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“Prostate cancer is the No. 1 killer of nonsmoking men, and the No. 2 cancer killer of men overall,” says Sarasota oncologist Dr. John Sylvester. “This is not a disease you’re going to take lightly.”

Sylvester is helping to lead a national clinical trial studying a prostate cancer treatment that appears to be highly successful with very minor side effects. The treatment, called immunotherapy modulation, involves the injection of a modified cold virus—containing a single gene from the herpes virus—directly into the prostate. The patient then takes valacyclovir (brand name Valtrex) in combination with IMRT beam treatment (often part of today’s typical prostate cancer treatment protocol) to trigger an immune system response that destroys the cancer cells wherever they are in the body.

Radiation alone triggers a slight immune response, but the introduction of the virus makes the cancer that much more delicate without increasing toxicity. Because only a single herpes gene is used, patients do not contract the herpes virus. 

Sylvester has been at the forefront of prostate cancer treatment for decades. In the 1980s in Seattle, he and two other doctors developed ultrasound-guided brachytherapy and then trained many of the nation’s oncologists in the technique, which has become a standard for prostate cancer care. In people with intermediate-risk prostate cancer, brachytherapy plus a milder dose of IMRT has a 92 percent nine-year relapse-free survival rate.

The immunotherapy trial is being performed by about 50 centers throughout the country, but Sylvester, based in the Lakewood Ranch office of 21st Century Oncology, has enrolled more patients than any other site. (Sarasota’s demographics, plus its collection of world-class physicians and medical infrastructure, make it ideal for clinical trials focused on older populations.

So far, the new treatment has a 96 percent six-year relapse-free survival rate. Though there are many ways to define success when it comes to prostate cancer treatments, Sylvester prefers “relapse-free survival,” which means that not only has the patient survived X number of years, but they’ve done so without any cancer in their system whatsoever.

Successful treatment of prostate cancer means eradicating the cancer from inside the prostate as well as the microscopic cancer cells throughout the body that can’t be detected in scans.

Sylvester roughly estimates that the immunotherapy treatment won’t be widely available until 2026 or so. To be a potential candidate for the trial, patients should have newly diagnosed intermediate-risk prostate cancer that can’t be treated by other approaches. (A full medical evaluation will determine who qualifies.)

To inquire about the prostate cancer immunotherapy modulation study, contact 21st Century Oncology’s Lakewood Ranch office at (941) 907-9053.

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