug discussed here already make abatacept, which is
      • by nbauman (624611)
        Mod parent up.

        An overactive immune system is just as dangerous as an underactive immune system.

        An overactive immune system causes autoimmune diseases, like asthma, multiple sclerosis, lupus, etc.

        Fortunately most of the snake oil peddled to "boost" the immune system has no effect at all.

    • by Ihmhi (1206036)

      Aren't T-Cells that shit that made the zombies in Resident Evil? I don't think anyone should be fucking with that stuff man!

    • Cancer cells do not reproduce indefinitely because of their rate of DNA degradation. Cancer cells reproduce indefinitely because the intracellular signaling (http://en.wikipedia.org/wiki/Signal_transduction) that controls apoptosis, survival, proliferation or differentiation has gone awry. Mutations associated with cancer usually result in a gene product that causes the aberrant signaling.

      One thing that concerns me about this study is that the authors use androgen ablation therapy (ABT) as a "pilot."
    • by Eris13 (647245)
      It's great for the primary cancer tumour, but there is no indication though if it will help the patient long term. Normally when the tumour becomes inoperable it's already metastasized - in case of prostate cancer, into the bones.
    • by Merpy (1475709)
      Would it be possible to find out how cancer cells shut of the T-cells and apply it to say, a heart transplant?
  • by metalhed77 (250273) <andrewvc&gmail,com> on Sunday June 21, 2009 @11:43AM (#28411103) Homepage

    The idea: use androgen ablation or hormone therapy to ignite an immune approach â" a pilot light â" and then, after a short interval of hormone therapy, introduce an anti-CTLA-4 antibody that acts like gasoline to this pilot light and overwhelms the cancer cells.

    Fry: Usually on the show, they came up with a complicated plan, then explained it with a simple analogy.
    Leela: Hmmm... If we can re-route engine power through the primary weapons and configure them to Melllvar's frequency, that should overload his electro-quantum structure.
    Bender: Like putting too much air in a balloon!
    Fry: Of course! It's all so simple!

    • Re: (Score:3, Informative)

      by linguizic (806996)
      Thank God!!!!! At last someone in the universe remembers that Melllvar is spelled with 3 L's!!!!
  • by Anonymous Coward on Sunday June 21, 2009 @11:54AM (#28411179)

    The Miracle Whip Clinic announced a similar breakthrough last year and they did it with much more tang.

    • But I wonder why the Baconnaise clinic still is in business. Especially since they specialized on chocolate chip pancakes and sausage on a stick therapy...

      • by TheLink (130905) on Sunday June 21, 2009 @02:34PM (#28412439) Journal
        Well that's because Baconnaise, choc chip pancakes and sausage have anti-cancer properties. Really!

        Eat enough of that and the odds of you getting cancer go way down.

        You'd just die of heart disease or something else first ;).

        Some people choose certain diets because they want to live longer. Others choose their diets based on how they want to die ;).

        You're eventually going to die of something. Imagine a pie chart where the slices represent the odds of you dying of a particular problem. Whatever you do, the pie is there and it doesn't go away. You can change the sizes of the slices, but it's unlikely you'll ever get to a slice that says "ran out of resources due to Heat Death of the Universe".

        So don't pick a diet or lifestyle that you can't grow to like. It's no point suffering your entire life just to die of cancer in the end. But it's probably not a good idea to die too early either, so find a decent balance and try to figure it out early enough so you can get on with more important stuff ;).
      • by jabithew (1340853)

        As a European just finding out about these wonders, I have to ask a couple of serious questions.

        Why are you all still alive? Have you heard of food? Are you aware of the concept of vegetables?

    • ...they did it with much more tang.

      One man's tang is another man's taint.

    • by bruthasj (175228)
      Who wants Tang in their Miracle Whip?
  • This is great news, but I was disappointed to read that they still had to operate in the end. Recently I've read stories about how doctors are reconsidering the need of surgical treatment of prostate cancer in benign cases, due to the bad side effects involved. In particular, prostate surgery has a very high risk of causing impotence. It would be nice if this new method could replace surgery altogether, at least for less severe cases.
    • by DeadPixels (1391907) on Sunday June 21, 2009 @12:18PM (#28411311)
      Know what else causes impotence?
      Being dead from cancer.

      True, it would be ideal to have a treatment that doesn't require any surgery, but if your choice is between impotence or death, I think most people will have the operation.
      • by shawb (16347) on Sunday June 21, 2009 @12:57PM (#28411581)
        Usually prostate cancer progresses at such a slow rate that an untreated patient will die of other unrelated causes before the prostrate cancer would kill them, or even cause significant quality of life issues. How many men would choose between impotence and a, say, 1/1000 (no idea if that is the actual chance) of dying earlier?

        Add in another possible side effect of cancer surgery: death. A small but significant number of patients die during prostrate sectioning surgery. Some patients die from sepsis caused by imperfect healing of the incisions (the large intestine is a very icky place, and you don't want what is inside there to get into the rest of the body.) For very mild cases of prostrate cancer, the risk of death due to surgery approaches the risk of death due to the cancer. Adding in other surgical complications involved, often times the best course of action with mild prostrate cancer is a wait and see policy, no matter how much the thought of this scares the patient (other types of cancer are usually "get it out as quick as possible" situations.) While surgery may indeed currently not be the best course of action in mild prostrate cancers, this will likely eventually change. The rates of surgical complications (including death) of course are going to keep going down as advances are made in surgical technique (such as cellular level laparoscopic microscopy allowing the surgeon to identify individual nerves to avoid sectioning, allowing for preservation of bladder control and sexual function.) However, these advanced procedures are indeed quite expensive and I think as a society we will eventually have to start asking whether extending a patients life is worth the financial cost.
        • True, but (Score:5, Insightful)

          by Weaselmancer (533834) on Sunday June 21, 2009 @01:35PM (#28411911)

          How many men would choose between impotence and a, say, 1/1000 (no idea if that is the actual chance) of dying earlier?

          You'd need to have the whole picture before you could make an educated choice.

          I lost my father to prostate cancer a couple of years ago. When it got bad he wanted to die at home. We arranged that for him. I was with him during his last day. I watched him die.

          I can tell you this. It's a life changing event watching someone die from cancer. Most people happily have no idea what it's like. I know though. Tumors up and down your spine, eyedroppers full of synthetic morphine to deal with the pain...it's absolutely unreal. Honestly.

          Believe me, if it came down to it and someone told me today that they'd have to remove everything from my balls to my bellybutton to avoid that fate, I'd go to the table with a smile. I'd happily sit to pee if it meant I could dodge that bullet. Anyone would if they knew what I know.

          Oh yeah, on an unrelated note - people who smoke are bat shit insane. They have absolutely no idea what's at the end of a losing roll of the dice.

          • by TheLink (130905)

            OK so you don't die of prostate cancer. But eventually you're going to die of something, and it could be a difference cancer (but very similar ending unfortunately) - in fact if your body is more prone to cancer, the odds are high you will get another cancer even if it's not related to the first one.

            You can dodge bullets. But you can't dodge all of them.

            See: http://www.cdc.gov/men/lcod/index.htm [cdc.gov]

            Eventually you lose the die roll.

            The people who smoke are not necessarily bat shit insane. They may figure the ple

            • Re:True, but (Score:4, Insightful)

              by Weaselmancer (533834) on Sunday June 21, 2009 @04:13PM (#28413161)

              The people who smoke are not necessarily bat shit insane. They may figure the pleasure is worth the final pain. I don't think it's worth it so I don't smoke.

              Yeah, that's kind of my point. They don't know what the "final pain" actually is. I'll betcha if they did they would feel differently.

              We all are building sand castles that will eventually be washed away. Learning to accept that is a good way to have more fun.

              Oh, I agree completely. We all die. But getting your end prematurely from something that painful...well, sucks.

              My dad was a tournament tennis player and a black diamond downhill skier when he was diagnosed. Cancer took it all from him. Hell, if it wasn't for the cancer he'd probably be playing tennis today.

          • Re:True, but (Score:4, Interesting)

            by ShawnX (260531) on Sunday June 21, 2009 @03:35PM (#28412861) Homepage Journal
            I know exactly what you went though, my dad had a very aggressive prostate cancer and seeing him slip away as he did was a horrible experience nobody should ever endure. I will always be forever haunted from those moments and to the last words he said to me during the day before he passed away that night. I am saddened if this treatment is found to be a breakthrough that it has come too late for us who have lost a loved one :`(
            • by Weaselmancer (533834) on Sunday June 21, 2009 @04:10PM (#28413127)

              I am saddened if this treatment is found to be a breakthrough that it has come too late for us who have lost a loved one

              Rejoice. For two reasons.

              1) Other people will be spared our experience.

              2) We're both genetically predisposed to prostate cancer, which means that this cure may help us someday. We might dodge the bullet. As a father myself I know I'd rather get cancer than my son. Easy decision. Maybe our Dads would feel the same way. "At least my son doesn't have to have this."

          • Thank you for saying that.

            What pisses me off when the subject of prostate cancer and increased funding for research comes up, or subsidizing PSA tests, or... one of the standard responses is that it's a low priority for additional resources because "it's slow growing and you'll likely die of something else first." So it's ok to spend 20 years knowing this thing is growing inside you and that your best hope is that something else kills you first so you don't die an agonizing death. The attitude is mind-boggl

          • by shawb (16347)
            I guess my post came off a lot more harsh against people and families suffering from cancer than I intended. I do support early diagnosis, and taking appropriate treatment where determined medically beneficial. It's just that with the current risks, which cases treatment would be beneficial can be hard to determine, so I also support research into better diagnostics in making those decisions. I suppose I did not made it clear enough that I am personally excited by advances in treatment, such as the topic
          • by squoozer (730327)

            Couldn't agree with you more. I watched my Gran die of lung cancer which was no doubt caused by years of smoking. I'm sure it will be the most horrific thing that I have ever seen. The most shocking thing was the lumps that formed on all the lymph nodes they are a picture I can't get out of my head. You would, I agree, have to be totally insane to regularly do something that is known to have a high risk of giving you cancer.

        • by rhsanborn (773855)
          Note that the cases cited were unusually aggressive forms of prostate cancer and had a high chance of mortality. So while it may be a very good idea to take the wait and see approach to many kinds of prostate cancer, there is new hope for people with life-threatening, aggressive prostate cancer. Also, possibly hope for similar applications in other cancers that aren't nearly so slow moving.
          • by vandelais (164490)

            So if you have non-agressive prostate cancer and could feel better if this works, wouldn't you choose the treatment?

        • by sjames (1099)

          True in many cases, but the cases in TFA were not like that. The cancer had already grown too large to surgically excise, meaning it was far more malignant and that watchful waiting was not an option.

        • by nbauman (624611) on Sunday June 21, 2009 @10:42PM (#28415769) Homepage Journal
          FWIW, I recently sent the following email to a friend with prostate cancer who asked for my advice.

          The most useful parts are the links to the free NEJM articles.

          Note the study that followed men 55-59 with Gleason Grade 6 localized prostate cancer. 15% died from prostate cancer at 15 years. I think that's the number you're looking for.

          They said you can often make a good case for "watchful waiting," essentially no treatment. Good story about the guy who got off the table right before the operation and decided not to have surgery. (They deliberately chose a case where there isn't enough evidence to make an easy decision.)

          Note also that they had 1,200 surgeries with no fatalities, so the surgery is a lot safer than it was in your father's day.

          Dear _______

          The best, most reliable source of information to make a decision on prostate cancer that I ever found is The New England Journal of Medicine. There are 2 problems: (1) It can be difficult reading, although they know patients will be reading some of their articles and they try to edit those articles to be as understandable as possible. I think it's easier to read one difficult article that gives you the information you want than to read ten easy articles that don't. (2) Often in medicine, especially in prostate cancer, they don't have enough scientific evidence to make a clear, easy decision. But if you have to make a difficult decision, it's easier if you at least have the best evidence.

          I remembered 2 articles in the NEJM in particular. One was free online; I'm attaching a PDF of the other. These articles are technical but you should be able to understand them by reading slowly and carefully (as I do). They do a good job of telling you how a doctor thinks about prostate cancer. You can find an explanation of anything you don't understand on Wikipedia. I'm also giving you my own notes that I made when I read the articles, and it might be easier to scan them first for an overview. Your best source of information should be your own doctor, but these articles will help you talk to him.

          One article was a survey of patients and their wives on the outcomes of prostate cancer surgery and radiation. The standard question about prostate cancer surgery is, "What's the probability of sexual impotence?" You assume that you'r going to have the best odds, with a surgeon who does a lot of cases, at a hospital that does a lot of cases. Surgeons (and the American Cancer Society) like to make reassuring claims, so you have to be skeptical about how they define impotence. I got the impression that it was about 50%, and that's what this article reported. However, the results are better for younger patients -- 75-year-old men have low sexual functioning to start with. This article also discusses the problems of urinary incontinence, which as I recall wasn't as much of a problem. There is a basic tradeoff between surgery (radical prostatectomy) and radiation (either external beam radiation or brachytherapy): surgery is more likely to cause urinary problems, radiation is more likely to cause rectal inflammation. This article got a lot of press coverage so you can search Google News for further discussion and explanation.

          The other was a case history of a 55-year old man with a Gleason score of 6 (grade 3+3) who decided in 1996 to get surgery, and then changed his mind at the last minute and walked out of the operating room. He's been followed ever since and the cancer hasn't metastasized. The NEJM likes to give cases that are in the very grey area of the evidence, with the hardest decisions, and this is one of them. They have experts explain the evidence and their thinking behind each option, there isn't any right answer, and any of the options would be a reasonable choice. I've attached a PDF of that article.

          They followed up that article by inviting 3 more advocates for each of the 3 options to argue their case, and then invited readers to vote in an on-line poll. That article is free

        • by yabos (719499)
          Maybe you won't die from the prostate cancer but if it metastasizes then you're screwed. Impotence can be cured with hormone replacement therapy. If your cancer spreads then you're done for.
        • by wwphx (225607)

          Uh, not exactly. My wife's father (he wasn't my F-I-L at the time) was diagnosed with prostate cancer. When they operated, they found it had spread to his liver and lungs. A month later they found two or three tumors in his brain. He died eleven days after our wedding.
           
          Maybe prostate cancer is slow, but if it spreads, the others might get you first.

      • by operagost (62405)
        Yeah, surgery only ruins your junk, so let's not look for a better alternative. That's why I don't support breast cancer research, either, because mostly old hags who are too old to make babies get it-- just lop those things off and be done with it!
    • In particular, prostate surgery has a very high risk of causing impotence. It would be nice if this new method could replace surgery altogether, at least for less severe cases.

      Yeah, and if they could develop the surgery-free treatment real fast, that would be great. My prostatectomy is scheduled for next Monday, and I'd be delighted to skip it.

  • Under the health care plan currently circulating Washington and mentioned on slashdot [slashdot.org] earlier, a treatment like this still wouldn't be availible to people under the proposed coverage. It only allows standardized accepted treatments. This means that off label applications wouldn't be covered and you couldn't participate in a program like this until such time it becomes a standard treatment.

    It sounds like this treatment, if it remains competent, has the potential to be a cheaper treatment then surgery as well

    • by ColdWetDog (752185) on Sunday June 21, 2009 @01:42PM (#28411973) Homepage
      Regardless of what I like or dislike about the health care plan, exceptions or provisions in any plan need to be in place so normal people can get treatments like this when they become available- even if they are still experimental and turn out to be a hail marry pass with the hopes of doing something other then the alternative of death.

      What prompts you to say that? This has been done on exactly two patients. If done on say, one hundred, maybe it helps five and kills the rest. The medical literature is quite full of therapies that held great promise but never lived up to their expectations for one reason or another. We waste an enormous amount of time and money on expensive, dangerous therapies that in the end, don't help patients much, and can hurt more patients then they help. Until and unless we do the real, long term, difficult and boring research (and the comparative research between different therapies) we're going to go off half cocked and fully broke.

      Your attitude, common as it is, is about 1/2 of what is drastically wrong with American healthcare. There is no substitute for good science.
      • by carlcmc (322350)
        actually this is incorrect. this reported 2 recent patients. It has been used on 50+ patients in the recent couple of years.
        • That still doesn't change the gist of my argument - it's still an experimental therapy and needs to be treated as such. Experimental therapies often look promising in the first couple of hundred patients then, somehow, never seem to work as well in the 'real world'. Unintended side effects often take a while to show up. Sometimes the initial patient selection process winnows out the more typical complex patient taking other medications or having other concurrent problems - and the therapy doesn't work we
      • by sumdumass (711423)

        Lol.. I suppose you already know it's been done on more then two patients. But that doesn't really matter.

        Here is what does matter, when the alternative is death because the condition is too far gone for existing treatments to be reasonably effective, experimental should mean nothing but here is another person to try it on. But if you think that only carefully selected people hand picked by researchers should be able to get these treatments until science has had their way, then please explain to me what the

    • Re: (Score:3, Insightful)

      by SydShamino (547793)

      The nation can't afford to fund every experimental or crazy expensive treatment for everyone - we'd go broke. It's a noble goal but just not possible.

      Instead, I see this as an opportunity for private insurance to thrive. I welcome government insurance as it will allow me to disconnect my health care from my employer. But I see an opportunity for a private company to offer supplemental insurance. With no preexisting conditions and, say, $20 a month, you could be covered up to $500,000 for experimental su

      • by Hubbell (850646)
        Those 'rich' folks won't have any extra money if government healthcare gets slammed through due to the enormous tax hikes that will be needed to fund it.
      • by sumdumass (711423)

        The nation can't afford to fund every experimental or crazy expensive treatment for everyone - we'd go broke. It's a noble goal but just not possible.

        Your right but when the disease is too far gone and the medically accepted treatment is death, then what makes the difference if the person doesn't get the treatment because he can't afford the insurance or because the government can't afford the treatment? I mean isn't that what the entire problem is in the first place, people not getting treatments becaus

    • by jabithew (1340853)

      It's a big problem in the British National Health Service. Essentially a lot of treatments aren't affordable on socialised healthcare, and so don't get rationed out by National Institute for Health and Clinical Excellence (NICE [wikipedia.org]). Not necessarily a problem, but if individuals want to try the treatment then they must go private for the whole package, not just buy in the drugs they want. This is because NICE usually rejects treatments because of either their lack of cost-effectiveness (how many good life-hours

      • by sumdumass (711423)

        Here is what I don't get.

        Under the British system, if they decide not to cover a treatment and you do it privately, you are out of the system for the rest of your life. Under the System circulating congress, you can't have more, that has to be a separate and additional policy charged separately.

        Now what makes the difference between the consumer not being able to pay for the treatment or make their own decisions regarding their health care verses the British or American government doing it. At best, the gove

        • by jabithew (1340853)

          the British system, if they decide not to cover a treatment and you do it privately, you are out of the system for the rest of your life.

          That's not quite right. You're out of the system for that particular treatment. If you stop it, you return. Equally, unrelated issues are still covered by the NHS. So if you contract AIDS and want to try a fancy new drug, you'd have to go privately for that. If you contracted TB from your AIDS-weakened immune system then the NHS would treat the TB. If you decided that the fancy new drug was a pile of pants after all and stopped using it, you'd be back in the system entirely.

          • by sumdumass (711423)

            Thanks for clarifying that. Turns out I understood a few concepts wrong. When I heard about it, it was over a cancer [dailymail.co.uk] patient who after paying out [timesonline.co.uk] of pocket for a drug that was supposedly 3 times as effective, was booted from the system and had to find a way to pay 11000 ero for two or three months treatment before he died.

            The worse part about this is that the people paid into the system all of their lives thinking they were getting proper coverage just to find out that someone is making penny pinching decis

      • by nbauman (624611)
        Under the UK NICE system, they pay for a treatment if it saves life at a cost of about $55,000 a year or less. They make a lot of exceptions.

        http://www.nytimes.com/2008/12/03/health/03nice.html [nytimes.com]

        The New York Times
        December 3, 2008
        The Evidence Gap
        British Balance Gain Against the Cost of the Latest Drugs
        By GARDINER HARRIS

        RUISLIP, England â" When Bruce Hardy's kidney cancer spread to his lung, his doctor recommended an expensive new pill from Pfizer. But Mr. Hardy is British, and the British health

  • One sided report (Score:2, Informative)

    by Anonymous Coward

    There were 54 patients and only 3 had dramatic response.
    They are hoping that by adjusting the dosage that this
    will improve.
    http://www.minnpost.com/healthblog/2009/06/19/9659

    Ipilimumab failed a prior clinical trial for prostate cancer.
    http://pmid.us/17363537

    and failed a prior clinical trial for skin cancer. Also its
    side effects can include rashes, diarrhea and hepatitis.
    http://en.wikipedia.org/wiki/Ipilimumab

    It would be great if it worked but this is more likely
    one of the numerous "breakthroughs" that never
    p

  • Hey guys...get your ass checked!

    Seriously. Not joking here, if you think that this shit won't kill you hard and fast you need a reality check. Get it young, you're probably going to die. Get it when you're older, probably going to live.

  • http://www.uromed.gr/ [uromed.gr] Prostate cancer is the leading cancer diagnosis and the second most common cause of cancer-related death in men in the United States. Worldwide, prostate cancer is the fourth most common cancer in men, with incidence and mortality rates that vary markedly among and within different countries. Since the early 1990s, new screening tests and improved treatments have been associated with dramatic shifts in the incidence, stage at diagnosis, and mortality of this disease. Major advances

To be a kind of moral Unix, he touched the hem of Nature's shift. -- Shelley

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