Feasibility and Toxicity of Degarelix for Prostate Downsizing Prior to Permanent Seed Prostate Brachytherapy
Prostate Cancer

About this trial
This is an interventional treatment trial for Prostate Cancer focused on measuring prostate neoplasm, brachytherapy, androgen ablation, benign prostatic hypertrophy, prostate size reduction, localized prostate cancer with prostate volume > 40 cc
Eligibility Criteria
Inclusion Criteria:
- Histologic diagnosis of prostate cancer
- Favorable risk disease (cT1 or T2a, Gleason score (GS) 6, and Prostate Specific Antigen (PSA) < 10 ng/mL)
- Low-tier intermediate risk disease (cT2c,GS=6,and PSA 10-15 ng/mL, OR GS=7 and PSA < 10 ng/mL)
- Intermediate risk disease AND androgen deprivation therapy recommended by the treating physician for oncologic reasons such as (≥ 50% positive biopsy cores,cT2c,PSA 15-20 ng/mL,GS=7)
- Patient requires baseline planning trans-rectal ultrasound for the purposes of prostate brachytherapy, showing prostate volume > 40 mL and pubic arch interference (not required for those requiring androgen ablation for oncologic reasons)
Exclusion Criteria:
- castrate serum testosterone level
- previous or concurrent pelvic radiotherapy
- unable to give written informed consent
- contraindications to permanent seed prostate brachytherapy or to androgen deprivation therapy
- prior treatment for prostate cancer
- prior trans-urethral resection of the prostate
- previous therapy with a 5-α reductase inhibitor, anti-androgen agent, or LHRH agonist
- previous therapy with degarelix
Sites / Locations
- Abbottsford Cancer Center
- Fraser Valley Cancer Center
- Vancouver Cancer Center
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Favorable prostate cancer with pubic arch interference
Intermediate risk prostate cancer, 6 months Degarelix
Men in this arm have chosen brachytherapy for management of localized prostate cancer and do not require androgen ablation for oncologic reasons but have an enlarged prostate causing pubic arch interference and thus require prostate size reduction prior to brachytherapy. They will have 2-3 months of Degarelix with measurement of prostate volume at 8 and 12 weeks.
Men in this arm have higher risk prostate cancer (upper tier intermediate risk by National Comprehensive Cancer Network [NCCN] guidelines) and require 6 months of androgen ablation in conjunction with brachytherapy. Prostate size must be > 40 cc at baseline so that prostate size reduction measurements are appropriate. Prostate measurements by transrectal ultrasound with be taken at 12 weeks and 20 weeks.