Below the Belt Award

When prostate cancer spreads, injections that suppress the male hormone testosterone can control the cancer for some time, but it almost always starts to grow again later. Hormone tablets to block testosterone on top of the injections can regain control of the cancer, but again, only for a limited time of about one year. Cancers grow like weeds; some of the cancer cells can be controlled by weedspray but other parts of the cancer aren’t affected and can flourish. These vulnerable and resistant cells of the cancer are often holding each other in balance; and when a treatment is used it can favour one group of cancer cells over another. This trial is designed to test the idea of taking breaks off taking hormone tablets, using them for long enough to control the cancer, but then stopping and saving them up until later to treat the cancer again (and again… and hopefully again and again). While every man’s cancer is predicted to eventually become resistant to hormone treatments, using hormone tablets in a sparing and cunning way is hoped to spread the benefit over a longer period of time, without more side-effects. Very early reports with other drugs support this idea; this will be the first trial testing this idea with enzalutamide (Xtandi). If this idea proves to be sound, it may improve the lives and survival of men with prostate cancer.