Prostate Cancer News - 2015-06-30
Choices you can make to influence the odds. Detection, Diagnosis, and TreatmentI recently completed Radical Prostate Surgery and Adjuvent ADT plus IMRT Radiation treatment at Moores. I can recommend it for quality of care with minimal side effects.
Choices you Make
First
clear evidence of a link between smoking and prostate cancer - Medical News
Today
Smoking is a known risk factor for the development of various forms of cancer. However, when it comes to the link between smoking and prostate cancer, the findings of previous studies have been contradictory. Now, for the first time, an international study led by MedUni Vienna and Basle University Hospital, has provided evidence of a clear link.
Smoking is a known risk factor for the development of various forms of cancer. However, when it comes to the link between smoking and prostate cancer, the findings of previous studies have been contradictory. Now, for the first time, an international study led by MedUni Vienna and Basle University Hospital, has provided evidence of a clear link.
Are you an “Illustrated Man”? | THE "NEW" PROSTATE
CANCER INFOLINK
Heavily tattooed men with prostate cancer should be aware that there is a low risk — and probably only a very low risk indeed — that tattoo ink can migrate to the pelvic lymph nodes leading to misdiagnosis of node-positive prostate cancer when such patients are given PET/CT scans.
Heavily tattooed men with prostate cancer should be aware that there is a low risk — and probably only a very low risk indeed — that tattoo ink can migrate to the pelvic lymph nodes leading to misdiagnosis of node-positive prostate cancer when such patients are given PET/CT scans.
Study
links more sex to less prostate-cancer risk | The Columbus Dispatch
The research found that more-regular sex — more specifically, ejaculation — was associated with a statistically significant lower risk of prostate cancer, about 20 percent.
The study compared men who ejaculated at least 21 times per month to men who did so four to seven times per month.
foodconsumer.org - Coffee drinking may boost prostate cancer risk - study
The research found that more-regular sex — more specifically, ejaculation — was associated with a statistically significant lower risk of prostate cancer, about 20 percent.
The study compared men who ejaculated at least 21 times per month to men who did so four to seven times per month.
foodconsumer.org - Coffee drinking may boost prostate cancer risk - study
Screening and Diagnosis
The original Gleason system was developed between 1966 and 1974. It was complex, with 25 potential scores. Now, the latest version divides prostate cancer into five groups, numbered simply from 1 to 5, in order of aggressiveness.
Vanderbilt-led study finds significant drop in new prostate cancer diagnoses - Medical News Today
A new study led by Vanderbilt University Medical Center investigators found new diagnoses of prostate cancer in the U.S. declined 28 percent in the year following the draft recommendation from the United States Preventive Services Task Force (USPSTF) against routine PSA screening for men. The new research, led by first author Daniel Barocas, M.D., MPH, assistant professor of urological surgery and medicine, was posted online in the June 15 issue of The Journal of Urology in advance of publication.
Dr. Guo and colleagues combined the Company's enhanced Barocycler
NEP2320 instrument and MicroPestle consumable ("PCT-HD") with AB Sciex's
SWATH-MS mass spectrometric system (together, "PCT-SWATH") to permit
what they characterize as the high throughput, reproducible,
quantitative profiling of proteins in biopsy tissues. The authors
concluded that PCT-SWATH (i) separated previously
histologically-indistinguishable tissue biopsy samples, and (ii)
identified new protein biomarker candidates for more precise
classification of prostate cancer. The authors indicated their results
await further validation in independent studies.
Prostate cancer screening said to be “not cost effective”
A clinical research team based on New Zealand (Lao et al.) came to this conclusion after evaluating a wide range of published data on the costs associated with screening for and treating prostate cancer, including the cost per cancer detected, the estimated costs per life-year saved, and cost per quality-adjusted life year (QALY) gained.
The most interesting information in this study actually appears to be the extraordinary range of the estimated economic costs: from $3,000 to $729,000 in the US alone for the estimated cost per life-year saved.
The authors argue that
- The most appropriate data for economic evaluation of prostate cancer screening should be the cost per QALY gained.
- The estimated costs per QALY gained by prostate cancer screening were
significantly
higher than the cost-effectiveness threshold.
Of course the authors’ conclusion can only be reached — or justified — on a societal level (as opposed to an individual level). The cost-effectiveness of annual screening for prostate cancer risk among known groups of high-risk individuals may be a great deal higher than the cost-effectiveness of annual screening for every man in America aged between 45 and 75.
Lao C1, Brown C, Rouse P, Edlin R, Lawrenson R.; Economic evaluation of prostate cancer screening: a systematic review. Future Oncol. 2015;11(3):467-77. doi: 10.2217/fon.14.273.
Tests
Tests
to gauge genetic risks for prostate cancer now are feasible - Medical News
Today
Men with an elevated, genetically inherited risk for prostate cancer could be routinely identified with a simple blood or urine test, scientists at UC San Francisco and Kaiser Permanente Northern California have concluded, potentially paving the way to better or earlier diagnosis.
Men with an elevated, genetically inherited risk for prostate cancer could be routinely identified with a simple blood or urine test, scientists at UC San Francisco and Kaiser Permanente Northern California have concluded, potentially paving the way to better or earlier diagnosis.
Imaging
Award-winning
agent developed for prostate cancer diagnosis and treatment - Medical News
Today
Prostate-specific membrane antigen (PSMA) is a surface protein that is normally present on healthy prostate cells, but is found at much higher levels on prostate cancer cells. It is barely found in the rest of the body. "Therefore, PSMA is an ideal target for diagnostic purposes as well as targeted therapies against prostate cancer," says biotechnologist Dr. Matthias Eder of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ).
Eder's group has developed a small molecule (PSMA-617) that is capable of specifically attaching to PSMA and can be labeled with various radioactive substances, called radionuclides.
Turning up the volume on prostate cancer: RIT research on targeted molecular imaging could improve detection and treatment - Medical News Today
"There is no reliable imaging screen for early prostate cancer," said Schmitthenner, research professor in RIT's Department of Chemistry and Chester F. Carlson Center for Imaging Science. "Initial diagnosis is dependent on measurement of PSA (prostate-specific antigen) levels followed by confirmation via biopsy. Prostate biopsies can be painful and can have side effects. Ultrasound guidance without a targeting compound is unreliable and often necessitates repeated biopsy for a positive diagnosis."
Schmitthenner is creating a targeted molecular probe for prostate cancer for use in conjunction with photoacoustic imaging. This emerging diagnostic medical technology combines activation by laser light and emission of ultrasound waves to differentiate between cancerous and healthy tissue.
Cancer cells coupled with fluorescent dyes light up like fireflies. Cells capped with these dyes also absorb heat from the laser and expand, producing acoustic waves like a faint buzzing noise.
"I like to say we make the cancer scream," Schmitthenner said.
The cellular scream detected via ultrasound waves shows up as glowing patch of cancer on a digital screen.
The design of Schmitthenner's compounds represents a new kind of architecture for targeted molecular imaging agents and is based on his patent-pending design. The patent application lists Schmitthenner and three of his former students, RIT graduates Taylor Barrett, Stefanie Beach and Chelsea Weidman. Their modular approach to building compounds around a chemical scaffold can be modified to target a variety of cancers using different contrast dyes and medical imaging technologies.
Prostate-specific membrane antigen (PSMA) is a surface protein that is normally present on healthy prostate cells, but is found at much higher levels on prostate cancer cells. It is barely found in the rest of the body. "Therefore, PSMA is an ideal target for diagnostic purposes as well as targeted therapies against prostate cancer," says biotechnologist Dr. Matthias Eder of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ).
Eder's group has developed a small molecule (PSMA-617) that is capable of specifically attaching to PSMA and can be labeled with various radioactive substances, called radionuclides.
Turning up the volume on prostate cancer: RIT research on targeted molecular imaging could improve detection and treatment - Medical News Today
"There is no reliable imaging screen for early prostate cancer," said Schmitthenner, research professor in RIT's Department of Chemistry and Chester F. Carlson Center for Imaging Science. "Initial diagnosis is dependent on measurement of PSA (prostate-specific antigen) levels followed by confirmation via biopsy. Prostate biopsies can be painful and can have side effects. Ultrasound guidance without a targeting compound is unreliable and often necessitates repeated biopsy for a positive diagnosis."
Schmitthenner is creating a targeted molecular probe for prostate cancer for use in conjunction with photoacoustic imaging. This emerging diagnostic medical technology combines activation by laser light and emission of ultrasound waves to differentiate between cancerous and healthy tissue.
Cancer cells coupled with fluorescent dyes light up like fireflies. Cells capped with these dyes also absorb heat from the laser and expand, producing acoustic waves like a faint buzzing noise.
"I like to say we make the cancer scream," Schmitthenner said.
The cellular scream detected via ultrasound waves shows up as glowing patch of cancer on a digital screen.
The design of Schmitthenner's compounds represents a new kind of architecture for targeted molecular imaging agents and is based on his patent-pending design. The patent application lists Schmitthenner and three of his former students, RIT graduates Taylor Barrett, Stefanie Beach and Chelsea Weidman. Their modular approach to building compounds around a chemical scaffold can be modified to target a variety of cancers using different contrast dyes and medical imaging technologies.
Guidelines
The NCCN patient guidelines have “come of age” | THE
"NEW" PROSTATE CANCER INFOLINK
Version 1:2015 of the NCCN Guidelines for Patients | Prostate Cancer is still not a perfect document. For example:
Version 1:2015 of the NCCN Guidelines for Patients | Prostate Cancer is still not a perfect document. For example:
- Detailed information about active surveillance and watchful waiting as management strategies is limited.
- There is still no reference to focal therapy for men with small amounts of low- or intermediate-risk, localized prostate cancer.
- There is no discussion of intermittent androgen deprivation therapy as a strategy in the management of M0 or M1 disease.
Risks
The complexity of assessment of prostate cancer risk | THE
"NEW" PROSTATE CANCER INFOLINK
By creating prostate cancer risk models based on 105 genetic mutations that have previously been confirmed as being associated with prostate cancer risk, the research team was able to show that
By creating prostate cancer risk models based on 105 genetic mutations that have previously been confirmed as being associated with prostate cancer risk, the research team was able to show that
- Each of these genetic variants has a modest impact on risk for prostate cancer.
- Men with combinations of these DNA variants that placed them among the highest 10 percent for risk were more than six times as likely to be diagnosed with prostate cancer compared to the men who ranked among the lowest 10 percent for prostate cancer risk.
Therapies
Prostate cancer devices market to grow at a CAGR of 13.48% over the period 2015-2019This report covers the present scenario and the growth prospects of the global prostate cancer devices market for the period 2015-2019. To calculate the market size, the report considers revenue generated from the sales of prostate cancer devices based on their applications.
Types of applications:
- External beam radiation therapy
- Radical prostatectomy
- Brachytherapy
- Cryotherapy
- HIFU
Radiation
Hormone
The researchers have shown that men who start immediately have a 15 per cent greater chance of being alive six years later than those who wait for symptoms before commencing therapy.
But there is a price for starting early. While the complications of the cancer are likely to occur later, the men are at a greater risk of the side effects of hormone therapy.
This is the first study to quantify the benefit of early hormone therapy in the PSA era, according to Gillian Duchesne, professor of radiation oncology at Melbourne's Peter MacCallum Cancer Centre.
Statin delays recurrence by an average of 10 months.
Should all patients starting on ADT be on a statin too? | THE "NEW" PROSTATE CANCER INFOLINK
Harshman et al. did two things:
- They carried out laboratory studies to demonstrate that the use of statins can interfere with the uptake of dehydroepiandrosterone sulfate (DHEAS) — a known precursor of testosterone. (And they had previously shown that DHEAS is a substrate for another molecule called SLCO2B1, and that statins use SLCO2B1 to enter cells.)
- They looked back through the available data on the cohort of 900+ patients treated with ADT through the Dana-Farber Cancer Institute in Boston to assess how many of those patients were on statin therapy at the time of initiation of ADT and whether being on a statin appeared to affect patient outcomes over time.
- 283/926 patients in their ADT cohort (31 percent) were taking a statin at the time of initiation of ADT.
- Average (median) follow-up was 5.8 years.
- During the follow-up period, 644/926 patients (70 percent) exhibited disease progression while receiving ADT.
- Average (median) time to disease progression (TTP) while on ADT was 20.3 months.
- For men on statin therapy at initiation of ADT, median TTP was 27.5 months.
- For men not taking a statin at initiation of ADT, median TTP was 17.4 months
- This difference was statistically significant (P < 0.001).
- The association was still statistically significant after adjusting for predefined prognostic factors (adjusted hazard ratio [aHR] = 0.83; P = 0.04).
Chemo
the results of the STAMPEDE trial were presented, showing that adding docetaxel up front with androgen deprivation therapy was useful in men with metastatic disease, positive nodes, or very high-risk node-negative disease.[2] After the trials presented over the past 2 years, there is little doubt that docetaxel should have a very real role in up-front therapy for prostate cancer. We do not know that it has a role in biochemical-only recurrence at this point, however.
Assessing the “value” of new drugs in the treatment of [prostate] cancer | THE "NEW" PROSTATE CANCER INFOLINK
As a society, here in America and in other countries around the world, we are not going to be able, successfully, to sustain the current business model, in which smaller and smaller health benefits are associated with higher and higher costs to society and to individual patients, particularly in the treatment of late stage diseases of any type. Trying to cure leukemia in a child who has 60+ years of productive life ahead of it is one thing. … Adding 3 months of non-productive life to an 80-year-old person with a possible life expectancy of another 3 years in quite a different thing. … Are they really “worth” the same? By comparison, even though they are expensive, some of the new drugs now available to treat hepatitis C can actually cure many people of the disease with a single course to treatment. Clearly that is a whole different scenario … and maybe we do need to work out how to “pay the piper” for a benefit that high.
Major trial confirms value of zoledronic acid dosed every 3
months in preventing pain, SREs | THE "NEW" PROSTATE CANCER INFOLINK
In this trial, the investigators set out to test whether giving zoledronic acid every 3 months would be just as effective (i.e., “non-inferior”) at reducing bone pain and skeletal-related events (SREs) in patients with bone metastases as giving it according to the standard recommended regimen (once a month) specified in the product’s prescribing information.
In this trial, the investigators set out to test whether giving zoledronic acid every 3 months would be just as effective (i.e., “non-inferior”) at reducing bone pain and skeletal-related events (SREs) in patients with bone metastases as giving it according to the standard recommended regimen (once a month) specified in the product’s prescribing information.
Side Effects
Does
diagnosis/treatment for prostate cancer increase risk for colorectal cancer
too? | THE "NEW" PROSTATE CANCER INFOLINK
the data from this study does seem to suggest the very real possibility that treatment for prostate cancer — and in particular treatment for prostate cancer by any form of androgen deprivation therapy or by radical prostatectomy — could increase a man’s risk for colorectal cancer by as much as 30 percent (from 1.1 percent to 1.4 percent in real terms).
the data from this study does seem to suggest the very real possibility that treatment for prostate cancer — and in particular treatment for prostate cancer by any form of androgen deprivation therapy or by radical prostatectomy — could increase a man’s risk for colorectal cancer by as much as 30 percent (from 1.1 percent to 1.4 percent in real terms).
ED
worsened, testosterone levels decreased by some treatments of prostate
enlargement - Medical News Today
Men with benign prostate enlargement who used finasteride (also known as proscar and propecia) to treat their condition, experienced worsening erectile dysfunction (ED) that did not resolve with continued treatment. In addition, they experienced a reduction in their testosterone levels leading to hypogonadism (little to no production of sex hormones). However, men who used tamsulosin (flomax) experienced none of these adverse side effects.
There’s life after prostate cancer | USC News
Developing fat and losing muscle mass are common side effects. Some men experience hot flashes and develop osteoporosis and other feminizing effects, including genital shrinkage and breast development.
And while some side effects may subside once treatment is complete, the accumulation of fat and loss of muscle, which can diminish overall physical function, persists even after the treatment is done.
Kiwata knew that many prostate cancer patients need a rigorous program of diet and exercise tailored to combatting the unwanted side effects of hormone therapy to meet their goals.
She designed a 15-week program for men over 50 undergoing ADT and set out to prove scientifically that this course of exercise and protein supplementation can help.
Men with benign prostate enlargement who used finasteride (also known as proscar and propecia) to treat their condition, experienced worsening erectile dysfunction (ED) that did not resolve with continued treatment. In addition, they experienced a reduction in their testosterone levels leading to hypogonadism (little to no production of sex hormones). However, men who used tamsulosin (flomax) experienced none of these adverse side effects.
The researchers found that in the testing and validation cohorts,
PCCI score and age correlated with similar hazards of other-cause
mortality. Equivalent risks were seen for each 6-year increase in age at
diagnosis of greater than 60 years and for 1 additional PCCI point. The
age-adjusted PCCI scores were strongly predictive of other-cause
mortality. For a score of 0, 1 to 2, 3 to 4, 5 to 6, 7 to 9, and 10+,
the subhazard ratios of other-cause mortality versus 0 were 2.0, 4.0,
8.7, 14.7, and 43.2, respectively; 10-year cumulative incidence of
other-cause mortality was 10, 19, 35, 60, 79, and 99%, respectively.
"The age-adjusted PCCI strongly stratifies the risk of long-term, other-cause mortality," the authors write. "It may be incorporated into shared decision-making to decrease overtreatment of older and chronically ill men with prostate cancer."
"The age-adjusted PCCI strongly stratifies the risk of long-term, other-cause mortality," the authors write. "It may be incorporated into shared decision-making to decrease overtreatment of older and chronically ill men with prostate cancer."
There’s life after prostate cancer | USC News
Developing fat and losing muscle mass are common side effects. Some men experience hot flashes and develop osteoporosis and other feminizing effects, including genital shrinkage and breast development.
And while some side effects may subside once treatment is complete, the accumulation of fat and loss of muscle, which can diminish overall physical function, persists even after the treatment is done.
Kiwata knew that many prostate cancer patients need a rigorous program of diet and exercise tailored to combatting the unwanted side effects of hormone therapy to meet their goals.
She designed a 15-week program for men over 50 undergoing ADT and set out to prove scientifically that this course of exercise and protein supplementation can help.
Recurrence
Astellas, Medivation initiate TRUMPET registry study | THE "NEW" PROSTATE CANCER INFOLINKThe goal of the TRUMPET registry trial is to give us all greater insight into the management of advanced prostate cancer by describing and evaluating patterns of care and disease assessment methods, as well as identifying factors that influence physician treatment decisions and settings, referral patterns, and patient characteristics associated with these factors. TRUMPET will also describe factors influencing treatment decisions — including reason(s) for treatment choices and triggers for treatment changes for CRPC — and clinical outcomes based on patient characteristics.
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