1) Doctors excited about targeted prostate cancer therapy, but can’t prescribe it yet

Courtesy Barrie360.com and Canadian Press

By Nicole Ireland

Dale Cousins was thrilled when he saw his body scans from before and after a new prostate cancer treatment. 

“(The doctor) said, ‘Do you see any difference?'” the 79-year-old from Petrolia, Ont., recalled.  

“I said, ‘all these spots around my abdomen, they’re gone.'”

Cousins is part of a clinical trial of radioligand therapy, or RLT — a precise targeting of cancer cells with radiation given intravenously. Oncologists say RLT is poised to become a new “pillar” of cancer care, alongside surgery, chemotherapy and radiation. But unlike Cousins, prostate cancer patients who aren’t in a clinical trial don’t have free access to it.

“We’re able to deliver this very specific therapy to specific cells in the body,” said Dr. David Laidley, a nuclear oncologist with Western University and London Health Sciences Centre. 

“We’re able to deliver lethal radiation therapy specifically targeted to cancer cells and at the same time generally sparing the normal tissues,” said Laidley, who is the principal investigator for the London, Ont., site of the Canada-wide clinical trial comparing RLT to chemotherapy. 

Cousins was diagnosed with prostate cancer in 2010 and has been through many treatments, including surgery. After being stable for several years, a scan last year revealed his cancer had spread and he was enrolled in the trial. 

With the last of his six RLT infusions coming on July 10, Cousins has already had a “dramatic reduction” in cancerous lesions and his prostate specific antigen levels have decreased significantly, suggesting an “excellent response,” Laidley said.  

Past clinical trials have already shown RLT’s effectiveness, leading to Health Canada approving Pluvicto — the radioactive drug that kills the targeted cancer cells — in August 2022 for patients whose prostate cancer has spread and chemotherapy has failed. 

But almost two years later, advanced prostate cancer patients still can’t get public access to radioligand therapy because negotiations on how much it should cost government health plans are ongoing. 

While waiting for that decision, there are men with prostate cancer who need the treatment to improve their quality of life and live longer, Laidley said. 

“Oncologists are asking ‘can we refer patients or is this an option?’ And unfortunately, we have to say that it’s not available.”

2) A rare voice box transplant helped a cancer patient speak again, part of a pioneering study

Courtesy Barrie360.com and The Associated Press

By Lauran Neergaard, July 9, 2024

A Massachusetts man has regained his voice after surgeons removed his cancerous larynx and, in a pioneering move, replaced it with a donated one.

Transplants of the so-called voice box are extremely rare, and normally aren’t an option for people with active cancer. Marty Kedian is only the third person in the U.S. ever to undergo a total larynx transplant – the others, years ago, because of injuries – and one of a handful reported worldwide.

Surgeons at the Mayo Clinic in Arizona offered Kedian the transplant as part of a new clinical trial aimed at opening the potentially life-changing operation to more patients, including some with cancer, the most common way to lose a larynx.

“People need to keep their voice,” Kedian, 59, told The Associated Press four months after his transplant – still hoarse but able to keep up an hourlong conversation. “I want people to know this can be done.”

He became emotional recalling the first time he phoned his 82-year-old mother after the surgery “and she could hear me. … That was important to me, to talk to my mother.”

The study is small — just nine more people will be enrolled. But it may teach scientists best practices for these complex transplants so that one day they could be offered to more people who can’t breathe, swallow or speak on their own because of a damaged or surgically removed larynx.

“Patients become very reclusive, and very kind of walled off from the rest of the world,” said Dr. David Lott, Mayo’s chair of head and neck surgery in Phoenix. He started the study because “my patients tell me, ‘Yeah I may be alive but I’m not really living.’”