Treatment Options for 9/11-Related Prostate Cancer

Prostate cancer is the most common cancer in men who were present in lower Manhattan during the many months after the 9/11 attacks. There is a strong, proven link between prostate cancer and exposure to the 9/11 toxic dust. Fortunately, advancements in treating prostate cancer through programs like the World Trade Center Health Program (WTCHP) offer hope. Various cutting-edge prostate cancer treatment options are now available for those who have been diagnosed.  Anyone who worked, lived, or was otherwise present in lower Manhattan between 9/11 and May 30, 2002, needs to be aware of the signs and symptoms, as well as various treatment options available for 9/11-related prostate cancer. 

How Common Is 9/11-Related Prostate Cancer?

Prostate cancer has become one of the most commonly diagnosed cancers among 9/11 responders and survivors, representing 9,000 diagnoses in the years since the attacks. Research from institutions like the National Institute for Occupational Safety and Health (NIOSH) and the Icahn School of Medicine at Mount Sinai found that those present in the aftermath of the attacks are more likely to develop prostate cancer. One study conducted by the WTCHP at Mount Sinai Hospital found that first responders in particular were diagnosed with prostate cancer at a rate 17% higher than the general population. Research attributes this increased risk to prolonged exposure to high levels of carcinogenic toxins in the WTC dust and debris, including asbestos, lead, smoke, and glass fibers. Prostate cancer cases among 9/11 survivors often have a long latency period, which means they may manifest years or even decades after exposure, making continued cancer screening and medical monitoring essential for those who were present in the many months after the 9/11 attacks.

Recognizing Prostate Cancer Symptoms

Early detection of prostate cancer is key to successfully treating prostate cancer. Common symptoms of prostate cancer to watch for include:

• Difficulty urinating or a weak urine stream.
• Frequent urination, especially at night.
• Blood in the urine or semen.
• Pain in the pelvis, back, or hips.
• Erectile dysfunction.
  
  

Since prostate cancer can often be asymptomatic in its early stages, regular screenings through the WTCHP or your healthcare provider are essential, particularly for those who were exposed to toxins on or after September 11, 2001. Screening for prostate cancer may include a physical exam and a prostate-specific antigen (PSA) blood test. If prostate screening shows any warning signs, your provider may use common cancer diagnostic tools such as ultrasound, biopsy, blood testing, MRI, bone scan, computerized tomography (CT) scan, and/or positron emission tomography (PET) scan to determine whether you have prostate cancer and, if so, how much it has spread. Determining the extent of the cancer will help your providers develop a treatment plan.

Treatments Are Available for 9/11-Related Prostate Cancer

Medical advancements have led to a variety of effective treatments for prostate cancer, which are tailored to the individual's unique circumstances, such as the disease's stage and the patient's overall health.

Active Surveillance

For early-stage, slow-growing prostate cancer, active surveillance is a common approach. This involves regular monitoring with blood tests, imaging, and biopsies. Treatment for prostate cancer will begin only if the cancer shows signs of progression. This approach helps to minimize unnecessary interventions.

Radiation Therapy

Radiation therapy, also known as radiotherapy,  is a non-invasive option that involves using high-energy beams to target and kill cancer cells within the prostate gland. These beams are typically delivered through one of two methods: 

1. External Beam Radiation Therapy (EBRT): A precise, outpatient procedure where the beams are delivered from a machine outside the body. 
2. Brachytherapy: Involves internal radiation, wherein radioactive seeds are implanted directly into the prostate for targeted treatment.

Depending on the stage of the cancer and individual circumstances, radiation therapy can be used in various contexts: to treat early-stage prostate cancer, as a post-surgical treatment to prevent recurrence of the cancer, or to manage advanced cancers that are causing pain in the patient.

Surgery 

If the cancer has not spread outside of the prostate, surgical options are a common choice. The most popular choice for prostate cancer is called radical prostatectomy, which involves removing the entire prostate gland and some of the surrounding tissue. This approach is often recommended for localized prostate cancer and may involve robotic-assisted techniques to improve precision and recovery times. There are two ways to approach a radical prostatectomy:

1. Open Prostatectomy: The surgeon operates through a single long incision in the skin to remove the prostate and nearby tissues.
2. Laparoscopic Prostatectomy: The surgeon makes several smaller incisions and uses long, thin surgical tools to remove the prostate and nearby tissues.

While radical prostatectomy is the most common choice, open prostatectomy may also be used in some cases of prostate cancer.

Hormone Therapy 

Hormone therapy, also known as androgen deprivation therapy (ADT), reduces levels of male hormones, called androgens, to slow cancer growth. Several types of hormone therapy may be used in the treatment of prostate cancer, and hormone therapy is often combined with radiation therapy or other treatments for advanced prostate cancer.

Chemotherapy 

Chemotherapy is not used for early-stage prostate cancer, but is typically used for more advanced cases or when prostate cancer has spread beyond the prostate gland. This treatment involves anti-cancer drugs that kill rapidly dividing cancer cells. Chemotherapy may be administered orally or intravenously and may be used with other treatments, particularly hormone therapy. Various chemotherapy drugs are used to treat prostate cancer, including docetaxel, cabazitaxel, mitoxantrone, estramustine, and carboplatin.

Immunotherapy 

Immunotherapy uses medication to stimulate the patient’s immune system to identify and fight cancer cells more effectively. Sipuleucel-T (Provenge) is a vaccine-based immunotherapy specifically designed for advanced prostate cancer, in which white blood cells are removed from the patient’s blood, sent to a lab to be mixed with a protein from prostate cancer cells, tand hen they are given back to the patient intravenously.

Immune checkpoint inhibitors are another type of immunotherapy used in cancer treatment. These drugs target “checkpoint” proteins on immune cells, which work like switches that need to be turned on or off to start an immune response. Cancer cells often use these checkpoints to prohibit the immune system from attacking them. Immune checkpoint inhibitors work on these checkpoints to strengthen the body’s immune response. Pembrolizumab and dostarlimab are immunotherapy drugs that may be used in the treatment of prostate cancer.

Other Targeted Therapies and Treatments

Newer types of drugs and treatments have been developed that target the specific changes that occur inside prostate cancer cells, which help them to grow. These include:

• PARP Inhibitors: A targeted drug therapy designed to attack specific genetic mutations in cancer cells. These drugs block the protein PARP (poly(ADP)-ribose polymerase), which cancer cells use to repair DNA and survive. 
• Prostate-specific membrane antigen (PSMA): A targeted therapy that specifically targets prostate cancer cells. It uses radioactive molecules that bind to PSMA, a protein found on the surface of prostate cancer cells.
• High-Intensity Focused Ultrasound (HIFU): A noninvasive treatment that uses sound waves to destroy prostate cancer cells.
  
  

Support Is Available for Those Suffering from 9/11-Related Prostate Cancer

If you’ve been diagnosed with prostate cancer and lived or worked in lower Manhattan on or during the many months after 9/11, you may qualify for comprehensive medical care and financial compensation. The WTCHP offers free medical monitoring, treatment, and mental health support for individuals who were present in the aftermath of the attacks who have been diagnosed with 9/11-related conditions, including various types of cancer. The 9/11 Victim Compensation Fund (VCF) provides financial compensation for medical expenses, lost income and benefits, and non-economic damages such as pain and suffering.

Working with an experienced attorney can help streamline the process of registering with the WTCHP and filing a claim with the VCF, ensuring you receive the full benefits and compensation you deserve. Reach out to one of the dedicated 9/11 attorneys at Hansen & Rosasco, LLP to find out more about your eligibility for free lifetime 9/11-related healthcare and financial compensation.