THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Friday, April 28, 1995 TAG: 9504280491
SECTION: FRONT PAGE: A6 EDITION: FINAL
SOURCE: BY MARIE JOYCE, STAFF WRITER
LENGTH: Medium: 74 lines
A new drug offers an easier treatment for prostate cancer, one of the leading causes of cancer death among men, according to a study conducted in part at Sentara Cancer Institute and Eastern Virginia Medical School.
A Hampton Roads physician, Dr. Paul F. Schellhammer, will present the results of the study on the drug, Casodex, at the American Urological Association meeting this week in Las Vegas.
Casodex is a hormone blocker. Prostate cancer uses the male hormone testosterone to help it grow. Casodex mimics testosterone, attaching itself to receptors on cancer cells so the hormone can't latch on.
Casodex is not a cure for prostate cancer, and it doesn't kill cancer cells as chemotherapy drugs do.
However, it slows the growth of the disease to the point that a patient might die of other causes before the cancer has a chance to kill him.
Prostate cancer killed about 38,000 American men last year, according to the American Cancer Society. About 244,000 American men will be diagnosed with the disease this year.
Other drugs on the market, such as flutamide, work the same way as Casodex. But they have unpleasant side effects, including diarrhea, diminished sex drive and loss of appetite. Studies have shown that as many of 15 percent of patients stop taking their medicine because of the side effects, Schellhammer said.
Casodex works just as well and has far fewer side effects, said Schellhammer, who is program director of the Virginia Prostate Center, a joint program of EVMS and Sentara Cancer Institute.
``It's actually a very, very safe drug,'' he said. It also is more convenient. Flutamide must be taken three times a day - Casodex is one pill in the morning.
In the $20 million study, doctors found that patients on Casodex were far more likely to take their medicine. Less than one percent of those men stopped treatment.
Fifty-eight local men participated in the trial, which included a total of 813 men at 60 sites around the United States.
Now those men will be followed to see if the Casodex improves long-term survival.
Unfortunately, the drug won't help, at least for now, with one of the key problems of medical treatments for prostate cancer - impotence.
Casodex doesn't cause impotence, and it has less of an effect on sex drive than some other hormone blockers have.
However, in the study, - which only looked at its effect on men with advanced prostate cancer - doctors used Casodex along with so-called ``chemical castration'' drugs. These drugs, which are sometimes female hormones, stop the testicles from producing testosterone.
The mix of Casodex and castrating drugs is stronger and more effective than Casodex alone, Schellhammer said. Casodex probably will be used in that combination if it becomes commercially available, he said.
Doctors have speculated about using Casodex by itself on early-stage cancer, without drugs that cause impotence. But Schellhammer is cautious.
``The other thoughts are tantalizing, but unproven,'' he said. ``That's a big leap.''
However, once a drug has received approval from the Food and Drug Administration for one type of use, doctors may chose to prescribe it for other uses.
The Virginia Prostate Center will participate in the next round of trials, in which doctors will look at the drug as a preventative - can it reduce the risk that someone who has had prostate cancer will get prostate cancer again?
The first study was paid for by the pill's manufacturer, England-based Zeneca drug company. However, the work has generated enough interest that the National Cancer Institute has agreed to fund the next round.
Zeneca has applied to the FDA for permission to sell the drug in the U.S. Several months ago, England became the first country to approve its use. by CNB