There are a vast assortment of unproven proposed treatments for prostate cancer, none of which have been shown conclusively to be of great value in the treatment of prostate cancer. This does not mean that these treatments are useless, but they have not been tested by formal methods in medicine. Some of these approaches have been evaluated for safety and this section is meant to provide all of the possible options.
Support for these alternative treatments is tempered by the understanding that simply having options available does not mean that those options are good; strong personal testimonials are not a proper substitute for careful and balanced investigation, and enthusiasm and faith may not be justification for alternative treatment when dealing with a serious illness such as prostate cancer.
Chemotherapy: This may be of value for men with advanced high stage prostate cancer who have failed hormone therapy. However, chemotherapy cannot cure cancer and is considered palliative only. This form of therapy is of great value for rapidly growing cancers but it has little utility other than experimental treatment for palliation of prostate cancer.
|Does not require surgery
||Serious side effects, some of which may be irreversible (side effects are dependent on the drug used)
|Does not require external beam radiation therapy
|May provide symptomatic relief of bone pain
||Still experimental and of little or no proven value for survival
|May improve survival
Considerable effort is being expended to change this situation, but the situation at present is not favorable. Some of the drugs and their actions are noted below:
Suramin: This drug was originally developed to treat parasitic infections but has been shown to block growth factors that stimulate cancer cell growth in test tubes and animal models. Up to 30% of men taking Suramin have a favorable response to their bone pain and the response can last up to three months. Side effects are serious, including kidney and nerve damage. The drug is administered as a shot or intravenous infusion.
Finasteride (ProscarR): This drug inhibits five alpha-reductase, the enzyme that converts testosterone to its more active form, dihydrotestosterone. This may be of value in preventing prostate cancer but there are no data to support this contention at present. Justification for its use in prostate cancer is based largely on its ability to depress serum PSA and its lack of significant side effects. A large national chemoprevention trial has been ongoing for a number of years, randomizing 18,000 American men between the ages of 55 and 70 into those receiving this drug and an equal group receiving placebo. The results of this trial should be available after the turn of the century.
Octreotide acetate (Sandostatin): This drug inhibits growth hormone and may block growth factors that stimulate prostate cancer cell growth.
Linomide: This experimental drugs exerts its effect by blocking new blood vessel formation, thereby starving cancer of its nutrients. This is an interesting hypothesis that remains untested in humans.
Lovastatin: This drug is used for treatment of high serum cholesterol and the question has been raised whether this may have an effect on hormonal activity and prostate cancer.
Estramustine (emcyt): This toxic drug combines the cell killing effect of estradiol and nitrogen mustard. It is the only drug approved for palliation of progressive or metastatic prostate cancer. Side effects include breast enlargement and tenderness which were both observed in more than 60% of men.
Other Chemotherapeutic Drugs: Drugs commonly used for other forms of cancer may show a small effect for prostate cancer. These drugs include methotrexate, cyclophosphamide, methylglioxal and adriamycin.
Low Dose Radiation: Certain radioactive drugs, referred to as radioisotopes, have shown encouraging results in the treatment of bone pain from metastatic prostate cancer. Examples include Strontium-89 (metastron), Rhenium-186 and Samarium-153. Combinations of radioisotopes and other chemotherapeutic agents may provide greater benefit.
Steroids: The bone pain from prostate cancer is also treated with corticosteroids, non-sex hormones produced by the adrenal glands. Side effects include blood pressure abnormalities, diabetes, ulcers and tissue swelling.
Biophosphinates: These drugs prevent bone destruction by metastatic prostate cancer. Examples include Clodronate, Etidronate, and Pamidronate.
Gene Vaccine: The use of dendritic cell infusions may stimulate the body's immune defenses to attack cancer cells directly or expose them to attack by other immune cells. Preliminary results are encouraging, but this remains experimental.
Thermal Therapy: Direct application of very high temperatures will destroy cancer cells, and this method has been exploited with laser therapy, microwave hyperthermia and electrocautery and electrovaparization. These techniques are of proven value for treatment of benign prostatic enlargement but none has been shown to be of value in prostate cancer.
Gene Therapy: This is an unproven therapy for prostate cancer and is still being investigated in laboratory animals and cell cultures.
Dietary Therapy: Diet may be of great value in preventing prostate cancer, but it is of no proven value in modifying progression of symptoms or metastases once the cancer is established. Despite the lack of evidence, such approaches are very popular but it must be remembered that the advantages or disadvantages have not, to date, been measured. Accordingly, such approaches may be useful adjuncts to conventional therapy. These are described under the section on Cancer Prevention.
Meditation: The mind exerts considerable effects on the body and many of these effects cannot be measured. Meditation is one form of mind-body therapy in which an altered state of consciousness is reached by focused concentration, usually resulting in relaxation or heightened awareness. Other therapies that are related include biofeedback, in which electrical monitors provide the patient with control of the bodies automatic physical processes; isualization, in which physical responses are evoked by focusing on mental images; Chinese acupuncture with needles inserted into the skin to induce natural painkillers such as endorphins; and other forms of therapy.