DES is another tool in the tool kit for men who are no longer responding to hormone therapy (2nd-line therapy) and have had spread outside of the prostate. Years ago it was more frequently used, but it fell out of favor when Lupron was introduced in the mid-80’s because of greater safety and efficacy (results) with less severe side effects. Severe heart & blood clotting problems have prevented it’s widespread use among elderly men…many of whom have heart and blood clotting issues. The newer “skin patch” version of the estrogen seems to have reduced side effects and is growing in favor.
Probably lots of us have heard about the original use of DES as an anti-miscarriage agent prescribed to mothers in the post-WWII baby boomer era, which was later found to pass cervical cancer to their daughters and cause breast cancer in the mother. Links of testicular cancer passed by DES-taking mothers to their sons has also been investigated, as well as 3rd generation effects. My mother took DES along with millions of others women. It was later proven to be ineffective as an anti-miscarriage agent, and triggered some serious reform in the FDA to establish new criteria for both safety and effectiveness for the intended purpose.
For prostate cancer 2nd-line therapy, DES does remain another tool in the existing tool kit that’s been around a long time, but it has been basically replaced by the more effective, more tolerant Lupron. We need more novel breakthroughs and advancement like Provenge.
Provenge is revolutionary and may be the future of cancer treatments by attacking cancer from a molecular level. The patient’s cells are collected and processed with proteins which helps activate the patient’s immune system and then infused back into the patient. The treatment basically “re-trains” the patient’s own immune system to fight PC cells.
One size does not fit all when it comes to PC. As far as I am concerned, anytime there is a revolutionary breakthrough on a new treatment mode (the first prostate cancer vaccine) it is extremely hopeful.