Vantas versus Zoladex

[Guest guest]

From todays papers:

"A pioneering treatment that improves the lives of prostate cancer sufferers has just been launched in the UK.

About 35,000 men are diagnosed with prostate cancer each year in the UK and more than 10,000 die from the disease.

While current treatments involve injections of synthetic hormones into the stomach every one or three months, which can be painful, the Vantas implant lasts up to a year.

Inserted under the skin, the implant contains a synthetic hormone - histrelin - which lowers testosterone. Reducing the amount of testosterone in the body can slow the growth of the tumour by many years.

Like other hormone treatments, Vantas also significantly reduced PSA levels (a marker for the disease) by the second week of treatment.

The use of histrelin - a luteinising - hormone-releasing hormone (LHRH) agonist - has become a standard option for men with advanced prostate cancer.

Vantas is different from other LHRH agonists in that it releases histrelin gradually for up to 12 months, compared to other treatments that have a maximum duration of three months.

One of the main benefits to this slow release is that it prevents testosterone levels flaring - which is better for long-term prognosis.

Mr Raj Persad, Consultant Urologist at Bristol Urology Associates and a prostate cancer specialist, says: 'Each time a patient has an injection in his stomach he gets a flare of testosterone, which is what we're trying to reduce.

'This flare may be problematic and cause a worsening of symptoms. Vantas patients don't have repeated injections, so this doesn't occur in the first place.'

In the past, the treatment for men with advanced prostate cancer would often involve removal of the testes.

However, during clinical trials, Vantas was shown to be just as effective at suppressing testosterone levels after four weeks' treatment. It also maintained these levels in patients during 52 weeks of therapy.

After 12 months, the implant is removed and, if treatment is to be continued, another implant may be inserted at the same time as removal.

Vantas has been offered to men in the U.S. for five years and has been available on the NHS since last January.

Porta, of the male cancer charity Orchid, said: 'We welcome new treatment options, especially those which can offer patients an improved quality of life.'

Mr Raj Persad, who has treated two of the first Vantas patients in the UK, says: 'A patient's quality of life is just as important as their life expectancy and it can be very stressful and time consuming going to hospital for regular injections.

'Vantas is all about patient lifestyle choice and the benefits of a onceyearly procedure versus multiple injections.

'It is suitable for patients with advanced prostate cancer, whether they are new to hormone therapy or on an existing treatment.'

Read more: http://www.dailymail.co.uk/health/article-1263830/Implant-ends-misery-prostate-jabs.html#ixzz0kM2AQBmN"

Fellas,

I take much of what I read about PCa with a pinch of salt, but this article intrigued me. I was unaware that there were testosterone flares with monthly or quarterly (12 weekly) Zoladex jabs, other than with the first jab when, at least in the UK, we're given 28 days of Cyproterone, ie 14 days either side of the first jab, to deal with the flare issue. If there are flares associated with regular Zoladex jabs then presumably there are effects on PSA readings. Thus, if quarterly PSA readings are taken (as in my case) they will not necessarily occur at at the same time in the 12 weekly Zoladex cycle. Might this account for some variability, even PSA bounce? Again, what if the medical practice cocks up and misses one of the regular 12 weekly jabs, as mine did recently so that I missed 3 weeks of "cover" (my fault for trusting them and not keeping a check myself), what might this do to the PSA reading? I

shall find out in a couple of weeks!

Do any of our colleagues in the US have any experience of Vantas? Is what is claimed in the article true? Any informed opinions about this treatment?