Immunotherapy is becoming more and more of a promising and exciting treatment option for prostate cancer, especially for those with metastatic prostate cancer, in which the cancer has spread into other areas of the body beyond the prostate. If the cancer isn’t responding to standard treatments like hormone therapy, immunotherapy might be suggested. This treatment is beneficial as it helps boost the immune system in helping it find and destroy cancer cells. Essentially, immunotherapy is a class of treatments that take advantage of a person’s own immune system to help kill cancer cells. Other types of cancer that are using immunotherapy as a treatment option include ovarian, pancreatic, melanoma, lymphoma, leukemia, lung, liver, esophageal, kidney, head and neck cancers, childhood cancer, breast, bladder, and colorectal cancer. Not every patient with prostate cancer will be a candidate for immunotherapy. To determine if it’s a good option, doctors may look for specific genetic traits in the cancer cells.Here’s a closer look at how immunotherapy works, the different types used for prostate cancer, and what patients can expect.
How Exactly Does Immunotherapy Work to Fight Prostate Cancer?
Our immune system is naturally designed to find and attack abnormal cells in the body. In an ideal world, it would easily recognize and eliminate cancer cells. But cancer cells are sneaky — they can disguise themselves in ways that make it harder for the immune system to spot them. Some tricks cancer cells use include:
Genetic changes that make them more challenging for the immune system to identify.
Surface proteins that block immune cells from attacking.
Modifying surrounding cells to weaken the immune response.
Immunotherapy aim and purpose is to boost the immune system by making it better equipped to fight cancer. It’s beneficial in advanced prostate cancer that no longer responds to other treatments. Immunotherapy for prostate cancer might involve receiving an IV treatment or getting a boost to your immune cells, which are specially trained in a lab to target and destroy cancer cells.The decision to use immunotherapy will be tailored to each patient and guided by their oncologist and healthcare team.
Types of Immunotherapy for Prostate Cancer
Immunotherapy for prostate cancer generally falls into two main categories: cancer vaccines and immune checkpoint inhibitors.
Cancer Vaccines
Unlike typical vaccines, which are given to prevent diseases before they occur, cancer vaccines are given after a cancer diagnosis to help the immune system fight an existing cancer. One example of a cancer vaccine used for prostate cancer is sipuleucel-T (Provenge®). This vaccine is used for men with advanced prostate cancer that hasn’t responded to other treatments and who have few or no symptoms.
Immune Checkpoint Inhibitors
Your immune system has built-in “checkpoints” to prevent it from becoming too aggressive and attacking healthy cells. However, cancer cells are sneaky and can trick the immune system into turning these checkpoints on, which stops the immune cells from attacking the cancer.Immune checkpoint inhibitors are medications that block these checkpoints, allowing immune cells to stay active and fight the cancer. These are used for patients with advanced prostate cancer, primarily when other treatments like hormone therapy or chemotherapy haven’t worked.Two medications in this category have shown promise for prostate cancer:
Pembrolizumab (Keytruda®) – This medication has been approved for certain types of metastatic prostate cancer, especially in cases where the tumor has specific genetic features. It’s given through an IV infusion every three to six weeks and typically takes 30 minutes.
Dostarlimab (Jemperli) – This medication may be considered for men with advanced prostate cancer and a specific defect in the mismatch repair gene. It’s typically administered every three weeks for the first four doses, then every six weeks afterward.
Side Effects of Immunotherapy for Prostate Cancer
Like any treatment, immunotherapy can cause side effects. Most people experience mild flu-like symptoms right after treatment, which usually go away within a few days. To ease the discomfort, doctors may recommend acetaminophen or antihistamines.For cancer vaccines (like sipuleucel-T), typical side effects include:
Fever
Chills
Fatigue
Back and joint pain
Nausea
Headache
Less commonly, some patients may experience difficulty breathing or elevated blood pressure.For immune checkpoint inhibitors, typical side effects include:
Cough
Nausea
Fatigue
Itching
Skin rash
Decreased appetite
Constipation or diarrhea
Joint pain
Sometimes, patients may have what’s known as an infusion reaction, which can feel like an allergic reaction. These symptoms often occur at the injection site and can include:
Fever
Chills
Facial flushing
Itchy or red skin
Dizziness
Wheezing or difficulty breathing
While these side effects can be uncomfortable, many are short-lived and resolve quickly. However, some side effects may need more immediate attention from your healthcare team.
Final Thoughts
Immunotherapy for prostate cancer can be a game-changer, especially for patients whose cancer has stopped responding to other treatments. While it might not be the right option for everyone, it’s a promising avenue that offers a new way to fight this challenging disease. Your oncologist will guide you through the process and help you understand the best treatment plan for your situation.If you or a loved one are considering immunotherapy for prostate cancer, don’t hesitate to ask your healthcare team about the potential benefits and side effects. Staying informed and involved in your treatment journey is essential to beating back this disease.Dr. David Samadiis the Director of Men’s Health and Urologic Oncology at St. Francis Hospital in Long Island. He’s a renowned and highly successful board-certified Urologic Oncologist Expert and Robotic Surgeon in New York City, regarded as one of the leading prostate surgeons in the U.S., with a vast expertise in prostate cancer treatment and Robotic-Assisted Laparoscopic Prostatectomy. Dr. Samadi is a medical contributor to NewsMax TV and is also the author of two books, The Ultimate MANual, Dr. Samadi’s Guide to Men’s Health and Wellness, and Prostate Cancer, Now What? A Practical Guide to Treatment, Diagnosis, and Recovery, bothavailable online both on Amazon and Barnes & Noble. Visit Dr. Samadi’s websites at robotic oncology and prostate cancer 911.
