Prostate Cancer (cont.)
Jay B. Zatzkin, MD, FACP
John P. Cunha, DO, FACOEP
John P. Cunha, DO, FACOEP
John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.
In this Article
It is preferable for cancer treatment to specifically target diseased cancer cells instead of indiscriminately damaging both healthy and cancerous cells.
Targeted therapy for prostate cancer includes both immune therapies such as Provenge and hormonal treatments that target receptors (specific pockets or substances on the surface of the cells). Chemotherapy can also have very targeted effects. In the case of Taxotere, the chemotherapy has some very specific targeted effects within the cell. The drug can both block a process essential to cell division, and also inactivates a protein that prevents the cell from dying.
The bisphosphonates are a group of drugs used to treat several conditions people can get including osteopenia and osteoporosis. They also can lower elevated blood levels of calcium in people with cancer. They work by affecting cells in the bones called osteoclasts, which work to remove bone. These drugs encourage the death of the osteoclasts. In prostate cancer they impact the course of skeletal-related events including reducing pain in the bones, and delaying the progression of bone metastases associated problems including the appearance of fractures (breaks in bones). While the bisphosphonates can affect the growth of prostate cells in the laboratory, they are presently not considered a targeted or direct-acting drug like a chemotherapy or hormonal treatment. They have also not been shown to prevent the appearance of bone metastases in prostate cancer patients. Nonetheless, they are an important part of the treatment of prostate cancer patients with bone metastases.
The most potent of the bisphosphonates is called zoledronic acid (Zometa). It is given intravenously. Its side effects are primarily reactions to the drug infusion. The dose of Zometa may need to be adjusted if the patient's blood tests show signs of deterioration in the function of the patient's kidneys. In addition, its use can predispose patients to serious dental conditions including what is called osteonecrosis of the jaw, which can result in breakdown of the bone of the jaw after dental extractions. Tell your dentist if you are taking this drug.
Medically Reviewed by a Doctor on 9/4/2014
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