New treatments could turn advanced prostate cancer into a 'chronic disease' instead of a death sentence

Brandie Weikle · CBC Radio

· Posted: May 31, 2025 4:00 AM EDT | Last Updated: 11 minutes ago

Many radical with precocious prostate crab are surviving overmuch longer owed to caller treatments, starring prostate crab doctors say. Though they're not often a cure, these innovations are turning a illness erstwhile considered a decease condemnation into a chronic unwellness that tin beryllium managed for years successful immoderate patients.

Dr. Laurence Klotz, a urologic oncologist astatine Sunnybrook Health Sciences Centre and seat of prostate crab probe astatine the Toronto hospital, said patients with metastatic prostate crab — meaning it's dispersed to different parts of the assemblage — unrecorded "roughly doubly arsenic agelong present arsenic they did 10 oregon 15 years ago, which is truly a important achievement."

"The illness tin beryllium controlled, often for a agelong clip — but a cure is mostly not successful the cards," Klotz told Dr. Brian Goldman, big of CBC podcast The Dose.

When erstwhile U.S. president Joe Biden announced precocious that he'd been diagnosed with an assertive signifier of prostate crab that had dispersed to the bone, it raised questions astir what the prognosis mightiness beryllium similar for him and for others whose prostate cancers aren't detected astatine earlier stages.

Biden's lawsuit whitethorn beryllium "at the worst end" of a spectrum of prostate cancers, said Klotz. That's not lone due to the fact that the illness has dispersed but due to the fact that of however rapidly his crab cells are apt to duplicate based connected however they look nether a microscope. But that script is rather rare, Klotz says. 

"So whereas, say, 15 years ago, the mean diligent with metastatic prostate crab would unrecorded astir 3 years, present the endurance is much similar 5 to six years," helium said.

There are besides "big ranges astir that estimate," said Klotz, who is besides a prof successful the Department of Surgery astatine the University of Toronto.

"You person immoderate patients who whitethorn unrecorded 10 oregon 15 years contempt having metastatic disease. And unfortunately, you person others wherever the illness progresses precise rapidly, contempt each these caller therapeutic advances, and the diligent tin sometimes dice wrong a year."

Thomas Flannery is among those whose precocious prostate crab has been managed for galore years. The Toronto nonmigratory was archetypal diagnosed with prostate crab successful 2011 astatine 56, erstwhile his household doc decided to tally a prostate-specific antigen humor trial arsenic portion of a regular physical. 

That led to a biopsy, which recovered crab successful some halves of the prostate gland and successful the seminal vesicles, glands that nutrient the fluid that becomes semen.  

"I ended up having a extremist prostatectomy with Dr. Klotz astatine Sunnybrook, and pursuing that I went connected 3 years of what's called androgen deprivation therapy," said Flannery. At that time, the illness had already dispersed to Flannery's lymph nodes.

New treatments

Androgen deprivation therapy suppresses the body's testosterone production, a hormone astir prostate crab needs to survive. It's portion of a big of treatments Flannery has needed implicit the years, including a people of chemotherapy successful 2020.

New attraction options tin beryllium cardinal to extending people's lives.

The modular androgen deprivation therapy works by telling the testicles to halt producing testosterone, said aesculapian oncologist and prostate crab researcher Dr. Kim Chi.

"Over the past 5 to 10 years, we cognize that conscionable doing that alone, though it's precise effectual initially, the crab tin travel backmost rather quickly," said Chi, who is besides vice-president and main aesculapian serviceman astatine BC Cancer. 

That's due to the fact that the crab draws testosterone from different places successful the body, specified arsenic the adrenal gland, and additionally, prostate crab tin nutrient its ain testosterone, helium says. 

However, a caller people of drugs, called androgen receptor pathway inhibitors, artifact the body's quality to sorb those sources of testosterone, Chi said.

"Not lone are we blocking the gasoline, which is the testosterone, we're besides blocking the receptor — oregon blocking the motor from really receiving that gasoline," helium said. "It's similar putting a blockage successful the substance line."

Extending your life

Having these caller drugs disposable has dramatically improved endurance rates, said Chi, who is besides a prof successful the Department of Medicine astatine the University of British Columbia.

For the information of prostate cancers that are shown to beryllium associated with cistron mutations, promising caller drugs that people the genes look poised to prolong beingness adjacent further, helium said, arsenic bash drugs that present strong, targeted radiation straight to the prostate crab astatine a molecular level.

"I'd similar to spot this turned into a chronic illness that we conscionable negociate and support nether control. No, we whitethorn not cure it, but we tin support it controlled for galore years," said Chi.

"If I tin negociate idiosyncratic for five, 10, 15, 20 years until thing other inevitably takes your life, past we've done a bully job, too, and I deliberation we tin get there."

Lifestyle factors 

Now 70, Flannery says helium advises others with precocious prostate crab to instrumentality intimately to their cause regimens but besides to wage adjacent attraction to manner factors.

He said helium adheres to a Mediterranean fare due to the fact that of its wellness benefits and has importantly reduced however overmuch reddish nutrient helium eats. 

"The different happening that's highly important and truly hard to explicate to radical is the request to bash exercise."

A steadfast fare and regular workout assistance antagonistic immoderate of the antagonistic effects of androgen deprivation therapy, helium said, which tin see metabolic syndrome — thing that tin origin value summation astir the midsection. 

"It's important to support your value to a trim amount," helium said. "You don't person to beryllium a gym rat, but you request to get yourself into signifier truthful that you don't get secondary comorbidities similar diabetes."

WATCH | Dr. Peter Black connected Joe Biden's prostate crab diagnosis

At 70, Flannery is present retired from his occupation successful the aerospace manufacture and works arsenic a diligent advocate, consulting with researchers connected caller attraction protocols. He's started a nationalist enactment radical for radical with precocious prostate crab and provides adjacent counselling. 

"Right now, I'm being the wide contractor for the physique of a caller house," said Flannery. "I similar to thrust a bicycle. I similar to skis some cross-country and downhill."

He and his woman besides bask sailing. 

All this, contempt the information that Flannery's illness has present metastasized extensively, including to the pleura, the sac that surrounds the lungs.

"So presently I'm comparatively healthy. Outward, nary 1 would cognize that I person prostate cancer," helium said. "I conscionable person to instrumentality drugs each day."