Striking early is key in prostate cancer fight

Early stage prostate cancer drug added to Pharmaceutical Benefits Scheme

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Associate Professor Arun Azad from Peter MacCallum Cancer Centre.

Associate Professor Arun Azad from Peter MacCallum Cancer Centre.


A new drug could reshape treatment for early stage prostate cancer patients.


A new drug that can significantly improve outcomes for men with prostate cancer by attacking the disease in its early stages has been added to the Pharmaceutical Benefits Scheme (PBS).

Erlyand (apalutamide) will be available under the PBS for Australian men with non metastatic prostate cancer who are not responding to traditional hormone therapy.

The oral treatment has been made available for men who experienced a rapid rise in Prostate Specific Antigen (PSA) levels despite treatment with testosterone-lowering medication.

A rise in PSA levels signals the imminent spread of the disease, but Erlyand - which will be prescribed in combination with androgen deprivation therapy, will offer a new line of defence.

Arun Azad from Peter MacCallum Cancer Centre said that the PBS listing meant eligible Australian patients would have affordable access to the treatment.

Erlyand was made available overseas more than four years ago as the first approved medicine to treat non-metastatic prostate cancer.

Associate Professor Azad said the PBS listing heralded "a new era" in the treatment of prostate cancer for patient's whose doctors pre-empted its spread.

"Stopping cancer before it spreads represents a shift in how we treat prostate cancer," Associate Professor Azad said.

"It's akin to identifying and dowsing flames before they form and spread as a bushfire."

Associate Professor Azad said that while there were treatments for advanced prostate cancer, suppressing it at an earlier stage was a more effective way of fighting the disease.

Erlyand works by blocking the action of testosterone in prostate cancer cells. This prevents the hormone androgen, which plays a role in prostate cancer growth, from binding to the androgen receptor. The therapy is taken as a tablet once a day, with or without food.

"Wherever possible we want to stop the spread of cancer. We now have treatment options that can be used earlier with the aim of preventing further spread of disease."

A rapid doubling of PSA levels in the blood indicates that men with non-metastatic prostate cancer are at heightened risk of their cancer spreading.4 "This is a red flag that signals a need for change in treatment," Associate Professor Azad explained.

Associate Professor Azad said that a decline in men participating in PSA testing due to COVID-19 had been concerning and would undoubtedly mean more men being diagnosed with advanced prostate cancer.

"It's vital that men undergo regular prostate health checks, so they are diagnosed at an earlier stage of the disease and don't miss out on this critical window to treat the cancer before it spreads.

"For men living with prostate cancer, regular monitoring is essential to detect changes in PSA levels, which can be a warning signal that cancer is on the move," he said.

Each year, more than 18,000 Australian men are diagnosed with prostate cancer and 3,500 lose their lives to the disease.

Prostate Cancer Foundation of Australia chief executive Anne Savage described PBS listing of the treatment as an "important development".

"Our message is clear - early diagnosis, early treatment and early identification of changes in cancer activity are key to containing and combatting prostate cancer," she said.

"We welcome this listing, which will give Australian men better prospects for slowing down the spread of prostate cancer.

"We are grateful for the efforts of industry to make these life-extending drugs available to all men who need them and will continue to advocate for expanded availability of this essential medicine."

Under the PBS listing, eligible patients will pay just $42.50 (general patients) or $6.90 (concessional patients) for each cycle of treatment with Erlyand.

For more information on the drug, click HERE. For more information on the Prostate Cancer Foundation of Australia click HERE.