Duran Duran’s Andy Taylor’s Prostate Cancer

In October 2018, guitarist and founding member of Duran Duran Andy Taylor was riding high. He had just signed a solo record deal and looked forward to starting this next phase of his life. However, he had also noticed that something seemed “off” while jogging, something he described as “arthritic” pain. Shortly after, he noticed two lumps in his neck, which turned out to be enlarged lymph nodes.

In a recent interview in People, Taylor, 61, said, “The first thing I thought of was, when was the last time I had a PSA [prostate specific antigen] test? My father passed away because of prostate cancer. So, there was the family history. So, I thought this could be, and sure enough.”

Taylor was diagnosed with stage IV prostate cancer. “As harsh as it is, it’s a death sentence. So, you sort of walk out of the hospital in a stunned silence, because you could never be prepared for … You’ve got to start from the fact that it’s a slow burn, so it’s not going to take you quickly.”

Taylor kept his diagnosis a secret until April 2022, when Duran Duran was announced as a possible inductee to the Rock and Roll Hall of Fame. Although Taylor prepared to perform with the band at Duran Duran’s November 2022 induction, he ultimately didn’t feel he could handle it physically or mentally. The band read portions of a letter Taylor had written to his band mates:

“Just over 4 years ago, I was diagnosed with stage IV metastatic prostate cancer. Many families have experienced the slow burn of this disease and of course, we are no different; so I speak from the perspective of a family man but with profound humility to the band, the greatest fans a group could have and this exceptional accolade…”

“I have [a top notch team] of doctors and medical treatment that until very recently allowed me to just rock on. Although my current condition is not immediately life threatening there is no cure. Recently I was doing okay after some very sophisticated life extending treatment, that was until a week or so ago when I suffered a setback, and despite the exceptional efforts of my team, I had to be honest in that both physically and mentally, I would be pushing my boundaries.”

Taylor has been treated with abiraterone acetate (Zytiga), until recently. In an interview, Taylor revealed that “there’s some new treatments that can help me.” He has committed to the idea that “I’m gonna live life … I’ve made three albums since [my diagnosis], I went on the road with some friends of mine … and played some shows, which were fantastic,” he said. “I often say to people, every minute’s like an hour, every day’s like a week. You really wanna get the most out of life.”

Taylor also wants to spread awareness about getting PSA testing in the hope of saving lives, particularly for the band’s “great female audience. Don’t just give him a poke, make him go get a PSA test!”

Prostate Cancer

Prostate cancer is the most common cancer in men and the third most common cancer diagnosis overall (behind breast and lung). According to the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program (SEER) database, in 2022, there were an estimated 268,490 new cases (14% of all new cancers) and 34,500 deaths (5.7% of all cancer deaths). Approximately 12.6% of men will be diagnosed with prostate cancer at some point during their lifetime. The median age at diagnosis of carcinoma of the prostate is 67 years.

More than 95% of primary prostate cancers are adenocarcinomas. Prostate adenocarcinomas are frequently multifocal and heterogeneous in patterns of differentiation.

The histologic grade of prostate adenocarcinomas is usually reported according to one of the variations of the Gleason scoring system, which provides a useful, albeit crude, adjunct to tumor staging in determining prognosis.

The Gleason score is calculated based on the dominant histologic grades, from grade 1 (well differentiated) to grade 5 (very poorly differentiated). The classical score is derived by adding the two most prevalent pattern grades, yielding a score ranging from 2 to 10.

Prostate cancer with a Gleason score of 6 is considered low grade, meaning it is less likely to grow and spread than cancer with a higher score (7-10). The vast majority of men diagnosed with localized, low-grade prostate cancer will die of something other than prostate cancer.

The Staging of Prostate Cancer

The stage of the cancer is based on the results of the staging and diagnostic tests, including the PSA test and the Grade Group:

• Grade Group 1 is a Gleason score of 6 or less
• Grade Group 2 or 3 is a Gleason score of 7
• Grade Group 4 is a Gleason score of 8
• Grade Group 5 is a Gleason score of 9 or 10

In stage I, cancer is found in the prostate only. The cancer is not felt during a digital rectal exam and is found by needle biopsy (done for a high PSA level) or in a sample of tissue removed during surgery for other reasons (such as benign prostatic hyperplasia). The PSA level is lower than 10 and the Grade Group is 1. Or, it is felt during a digital rectal exam and is found in one-half or less of one side of the prostate. The PSA level is lower than 10 and the Grade Group is 1.

In stage II, cancer is more advanced than in stage I, but has not spread outside the prostate. It is subdivided into stage IIA, B and C.

Stage IIA is found in half or less of one side of the prostate. The PSA level is either 10-19 and Grade Group is 1 or it is found in more than half of one side of the prostate or in both sides of the prostate with a PSA level <20 and Grade Group of 1.

Stage IIB is found in one or both sides of the prostate, with a PSA level <20 and Grade Group 2. Stage IIC is found in one or both sides of the prostate, with PSA <20 and Grade Group 3 or 4.

Stage IIIA is found in one or both sides of the prostate, with PSA ≥20 and Grade Group of 1-4.

Stage IIIB has spread from the prostate to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. The PSA can be any level and the Grade Group is 1-4.

Stage IIIC cancer is found in one or both sides of the prostate and may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. The PSA can be any level and the Grade Group is 5.

Stage IVA, cancer is found in one or both sides of the prostate and may have spread to the seminal vesicles or to nearby tissue or organs, such as the rectum, bladder, or pelvic wall. Cancer has spread to nearby lymph nodes. The PSA can be any level and the Grade Group is 1-5.

In stage IVB, cancer has spread to other parts of the body, such as the bones or distant lymph nodes. Prostate cancer often spreads to the bones.

Treatment of Stage IV Prostate Cancer

Treatment selection depends on the patient’s age, coexisting medical illnesses, symptoms, and the presence of distant metastases (most often bone). Hormonal treatment is the mainstay of therapy for metastatic prostate cancer. Cure is rarely, if ever, possible, but striking subjective or objective responses to treatment occur in most patients.

The most common symptoms originate from the urinary tract or from bone metastases. Palliation of symptoms from the urinary tract with transurethral resection of the prostate or radiation therapy and palliation of symptoms from bone metastases with radiation therapy or hormonal therapy are an important part of the management of these patients. Bisphosphonates may also be used for the management of bone metastases.

The cornerstone of hormonal therapy for prostate cancer is medical or surgical castration (androgen deprivation therapy, ADT) to stop production of testosterone by the testes. This can be accomplished with bilateral orchiectomy or with administration of gonadotropin-releasing hormone agonists or antagonists, such as abiraterone acetate (an inhibitor of cytochrome P450c17, a critical enzyme in androgen biosynthesis) or the androgen receptor antagonists apalutamide (Erleada) and enzalutamide (Xtandi).

Newer approaches to treating advanced prostate cancer involve immunotherapy. One form is a cancer vaccine called sipuleucel-T (Provenge), which is made from dendritic white blood cells from the patient’s blood and stimulating them to build up immunity. These cells are re-injected into the patient three times at 2-week intervals.

Checkpoint inhibitor therapy targets immune system “checkpoints” that function to protect healthy cells from the immune system. Inhibiting these checkpoints, typically T-cells, helps target cancer cells. Most of these drugs are still in clinical trials; however, a very small subset of patients with mismatch repair deficiency or high levels of microsatellite instability have been approved for this therapy.

Michele R. Berman, MD, is a pediatrician-turned-medical journalist. She trained at Johns Hopkins, Washington University in St. Louis, and St. Louis Children’s Hospital. Her mission is both journalistic and educational: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.