Zytiga (abiraterone acetate), an ingested pill treatment manufactured by J&J, has been found to potentially extend life by up to four months in men with spreading cancer who have already been treated with chemotherapy. However, there are other altervatives if so desired.

According to the Centers for Disease Control and Prevention, prostate cancer is the second most frequently diagnosed form of cancer among men in the U.S., following skin cancer. More than 220,000 men develop the condition each year, the organization notes.

The new drug Zytiga, which was approved by the FDA in April 2011, inhibits a protein that helps form male hormones. The findings may help reshape the way doctors view and treat advanced prostate cancer. Men who took the pill also saw greater responses in levels of prostate-specific antigen (PSA) than men who received placebo. Elevated levels of PSA may be a marker for prostate cancer.

Those men who received steroid therapy along with the new pill survived for 14.8 months, on average, compared with 10.9 months seen among those who received a placebo along with steroids.

This translated into a significant 34% reduction in risk of dying.

The measurement of the circulating cancer cells in relation to patient survival was part of a formal collaboration with the FDA. The cells represent about one cell in a billion in the blood stream.

These findings will be tested in subsequent studies that may eventually determine if the measure could help guide treatment decisions for individual patients.

The $5 billion dollar prostate cancer drug market provides an alternative to testicular removal for many men. Testicles produce the sex hormone testosterone which is responsible for producing the primary male characteristics for the fetus in utero as well as the secondary sexual characteristics that develop during puberty.

Testosterone fuels the production and growth of the prostate gland, and when a man develops prostate cancer, the growth of the organ can be stopped by removing testosterone. One way therapists ablate the amount of testosterone in the body is by surgically removing the testicles in a process called surgical castration or orchiectomy. Surgical castration removed only the testicles, not the scrotal sac, so men who opt for surgical castration may also request the insertion of a testicular prosthesis.

Cryotherpy is another treatment and a relatively new procedure. Prostate cryotherapy works because as cells freeze, ice crystals form inside and around them. The freezing and thawing processes destroy cells through dehydration, drastic changes in the pH levels, or prevention of the flow of red blood cells. Subjecting the prostate gland to freezing temperatures, specifically negative 40 degrees Celsius, also activates an anti-tumor response in the body. An anti-tumor response begins with the production of anti-bodies that work to eradicate the tumor.

Radiation is also an option, but not so desirable. There are two types of prostate cancer radiation treatments: external and internal which is also called interstitial. Brachytherapy is interstitial, meaning treatment is administered from “within the tissue.” External radiation therapy involves the projection of photon, neutron, or proton beams into the prostate gland from a remote tool called the linear accelerator.

Radiation is used in the treatment of prostate cancer because exposure damages the DNA of cells. Cells will not be damaged unless they attempt to divide. Cancerous cells divide more quickly than healthy cells. Therefore, healthy cells are able to repair damage before undergoing mitosis, while cancerous cells are not.

Unfortunately, if the dose is strong enough, healthy cells will be damaged to the point where they cannot repair themselves before division. Interstitial brachytherapy is able to deliver higher doses of radiation to an area concentrated within the prostate gland.

Sources: Johnson and Johnson and The Prostate Cancer Treatment Guide

Written by Sy Kraft