Limitations of Current Solutions
Limitations of Current Solutions
While several treatments for prostate cancer exist, the specific therapeutic recommended for patients varies based on their prostate cancer diagnosis, considerations for the patient’s quality of life, and possible other complications regarding the individual’s overall health (Singh et al., 2010). Prostate cancer severity is stratified into different stages ranging from low to high risk. Classification involves a combination of a Gleason score (likelihood of tumor growth), Prostate-Specific Antigen (PSA) concentrations, and the patient’s clinical stage (Litwin & Tan, 2017). The different treatments available for each stage of prostate cancer each have their own associated adverse health effects, in addition to common concerns of being costly, time-consuming, invasive, and disruptive to the daily lives of patients–all of which may cause individuals to be hesitant to partake in treatments (Zeliadt et al., 2006).
Low-risk grade 1 cancer is characterized by a Gleason score below 6 and PSA levels below 10 ng/mL (Litwin & Tan, 2017). The most common approaches for patients with low-risk prostate cancer diagnoses are active surveillance of the tumor through regular imaging of the site, biopsies, and serum PSA measurements, as well as ablative therapies that employ either high-intensity energy or low-temperature cryotherapies to destroy tumors (Evans, 2018). While active surveillance has not been found to induce physical side effects, there are studies investigating concerns about related heightened anxiety, psychological stress, and depression over time (Singh et al., 2010). Ablative treatments have been linked to negative side effects such as fibrosis, damage to nearby tissues, bladder outlet obstructions, and erectile dysfunction, and are known to have variable success in eradicating tumor cells (Evans, 2018).
Intermediate-risk grades 2 and 3 prostate cancers have a Gleason score of 7 and PSA levels between 10 to 20 ng/mL (Litwin & Tan, 2017). Patients that fall in these grade groups are typically recommended either a prostatectomy to surgically remove the prostate gland or radiotherapy, which utilizes radiation to irradiate and destroy cancer cells (Trewartha & Carter, 2013). Even with recent developments to mitigate the undesirable consequences of these treatments, surgical and radiation therapies still pose high risks of gastrointestinal, peripheral neurological, and urinal complications that may require further treatments or surgeries to address (Michaelson et al., 2008).
High-risk grades 4 and 5 tumors have Gleason scores of above 8 and over 20 ng/mL of PSA (Litwin & Tan, 2017). In conjunction with prostatectomy or radiotherapy treatments, chemotherapies and androgen deprivation therapies (which employ chemical drugs to suppress the production and activity of androgen hormones) are also recommended at these stages (Litwin & Tan, 2017). Additionally, cases of metastasis where the tumor has spread to other areas of the body are also often treated with chemotherapy or hormone therapies (Sternberg, 2002). However, chemotherapy and androgen deprivation can lead to complications such as general fatigue, vasomotor flushing, anemia, bone density loss, and increased risks of cardiovascular diseases and diabetes that may have long-term impacts on quality of life (Litwin & Tan, 2017).
As a result, investigation into novel methods with minimal health effects, low costs, and increased accessibility to circumnavigate the challenges of current treatments is necessary. There are many promising studies on cancer immunotherapies being conducted, which utilize cancer vaccines to stimulate immune responses against prostate cancer cells or immune checkpoint inhibitors to allow T cells to eliminate tumor cells; however, these therapeutics are often even more costly and have had limited efficiency thus far (Evans, 2018; Nevedomskaya et al., 2018; Trewartha & Carter, 2013).