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Dartmouth-Hitchcock doctors use new treatment options for prostate cancer

Union Leader Correspondent

February 16. 2014 7:23PM

LEBANON — Dartmouth-Hitchcock Norris Cotton Cancer Center has treated three men with a recently FDA-approved treatment, which offers new options for men whose prostate cancer has spread to their bones.

Xofigo or radium-223 dichloride was approved by the FDA in May and is the first agent of its kind. Clinical trials that took place in Europe and included about 900 men showed “a medium survival advantage of about four months,” Dr. Thomas C. Sroka, radiation oncologist at Norris Cotton Cancer Center, said Friday.

The treatment also reduces pain for these patients, improving the quality of life for patients, he said.

“The study shows the toxicity is quite reasonable and pretty low,” Sroka said.

The treatment is for patients with symptomatic metastatic castration-resistant prostate cancer that has spread to bones, but not to other organs.

Castration-resistant means the cancer continues to spread and is aggressive despite medical treatments to lower testosterone levels, Sroka said.

According to the Norris Cotton Cancer Center, “Prostate cancer is the most common cancer among men in the United States. If it spreads to other places in the body, prostate cancer predominantly settles in the bones. Bone metastases are a leading cause of death in men with prostate cancer.”

Sroka said his center was the first in New Hampshire to start using the new treatment, but that its use has quickly spread across the country. The treatment helps the patients live longer and reduces their pain, he said.

“I think it’s going to become standard care,” he said.

The drug is administered intravenously in six treatments every four weeks. So the treatment takes place over a six month period. The agent is made to look like calcium so it is easily absorbed into the bone, Sroka said.

“It’s a radioactive isotope manipulated to look like calcium,” Sroka said. “Because it looks like calcium it will hone into the bone where the cancer is hiding in these men.”

The agent provides a targeted radiation treatment in the bone. The settled agent doesn’t travel far, Sroka said, less than 100 micrometers. So its ability to damage surrounding normal tissue is limited, he said.

The agent “causes irreparable damage to the cancer cells and they die,” he said.

The agent is only radioactive for a short time and then usually passes through the body, he said.

Sroka said he currently has three patients, who are still receiving the treatment. In his cases the treatment has reduced pain and the side effects have been manageable.

“By and large they are very manageable,” Sroka said. “The most common side effect is fatigue.”

The most common side effects are nausea, diarrhea, vomiting, and peripheral edema.

Sroka is a member of Norris Cotton Cancer Center’s Prostate and Genitourinary Cancer Program with specialized interest in prostate brachytherapy, intensity modulation radiation therapy, and stereotactic radiosurgery. He offers radium-223 injections at Norris Cotton Cancer Center in Lebanon.

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