According to a study reported in the Journal of Urology, Thalidomide is associated with an increase in prostate specific antigen (PSA) progression-free survival in men with biochemically recurrent prostate cancer who are on intermittent androgen deprivation therapy (ADT). The study leader, Dr William Figg, from the National Institutes of Health in Bethesda, Maryland, said, “These effects were independent of any effects on testosterone. This is the first study to our knowledge to demonstrate the effects of thalidomide using intermittent hormonal therapy.”

Thalidomide is the drug that in the 1960s that when administered to pregnant woman caused them to give birth to severely deformed babies.

Advanced and recurrent prostate cancer, if it is not caught very early (usually prior to the PSA reaching 1.0, is not curable. Treatment goals at this stage are simply to control and slow down the disease progression. ADT, both continuous and intermittent are the usual first line of attack at this stage. ADT’s simple goal is to prevent the male hormone testosterone from fuelling the tumors.

The study found that adding thalidomide to ADT increases progression-free survival. The drug attacks the cancer by blocking the growth of new blood vessels supplying tumors with vital oxygen and nutrients. It was this effect on blood vessel development, which led women taking the drug for morning sickness to give birth to babies without limbs.

The study found that adding thalidomide increased the typical time before PSA went up after administering ADT from 6.6 to 17 months. If additional research confirms this result, the potential for extending PSA free progression is very significant, especially if the thalidomide can continue to have a similar effect on each cycle.

On the flip side, we have no evidence that slowing down the PSA progression will actually have any effect on survival.

Joel T Nowak MA, MSW