A Cure? Not Likely! was.... Provenge moves forward!

[Guest guest]

Ever since I started learning a little

about prostate cancer I have become more and more convinced that there cannot

be a “one cure fits all†outcome because what we are dealing with is a

multiplicity of diseases that react in a multiplicity of ways with individual

men. I don’t know how many of you saw the piece in the Wall Street Journal titled

“The Prostate Cancer Quandary†which dealt with the work done on genetically

identifying the different ‘brands’ of prostate cancer. (I have loaded the file

here – go down to ‘Files’ and click on that then page down). That identified 24

varieties, with most diagnoses being of the type that might fit the ‘indolent

disease’ description.

Mentioned in passing in that article was

the fact that 2 out of the 24 varieties have similar genetic make up to the genes

that drive malignant melanoma. That brought to mind some of the other material I

had read on genetics (low level, not too technical!) one item of which

suggested that the focus on treating cancers was wrong because they were

identified by site, rather than their genetic make-up. Whilst certain genetic ‘types’

might be more common in, for example, tumors currently identified as lung tumors,

which are notoriously aggressive, than in prostate cancer tumors, perhaps the

very aggressive prostate cancer tumors were the same genetic ‘type’ as the lung

tumors. The thrust of this article, simply put, was that if all tumors could be

genetically ‘typed’ they might be more successfully treated rather than treat

all ‘site’ tumors in the same way.

It makes a deal of sense to me, but

whether that makes the chances of finding a cure more or less likely is another

matter all together. But to take ’s auto analogy a step further it might

stop the mechanics trying to correct a problem with the ride of a car because

of a faulty suspension system by changing the tires – or indeed stop them replacing

the entire suspension system when all that was needed was a bit of air in the

tires.

All the best

Prostate men need enlightening, not

frightening

Terry Herbert - diagnosed in 1996 and

still going strong

Read A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Kennedy

Sent: Saturday, 20 November 2010

3:36 AM

To:

ProstateCancerSupport

Subject: Re:

Provenge moves forward!



 

wrote:<snip> " A cure? No,

not yet. In all likelihood not in my short lifetime

either. " <snip>

I hope you are wrong about this but how many patients

lifetimes will it take? Any statistics on that. I will take some liberty here

and say that the medical profession has been pursuing a cure for cancer, any

variety, for two hundred years at a cost of trillions of dollars, pounds,

drachmas pesos, whatever. And if a doctor were a car mechanic his tool box

would contain a hammer, a larger hammer, seven oil cans with various labels,

hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some

dry ice, and five different types of epoxy cement. That's it! That is all they

have to fix your $60,000 Mercedes.

What is wrong? I wish I had better answers to that but I do

think that when new discoveries are made the reporting is often directed at

those who would most stand to gain monetarily. Wall Street loves Dendreon. For

me, not so much.

" Il faut d'abord durer " Hemingway

[Guest guest]

Terry while this makes sense intellectually if I remember correctly The same genetic cancer originating in a different organ may not react the same way to the same treatment. Part of the problem is that there may be another separate gene or protein that may come into play. Why would one person get malignant melanoma and another prostate cancer? There is an IPad app called The Human Genome at 10 that may be of interest. Also researchers are talking alleles and SNP’s. My eyes glass over so I can’t explain this very well but you can read at http://www.cancer.gov/cancertopics/understandingcancer/geneticvariation/allpages   Like everything else the more you know the less you know but they are getting closer. Kathy From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of Terry HerbertSent: Friday, November 19, 2010 1:46 PMTo: ProstateCancerSupport Subject: A Cure? Not Likely! was.... Provenge moves forward! Ever since I started learning a little about prostate cancer I have become more and more convinced that there cannot be a “one cure fits all†outcome because what we are dealing with is a multiplicity of diseases that react in a multiplicity of ways with individual men. I don’t know how many of you saw the piece in the Wall Street Journal titled “The Prostate Cancer Quandary†which dealt with the work done on genetically identifying the different ‘brands’ of prostate cancer. (I have loaded the file here – go down to ‘Files’ and click on that then page down). That identified 24 varieties, with most diagnoses being of the type that might fit the ‘indolent disease’ description. Mentioned in passing in that article was the fact that 2 out of the 24 varieties have similar genetic make up to the genes that drive malignant melanoma. That brought to mind some of the other material I had read on genetics (low level, not too technical!) one item of which suggested that the focus on treating cancers was wrong because they were identified by site, rather than their genetic make-up. Whilst certain genetic ‘types’ might be more common in, for example, tumors currently identified as lung tumors, which are notoriously aggressive, than in prostate cancer tumors, perhaps the very aggressive prostate cancer tumors were the same genetic ‘type’ as the lung tumors. The thrust of this article, simply put, was that if all tumors could be genetically ‘typed’ they might be more successfully treated rather than treat all ‘site’ tumors in the same way. It makes a deal of sense to me, but whether that makes the chances of finding a cure more or less likely is another matter all together. But to take ’s auto analogy a step further it might stop the mechanics trying to correct a problem with the ride of a car because of a faulty suspension system by changing the tires – or indeed stop them replacing the entire suspension system when all that was needed was a bit of air in the tires. All the best Prostate men need enlightening, not frighteningTerry Herbert - diagnosed in 1996 and still going strongRead A Strange Place for unbiased information at http://www.yananow.net/StrangePlace/index.html From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of KennedySent: Saturday, 20 November 2010 3:36 AMTo: ProstateCancerSupport Subject: Re: Provenge moves forward!  wrote:<snip> " A cure? No, not yet. In all likelihood not in my short lifetime either. " <snip> I hope you are wrong about this but how many patients lifetimes will it take? Any statistics on that. I will take some liberty here and say that the medical profession has been pursuing a cure for cancer, any variety, for two hundred years at a cost of trillions of dollars, pounds, drachmas pesos, whatever. And if a doctor were a car mechanic his tool box would contain a hammer, a larger hammer, seven oil cans with various labels, hacksaws, robotic hacksaws, right angle hacksaws, a couple of blowtorches, some dry ice, and five different types of epoxy cement. That's it! That is all they have to fix your $60,000 Mercedes. What is wrong? I wish I had better answers to that but I do think that when new discoveries are made the reporting is often directed at those who would most stand to gain monetarily. Wall Street loves Dendreon. For me, not so much. " Il faut d'abord durer " Hemingway

[Guest guest]

Unfortunately at the recent CMS review Provenge was not approved for off label usage so there is only a specific set of men who fit the profile. Provenge® has FDA approved labeling for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer. We will be unable to find the answer to your questions except through the clinical trial process. This is very expensive. The company has set up a registry to gather information that may answer some of your questions. The faster men agree to participate in the trials now and when they open, if they open, the faster we will get the answers. Phase 3 Clinical Trial Costs Exceed $26,000 per Patient http://www.lifesciencesworld.com/news/view/11080 Men have been historically slow to join clinical trials so that increases the cost. In an environment where there is a strong push on capitol hill on cost containment, research funding is particularly vulnerable. There is one proposal to cut $6B from NIH funds, I doubt this will be the final amount, at least I hope so. In addition they are looking at cuts to not essential military budgets. The CDMRP program is unessential so it is very vulnerable. http://cdmrp.army.mil/pcrp/default.shtml Funding for the programs that have just gone through peer reviewed are vulnerable. FY 2011 which begins Oct 1st has not been approved yet. There was a continuing resolution. The D’s want to get things done during lame duck but the R’s want to carry it over until next year so they have more control. Either way if you care about getting research funding you can write now to your legislators asking them to maintain levels for CDMRP and NIH. Kathy Meade From: ProstateCancerSupport [mailto:ProstateCancerSupport ] On Behalf Of tarhoosierSent: Saturday, November 20, 2010 8:24 AMTo: ProstateCancerSupport Subject: Re: A Cure? Not Likely! was.... Provenge moves forward! While the Provenge issues of usefulness, appropriateness, durability of effect, cost, coverage, and so on are maintained here and at many other sites of the interweb, one of the most pressing issues is nowhere to be found in my searching. What is the real effect, by accuculated patient experiences, of this treatment. We have the Phase III data, but it is not complete as the range of survival had not been recorded by the time of data submission, and may still be incomplete. THere is an open label Phase II ongoing with no results likely for some time. This for men pre-chemo+metastatic. What about those treated earlier in the disease state, whose further treatment continues? The same goes for the earlier trials of Provenge. The doctors who see patients under treatment, and after treatment, do not publicize their observations. A precious few patients are posting their experience. What is the effect of Provenge as the first in a series of treatments? How does a second series of Provenge affect the patient. It seems that this treatment could be repeated with no negative issues. Has this been tried? Even after years of trials there is less known here than one would wish. For an entirely new method of disease treatment I am frustrated by the holes in experience.