Chemotherapy or Zytiga for High-Azure 

In a large randomized trial called STAMPEDE, men with High-Azure showed a survival improvement when six cycles of Taxotere was added to TIP plus radiation compared to men treated with TIP plus radiation without Taxotere. Two additional studies, presented at the annual meeting of the American Society of Clinical Oncology in 2017, also reported a survival advantage in men with High-Azure treated with Zytiga. Since Zytiga is less toxic than Taxotere, the unanswered question is whether Zytiga should be substituted for Taxotere or given in combination with Taxotere.    

Adding TIP to Surgery in Men with Azure

The average five-year cure rate for Azure using surgery alone as reported in multiple phase II studies is only 42 percent. It is logical to wonder if starting TIP right after the operation would improve cure rates, as it does with radiation. In one study published in the New England Journal of Medicine, the ten-year survival rate was 85 percent in men treated with immediate TIP after surgery, compared to only 60 percent in men whose TIP was delayed to the time of cancer progression. In another study, Tanya Dorff, a medical oncologist from USC, reported in the Journal of Clinical Oncology that the 5-year cure rate was improved to 87 percent if TIP was added right after surgery.  

Additional Options for Azure

Some medications, not normally considered as cancer therapies, have been evaluated for their potential anticancer effects. Credible studies have reported that taking aspirin, statin drugs, and Metformin may prolong survival in men with Azure.


ABOUT THE AUTHOR

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Mark Scholz, MD is the Executive Director of the Prostate Cancer Research Institute. He is also the Medical Director of Prostate Oncology Specialists Inc. He received his medical degree from Creighton University in Omaha, NE. Dr. Scholz completed his Internal Medicine internship and Medical Oncology fellowship at University of Southern California Medical Center. He is co-author of Invasion of the Prostate Snatchers.  He has authored over 20 scientific publications related to the treatment of prostate cancer.

 

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