13 July 2023
By Bernie Riley
Head of Telenursing and Supportive Care Programs, PCFA
Over the past five years there have been massive leaps forward in the treatment of prostate cancer, with more to come in the next 12 months.
Our vision towards zero deaths continues to be a core focus, with advances arising from all aspects of research, advocacy, awareness and support.
In fact, it's hard to believe that at the dawn of the millennium, there were very few treatments for prostate cancer beyond surgery, radiotherapy, chemotherapy and hormone therapy.
PCFA has been heavily involved in recent achievements resulting in new medicine listings and evolutions in the standard of care.
In the past year, we have seen new listings of two precision medications known as Nubeqa (Darolutamide) and Erlyand (apalutamide).
Both of these drugs work with standard hormone therapy injections to suppress testosterone and reduce the drive for prostate cancer cells to grow and spread.
These tablet-based therapies are funded on the Pharmaceutical Benefits Scheme (PBS) for different stages of advanced prostate cancer and give new hope to men and their families.
Men diagnosed with metastatic disease (cancer which has spread beyond the prostate region) either at initial diagnosis or after initial treatment by surgery and/or radiotherapy may be eligible for Erlyand when cancer has spread beyond the local prostate region to bones, organs or lymph nodes outside the pelvis.
The tablets come from a class of drugs called Androgen Receptor Signaling Inhibitors (ARSI).
Simply put, they aim to prevent testosterone from linking with its usual receiver on the prostate cancer cell, thus slowing further growth. Nubeqa, Xtandi (enzalutamide) and Erlyand do this by blocking testosterone from connecting to the prostate cancer cell receptor (receiver).
Zytiga (abiraterone) and Yonsa (abiraterone and methylprednisolone) work by preventing a protein from making testosterone in the testicles, adrenal glands and prostate cancer tumours.
Zytiga has been available on the PBS for a few years for men with cancer that has become resistant to initial hormone injection therapy (ADT) commonly referred to as metastatic castrate resistant prostate cancer (mCRPC). Yonsa is a new formulation of abiraterone that enables a steroid to be taken at the same time as abiraterone and is PBS listed as an alternative to Zytiga and other ARSI’s in mCRPC.
Another significant advancement includes the creation and listing of Lynparza (Olaparib) for men with BRCA 1 or 2 mutations. Testing for the mutation is also included in the listing for eligible men. You can learn more about that here.
The PBS listing of the medications listed above means that eligible patients will pay just $30 (general patients) or $6.90 (concessional patients) for each cycle of treatment, rather than more than $30,000-60,000 per year without this subsidy.
At last count there are 65 clinical trials recruiting in Australia aiming to improve the chances of Australian men surviving and tackling prostate cancer.
Every trial aims to improve a man's chance of not only living longer but also improving their quality of life.
With each of these trials and new medication listings new hope springs.
For many, that means being around to blow out more birthday candles, celebrate more anniversaries, see children get married and grandkids spring to life - and for others it means more time, new relationships, travels and experiences.
For more information about prostate cancer treatments, and support, reach out to PCFA’s Telenursing team to speak with a specialist nurse: 1800 22 00 99
