What Are Current Prostate Cancer Treatments?
Treating advanced prostate cancer often involves lowering the levels of male hormones (called androgens) in the body. This is because prostate cancer cells usually need these hormones to grow. One common treatment is called androgen deprivation therapy (ADT), which uses special medicines to stop the body from making these hormones.
Newer medicines, like enzalutamide, apalutamide, and darolutamide, work by blocking the places in the cancer cells where these hormones attach. These newer drugs work better than older ones because they are more precise and stronger. Another medicine, called abiraterone acetate, stops the body from making androgens in areas outside the testes.
Together, these newer treatments are called novel hormonal therapies (NHT). When they are used with ADT, they do a better job of slowing down prostate cancer than ADT alone or ADT with older drugs.
Many large studies have shown that these new treatments help men with advanced prostate cancer live longer. Because of this, the U.S. Food and Drug Administration (FDA) has approved them for men whose prostate cancer has spread or who are at high risk of it spreading.
However, even though these treatments work well, we don’t fully understand how often they are being used in the general population. There are also concerns about whether people of different races and ethnic backgrounds have equal access to these medicines.
What Did the Research Discover?
Thestudy examined whether there are racial and ethnic differences in the use of novel hormonal therapy (NHT) for advanced prostate cancer. Researchers analyzed data from 3,748 men diagnosed between 2011 and 2017 using information from the Surveillance, Epidemiology, and End Results (SEER)–Medicare database, which tracks cancer diagnoses and prescription drug use.
The study found that Black patients were significantly less likely to receive NHT compared to White patients, even after considering factors like cancer stage, disease severity, and socioeconomic status. The key findings were:
- Only 20% of Black patients received NHT within two years of diagnosis, compared to 27% of White patients.
- This gap persisted over time, with 37% of Black patients receiving NHT after five years, compared to 44% of White patients.
- There was no significant difference in NHT use between White, Hispanic, and other racial/ethnic groups.
- Even in patients with the most advanced form of prostate cancer (M1 disease), Black patients still had lower NHT use than White patients.
- After adjusting for factors like age, income, tumor characteristics, and access to healthcare, Black patients were still 24% less likely to receive NHT compared to White patients.
The study highlights racial disparities in access to life-extending prostate cancer treatments, suggesting that Black patients face additional barriers to receiving NHT.
How Can I Apply This Information?
If you or a loved one has advanced prostate cancer, it’s important to discuss all available treatment options with your doctor. Novel hormonal therapies (NHTs) like abiraterone, enzalutamide, apalutamide, and darolutamide have been shown in clinical trials to extend survival and should be considered as part of treatment.
This study suggests that not all patients are receiving these recommended treatments equally. Everyone should take note of this—it’s especially important if you are Black or belong to a minority group it’s crucial to:
- Ask your doctor if NHT is right for you based on your specific cancer stage and health condition.
- Be aware of treatment disparities and advocate for your care.
- Seek a second opinion if you are unsure whether you are receiving the best possible treatment.
- Consider joining a clinical trial, as this can provide access to the latest prostate cancer treatments and help researchers address racial disparities in cancer care.
If you’re interested in learning about clinical trials for prostate cancer, talk to your doctor.
Source:
Ma TM, Agarwal N, Mahal B, Barragan-Carrillo R, Spratt D, Rettig MB, Valle LF, Steinberg ML, Garraway I, Vapiwala N, Xiang M. Racial and ethnic disparities in use of novel hormonal therapy agents in patients with prostate cancer. JAMA network open. 2023 Dec 1;6(12):e2345906-. https://pmc.ncbi.nlm.nih.gov/articles/PMC10692845/
