Prostate Cancer Spotlights in 2020: A Year in Review


2020 has been quite a year. We wanted to spotlight a couple of exciting advancements in the prostate cancer world and beyond as well as looking forward to the future.


The Promise of a Vaccine

Some of the biggest news in the last couple weeks is the promise of the COVID-19 vaccines.  There are several different vaccines moving on to large scale, phase three trials with several pushing for emergency use authorization from the FDA.  This exciting news may be hampered by the reality of how quickly the vaccination can be manufactured and distributed.

How Does it Work?

The goal of vaccinations is to teach the immune system to recognize and fight viruses.  All types of vaccines give the immune system a “memory” of the virus, providing long-term protection.  Because of the rapid development of the new COVID-19 vaccines, we do not yet know how long the vaccinations will offer protection from the virus.  Some vaccines such as the measles vaccination offer lifelong protection, while others, like the flu vaccine must be given yearly or in shorter intervals.  Further research (and time) will shed light on the long-term efficacy of these new vaccines. 

The majority of the developing COVID-19 vaccines require two separate dosages several weeks apart.  Studies have shown minimal side effects; however, the second of the two shots typically incurs more side effects than the first.  These adverse effects include pain at injection site, chills, and fatigue.

Remember, just like the seasonal flu vaccine, COVID-19 vaccines will take a couple of weeks for immunity to develop.  During this waiting period, continue to take protective measures like frequent handwashing, mask wearing, and social distancing. 

Will I Get the Vaccine When it is Available?

Lately the most common question I’m asked is: “Will you get the COVID vaccine, Dr. Scholz?”  Personally, I have the same reservations and nervous feelings about vaccines as most everyone does.  A couple of weeks ago I got my pneumonia vaccination and my arm was sore for two days and I felt achy and disgruntled for a day or so.  Bottom line, I look at everything from a risk-benefit ratio.  What is the chance this new vaccine will seriously harm me?  Probably less than one in ten thousand.  What is the chance for permanent debility or death for me at age sixty-five if I catch COVID-19?  Probably about one in a hundred.  Considering these odds, I’ll be first in line to be vaccinated.  

New Life-Prolonging Treatment

This year there have been several exciting prostate cancer FDA approvals including Lynparza (Olaparib) and Rubraca (Rucaparib).  Olaparib and Rucaparib were originally indicated for women with BRCA-mutated ovarian cancer.  When the connection was made between BRCA and prostate cancer, it was correctly assumed that these medications may be beneficial for men with prostate cancer who have the BRCA mutation as well.  A little more than 10% of men with advanced prostate cancer harbor this mutation.  To learn more about genetics and treatments like Rucaparib and Olaparib, listen to the PROSTATE PROS episode Applying Genetic Therapy.”  Rucaparib and Olaparib are FDA approved for men with BRCA and metastatic castration-resistant prostate cancer who have already received certain treatments (please visit www.rubraca.com or www.lynparza.com)

More Accurate Scanning

On December 1, 2020 the FDA approved the PSMA PET scan for prostate cancer.  The PSMA PET scan will be a game changer because it detects prostate cancer at a much earlier stage than other scans.  To learn more about the PSMA PET scan listen to PROSTATE PROS Episode 18: “PSMA Imaging Detects Prostate Cancer Spread.”

Telehealth

Telehealth has exploded in popularity due to the COVID-19 pandemic.  Telehealth is super-efficient because patients can access their doctors from anywhere in the world saving time, reducing travel, and avoiding crowed doctor’s offices. 

Tips to improve your virtual visit:

  1. Write down your questions beforehand.  The more prepared you are for your doctor’s appointment, the more you will get out of it.
  2. Invite your spouse, friends, children, or PMD to join in on the phone call.  Having an extra set of ears can help with comprehension and decision making.   
  3. Set yourself up in a quiet space with good cell phone reception.  Doctor’s appointments require focus and attention, allow yourself to be present even when visiting with your doctor from the comfort of your own home.   
Looking Forward:

Men with hormone resistant prostate cancer are looking toward FDA approval of a variety of new technologies.  Xtandi, Nubeqa, Erleada, and Zytiga are amazing hormone medicines but if they stop working the next step will usually be chemotherapy like Taxotere or Jevtana or an injectable type of radiation called Xofigo.  Alternatives to consider are experimental immunotherapies like Keytruda, Opdivo, Amgen’s new “BiTE” platform, or another injectable form of radiation based on PSMA called Lutetium-177.  As clinical trials continue to mature, more and more alternatives benefiting men with prostate cancer will become available.  

New Year’s Resolutions

2020 was the 10 year anniversary of my first book, The Invasion of the Prostate Snatchers, co-written with Ralph Blum.  In the book Ralph and I aimed to expose the prostate industry’s misplaced goals and also present better options for men with prostate cancer.  Unfortunately, the treat-first mentality is still pervasive throughout the industry today.  I’m excited to announce that a second edition of Invasion of the Prostate Snatchers will be coming out in 2021.  This updated edition introduces the latest thinking about managing prostate cancer with a focus on quality of life and prolonged lifespan.  I want to continue pushing for change in the industry and that will only come about if patients become more knowledgeable about prostate cancer.  Patients who are well versed in prostate cancer can nudge their primary care doctors to stop reflexively referring men with elevated PSA to urologists for random biopsy.  Instead, PMDs can take a bigger role in evaluating men with high PSA by ordering a prostate MRI, which is both more accurate and less likely to lead to over-diagnosis and over-treatment than random biopsy.  Through using less invasive, more accurate technologies I believe men with prostate cancer will both receive more personalized treatment and maintain a more appealing quality of life. 

Listen to the podcast on 2020 prostate cancer updates and advancements here:

The purpose of this podcast is to educate and inform.  The information presented on this podcast and corresponding blog posted on prostateoncology.com/blog should not be used in place of a physician consult. Guests on the podcasts present their own opinions and conclusions, these views do not necessarily represent that of Prostate Oncology Specialists.

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