"Health wise I am feeling great. I am a big supporter of trials - it allows new treatments and drugs to be brought in.”
A trial of triamcinolone with hormone therapy for prostate cancer (TRICREST)
More about this trial
Doctors can treat prostate cancer with hormone therapy. But after some time, the cancer may stop responding to hormone treatment and start to grow again. Doctors call this hormone refractory prostate cancer or castration resistant prostate cancer.
In this situation, you may have steroids. In this trial, researchers are looking at a steroid drug called triamcinolone. The men taking part have triamcinolone alongside hormone therapy.
The aim of the trial is to see if triamcinolone helps men who have prostate cancer that is no longer responding to hormone therapy.
Who can enter
You may be able to enter this trial if you
- Have prostate cancer that is getting worse despite having hormone therapy
- Have a PSA level of 5 ng/ml or higher
- Are at least 18 years old
You cannot enter this trial if you
- Are in bed or a chair all the time and need complete care (performance status of 4)
- Can’t take steroids or have injections into a muscle
- Have already had steroids or chemotherapy as treatment for prostate cancer
- Are taking part in any other trial of an experimental drug
- Have had any other type of cancer, apart non melanoma skin cancer or another cancer if it was successfully treated at least 5 years ago
If you have
This is a phase 2 trial. Everybody taking part has triamcinolone.
The first time you have triamcinolone, you have 2 injections. After that you have 1 injection each time. A member of the trial team will give the injections into the muscle in your bottom. Within a week of having the first injections, they will phone you to see how you are and ask if you’ve had any side effects.
The trial team will check the level of PSA in your blood after 12 weeks of treatment. If the level is falling, you carry on having triamcinolone.
As long as you don’t have bad side effects, you can carry on having the trial treatment until your prostate cancer starts to grow again.
The trial team will ask you to fill out a questionnaire when you join the trial, and then every month. The questionnaire will ask about side effects and how you’ve been feeling. This is called a quality of life study.
The trial team will ask your permission to take an extra blood sample to study your genes and other substances in your blood. You don’t have to give this sample for research if you don’t want to. You can still take part in the main trial.
You see the trial team and have some tests before you start the trial treatment. The tests include
- Physical examination
- Blood tests
- Bone scan
You go to hospital once a month to have the triamcinolone injections. You can have your hormone therapy injections at your GP surgery
During the trial, you have regular blood tests and a bone scan every 12 weeks. At different times during your treatment, the trial team will ask you to keep all the urine you pass in a 24 hour period.
The side effects of triamcinolone include
- Mood changes
- Stomach problems, indigestion or bloating
- Increased appetite and weight gain
- Feeling weak or tired
- Increased risk of infection and wounds being slow to heal
- Water retention
- Skin problems such as thinning of the skin, bruising, rash, redness, itching or itchy raised lumps (hives)
- Increased hair growth and sweating or flushing
- Eye problems such as cataracts
- Anxiety and problems sleeping
- Thinning of your bones and muscle wasting
Rarely, people can have severe reaction to steroids. If you take steroids for a few months, you may notice weakness of your arms and legs and develop a rounder face.
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Dr Jonathan Shamash
Barts Health NHS Trust
Experimental Cancer Medicine Centre (ECMC)
Orchid Cancer Charity