Professor Kevin Mortimer, a respiratory medicine consultant, was diagnosed with incurable prostate cancer at age 48. Two years later, he is in remission and cancer-free, attributing his recovery to a new treatment regimen. The diagnosis came as a shock on his daughter's 11th birthday, with doctors initially telling him his condition was palliative and he had only a few years to live.
Prostate cancer is the most common cancer in men in the UK, with over 64,000 diagnoses annually and more than 12,000 deaths each year. However, recent advancements have offered new hope for patients with advanced stages of the disease.
A New Treatment Regimen
Since 2023, many men with advanced prostate cancer have been offered a combination therapy, often referred to as 'triple therapy.' This treatment combines two standard therapies with a potent new hormone drug, darolutamide. Prostate cancer cells are fueled by testosterone, and darolutamide works by binding to tumor cells, preventing testosterone from reaching them. The regimen also includes chemotherapy and a tablet to limit testosterone production. Initially, this combination was projected to extend patients' lives by approximately four years.
Professor Mortimer described experiencing intense pain during treatment but noted immediate positive results. His prostate-specific antigen (PSA) levels, a marker for prostate cancer, dramatically decreased. "Each time I went for a scan, the cancer was shrinking," he stated. "When I started treatment my prostate-specific antigen score was over 600... Within a few months, it was near zero."
'Super-Responders' and Future Outlook
Researchers have identified a subset of patients, like Professor Mortimer, who respond exceptionally well to this therapy, calling them 'super-responders.' Amy Rylance, director of health services, equity and improvement at Prostate Cancer UK, noted that about 45 percent of men fall into this category, with younger and fitter individuals tending to achieve these outcomes.
Further research is exploring the potential to eliminate chemotherapy from the treatment protocol. Professor Gert Attard, a cancer researcher at University College London, indicated that darolutamide might be performing the majority of the therapeutic work. "We’re now running trials looking at the effect of giving darolutamide to advanced patients without chemo," he said. Attard also highlighted the significant increase in survival rates, noting that 20 years ago, the average survival for prostate cancer patients was two years, whereas now, 40 percent of patients on darolutamide are alive and healthy 12 years later.
Access to Treatment
Despite these advancements, experts emphasize the need to improve access to these new treatments across the National Health Service (NHS). Ms. Rylance pointed out significant disparities, stating, "In some hospitals, less than half of men get hormone therapy, while in others 90 percent do." She stressed that men with previously incurable prostate cancer are now being cured, underscoring the urgency to ensure more patients receive these life-saving drugs.
Professor Mortimer, who was declared cancer-free three months prior to the report, acknowledged the risk of recurrence, which affects about a third of cases. However, he maintains a positive outlook, focused on his recovery and his desire to return to his medical practice and see his daughter off to university. He stated, "I’ve gotten to do one of those – and I believe I’ll do the other, too."