Prostate Cancer News - 2015-10-01
General Case Management
Choices you Make
More sex for a healthy prostate - report - Life & Style - NZ Herald News
A new report, Prostate Health... Sex, Lies and Misconceptions, released by Christchurch-based natural health researcher Warren Matthews, says men as young as 40 need to adopt a natural preventative approach, which includes more sex, to improve prostate health.Screening and Diagnosis
Choosing Wisely Campaign to Cut Unnecesary Medical Tests - AARP
PSA to screen for prostate cancer
Cancer is always scary, but the PSA test
often finds slow-growing cancers that won't kill men. "The evidence is extremely
convincing that in a man with usual risk and no symptoms, the PSA test causes
more harm than benefit," says Reid Blackwelder, president of the American
Academy of Family Physicians (AAFP). As a result of the test, he says, men
often have ultrasounds, repeat lab tests and even biopsies for a problem that
isn't there — an estimated 75percent of tests that show high PSA levels turn
out to be false alarms.When men do have treatments such as surgery or
radiation, 20 to 40 percent end up with impotence, incontinence or both.Not all doctors agree with AAFP's recommendation against routine PSA screening, but many agree that the test is overused. Even the American Urological Association, which supports the use of PSA testing, says that it should be considered mainly for men ages 55 to 69. The American Society of Clinical Oncology recommends against PSA testing for prostatecancer screening in men with no symptoms when they are expected to liveless than 10 years. A recent study published in the journal Cancer found that Medicare spent almost $450 million a year on PSA screenings, one-third of which was for men over age 75.
Some prostate screening may hurt more than help - News - McPhersonSentinel - McPherson, KS - McPherson, KS
Finding and treating prostate cancer before symptoms occur
may not help men live longer or improve health, reports the U.S. Preventive
Services Task Force (USPSTF).
Research by the USPSTF showed that the prostate-specific
antigen (PSA) test, a blood sample that gauges levels of cancerous proteins to
screen for prostate cancer, is less effective and possibly more harmful to
patients.
The USPSTF gave a final recommendation in 2012 against
PSA-based screening in men that do not show symptoms of prostate cancer in the
general population, regardless of age.
According to USPSTF Co-vice Chair Michael LeFevre, a family
physician from Columbia, Missouri, more than 300,000 men have been enrolled in
randomized screening trials in nine countries and, after 10 years of follow-up,
there are no visible benefits to screening.
Biopsies, Genomics and Pathology
Not all men with Gleason 8-10 disease are going to do badly after treatment | THE "NEW" PROSTATE CANCER INFOLINKThere is a perception among a lot of patients — especially when they get diagnosed — that having a high Gleason score of 8, 9, or 10 is essentially a “death sentence”, regardless of how they get treated. This is notactually the case at all. Plenty of men with Gleason 8 to 10 disease actually do well after treatment. And it has long been assumed that thiswas the case in particular if they were identified and treated early — while they had truly organ-confined disease.
A newly published paper by Fischer et al. has now confirmed this assumption through a careful retrospective analysis of data from > 450 men whose records could be identified in the SEARCH database, all of whom received surgical treatment for Gleason 8 to 10 prostate cancer.
Tests
Prostate cancer: Analysing prostate cancer biomarkers in voided urine : Nature Reviews Urology : Nature Publishing GroupNew Catalyst Yields More Accurate Prostate Cancer Test | Lab Manager
Imaging
Molecular imaging study reveals improved detection of early recurrent prostate cancer - Medical News TodayGallium-68 PSMA as an imaging agent in prostate cancer recurrence | THE "NEW" PROSTATE CANCER INFOLINK
Treatment
Prostate Cancer Surgery, Radiotherapy Offer Similar Overall Survival - Renal and Urology NewsRadical prostatectomy and radiation therapy are associated with similar overall survival among men with localized prostate cancer (PCa), but progression-free survival rates are better with radiation therapy, Japanese researchers reported at the 2015 European Cancer Congress in Vienna.
Active Surveillance
Active surveillance redefines paradigm for prostate cancer management | Hemonc Today“Active surveillance does not mean ‘don’t treat,’” Matthew R. Cooperberg, MD, MPH, associate professor of urology and epidemiology & biostatistics at University of California, San Francisco, told HemOnc Today. “It means, ‘Don’t treat now and follow carefully with every intention of cure if there is progression.’”
The strategy has gained considerable acceptance. In community-based practices, the percentage of men with low-risk disease who underwent active surveillance climbed steadily from 6.7% in 1990 to 14.3% in 2009, a study by Cooperberg and colleagues showed. Between 2010 and 2013, the figure exceeded 40%.
Prostate cancer: Growth of AS in the USA signals reduction in overtreatment : Nature Reviews Urology : Nature Publishing Group
New prostate cancer screening review article advocates for active surveillance - Medical News Today
'Era of Active Surveillance Has Arrived' in Prostate Cancer
Prostate cancer: AS-contemplation, not intervention : Nature Reviews Urology : Nature Publishing Group
Surgery
Natural orifice transluminal endoscopic surgery (NOTES) and
laparoendoscopic single-site (LESS) surgery are two new techniques that have the
potential to make prostate cancer surgery even less traumatic. They are both
under investigation. –
Radiation
Scanning the Horizon: Advances in Radiation Treatment for Prostate Cancer | Cure MagazineTackling the global shortfall in radiotherapy could save millions of lives and boost the economy of poorer countries
Millions of people are dying from potentially treatable cancers like breast and prostate because of a chronic underinvestment in radiotherapy resources, according to a major new Commission on access to radiotherapy, published in The Lancet Oncology, and being presented at the 2015 European Cancer Congress in Vienna, Austria.
New estimates produced for the Commission reveal that 204 million fractions of radiotherapy will be needed to treat the 12 million cancer patients worldwide who could benefit from treatment in 2035. Despite the enormity of the problem, say the authors, the cost per fraction is highly cost-effective and very low compared to the high price of many new cancer drugs.
Video - Today is a medical alert day. And there is new state
of the art technology in use right here in Palm Beach County. There are better
options when it comes to fighting prostate cancer.
Reporter: it's a $5 billion robotic radiation technology.
The only one currently being used in the state of Florida and cancer treatment.
We tell the robot where we want the radiation to go and where we don't want it
to go.
Reporter: With the M Six edition of the Cyber Knife you do
not actually use a knife at all. It uses a computer mapping system, it's
noninvasive, pain free, and quick. What would normally take us close to an hour
to treat for a prostate cancer patient in a single session, we're doing now in
and about 20 minutes or less. First a urologist inserts tiny markers using a
needle. It takes less than a minute. There are tiny pieces of gold the size of
an uncooked grain of rice that will act as markers for the robot.
Reporter: the patient then under goes the CAT scan and an MRI.
They combine the images to - create a visual mapping system that the robot
fellows. Directing cancer sells. A precision like no other. We can track the exact
position of our target.
Reporter: the Cyber Knife delivers a dose of radiation using
100s of tiny wires thinner than a strand of human hair and invisible to the naked
eye. They intersect at the exact point to kill the cancer cells. We use 100,
2200 bales.
Reporter: and the results impressive. Better imaging, more
accurate therapy. And shorter treatment time.
Reporter: patients under go the treatment in only five
sessions of the cyber knife which could be done during lunch break.
OnMedica - News - Fewer but higher doses of radiotherapy good for prostate cancer
Giving fewer but higher doses of radiotherapy, is as effective at treating prostate cancer as giving lower doses for a longer period, according to new research.The findings,* presented today at the 2015 European Cancer Congress, could mean men need fewer trips to hospital – over four weeks rather than seven and a half – without reducing the quality and impact of their prostate cancer treatment.
New wonder gel lowers risk of radiation during prostate cancer treatment | Health | Life & Style | Daily Express
A GEL that prevents damage from radiotherapy could help
thousands of men treated for prostate cancer by separating the prostate gland
from the rectum.
Hormone
Intermittent ADT for Prostate Cancer May Improve QoL | Cancer NetworkContinuous androgen deprivation therapy (ADT) is the standard treatment for advanced prostate cancer, but a new meta-analysis suggests that overall survival outcomes between intermittent and continuous ADT are similar. The study also found that physical and sexual function was better among men who received intermittent ADT.
The research is published in JAMA Oncology.
Some Prostate Cancer Patients May Not Benefit From Hormone Therapy
Intermittent ADT may improve quality of life in men with prostate cancer
New Techniques
Similar long-term outcomes after treatment with HIFU or LDR brachytherapy | THE "NEW" PROSTATE CANCER INFOLINKThe chances that we will ever see a large, randomized, comparative trial of high-intensity focused ultrasound (HIFU) and low-dose-rate (LDR) brachytherapy in the treatment of localized prostate cancer are near to zero. But we do have some new comparative data that are, at least, suggestive of what happens in the “real world”.
A new paper by Aoun et al., which is available as a full-text article on line in Advances in Urology, provides data from a “matched pair” analysis of the outcomes of 212 men who were treated at one or other of two academic medical centers in Belgium between September 2001 and December 2012. All 212 patients received whole gland primary therapy with curative intent for organ-confined prostate cancer; had a PSA level of < 20 ng/ml; had a Gleason score of ≤ 3 + 4 = 7; had clinical stage T1-2N0M0 disease; and had a follow-up of > 12 months. All HIFU patients were treated by a single surgeon using Ablatherm technology. All LDR brachytherapy patients were treated by the same radiation oncologist and radiation physicist with the support of one or other of two surgeons.
Side Effects
Mental and psychological impact of ADT on prostate cancer patients and their partners | THE "NEW" PROSTATE CANCER INFOLINKTwo recent papers have addressed evolution in our knowledge of the impact of androgen deprivation therapy (ADT) on various mental aspects of the health of patients with prostate cancer and their partners as well.
Erectile function post-radical prostatectomy: the past 20 years | THE "NEW" PROSTATE CANCER INFOLINK
The authors conclude that their analysis suggests that (a) the rate of undisturbed erectile function is in the range 20 to 25 percent in most studies and that (b) these rates have not substantially improved or changed over the past 17 years.
In other words, any improvements in the quality of surgery over the past 17 years, on their own, have really been having a very limited impact on the quality of erectile/sexual function for radical prostatectomy patients over most of the past 20 years.
Saving Prostate Most cancers Sufferers from Collateral Injury | Observer
Advanced/Recurrence
Long-term
survival of men initially diagnosed with advanced (Stage IV) prostate cancer
| THE "NEW" PROSTATE CANCER INFOLINK
An article in the July issue of the journal Radiation
Oncology, along with a commentary on the UroToday web site,
provides us with some interesting insights about the long-term survival of
patients initially diagnosed with more advanced forms of prostate cancer.The full text of the original paper in Radiation Oncology (by Muralidhar et al.) can be accessed on line. The additional commentary by Faltas on the UroToday web site requires readers to register as members of the UroToday web site.
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