DR. STEPHEN FREEDLAND:
With tumors that spread, hormonal therapy is usually
the first line that we do.
What it does, it takes
testosterone levels from about 200, 300
in a normal person, brings it down to about 20.
But you'd think
about, like look, if this is a growth factor
for prostate cancer, I don't want mine at 20.
I want mine at 0.
How do we get it
from 20 down to 0? And that's where a medicine like
abiraterone, trade name Zytiga, comes into play.
What Zytiga does is it goes
to actually the root of where testosterone is made.
It doesn't matter if it's
coming from the tumor, the adrenal gland.
It actually blocks
the enzyme that actually is responsible
for making testosterone.
So when you take
Zytiga, any cells that are able to absorb it, and gets
into the cell, will block it.
Those cells won't be able
to make testosterone.
We now know from men who present
with advanced disease, cancer in the bones, in the liver,
in the lungs, that if they go, either on a hormonal
therapy or standard androgen deprivation, what we've
done since the 1940s, which is effective, versus
androgen deprivation therapy plus Zytiga, that
the men who get the combination with
Zytiga, actually live almost a year
and a half longer, and the side effects tend
to be relatively manageable.
It's a little bit higher
risk of hypertension.
You have to take prednisone,
which is a steroid.
You need to be
checked once a month.
Make sure you're getting
your blood and you're safe.
But for most men, they're able
to tolerate it pretty well.
And it actually,
in that scenario, makes a huge difference in
terms of men living longer.
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