I recently came across an excellent review on the pros and cons of prostate cancer surgery as published by the Prostate Cancer Research Institute (PCRI). I am linking the review. If you are contemplating surgery, please read it and discuss it with your surgeon. You might also want to verify the opinions expressed in this article with him or perhaps consider other therapeutic options if they apply. This post and its contents is for informational purposes only. Even though I was a satified surgery patient in 1995, and speak highly of my Johns Hopkins surgeon, I realize each man’s situation is different so read and apply it accordingly.
Zero-the Project to End Prostate Cancer recently published an e mail manual for men newly diagnosed with prostate cancer and for their families. It can be found at the following link.
Topics include prostate cancer basics, methods used in its diagnosis including genomic testing, interpretation of test results, choosing the right health care professionals and treatment plan, treatment options and their potential side effects, research and clinical trials, monitoring for recurrence, nutrition and exercise and additional tools. This is a very useful guide.
P.S. To those of you who subscribe my e mail to these posts, I apologize that the most recent contained a lot of material that should have not been there. Hoopefully this post clarifies all that.
The Prostate Cancer Foundation recently published a 32-page guide containing diet recommendations for men living with prostate cancer. There is considerable discussion on plant-based foods, dietary fats, sugar, beverages and nutrients. See the following link for the guide.
I personally know of two Vietnam era veterans who were exposed to Agent Orange during their military service; both contracted prostate cancer. Hence it was of interest that I read the following linked article from the Prostate Cancer Foundation describing long over-due efforts to study and determine the best prostate cancer diagnostic (as to aggressiveness) and treatment options for such veterans.
HIGHLY RECOMMENDED: The Prostate Cancer Foundation (PCF) recently published (November 2017) an electronic patient guide which can be downloaded to your computer or obtained as a hard copy. Main topics include: 1) You and Prostate Cancer – General Information -Medical Basics; 2) For the Newly Diagnosed; 3) Treatment Options for Localized or Locally Advanced Prostate Cancer; 4) Living With and After Prostate Cancer; 5) What to Do if Your PSA Starts to Rise; 6) Cutting Edge Developments in Prostate Cancer Research; and, 7) For Our Sons and Daughters (genetics). One can receive the guide from the PCF electronically or by mail.
The National Cancer Institute (NCI, the largest of the institutes of the National Institutes of Health, NIH) recently published an excellent fact sheet describing many aspects related to prostate-specific antigen (PSA) testing. Specific subjects addressed include: a) what is the PSA test? b) Is the PSA test recommended for prostate cancer screening? c) What is a normal PSA result? d) What if screening shows an elevated level? e) Limitations and potential harms of using the PSA test for prostate cancer screening; f) Recent research on prostate cancer screening; g) How is the PSA test used in men who have been treated for prostate cancer? h) What does a PSA increase mean for men who have been treated? i) How are researchers trying to improve the PSA test?
Decreasing bone mineral density (BMD) is also an undesirable side effect of androgen deprivation (hormonal) therapy (ADT). The therapy is associated with many potential adverse effects, including significant bone loss and increased risk for low trauma or fragility fractures similar to that in persons with primary osteoporosis. A recent review of clinical trial results revealed that patients with non-metastatic prostate cancer receiving ADT can benefit from osteoporosis therapies, known as bisphosphonates e.g. (Fosamax, Boniva), and from Prolia (denosumab), which significantly increase bone mineral density (BMD). The review, entitled “Bone Health and Bone-Targeted Therapies for Nonmetastatic Prostate Cancer” was recently published in the journal Annals of Internal Medicine.
The new study by researchers at the University of Toronto found that non-metastatic prostate cancer patients starting or continuing ADT had significantly less BMD loss when they were given bisphosphonates (a class of medicines that slow down or prevent bone loss) and Prolia (the only FDA-approved therapy for cancer treatment-induced bone loss), compared with those receiving a placebo, normal care, or other active treatments.
The review set out to evaluate the effectiveness of drug, supplement, and lifestyle interventions currently employed as measures to prevent fractures, improve BMD, and delay osteoporosis in non-metastatic prostate cancer patients. Bisphosphonates were found to increase BMD over a placebo, but had no effect at preventing fractures among patients with non-metastatic prostate cancer. Prolia, administered subcutaneously every six months in a 60 mg concentration, improved BMD and reduced the incidence of new vertebral fractures, according to the results of one clinical trial.
According to Dr. David Samadi, MD, chairman of urology at New York’s Lenox Hill Hospital, “this study should remind all urologists of the gap in regards to bone health care for men with prostate cancer. More testing of bone mineral density both before and during ADT treatment is an important step in identifying those men who may be at risk. One beginning step is to do a risk assessment tool evaluating men with prostate cancer receiving ADT and educating them on the adverse effects of ADT. We also need to be mindful of talking to our patients about their diet and lifestyle making sure they are getting adequate sources of calcium and exercising regularly,” Samadi said.
Testing for two biomarkers in urine may help some men avoid having to undergo an unnecessary biopsy to detect a suspected prostate cancer, findings from a new study show.
In the NCI-supported study, researchers from Emory University in Atlanta and M.D. Anderson in Houston tested urine samples from men referred for a prostate biopsy for elevated levels of two biomarkers (RNA biomarkers called PCA3 and T2:ERG) that studies have shown are associated with aggressive prostate cancer. Restricting biopsies to only those men with elevated levels of either of the biomarkers would have reduced the number of these unnecessary biopsies by an estimated one-third to one-half, the researchers report May 18 in JAMA Oncology.
At the same time, this pre-biopsy screening approach would still “preserve the ability to detect the more aggressive cancers,” explained the study’s lead investigator, Martin Sanda, M.D., of the Emory University Winship Cancer Institute.
The PCA3 gene is expressed at high levels in prostate cancers, and a urine test for PCA3 RNA is commonly used in clinical practice to monitor for potential disease in men who have a negative biopsy following an abnormal PSA test or digital rectal exam, Dr. Sanda explained. There is also a urine test for T2:ERG, which is the result of a fusion, or translocation of parts of two different genes, TMPRSS2 and ERG. This translocation is found in approximately half of advanced prostate cancers. Currently, the T2:ERG test is only available at a few academic cancer centers.
Currently, there are hurdles to implementing this testing in everyday care, Dr. Sanda cautioned. But the study findings “clearly demonstrate” that testing for these biomarkers could help to address some of the limitations of the current paradigm for prostate cancer screening and early detection, he said. Implementing this pre-biopsy testing in clinical practice may not yet be practical because of the limited availability of the T2:ERG test.
One of the biggest challenges for researchers has been identifying a way to screen for prostate cancer that can differentiate between indolent and potentially life-threatening cancers. One approach being tested is to develop ways to better triage care decisions following an abnormal PSA test, including making more informed decisions about whether to pursue a biopsy. Prostate biopsies have risks, including pain, bleeding, and potentially serious infections. The resulting oversiagnosis and overtreatment of indolent prostate cancers identified via biopsy have their own harms and costs.
You may find it useful to discuss this article and genetic testing with your urologist if you are contemplating a prostate biopsy. For a full description of the study methodology, see the full article which appeared in the June Cancer News Bulletin published by the National Cancer Institute (NCI) of the National Institutes of Health (NIH).
According to the Prostate Cancer Foundation, antioxidants play a role in the fight against cell damage and cancer development. Consuming them is highly recommended for men with prostate cancer. Different types of antioxidants can be grouped by color. For example, antioxidants in red tomatoes are identical to those in red watermelons or pink grapefruits. Antioxidants fall under six main color categories.
1) Tomatoes, pink grapefruits and watermelons contain the red antioxidant, lycopene.
2) Grapes, plums, assorted berries and pomegranates contain the red-purple antioxidant, anthocyanin.
3) Carrots, mangoes, apricots, cantaloupes, pumpkins and sweet potatoes contain the orange antioxidants alpha and beta carotenes.
4) Oranges, peaches, papaya and nectarines contain the orange-yellow antioxidant beta-cryptoxanthin.
5) Spinach, collard, yellow corn, green peas and avocados contain the yellow-green antioxidants lutein and zeaxanthin.
6) Broccoli, brussel sprouts, cabbage, kale and bok choy contain the green antioxidants sulforaphane, isothiocyanates and indoles.
7) Garlic, onions, asparagus, leeks, shallots and chives contain the white-green antioxidants allyl sulfides.
The last post discussed the concept of vaccines for prostate cancer. The second part of the PCF trilogy is an overall simplified view of the immune system, including the various cell types and how they work under both normal and cancerous conditions. This section also describes checkpoint inhibitors and how they are being developed to fight prostate cancer among other types. I again will not summarize the article here but refer the reader to the well-written review in the following link.
The third section describes checkpoint inhibitors in detail focusing on successful applications as well as those scenarios wherein their effects were less than desired. While prostate cancer is the main focus, application to other cancers is also discussed.