Treatments for Prostate Cancer

Malcolm Berko
Tue, 29 Jan 2019 21:00:00 -0800
Lifestyle

Dear Mr. Berko: My husband of 34 years is a retired Marine colonel with prostate cancer, and the doctors told him that it is aggressive and could metastasize. I know that you know a lot about prostate cancer because you mentioned at a lecture in Gainesville that Johnson & Johnson had a new drug to treat prostate cancer. You told us your son, who is a doctor, keeps up on the latest treatments. Is there anything new that you could share with us? — RS, Gainesville, Fla.

Dear RS: I'm told prostate cancer is the second-most common cancer in men. Last year in the U.S., over 164,000 cases were reported, and so were about 29,000 deaths. Worldwide, according to the American Cancer Society, there are 1.1 million new cases annually and 310,000 deaths. That's a lot of potential pills. Meanwhile, the two pill companies your doctor should peruse are Johnson & Johnson and Pfizer. Each has a new prostate cancer drug coming out soon, and each is a company I'd recommend, in a Minnesota second, for a long-term investment. However, other than this information, my son can't provide any personal advice or service. That's the provenance of your family physician.
Updated: Wed Jan 30, 2019

Dear Mr. Berko: My husband of 34 years is a retired Marine colonel with prostate cancer, and the doctors told him that it is aggressive and could metastasize. I know that you know a lot about prostate cancer because you mentioned at a lecture in Gainesville that Johnson & Johnson had a new drug to treat prostate cancer. You told us your son, who is a doctor, keeps up on the latest treatments. Is there anything new that you could share with us? — RS, Gainesville, Fla.

Dear RS: I'm told prostate cancer is the second-most common cancer in men. Last year in the U.S., over 164,000 cases were reported, and so were about 29,000 deaths. Worldwide, according to the American Cancer Society, there are 1.1 million new cases annually and 310,000 deaths. That's a lot of potential pills. Meanwhile, the two pill companies your doctor should peruse are Johnson & Johnson and Pfizer. Each has a new prostate cancer drug coming out soon, and each is a company I'd recommend, in a Minnesota second, for a long-term investment. However, other than this information, my son can't provide any personal advice or service. That's the provenance of your family physician.

Prostate cancer patients are among the most challenging patients to treat. There are some 165,000 of us living, dancing and working in the U.S. Many have aggressive cancers that defy the standard therapy and are just waiting to metastasize. When cancer does metastasize, the patient lives in a medical limbo that can't end too quickly as the tormenting cancer insidiously infects the bones, the lymph nodes, the bladder or other organs. But researchers at Johnson & Johnson and Pfizer posted results from clinical trials showing that their two new drugs can extend patients' pain-free living by several years.

I'm truly sorry to hear of your husband's cancer, but I'm pleased as a pasha that the Prescription Drug User Fee Act, passed by Congress in 1992, authorized Congress to collect fees from companies that produce specific human drug and biological products. The user fees have played an important part in getting quicker Food and Drug Administration approval. And in mid-February of last year, Johnson & Johnson (JNJ-$130) won quick approval for the very impressive prostate cancer drug called apalutamide. It will be available in the fall. Branded as Erleada, apalutamide also won approval for use in Europe. For the first time, we'll have a drug that clearly allows patients several more years of a comfortable life before the menacing cancer begins to metastasize and radiation or hormone therapy must be prescribed. The use of apalutamide promises a normally painless delay of least 24 months before chemotherapy or radiation therapy must be used to mitigate the symptoms that attack the kidneys, bladder and stomach. If you'd like more information about apalutamide, results are detailed in past issues of The New England Journal of Medicine.

Meanwhile, Pfizer (PFE-$40) recently developed a similar drug, called enzalutamide (branded as Xtandi), which the FDA has put under priority review, and approval is expected in about six months.

Both drugs should be Golcondas for Johnson & Johnson and Pfizer, and their use should pave the way for additional research, which may lead to drugs that can eliminate this cancer. These elixirs have but a few side effects, such as slight memory slippage, rashes, mild cognitive impairment, some hypertension, nausea and daily fatigue. I'm guessing that the consumer's cost of either drug will be in the neighborhood of $10,000 to $11,000 a month. But if you mortgage your home and redeem your retirement funds, you may be able to afford it.