Prostate cancer - Signs, Symptoms and Treatment

Balding linked to cancer risk

2011-03-10T22:30:00.000-08:00

M en with prostate cancer may be twice as likely to have started showing signs of male pattern baldness at the age of 20 than those without prostate cancer, a new French study suggests.

Men who start losing their hair in their 30s or 40s do not appear to face a similar boost in prostate cancer risk. And those whose hair loss starts in their 20s do not face a higher risk of developing the cancer at an early age or of developing more aggressive tumors, the research team noted.

Whether or not men who experience youthful hair loss may benefit from prostate cancer screening is yet to be determined, the study authors added.“At present, there is no hard evidence to show any benefit from screening the general population for prostate cancer,” study author Dr. Philippe Giraud, from the European Georges Pompidou Hospital in Paris, said in a news release from the European Society for Medical Oncology. “We need a way of identifying those men who are at high risk of developing the disease.”

Noting that androgens associated with hair loss are also associated with prostate cancer, he and the other researchers called for more studies to see whether interventions might be appropriate for men with very early balding.

Physicians need to know “who could be targeted for screening and also considered for chemo-prevention using anti-androgenic drugs such as finasteride,” Giraud said.

“Balding at the age of 20 may be one of these easily identifiable risk factors, and more work needs to be done now to confirm this,” he added.

The authors noted that male pattern baldness (androgenic alopecia) is very common, affecting about half of all men at some point in their lives.

Its onset has previously been linked to the conversion of testosterone to androgenic hormones, and androgens also have been previously implicated in the onset and growth of prostate cancer.

The drug finasteride — used to treat baldness — blocks the conversion of testosterone to an androgen thought to cause hair loss, and the drug also has been demonstrated to lower the incidence of prostate cancer.

To explore the possible connection between balding patterns and prostate cancer, the research team spent more than two years analyzing disease progression and hair loss patterns in 388 men with prostate cancer.

The men were diagnosed between the ages of 46 and 84. Starting in 2004, the investigators asked them to indicate whether or not they had experienced any previous balding, when their hair loss began, and specifically what type of hair loss had occurred at 20, 30 and 40.

Another 281 healthy men were enlisted in the study for comparison.
source: www.suntimes.com

HIFU for Prostate Cancer: Reasons for Caution

2011-03-10T22:15:00.000-08:00

March 10, 2011 — High-intensity focused ultrasound (HIFU) has moved from salvage treatment for prostate cancer to being considered for front-line use, although both the US Food and Drug Administration and the European Association of Urology classify HIFU as experimental.

The first case series to report outcomes in men after failed whole-gland HIFU and salvage radical prostatectomy suggests that there is reason for caution.

The pathology results were "alarming," and morbidity was higher after salvage prostatectomy than after primary surgery, researchers report in the March issue of the Journal of Urology.

The findings come from 15 patients treated with HIFU by Nathan Lawrentschuk, MD, from the Department of Surgical Oncology at Princess Margaret Hospital in Toronto, Ontario, and colleagues in Melbourne and Sydney, Australia.

In this case series, pathologically extensive periprostatic fibrosis with persistent prostate cancer (pT3) was seen in 9 of 14 patients, and focally positive margins (pT3a) were seen in 3 of 11 patients. The authors note that early follow-up data suggest acceptable disease control after the salvage prostatectomies.

In an accompanying editorial comment, Declan G. Murphy, MD, from the Department of Urological Oncology at the Peter MacCallum Cancer Centre in Melbourne, Australia, writes: "Whether it is that standard prostate biopsy cannot be relied on to predict final pathological outcome, or that HIFU 'makes cancer angry,' patients should be fully counseled about what we know and, importantly, what we do not know about HIFU treatment for localized prostate cancer today."

"Our own initial experience with HIFU treatment for primary and recurrent prostate cancer unfortunately led us to conclude that the technology is not yet suitable for mainstream clinical practice, and led us to suspend our program," Dr. Murphy added.

Dr. Lawrentschuk told Medscape Medical News that the case series shows that radical prostatectomy as salvage is feasible after the failure of primary HIFU, but that the rate of extraprostatic extension is a concern.

Dr. Lawrentschuk said that "HIFU is experimental and should only be done in studies where patients are told of the risks of failure and the poor results of salvage. They need very careful monitoring, follow-up biopsies, etc. I do not advise patients to have HIFU. There may be a problem with HIFU selecting out more aggressive cells, but this warrants further study."

I think HIFU is inadequate in its current form.

"Experimental treatments are fraught with danger. I was surprised at the aggressive nature of the disease and the recurrences in this supposedly low-risk group," Dr. Lawrentschuk said. "I think HIFU is inadequate in its current form, perhaps because of poor patient selection for HIFU and a lack of standardized ways of detecting post-HIFU recurrences in a timely fashion."

Howard Sandler, MD, chair of radiation oncology at Cedars-Sinai Medical Center's Samuel Oschin Comprehensive Cancer Institute in Los Angeles, California, reviewed the study for Medscape Medical News.

"I wouldn't conclude that the high number with extracapsular extension is a result of HIFU. It is more likely that patients who fail HIFU had worse cancers in any case from the start. Additionally, there may have been a bit of a delay after some suspicion of recurrence before salvage surgery was done, given the presurgery PSA [prostate-specific antigen] of 3.8, with the nadir PSA of 1.0. Thus, patients waited on average for their PSA to rise from 1.0 to 3.8 before something was done. During this interval, extracapsular extension may have occurred," Dr. Sandler said.

He noted that HIFU is being tested for whole-gland ablation, although that approach might be waning. However, that there is growing enthusiasm for HIFU (and other modalities) for focal therapy. "I think that HIFU is a poor choice for both approaches," he said.source: www.medscape.com

Adamis looks to test prostate cancer drug on humans

2011-03-10T22:13:00.000-08:00

Adamis Pharmaceuticals said Wednesday it is seeking permission from federal regulators to begin testing APC-100, an experimental prostate cancer drug, on human patients for the first time.

The Del Mar company’s Investigational New Drug application with the Food and Drug Administration seeks to recruit 30 men with castrate-resistant prostate cancer for a Phase 1 clinical trial. The testing will be conducted through the University of Wisconsin Carbone Cancer Center in Madison and Wayne State University’s Karmanos Cancer Institute in Detroit.

Adamis shares rose 2 cents, or 15 percent, to 19 cents on Wednesday.

The oral drug, an organic molecule that was discovered by researchers at the Carbone center, is designed to block male hormones tied to prostate cancer in men who have become resistant to other hormone-blocking therapies.

In tests on mice with the disease, the drug worked 90 percent of the time in comparison to standard treatments that worked 55 percent of the time, the company said.

The drug previously received a Rapid Access to Preventive Intervention Development grant from the National Cancer Institute.

Adamis licensed APC-100 along with two other preclinical prostate cancer therapies in February 2010 from Colby Pharmaceutical, which had licensed the drug candidates from the Wisconsin Alumni Research Foundation.

Adamis also is working on a lower-cost, single-dose epinephrine injection to treat deadly allergic reactions.

A number of drug companies are working on new prostate cancer therapies in part because patients often develop resistance to existing medicines, said John McCamant, editor of the Medical Technology Stock Letter in Berkeley.

The niche also is attractive because prostate cancer cases, and the demand for more effective drugs, are expected to rise as the American population ages.
source: www.signonsandiego.com

Screening for Colorectal Cancer Saves Lives -- No Debate, Says ACS

2011-03-10T22:09:00.000-08:00

March 10, 2011 — The majority of colorectal cancer could be prevented by applying existing knowledge about cancer prevention and by increasing the use of established screening tests, according to the American Cancer Society (ACS).

"The value of early detection has become a topic of wide debate for some cancers," said Edward Partridge, MD, national volunteer president of the ACS. For example, debates have raged about prostate-specific antigen testing for prostate cancer and mammography for breast cancer, as previously reported by Medscape Medical News.

"But for colorectal cancer there should be no debate," Dr. Partridge said in a statement. "Screening for colon cancer saves lives."

However, despite the evidence supporting the effectiveness of colorectal cancer screening and the availability of various screening tests, only about half the American population 50 years or older is current for recommended testing, the ACS points out.

"The American Cancer Society has identified colorectal cancer as a major priority because of the enormous potential to prevent disease, diminish suffering, and save lives," Dr. Partridge said.

The ACS has just released a new report, Colorectal Cancer Facts & Figures 2011-2013, to coincide with National Colon Cancer Awareness Month in the United States. Throughout March, and throughout the year, the ACS encourages colorectal cancer screening for people 50 years and older.

The ACS also encourages physicians to proactively recommend regular screening and, to that end, it highlights the online resource How to Increase Colorectal Cancer Screening Rates in Practice: A Primary Care Clinician's Evidence-Based Toolbox and Guide.

More Than Half the Deaths Could Be Avoided

The ACS report estimates that during the course of this year, some 141,210 new cases of colorectal cancer will be diagnosed (about 72% in the colon and 28% in the rectum). It also predicts about 49,380 deaths from the disease during 2011, and says that more than half of these lives could have been saved with recommended screening.

In addition, about one quarter of cases of colorectal cancer could be prevented by a healthy lifestyle, the report notes. This involves maintaining a healthy abdominal weight, being physically active at least 30 minutes per day, eating a healthy diet, not smoking, and not drinking excessive amounts of alcohol.

However, the key message for people 50 years and older is that "screening is the most important step you can take to help protect yourself from colon cancer," the report states.

Screening Options

There are several recommended options for colorectal cancer screening; any of these is useful in average-risk adults, the report notes.

Options for Screening for Colorectal Cancer

Test	Test Interval
Flexible sigmoidoscopy	5 years
Colonoscopy	10 years
Double-contrast barium enema	5 years
Computed tomography colonography (virtual colonoscopy)	5 years
Fecal occult blood test	1 year
Stool DNA test	undetermined

Of the available options, structural exams (flexible sigmoidoscopy, colonoscopy, double-contrast barium enema, virtual colonoscopy) are preferable to stool tests (fecal occult blood test, stool DNA test) because they are likely to detect precancerous polyps and growths in addition to early cancer.

This is the recommendation of consensus guidelines for colorectal cancer screening issued in 2008 by the American Cancer Society in association with the US Multi-Society Task Force (which includes the American College of Gastroenterology and the American College of Physicians) and the American College of Radiology (CA Cancer J Clin. 2008;58:130-160).

Colonoscopy has the potential to prevent about 65% of colorectal cancer cases, the report notes, whereas sigmoidoscopy is associated with a 60% to 80% reduction in colorectal cancer mortality for the area of the colon within its reach.

Regular use of fecal occult blood tests reduces the risk for death from colorectal cancer by about 15% to 33%. However, its effectiveness is dependent on repeat screenings over time, the report notes, and a recent study has shown that the majority of people who choose this option fail to adhere to a regular testing schedule.

Guaiac-based "toilet-bowl tests" that are sold over the counter are not recommended by the ACS or any other major medical organization. These tests, often promoted as a type of fecal occult blood test, consist of strips of paper that are dropped into the toilet water containing the stool, but these tests have not been evaluated in rigorous clinical studies, the report notes.

Screening Shows Modest Increase

Screening for colorectal cancer has been increasing modestly since 2000, owing exclusively to an increase in endoscopy (both sigmoidoscopy and colonoscopy), the report notes.

Nevertheless, data for 2008 show that only 50% of the adult population 50 years and older reported having had an endoscopy and only 10% reported having a fecal occult blood test within the recommended time intervals.

Screening prevalence is lower among people 50 to 64 years than among those 65 years and older. This is especially low among those who are nonwhite, who have fewer years of education, who lack health insurance, and who are recent immigrants, the report notes.

Rates Declining in Recent Years

The incidence of colorectal cancer has been declining in the United States since the mid-1980s, and this decline has accelerated in recent years. Since 1998, incidence rates have fallen by 3% per year in men and by 2.3% per year in women.

The acceleration in this decline in the past decade has been largely attributed to colorectal cancer screening and the detection and removal of precancerous polyps, the report notes.

However, although the incidence rates have been declining in adults 50 years and older, there has been an increase in the incidence of colorectal cancer among adults younger than 50 years. This increase appears to be confined to cancers of the distal colon and rectum. "The reasons for this increase are unknown, but may reflect increasing trends in obesity and/or unfavorable dietary patterns in children and young adults," according to the report.

As with incidence rates, deaths from colorectal cancer have been decreasing in the United States, since around 1950 in women and around 1980 in men. Since 1998, deaths from colorectal cancer have been decreasing by 2.8% per year in men and by 2.6% per year in women.

However, over the past 3 decades, there has been an increasing divergence of mortality trends between whites and blacks. Steep declines in mortality, largely the result of substantial improvements in the early detection and treatment of colorectal cancer, began in whites in the early 1980s, but were not see in blacks until the late 1990s. As a result, colorectal mortality rates have been substantially higher among blacks than among whites (they were 44% higher in 2007).

Blacks are less likely than whites to receive most appropriate surgery, adjuvant chemotherapy, and radiation treatments after a cancer diagnosis, studies have found. But clinical trials have also shown that when treatment is equal among study groups, racial differences in survival disappear, the report notes.

source: www.medscape.com

Scientists develop 'groundbreaking' cancer test

2011-03-01T04:40:00.000-08:00

By Stephanie Jones-Berry
March 01, 2011 - SCIENTISTS at the University of Surrey have made a major breakthrough in accurately being able to predict prostate cancer – a disease that kills 10,000 men each year.

The three-year groundbreaking study, published on Tuesday in the US journal Clinical Cancer Research, shows that a protein called Engrailed-2 (EN2) is made by prostate cancers and secreted into urine.

Accordingly, a simple urine test that accurately predicts up to 70% of prostate cancers – twice as effective as the current test - has been developed at the university's Postgraduate Medical School, which detects the cancer by picking up the presence of the EN2 protein.

This could be available in GPs surgeries in as little as a year’s time.

Scientist, medical doctor, and TV presenter Professor Robert Winston, who champions public engagement with science, said: "This is an exciting discovery which advances the early detection of this cancer.

"It also shows just how vital the research carried out in universities such as Surrey really is in helping to find faster, better solutions to some of the healthcare challenges that face us all."

The standard 30-year-old PSA test for prostate cancer is invasive and involves taking a blood sample.

It is unable to detect a significant proportion of early prostate cancers.

Professor Hardev Pandha, the Prostate Project chairman of urological oncology at the University of Surrey's Postgraduate Medical School, said: "In this study we showed that the new test was twice as good at finding prostate cancer as the standard PSA test."

The three-year research study was a joint project - largely funded by the Prostate Project charity.

source: www.getsurrey.co.uk

'Superior' Test For Prostate Cancer Unveiled

2011-03-01T04:34:00.000-08:00

Scientists have unveiled the first reliable test for diagnosing early prostate cancer.

The urine test is so accurate that it could be used to screen all older men for the disease.

Prostate cancer is the most common male cancer, killing more than 10,000 men in the UK every year.

Scientists at the University of Surrey identified a protein called EN-2, which is only produced by prostate cancer cells.

Studies show a test for the protein detects 60 to 70% of cancers.

But the false positive rate - men who are wrongly diagnosed with cancer - is just 4%.

On both counts, the new test is vastly superior to the existing PSA blood test, which detects fewer than 40% of cancers and has a false positive rate of over 50%.

Professor Hardev Pandha, who led the research, told Sky News: "I think the lack of false positives is clearly very, very encouraging.

"The technology that underlies the test is so simple that actually having a desktop apparatus in a GP's surgery would be very, very straightforward.

"It's very exciting."

In conjunction with other tests and clinical signs of cancer I think it will have a very important part to play in diagnosis and in monitoring the disease.

Dr Richard Morgan developed the test

Further studies are now planned.

But the results so far show the test is as accurate as NHS screening programmes for other cancers.

The scientists hope the EN-2 test could be in widespread use in 12 to 18 months' time.

Early indications also suggest high levels of EN-2 in the urine indicate aggressive tumours that need immediate surgery.

Men with lower levels could be monitored, avoiding the need for an operation which can cause impotence and incontinence.

Dr Richard Morgan, who also developed the test, said it was a significant step forward in detecting the most common male cancer.

"In conjunction with other tests and clinical signs of cancer, I think it will have a very important part to play in diagnosis and in monitoring the disease," he said.

Tim Sharp is a trustee of The Prostate Project, which largely funded the research.

As a man in his 70s, he has also had a PSA check - and longs for the certainty the new urine test would bring.

"This is brilliant. Early treatment is absolutely the key to prostate cancer. If you catch it early, you've got an 80% chance of a cure. If you catch it late, that drops down to 20%," he said.

The scientists describe their test in the journal Clinical Cancer Research.
source: news.sky.com

Rise in PSA protein 'not prostate cancer sign'

2011-03-01T04:31:00.000-08:00

Further concerns have been raised over the reliability of protein testing as an indicator of prostate cancer.

A US study of 5,000 men in the Journal of the National Cancer Institute found even a rapid "doubling time" in prostate specific antigen (PSA) levels was not necessarily linked to cancer.

The researchers said a rise was not a cause for concern if a man's PSA was low, and he had no other symptoms.

UK men can request PSA tests, although there is no screening programme.

The National Screening Committee ruled that out because of concerns about over-diagnosis.

Simply having raised PSA is not a clear sign that a man will have cancer.

It could also be an indication that he has another condition, such as a benign prostate condition or a urinary infection.

In addition, a normal PSA result does not guarantee that a man does not have cancer.

Around 35,000 men are diagnosed with prostate cancer every year in the UK, and 10,000 die from the disease.
'Stronger evidence'

The researchers from the Memorial Sloan-Kettering Cancer Center gave healthy men aged over 55 annual PSA tests for seven years.

At the end of the study, men not diagnosed with prostate cancer had biopsies.

The researchers found that basing decisions on biopsies on high PSA velocity - a rapid doubling time in their PSA level (ie from three to six) - would lead to a larger number of procedures, with around one in seven men being biopsied - having a tissue sample removed.

They say that while some cancers would be diagnosed, it would also mean a large number of unnecessary biopsies.

Dr Andrew Vickers, who led the study, said: "If a man's PSA has risen rapidly in recent years, there is no cause for concern if his total PSA level is still low and his clinical examination is normal."

Dr Peter Scardino, chair of the Department of Surgery at Memorial Sloan-Kettering, who also worked on the research, said: "We have previously published papers determining that PSA naturally varies from month to month and have urged men whose PSA suddenly rises to wait six weeks and repeat the test before agreeing to a needle biopsy.

"This new study in a large population of men provides even stronger evidence that using changes in PSA as a basis for recommendation for biopsy leads to many more unnecessary biopsies and does not help to find the more aggressive cancers that we want to find and treat."

Emma Malcolm, chief executive of the UK charity Prostate Action, said: "This study's findings are consistent with those of a 2009 European study that showed doubling time is not significant for prostate cancer."

She said a family history of prostate or breast cancer could increase a man's risk, as did being of Afro-Caribbean origin, and that those men should have further investigations if they had raised PSA levels.

However Ms Malcolm added that men in their 50s who did not have those risk factors should simply be aware of the symptoms of prostate problems, including having to go to the toilet a lot in the night, not being able to urinate and feeling the need to empty their bladders but being unable to.
source: www.bbc.co.uk

Prostate cancer exams critical

2011-03-01T04:29:00.000-08:00

Men and women striving for equality are finding it in surprising areas.

For example, about 200,000 men are diagnosed every year with prostate cancer, most of them over age 55.

"For men, it is the equivalent of breast cancer and behaves very much the same way," says Dr. S. Adam Ramin, diplomate of the American Board of Urology.

An expert in prostate cancer and robotic laparoscopic prostatectomy, he has published numerous peer review articles and research papers. He is on staff at a number of medical centers, including Cedars Sinai Medical Center, Century City Doctors Hospital, Ventura Community Memorial Hospital and City of Hope Medical Center. He is the president of the Los Angeles Urological Association.

Q: Women often find a lump before a medical diagnosis of breast cancer. What should men look for?

A: Nowadays, prostate cancer is diagnosed at such an early stage there are no apparent symptoms. The patient is initially screened and diagnosed through a digital rectal exam and a PSA blood test.

If these are abnormal, either a biopsy of the prostate or a more specific type of test is ordered. Not all patients with elevated PSA have cancer, for example, which makes this test good but not completely accurate in making a diagnosis.

Q: Tell me about the tests.

A: One test is doing a transrectal ultrasound looking for abnormal areas in the prostate.

Another test, PCA3, is relatively new. This is a urine test. It is done after a prostate massage. The massage expresses urine in the prostatic fluid that comes out. The urine contains those prostate massage fluids, and if that's elevated, we definitely do a biopsy of the prostate.

Q: Who is at risk for prostate cancer?

A: The median age for men who show signs of this disease is 55 to 65. However, we know as a man gets older the risk increases.

Prostate cancer is very much like breast cancer and the two behave much alike.

For example, one in eight men get prostate cancer and one in eight women get breast cancer. If you have a mother or sister with breast cancer, you are more likely to get it. If you have a father or brother with prostate cancer, you are more likely to get it.

But also, the fact is a man is more likely to get prostate cancer if his mother or sister had breast cancer. The genes that cause breast cancer in women are the same with men in prostate cancer.

Q: What are the treatment options?

A: Broadly speaking, they range from watchful waiting (or not doing anything at all) to hormone therapy, which is one of the more exciting treatments available today.

And then there is robotic-assisted surgery and radiation and seed implantation.

Q: Robotic surgery is the fastest-growing treatment, and you are considered one of the top experts. Can you explain this treatment?

A: This newer way of treatment can avoid complications.

But there are three things for patients to know:

—Always look for an expert doctor in the field.

—It's critical for every man over 55 to get a yearly PSA or rectal exam.

—Not all forms of prostate cancer require treatment. Some are slow-growing and can be monitored.

Q: Diagnosis then determines treatment?

A: Absolutely.

And if the prostate is removed, there is a recovery period that may include loss of continence. However, with robotic surgery, the chance of any long-term incontinence is reduced to 2 to 3 percent.

Most problems associated with this surgery — such as loss of erection or bladder control — can be eliminated through newer forms of treatment. And, yes, Viagra even helps very well with the combination of nerve-sparing surgery.

source: www.nwitimes.com

New Chemo in Progressive Prostate Cancer

2011-03-01T04:26:00.000-08:00

Hello, I'm Bret Stetka, Editorial Director at Medscape. Welcome to the F1000 Practice-Changing Minute, where we report commentaries from the Faculty of 1000 on highly-rated studies that may change clinical practice. Our commentary today covers the study Prednisone Plus Cabazitaxel or Mitoxantrone for Metastatic Castration-Resistant Prostate Cancer Progressing After Docetaxel Treatment from de Bono and colleagues published in the Lancet.[1] The Faculty of 1000 Medicine has given this a ranking of Must Read with a factor of 8.

The following F1000 commentaries on this study were written by Drs. Thomas Flaig and Michael Glode of the University of Colorado, Denver School of Medicine in Aurora, Colorado.

In their commentary on this study, Drs Flaig and Glode wrote:

"Doctors now have the option of using cabazitaxel for the treatment of prostate cancer patients with progressive disease after docetaxel-based chemotherapy.

This is the first randomized, phase III study to demonstrate a survival advantage in prostate cancer patients with progressive disease after first-line chemotherapy.

Currently, docetaxel chemotherapy is utilized in patients with metastatic, hormone-refractory prostate cancer, especially when symptomatic. In this setting, docetaxel is commonly palliative and provides an approximate 3-month survival advantage over mitoxantrone chemotherapy, the previous standard chemotherapy used for palliating prostate cancer. However, once patients have progressed from docetaxel chemotherapy, effective medical therapy has not been clearly identified.

In this study, 755 men with metastatic, castrate-resistant, prostate cancer with progressive disease after docetaxel chemotherapy were randomized to cabazitaxel or mitoxantrone, both with prednisone dosed at 10mg a-day. Cabazitaxel was given intravenously as 25mg/meter squared every 21 days. The median survival was improved in the cabazitaxel arm by 2.4 months (15.1 versus 12.7 months).

Important grade 3 or higher toxicities included neutropenic fever (8% versus 1%) and diarrhea (6% versus < 1%) in the cabazitaxel versus the mitoxantrone arms, respectively. The proportion of deaths on study (within 30 days of the last study drug administration) was higher in the cabazitaxel (5%) than the mitoxantrone (2%) group and may be related to an increased proportion of neutropenic infections and significant diarrhea in the cabazitaxel treatment arm.

In conclusion, cabazitaxel is a new option for men with progressive prostate cancer after docetaxel chemotherapy, offering a survival advantage in this setting. A higher incidence of neutropenic fever was observed with cabazitaxel compared to mitoxantrone therapy and the use of prophylactic granulocyte colony-stimulating factor (GCSF) should be pursued in appropriate patients. Additionally, rehydration, anti-diarrheal medication and dose reduction may be needed for treatment-associated diarrhea. Premedication with a corticosteroid and histamine antagonists was performed to minimize the risk of hypersensitivity reactions."

This concludes today’s F1000 Practice-Changing Minute. I am Bret Stetka. Thank you for listening.

source: www.medscape.com

Urine Exam Proves Critical in Diagnosing Prostate Cancer

2011-02-04T02:35:00.000-08:00

4 February 2011 - Experts from the UK specifically those based in the Cancer Research UK Cambridge Research Institute and the Institute of Cancer Research (ICR) are suggesting that the protein found in urine could be a concrete and strong indicator of the risk one has in terms of contracting prostate cancer.

Accordingly, the protein is named microseminoprotein-beta or MSMB. It has relatively lowered levels in men diagnosed with the dreaded cancer as well those men with the more aggressive types of the said cancer.

Lead researcher Hayley Whitaker confirmed, “The protein is easy to detect because it is found in urine and would potentially be a very simple test to carry out on men to identify those most at risk of developing the disease.” He further added that an additional projected five years will have to pass before doctors will finally be able to use the test in order to better serve patients suffering from prostate cancer.

source: seerpress.com

Prostate Cancer – New Clues for Treatment Found

2011-02-04T02:32:00.000-08:00

4 February, 2011 - A report from researchers indicates four genes identified appear to have a critical influence in determining whether the early stages of prostate cancer will develop into an aggressive and lethal disease.

With this information, doctors and patients will be better able to make decisions after diagnosis of prostate cancer. The researchers said that this disease is today is generally “over-treated”.

According to the American Cancer Society, about one in six men will eventually have prostrate cancer. It is the second cancer killer of men, following lung cancer and approximately 32,000 victims die from it every year.

Every year in the United States, diagnosis reveals about 220,000 new prostate cancer cases. This is due mainly to the widely used PSA tests that are able to detect the disease in its early stages. However, the cancers develop slowly and for the majority of patients, are unlikely to create symptoms that affect their lives.

The rate, at which the tumors are likely to progress, is accurate between 60 to 70 percent of the time. This is when predicted by conventional methods, based in part by viewing the cells under a microscope. This can result in many men undergoing aggressive surgery. As the radiation treatment provides little benefit, some delay or ignore other treatment that would help them

Indications are that studies showed 48 men with prostate cancer, received treatment with either surgery or radiation, with one death prevented from the disease. Furthermore, the new study suggested a test based on the four genes. This test when added to the current protocols of prediction could increase accuracy to about 90 percent.

In order to discover the genetic signature for aggressive prostrate cancer, researchers initially analyzed mice, lacking a gene called “PTEN”. Although the species develop cancer, it is generally of an indolent type that does not metastasize or spread to other parts of the body. Added gene studies, showed that the cancer related to “PTEN” became aggressive, after extinguishing the activity of another gene, SMAD4.

Two other genes were in turn regulated by SMAD4; one related to growth of the tumor, the other with movement. In the absence of SMAD4, both genes were active, producing proteins to promote the growth and spread of the cancer. A researcher said that the four genes are linked directly to the aggressive behavior of the cancers.

Another medical authority suggested that if it transpired that the new test would increase accuracy to 90 percent, it would have an impact. A possibility is that many men with a favorable profile may decide to monitor the progress of their cancer for a period, before undergoing aggressive medical treatment.

A caution was given that gene signatures, similarly proposed in the past, produced inconclusive results. However, the genes, which have been the subject of this research, appeared to have a functional role in the regulation of cancer development. Further, that additional research was necessary, to establish the value of the test for doctors and patients.

source: personalfinancebulletin.com

2011-02-04T02:30:00.000-08:00

With all the technological advancement, Cancer still remains one of the most dreaded disease till date. There are more than 12 types of Cancers out of which Leukemia, and breast Cancer have the maximum number of cases. The year 2009, however, saw the raise in the number of Prostate Cancer patients in the World. In 2009 alone, the number of Cancer patients were 29,000 and since then the number have been ever increasing.

Buzz up!
Prostate is the male reproductive organ and is located under the bladder, in front of the rectum. In case of this Cancer, the cancerous tissues develop on the Prostate. As the tumour increases in size, It pushes the uterus and pinches tighter, thus, creating urination problem and causes pain. Usually men within the age of 65-70 are at the risk of this cancer. In genetic cases, men can be infected below the age of 60.

Symptoms of Prostate Cancer -

1. As the cancer tissues directly affects the uterus, the fist and the major symptom of Prostate Cancer is urination trouble -

Frequency – One tends to urinate several time sin a day.
Urgency – One finds it difficult the urge to urinate.
Hesitancy – Interrupted urine stream.
Pain - Pain during urination is one of the first symptoms of prostate Cancer. The pain is often accompanied by irritation and burning sensation.

2.In more advanced stages, the patient may have blood in urine and seamen.
3.Problem in erection and painful ejaculation.
4.Swelling in the leg and bone and muscle pain.
5.Swelling of the lymph glands
6.As the cancer grows from one stage to another, it affects other organs like liver, lungs, chest and the respiratory organs.

Prostate Cancer Symptom Detection

Prostate Cancer Symptoms can now be detected before the occurrence of the symptoms. This is possible through screen test through Digital Rectal Exam (DRE). In this the doctor feels the prostate to check of an occurrence of a lump and also a blood test that detects a substance made by the prostate called prostate specific antigen. In the United States 90% of the men were detected of the cancer before the appearance of the symptoms of Prostate Cancer.

source: living.oneindia.in

Prostate cancer 'can be made to kill itself' by newly-found protein

2011-02-04T02:25:00.000-08:00

4 February, 2011 - Scientists have made a breakthrough in the battle against prostate cancer.

They have pinpointed a protein that stops cancerous cells from growing and even drives them to kill themselves.

A drug that boosts levels of the protein, called FUS, could stop the disease from spreading around the body, saving many of the 10,000 lives lost to the disease each year.

The research, at Imperial College London, could also help doctors more accurately distinguish the more common, slower-growing forms of the disease from the more aggressive, faster-growing types.

Such a test could save thousands of men from gruelling and unnecessary treatments.

Doctors currently use a variety of techniques, including blood tests, biopsies, microscopy and scans, to determine who are most at risk and how they should be treated.

But the results are not wholly reliable – meaning that many men are subjected to unnecessary surgery and radiotherapy, both of which carry a high risk of incontinence and impotence.

Now researchers at Imperial College have shown that FUS, which occurs naturally in cells, can stem the growth of prostate tumour cells in a dish – and trigger a series of reactions that leads to their death.

When they boosted the amount of FUS, more cells died, suggesting that a drug that boosts levels in patients could be of real benefit.

Dr Charlotte Bevan, the study’s senior author, said: ‘These findings suggest that FUS might be able to suppress tumour growth and stop it to spreading from other parts of the body where it can be deadly.

‘It’s early stages yet, but if further studies confirm these findings, then FUS might be a promising target for future therapies.

‘FUS slows the cancer cells right down when grown in controlled conditions. So ultimately what we hope is a cure will be somewhere down the line.’

FUS is also linked to the severity of the disease, with prostate cancer tending to be more severe in men with lower levels of the compound, the journal Cancer Research reports.

Researcher Greg Brooke described FUS as a ‘crucial link’ in the progression of the disease.

He added: The next step is to investigate whether FUS could be a useful test of how aggressive prostate cancer is. Then we might look for ways to boost FUS levels in patients to see if that would slow tumour growth or improve response to hormone therapy.

‘If FUS really is a tumour suppressor, it might also be involved in other cancers, such as breast cancer, which has significant similarities with prostate cancer.’

Dr Helen Rippon, of the Prostate Cancer Charity, which part-funded the study, said: ‘This provides us with an important clue.’

But she added: ‘It is important to remember that this is a laboratory study, looking at how prostate cancer cells respond in a lab rather than in the human body, meaning that it will still be some time before men affected by prostate cancer will see any direct benefit.’

Prostate cancer is the most common form of the disease among British men. Each year 36,000 men are diagnosed with the condition, which kills one man every hour.

source: www.dailymail.co.uk

Inovio Pharmaceuticals' preclinical study on prostate cancer vaccine published in medical journal

2011-02-04T02:22:00.000-08:00

February 04Inovio Pharmaceuticals (NYSE Amex: INO) said Wednesday that a scientific paper comprising the positive results of a preclinical study on the company's DNA vaccine for prostate cancer was published in a journal titled Human Vaccines., 2011 - DNA vaccination is a technique for protecting the body against disease by injecting it with genetically engineered DNA to produce an immune response, which then fights against potentially harmful invading cells, or antigens. DNA vaccines are considered to have many advantages over traditional vaccines, including the ability to induce a wider range of immune response types.

The company's SynCon DNA vaccine for prostate cancer targets two antigens, while current therapies for the disease target only single antigens. The study published in the journal tested the hypothesis that a broader collection of antigens, administered through Inovio's electroportation technology, would improve the effectiveness of the therapy in mice.

Indeed, the preclinical trial showed that just one week after a second vaccination, the mice demonstrated potent immune responses.

Currently, therapies for prostate cancer, which include radiation, hormone deprivation and surgery, have many side effects and often do not provide for a long term cure. Across the US alone, there were 218,000 new cases of prostate cancer and more than 32,000 deaths in 2010.

"This is an important study in which the first SynCon DNA vaccine against a cancer target was successfully tested," said president and CEO Dr. J. Joseph Kim.

"This immunotherapy targeting more than a single antigen as a treatment for prostate cancer generated strong antibody and T-cell immune responses, which are considered vital to addressing prostate cancer.

"Taken together with the previous preclinical and clinical data, the current published results support the advancement of this product into a Phase I clinical study."

Aside from the company's vaccine for prostate cancer, it is also working on such therapies for cervical cancer, HIV and avian flu.

Inovio rallied more than 4.6% on Wednesday morning to trade at $1.35 as of 10:56am EST.

source: www.proactiveinvestors.com

Prostate Cancer in Men Over 70 More Aggressive

2011-02-04T02:19:00.000-08:00

January 31, 2011 - As men age, parameters that are consistent with more aggressive prostate cancer become prevalent, according to research published in the January issue of The Journal of Urology.

MONDAY, Jan. 31 (HealthDay News) -- As men age, parameters that are consistent with more aggressive prostate cancer become prevalent, according to research published in the January issue of The Journal of Urology.

Stephen A. Brassell, M.D., of the Walter Reed Army Medical Center in Washington, D.C., and colleagues analyzed data from 12,081 men in the Center for Prostate Disease Research database. Patient clinicopathological features and outcomes were analyzed.

The researchers found that men 70 years or older (30.2 percent) had a higher clinical stage, biopsy grade, and prediagnosis prostate-specific antigen velocity. For patients of this age group who underwent prostatectomy, pathological stage, grade, and surgical margin status were all significantly increased compared with younger men. Men aged 70 or older had a 1.45-fold greater hazard risk of biochemical recurrence following prostatectomy. Overall survival was lowest for men of this age group who underwent surgery.

"Clinicopathological features of prostate cancer appear to be more aggressive as one ages. We found that men 70 years old or older had worse outcomes with respect to biochemical recurrence-free, prostate cancer specific and overall survival. Implications for screening and treatment recommendations are yet to be defined," the authors write.

One of the study authors disclosed financial relationships with GlaxoSmithKline and AstraZeneca.

source: www.doctorslounge.com

'Sunshine vitamin' helps beat cancer

2010-08-16T05:33:00.000-07:00

Milk fortified with vitamin D can make our bones not only stronger but also prevent heart disease and cancer, a new study says.

In colder countries with poor or erratic sunshine, half the population is likely to be low in the 'sunshine vitamin'.

The vitamin is vital for calcium absorption and bone health and may help to prevent Alzheimer's, reports the Daily Mail.

Vitamin D-rich foods include oily fish and eggs but with 90 percent coming from the action of sunlight on the skin there are concerns that advice on abstaining from sunbathing is unnecessarily restrictive.

Recent research has shown that vitamin D supplements are as good as some drugs at keeping prostate cancer under control.

It is also being said that taking vitamin D supplements in pregnancy and childhood could wipe out 80 percent of cases of multiple sclerosis.

Susan Lanham-New, the member of the Scientific Advisory Committee on Nutrition and Surrey University nutritionist, said a study of 14,000 pregnant women in Bristol during the 1990s found that more than 90 percent of them were not getting enough of the vitamin.

She said: "Vitamin D is known to be vital for a wide range of body functions. A lot of us are very worried about (deficiencies) and think it needs looking at."

Read more: 'Sunshine vitamin' helps beat cancer - Health - Health & Fitness - Life & Style - The Times of India http://timesofindia.indiatimes.com/life-style/health-fitness/health/Sunshine-vitamin-helps-beat-cancer/articleshow/6319066.cms#ixzz0wlufRj9D
source: timesofindia.indiatimes.com

Prostate cancer treatment sex truths played down: conference

2010-08-16T05:31:00.000-07:00

Many doctors play down the possible side effects of prostate cancer treatment on men's sex lives, for fear they'll be scared off, a world leader in the field has told an international conference on the Gold Coast.

Professor Peter Scardino from the Memorial Sloan-Kettering Cancer Centre in New York says while doctors mention the possibility of sex problems they often tend to gloss over them.

"When a man's initially diagnosed with prostate cancer, particularly if he's sexually active, his concerns about his sexual wellbeing tend to dominate his rational assessment of the risk of the cancer," he said.

"Since all the treatments for prostate cancer can have an adverse affect on sexual function, doctors tend to be reluctant to overly describe the possibilities because patients can get very much afraid of treatment.

"There has been a bit of a tradition in the field of minimising the side effects and quoting only the best possible results, or talking about partial sexual function as thought it's full sexual function."

Director of the Sloan-Kettering centre's sexual and reproductive medicine program Dr John Mulhall says GPs have a responsibility to educate their patients.

"It's surprising to me how many men I see after radical prostate surgery who are unaware they will not ejaculate again," he said.

"While some doctors don't mention this there are some patients who are so stressed before surgery they simply forget what they've been told."

Dr Rosie King from the Sydney Centre for Sexual Relationship Therapy says many men find themselves facing a menage a trois of taboos when they try to find out what they're facing.

"You've got a triple whammy going here because you've got one unspeakable and that's the Big C because people are very uncomfortable talking about cancer.

"There's the issue of death, which is another taboo conversation topic, and added to that is the taboo of talking about sex, and these can be difficult for many men to talk about either with their health care professional or their partners."

Dr King said men need to remember that prostate cancer is very treatable and in many cases may not need any treatment at all.

"In some men who have a slow growing cancer the best course may be simply watchful waiting - monitoring the disease."

source: www.smh.com.au

Andrew Lloyd-Webber calls for prostate cancer screening

2010-08-01T19:35:00.000-07:00

The composer was given the all-clear from the disease this year following treatment.

Lord Lloyd-Webber, a Conservative peer, said at question time on 19 July 2010 in the House of Lords: "The Prostate UK charity reckons that 10,000 men a year die needlessly not diagnosed with prostate cancer."

He said that while the prostate-specific antigen (PSA) test was "not wholly reliable" he believed that "all men over 50 should have the PSA test and GPs should be encouraged to encourage them to do so".

Andrew Lloyd-Webber has called for all men over the age of 50 to have a test for prostate cancer.
Shadow Lords leader Baroness Royall of Blaisdon, whose husband Stuart Hercock died of prostate cancer aged 62 during the general election campaign, warned that too many GPs "were not vigilant enough and they don't recognise the symptoms".

Labour peer Lord Winston, a doctor noted for his television appearances, warned: "One of the problems with the PSA test is that there are a vast number of false positives which would mean that a number of people would get mutilating treatment or the risk of mutilating treatment."

In reply to Lord Lloyd-Webber, Health Minister Earl Howe said that last year the Department of Health had written to two primary care trusts "to remind them that any man without symptoms of prostate cancer who wishes to have a PSA test is entitled to have one".

But he added: "It is important that anyone availing of the test does so on a fully informed basis because the test is unreliable and can lead to unpleasant side effects."

Peers also asked the government questions on peerages for representatives from the nursing profession, the Independent Commission on Youth Crime and Antisocial Behaviour, and the EU.

source:

Epidemiologist suggests discouraging PSA testing

2009-06-06T07:10:00.000-07:00

Virginia McMillan
vmcmillan@clear.net.nz

DAILY NEWS: PSA testing may need to be discouraged, an epidemiologist says [image: RCPA]

Epidemiologist Brian Cox is not only promoting caution around PSA screening but also suggests such testing should be discouraged.

Dr Cox says population screening for prostate cancer would be unwise, and suggests PSA (prostate-specific antigen) testing on asymptomatic men should be specialist-ordered only.

Director of the Hugh Adam Cancer Epidemiology unit at Otago University, Dr Cox was commenting on an editorial he wrote with colleague Mary Jane Sneyd in today’s New Zealand Medical Journal.

Dr Cox acknowledges high public concern about prostate cancer and widespread belief that early detection must be good.

Patients being ‘sold a pup’

“If you have had prostate cancer detected and treated, you will naturally believe your life has been saved. But 50 per cent of these people have been ‘sold a pup’,” he says.

The problem is, “we don’t know which 50 per cent”.

Thirty per cent of men aged over 50 have a small tumour in the prostate gland. Under a microscope, these tumours are indistinguishable from cancer but, Dr Cox says, “the vast majority” will never cause symptoms, and may or may not grow.

He also says 50 per cent of men diagnosed via the PSA test would never experience symptoms if left untreated.

Benefits small, if any

Having analysed the two major controlled trials reported in the US and Europe recently, he has concluded that at present, the benefits of PSA testing in asymptomatic men are small, “if they exist at all”.

Even if the at-best 20 per cent mortality reduction suggested by the European randomised study is correct, there are still “major issues” in the harm of over-diagnosis and over-treatment, Dr Cox says.

It’s estimated that 12 to 14 per cent of men who undergo radical prostatectomy develop incontinence and 5 per cent become impotent; 3 to 4 per cent of those undergoing radiotherapy become faecally incontinent and 5 to 10 per cent, impotent.

Screening not only leads to treatment of well men who have no symptoms, it also soaks up resources that could be used on others in the health system, Dr Cox points out.

Although he anticipates opposition to the idea of specialist-ordered PSA tests for asymptomatic men, Dr Cox says it should be considered.

“That’s the only technical way I can see this being manageable.”

Live in the real world

But Peter Foley, chair of the NZMA, says doctors must live in the real world, and public expectations have already been created.

Most men will interact with their GP and he considers this the right place for working through the information on, and uncertainties around, prostate cancer.

Some may decide against getting a PSA test, he says.

Not enough education

Jim Tucker, who blogs about his own prostate surgery and prostate cancer issues says resources must be provided for a public education campaign.

Men often don’t recognise symptoms and need to be encouraged to talk to their doctors about whether tests (PSA and digital) are advisable in their individual case, he says.

The idea of discouraging PSA tests is “extraordinary”, says Mr Tucker.

Minister considering blogger’s letter

He has written to health minister Tony Ryall asking what the Government will do to bring down prostate cancer rates, noted by Mr Ryall earlier this year as a priority.

Jackie Maher, of the minister’s office, says only that the matter is “under consideration”.

Mr Tucker says he was advised of an update to be issued by the health ministry next week.

“There is no imminent announcement on prostate screening,” a ministry spokesperson told New Zealand Doctor today.
source: www.nzdoctor.co.nz

Gene Test May Predict Prostate Cancer Study Shows Experimental Blood Test May Be More Accurate Than PSA Test

2009-06-06T07:05:00.000-07:00

By Charlene Laino
WebMD Health News
Reviewed by Louise Chang, MD

June 2, 2009 (Orlando, Fla.) -- A blood test that characterizes each prostate tumor by its unique genetic fingerprint may help pinpoint which men actually have prostate cancer, researchers say.

In a new study, the powerful genetic tool beat out standard PSA testing in discriminating between men who had cancer and those who did not, says Robert Ross, MD, of the Dana-Farber Cancer Institute in Boston.

PSA levels are a measure of a protein called prostate-specific antigen, which is produced by cells in the prostate. High PSA levels can signal cancer.

The new test, which looks at the activity of six genes involved in prostate cancer, was described at the annual meeting of the American Society of Clinical Oncology.

Men whose PSA levels signal a high chance of prostate cancer typically undergo a biopsy, but 60% of these biopsies turn out to be negative, Ross says.

"Each year in the U.S., over 1 million men undergo the anxiety and pain of prostate biopsies at a considerable psychological cost," he tells WebMD.

The hope is that a new genetic test can help men avoid the pain, discomfort, and anxiety of unnecessary biopsies, Ross says.
Six-Gene Test for Prostate Cancer

For the study, which employed a commercially available gene chip, the researchers started with a set of 392 genes that had been associated with cancer.

Using blood samples from 76 men with prostate cancer and 76 healthy men, the researchers homed in on six genes whose activity was significantly associated with prostate cancer. The technique was then validated on blood samples from 128 men with prostate cancer and 84 who didn't have the disease.

"We found that the six-gene test correctly classified 86% of men with the disease," Ross says. In contrast, PSA testing was correct only 70% of the time.

When the gene test and PSA were used in combination, researched achieved the best results of all.

The results are a "significant improvement" over PSA alone, Ross says.

The next step will be to see if the gene test correctly predicts biopsy results in a 1,000-patient study.

Howard Sandler, MD, a prostate cancer specialist at Cedars-Sinai Medical Center in Los Angeles, tells WebMD that PSA testing "is incredibly valuable" for prostate cancer screening.

The gene screen "could be another test that helps to improve early prostate cancer detection," he says.

"But the problem with all these tests is their inability to answer the question we really want to know: Do you have potentially lethal cancer or do you have cancer that will never kill you?" Sandler says.

Sandler is referring to the fact that many prostate tumors grow so slowly that some men are likely to die from other causes long before the tumor itself becomes deadly.

Ross says the test may be able to distinguish between slow and faster growing cancers, but that further testing is needed before that claim can be made.

The study was supported in part by Source MDx, which developed the new test.
source: www.webmd.com

Finasteride Recommended to Prevent Prostate Cancer

2009-06-06T06:59:00.000-07:00

Men may benefit from taking Proscar (finasteride), a drug that can reduce their risk of getting prostate cancer, according to new guidelines issued in February by the American Society of Clinical Oncology and the American Urological Association.

“The recommendation is long overdue,” says Eric Klein, MD, chair of the Glickman Urological and Kidney Institute and professor of surgery at Cleveland Clinic Lerner College of Medicine. “We have the highest level of scientific evidence; a phase III randomized control blinded trial that shows finasteride reduces the risk of prostate cancer by 25 percent.”

The new guidelines are based on the latest information emerging from the Prostate Cancer Prevention Trial (PCPT), a study of 18,882 healthy men ages 55 and older that was originally published in 2003. While the PCPT initially reported a 25 percent risk reduction of prostate cancer in men who received 5 milligrams daily of finasteride as compared to the placebo group, it also showed that of the men in the finasteride group who developed prostate cancer, their tumors were more likely to be high-grade.

“As part of the trial findings, it appeared as though some of the men who were diagnosed with prostate cancer actually had worse prostate cancer than expected, and it was worse than in the placebo group,” says Oliver Sartor, MD, professor of cancer research in the department of medicine and urology at Tulane Medical School in New Orleans. “This was a bit of a paradox—that there was an improvement in the overall cancer diagnosis rate but a worsening of some of the cancers in the finasteride-treated group.”

It was previously thought the drug itself was possibly causing the high-grade cancer. But this past year, researchers analyzed biopsy results from PCPT participants and found that the high-grade cancer was simply more detectable in men who took finasteride because the drug shrinks the prostate, making the cancer more visible.

Klein adds, “The secondary analyses show the concern over this drug causing high-grade cancer is not a biologic phenomenon but is related to the fact that it is easier to find high-grade cancer in men on finasteride. Men should not have any hesitation about that issue anymore.”

Finasteride is part of a class of medications called 5-alpha reductase inhibitors (5-ARIs), drugs that work by blocking the production of a hormone that causes the prostate to enlarge. Avodart (dutasteride), another 5-ARI, was recently found to reduce the risk of prostate cancer by 23 percent in men with elevated PSA levels (2.5 to 10 ng/ml) in an international trial entitled Reduction by Dutasteride of Prostate Cancer Events (REDUCE).

Finasteride is also used under the brand name Propecia to treat male pattern baldness and benign prostatic hypertrophy, or enlargement of the prostate gland. Side effects of finasteride include decreased libido, erectile dysfunction, ejaculatory dysfunction, and breast tenderness.

In regards to the side effects, “There was a companion quality of life study that looked at sexual function over the course of seven years in the men on the PCPT that showed, on a 100-point scale, a three point drop in sexual function score, which may be statistically significant but clinically meaningless,” Klein notes. “No one can reasonably argue there are too many side effects with this drug.”

Barnett Kramer, MD, MPH, lead researcher on the new study and associate director for disease prevention at the National Institutes of Health, notes the results of the data are “not thick enough to calculate a cost benefit analysis” yet. However, he called a local pharmacy in Bethesda, Maryland, that estimated the cost of one pill of finasteride around $3, which adds up to $90 a month or $1,080 a year. Kramer says he did not know if insurance would cover the drug since individual health insurance plans vary.

“This still leaves some remaining questions,” Kramer says. “We do not know the impact of 5-ARIs or finasteride on prostate cancer mortality. We also don’t know if we can use lower doses that would lower the risk, and finally, all we know is the efficacy on men being screened for prostate cancer. We cannot see confidence of its effects in men who choose not to be screened.” Researchers hope to continue follow-up studies on PCPT participants.

Sartor says it is important to note how the AUA and ASCO worded the new recommendation. “It’s not a recommendation that people should be on finasteride or not on it. It’s something you should discuss with your physician if you are interested in prostate cancer prevention,” he says.

source: www.curetoday.com

AUA 2009 - The Obstructed Bladder after External Radiation Therapy (XRT) - SUFU Meeting - Session Highlights

2009-06-06T06:53:00.000-07:00

CHICAGO, IL, USA (UroToday.com) - Dr. Timothy Boone presented on the obstructed bladder following radiation therapy for prostate cancer. He noted that most men develop urinary retention after external beam radiation therapy (EBRT), after brachytherapy with or without EBRT, and in those who have a combination of EBRT and a RRP. Some of the later develop refractory BNCs. Dr. Boone felt the experience of the person doing brachytherapy affects the incidence of acute urinary retention (AUR) which may be the results of a “learning curve.” He quoted 2 authors who have published their AUR numbers: Keyes, et.al.1 reported overall AUR (n=805) was 12.7%, and prolonged urinary obstruction incidence (> 20 days) was 5%.

He quoted Dr. Landis from the University of Washington who felt that the risk of UR and long-term urinary dysfunction is probably multifactorial and only crudely defined by known clinical variables. But overall, 30 – 50% of men develop “acute” retention symptoms. Bladder outlet obstruction (BOO) beyond 3 months occurs in 2-15% of men who require TURP/dilation.2

Dr. Boone reviewed two large retrospective studies of brachytherapy:

Kollmeier, et al.3, reported on 38 out of 2,050 men (2%) who underwent minimal (channel) TURP due to urinary symptoms or retention.

Chen, et al.4, reported on Medicare claims data from 1991- 1996 that included 5,621 men and indicated that 30% developed BOO within 2 years, with 10% requiring surgery.

Risk factors for developing symptomatic UR following brachytherapy have been identified by Keyes et al and include: older age, use of androgen suppression, large prostate volume (>40 -50 cc), high IPSS (>16) pre-brachy, EBRT before or after, previous TURP and PVR<>3 months) include permanent Urolume Wallstent and there are dissolvable PGA stents for temporary use. Another option is the Mitrofanoff to native bladder or diversion. Dr. Boone concluded that most early BOO occurs following brachytherapy with or without XBRT and that prevention is probably the best medicine. Limited TURP can be successful in many cases but these men have a higher risk of UI (up to 18%) and a higher risk of “non-healing” urothelium, strictures and dystrophic calcification with ongoing necrosis. And there is little published data on the use of Stents post-brachytherapy. But men with PPI and BNC can be successfully managed with a stent and AUS if carefully selected.

References:

1. Keyes M, Schellenberg D, Moravan V, McKenzie M, Agranovich A, Pickles T, Wu J, Liu M, Bucci J, Morris WJ. Decline in urinary retention incidence in 805 patients after prostate brachytherapy: the effect of learning curve? Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):825-34.
2. Landis, D.,Wallner K, Locke J, Ellis W, Russell K, Cavanagh W, Blasko J. Late urinary function after prostate brachytherapy. Brachytherapy. 2002;1(1):21-6.
3. Kollmeier MA, Stock RG, Cesaretti J, Stone NN. Urinary morbidity and incontinence following transurethral resection of the prostate after brachytherapy. J Urol. 2005 Mar;173(3):808-12.
4. Chen AB, D'Amico AV, Neville BA, Earle CC. Patient and treatment factors associated with complications after prostate brachytherapy. J Clin Oncol. 2006 Nov 20;24(33):5298-304.
5. Hu K, Wallner K. Urinary incontinence in patients who have a TURP/TUIP following prostate brachytherapy. Int J Radiat Oncol Biol Phys. 1998 Mar 1;40(4):783-6.
6. Kollmeier MA, Stock RG, Cesaretti J, Stone NN. Urinary morbidity and incontinence following transurethral resection of the prostate after brachytherapy. J Urol. 2005 Mar;173(3):808-12
7. Terk MD, Stock RG, Stone NN. Identification of patients at increased risk for prolonged urinary retention following radioactive seed implantation of the prostate. J Urol. 1998, Oct;160(4):1379-82.
8. Blaivas JG, Weiss JP, Jones M. The pathophysiology of lower urinary tract symptoms after brachytherapy for prostate cancer. BJU Int. 2006 Dec;98(6):1233-7

Presented by Timothy Boone, MD at the Annual Meeting of the American Urological Association (AUA) - April 25 - 30, 2009 - McCormick Place Convention Center - Chicago, Illinois, USA.

source: www.urotoday.com

Associations Between {Alpha}-Tocopherol, {Beta}-Carotene, and Retinol and Prostate Cancer Survival - Abstract

2009-06-06T06:43:00.000-07:00

Previous studies suggest that carotenoids and tocopherols (vitamin E compounds) may be inversely associated with prostate cancer risk, yet little is known about how they affect prostate cancer progression and survival. We investigated whether serum alpha-tocopherol, beta-carotene, and retinol concentrations, or the alpha-tocopherol and beta-carotene trial supplementation, affected survival of men diagnosed with prostate cancer during the alpha-Tocopherol, beta-Carotene Cancer Prevention Study, a randomized, double-blind, placebo-controlled primary prevention trial testing the effects of beta-carotene and alpha-tocopherol supplements on cancer incidence in adult male smokers in southwestern Finland (n = 29,133). Prostate cancer survival was examined using the Kaplan-Meier method with deaths from other causes treated as censoring, and using Cox proportional hazards regression models with hazard ratios (HR) and 95% confidence intervals (CI) adjusted for family history of prostate cancer, age at randomization, benign prostatic hyperplasia, age and stage at diagnosis, height, body mass index, and serum cholesterol. As of April 2005, 1,891 men were diagnosed with prostate cancer and 395 died of their disease. Higher serum alpha-tocopherol at baseline was associated with improved prostate cancer survival (HR, 0.67; 95% CI, 0.45-1.00), especially among cases who had received the alpha-tocopherol intervention of the trial and who were in the highest quintile of alpha-tocopherol at baseline (HR, 0.51; 95% CI, 0.20-0.90) or at the 3-year follow-up measurement (HR, 0.26; 95% CI, 0.09-0.71). Serum beta-carotene, serum retinol, and supplemental beta-carotene had no apparent effects on survival. These findings suggest that higher alpha-tocopherol (and not beta-carotene or retinol) status increases overall prostate cancer survival. Further investigations, possibly including randomized studies, are needed to confirm this observation.

Written by:
Watters JL, Gail MH, Weinstein SJ, Virtamo J, Albanes D
source: www.urotoday.com

Fighting prostate cancer

2007-12-26T08:19:00.000-08:00

By: Lena Butler

A guide on how to prevent, detect and survive prostate cancer.

Prostate cancer claims its turf silently. The tumor grows in the prostate gland discreetly without any obvious symptoms until an advanced stage of growth is reached. The symptoms that do show up at this stage are too mellow to be associated with something as serious as cancer, and men usually ignore them attributing them simply to signs of advancing age.

Any man will get Prostate Cancer if he lives long enough. How come? 70% of all men above 90 have a tumor of some kind in his prostate gland. Nobody is immune to this deadly cancer. The only means of protection is to know it in and out and to detect it early on.

Billions have been spent on researching Prostate Cancer and none of that has resulted in a solid conclusion as to how it is caused although some factors that influence its formation have been identified conclusively. For instance, the age of a person affects the probability of cancer considerably. The older you are the higher is your chance of having prostate cancer. Men of African-American descent are genetically predisposed towards prostate cancer, and so are men who habitually consume a diet rich in fat and predictably so.

It is quite possible to detect prostate cancer before it reaches an advanced stage through one of the various tests that are available. The most rudimentary of them all is the rectal analysis which is conducted to determine whether there is an enlargement of the prostate gland. The DRE, as it is referred to, is the ingenuous process of inserting a gloved and lubricated finger into the back passage to actually feel the prostate gland to determine its size. Ultrasound test, a more refined version of this test, is performed by inserting an ultrasound probe instead of the customary finger of the rectal analysis. Another noteworthy procedure that joins this league is the biopsy where small cylindrical tissue cores are extracted from the prostate gland itself by the use of a probe with a special spring loaded needle. These samples are then analyzed under a microscope to detect instances of cancerous growth.

Although these tests sound macabre and intimidating, there is a blood test that could determine Prostate Cancer. The PSA test (Prostate Specific Antigen test) is performed by extracting a blood sample from the patient and analyzing this sample for abnormally high levels of a particular antigen produced in the prostate gland, high levels of which are a telltale sign of Prostate Cancer.

When prostate cancer is detected early on, there is a very high probability of achieving a complete cure without a possibility of recurrence. Early detection of Prostate Cancer is the key to a successful cure since for a case where the tumor growth has advanced to the bones; even surgery simply fails to cut it, literally.

Source: http://www.ArticleBiz.com

What to do For Enlarged Prostate or for Prostate Cancer

2007-12-06T09:13:00.000-08:00

by: Rudy Silva

By age of 50, most men will already have an enlarged prostate and three of these men will have cancer cells forming in their prostate. Prostate cancer is the main cancer found in men and by age 75 three out of four men will have prostate cancer.

The facts are pretty clear, if you are a male you will have to deal with BPH, enlarged prostate, or prostate cancer.

So how do you know if you have BPH or prostate cancer? Well, here are a few of the symptoms:

" getting up at night to urinate
" having difficulty urinating
" not completely emptying your bladder
" having pain during sex
" having pain when urinating

Medical test that you can get for enlarged prostate or prostate cancer.

" PSA, prostate specific antigen, which gives a good indication of your prostate health
" PAP, prostate acid phosphatase, a test that is more accurate than PSA, but many doctors don't use it or are unfamiliar with it.
" Sonogram is a safe and accurate way to check your prostate
" MRI, magnetic resonance imaging, is also accurate but is the most expensive test.

There is other tests that doctors like to make and that is,

Biopsy of the prostate - Don't have it done. It's very harmful to the prostate and should never be done.

The ideal way to take care of prostate health issues is to change or improve you diet and lifestyle. Here are some area that you need to look at to make changes.

" diet
" supplement
" fasting
" hormone balancing
" eliminate addictive substances - smoking, alcohol, coffee, non-herbal tea)
" exercise
" stress, anxiety, and emotional issues

The first thing you need to do is start using a supplement that will start to heal your prostate condition. Then you need to change your diet. Here I will tell which supplement to buy immediately and in another article I will outline a good diet to follow.

Go out and immediately but a supplement that contains Beta-sitosterol. You will find beta-sitosterol in saw palmetto and pygeum africanum, but these herbal plants have very little beta-sitosterol. This make them useless for prostate health. You need 325 to 610 mg per day and these herbal products 30 mg or less.

A good beta-sitosterol to buy is the NSI Phytosterol Complex with Beta-sitosterol -- 240 Tablets. This is only $20.00 plus shipping.

You will find this product contains the following ingredients:

Betasitosterol
Stigmasterol
Campesterol
Brassicasterol

All of these chemicals are called Phytosterol, which are consider the fat inside a plant. These sterols have an anti-inflammatory property and help to buildup your immune system. They have been found effective in reducing the inflammation of the prostate, BPH, lowering cholesterol, and aiding in many other illnesses.

Take the first step in keeping a health prostate and avoid having to deal with enlarged prostate or prostate cancer. Look for more of my articles on prostate health.

Source: http://www.articlecity.com/

'It's not always prostate cancer.'

2007-12-02T09:06:00.000-08:00

by Brian A. Stone

Medical experts, such as Dr. Brian A. Stone, say African-American men are exceedingly vulnerable to prostate cancer, but that symptoms usually associated with the disease can also be associated with other conditions.

Just in case you didn't know, prostate cancer remains the most commonly diagnosed cancer in American men. Over 200,000 cases are diagnosed and almost 30,000 men die from this disease annually. The bad news is that men of African descent in America die from prostate cancer three times the rate of Caucasians. Prostate cancer is typically a silent invader. The majority of cases are detected based on an abnormal blood test called PSA (prostate specific antigen). The normal range for PSA in a man between 40 and 60 years of age is 0 to 2.5. When this test is elevated, the diagnosis of prostate cancer is made based on a biopsy of the gland. Some patients with prostate cancer develop problems with urination--frequency, waking at night to urinate, a weak flow, severe urgency, hesitation of flow, incomplete emptying, deviated stream and difficulty postponing urination.

The good news is that there are other non-cancerous conditions that can affect the prostate and cause the same symptoms as prostate cancer. The prostate gland is a small, chestnut shaped organ, found only in the male. It is located beneath the bladder and acts as a conduit through which urine flows. The prostate is a part of the urethra, which is the tube that passes from the bladder to the penis. Conditions that affect the urethra can also cause symptoms that can be seen in prostate cancer.

Source: http://findarticles.com/

Laparoscopic Radical Prostatectomy: The surgery for prostate cancer

2007-11-06T08:13:00.000-08:00

By: Charleston C

The surgery for prostate cancer or any other prostate disorder is called radical prostatectomy. In this process of surgery the prostate gland is cut out along with the lymph nodes and seminal vesicles. Surgery is the most applicable treatment to remove the tumor or the prostate gland so that it doesn't spread more cancer cells to the surrounding cells.

The surgery done in laparoscopic mode is called laparoscopic radical prostatectomy. It's nothing different from the radical surgery, the only difference is that the surgery is carried out in laparoscopic technique to remove the prostate and the associated gland in cancerous states.

What is laparoscopic surgery? Laproscopic surgery is a modern form of surgery that is carried out with very small incisions. In this procedure of surgery the doctor is guided by a lens connected to a video camera that gives the accurate image of the organ to be operated. And the radical prostatectomy done by laparoscopy method is called laparoscopic radical prostatectomy.

In this type of surgery, small incision is made in the perineum region and the laproscope along with the required instruments to carry out the surgery is inserted. The telescopic view makes the image of the organ much larger on the screen and the doctors find it very easier to carry out the operation. There are some advantages of this surgery than open radical prostatectomy. These include:

- It takes less time to operate thus the person has to remain under anesthesia for shorter duration. Less blood flows out through smaller incisions. So, in very rare cases, blood transfusion is required if the person is having anemia.

- Smaller incision means very less pain and quick recovery.

- Less medications for post operative pain and other healing.

- And the most important is 'nerve-sparing procedure' that preserves the normal urinary routine and libido.

The surgery removes the complete cancer cells effectively.

Source: http://www.ArticleBiz.com

The Breakthrough for prostate cancer: HIFU

2007-09-26T08:08:00.000-07:00

By: Varina Andrews

There are numerous treatments for prostate cancer and each has its own benefits and drawbacks. Patients and their prostate specialist must weigh many factors when determining the best treatment option. Age, Gleason score (measure of aggressiveness), PSA, lifestyle and quality of life issues all play a very important part in the equation of finding the optimal treatment. HIFU treatment, which is short for High Intensity Focused Ultrasound, is a state-of-the-art technology acoustic ablation technique that utilizes the power of ultrasound to destroy deep-seated tissue with pinpoint accuracy for treatment of prostate cancer. HIFU focuses sound waves in a targeted area which rapidly increases the temperature in the focal zone causing tissue destruction.

The control and precision of HIFU treatment reduces the risk of common side effects such as impotence and incontinence.

HIFU is a 1-3 hour, one-time procedure preformed on an out-patient basis under spinal or epidural anesthesia. Unlike radiation, HIFU is non-ionizing so it can be repeated if necessary without damaging healthy tissue. This means that HIFU can also be used as a salvage technique if other prostate cancer treatments fail.

HIFU Treatment Information

An overview of what patients may expect during each phase of HIFU treatment - should you have any specific questions regarding treatment, please visit www.drlotenfoe.com.

Before HIFU Treatment The night before your HIFU procedure, you will be given two enemas that are administered 2 hours prior to the procedure. It is very important that you do not move during the HIFU procedure, therefore, after arriving at the treatment facility, you will be given an epidural (spinal) anesthesia that will numb you from the waist down. You will also be given light intravenous sedation.

During HIFU Treatment The patient experiences no pain during treatment. A small probe that emits ultrasound waves directly to the prostatic tissue, is inserted into the rectum. First, the prostate specialist captures real-time images of the prostate and the surrounding area. Treatment time varies depending on the size of the prostate, but generally lasts one to three hours. You may experience swelling in the abdomen as a result of the destruction of tissue, therefore a catheter is inserted and is typically worn for 2-3 weeks to make sure that the bladder can empty properly as your body heals. Most patients are able to resume a normal diet and lifestyle almost immediately. No hospital stay is required and the procedure involves no incision and no scalpel.

After HIFU Treatment Immediately after HIFU there is a one to two hour recovery period at the treatment facility and then you are discharged to recover comfortably at your hotel. Your prostate specialist will prescribe some antibiotics and other medications for after HIFU, but most people don’t experience any pain after the procedure. You may experience some discomfort or body aches which is normal and is temporary. Additionally, in the first one to two weeks after HIFU, you may experience very mild urinary symptoms such as frequency and/or urgency to void (the compelling urge to urinate, along with discomfort in your bladder), which are also normal and temporary.

Source: http://www.ArticleBiz.com

Prostate Examinations Could Quickly And Easily Spot Prostate Problems

2007-09-16T08:03:00.000-07:00

By: Donald Saunders

A lot of men will experience some type of prostate problem with nearly half of all men having benign prostatic hyperplasia (a swollen or enlarged prostate gland) by the time they reach the age of 60 and about ninety percent getting the problem before they reach 80.

Benign prostatic hyperplasia is a benign or non-cancerous swelling of the prostate gland and can normally be treated using drugs or with minor minimally invasive surgery. The first step however is to ensure that the problem is benign prostatic hyperplasia and that the symptoms are not being caused by another problem, such as difficulties with the kidneys or bladder or an infection of the urinary tract.

At the same time as checking for a swollen prostate gland it is imperative to also check for the presence of prostate cancer as, despite the fact that a swollen prostate gland does not produce prostate cancer, it is possible for a swollen prostate gland and prostate cancer to exist alongside each other.

Testing normally involves a prostate exam, or digital rectal exam, along with an assessment of the patient's symptoms and medical history. As the prostate gland lies between the rectum and the bladder it is an easy matter for a doctor or nurse to put a gloved and lubricated finger into the rectum while the patient lies on his side to examine the prostate gland for signs of swelling or irregularities. A prostate exam is not perhaps the most agreeable experience but is more embarrassing than painful.

It is also feasible for you to do your own prostate exam or for your partner to carry this out for you. Indeed, a growing number of men find that this reasonably simple examination may be done quite easily once a month or so while having a shower. This examination provides considerable peace of mind and can also allow any enlargement to be found at a very early stage so that it can be treated.

Your doctor may also order a number of laboratory tests at this point. These tests may include a blood test to check PSA levels, blood urea nitrogen and creatinine together with a urine test.

PSA is found in the blood and is produced by the prostate gland with levels increasing a bit in response to benign prostatic hyperplasia and quite markedly in the case of prostate cancer.

The other tests are designed to look for the existence of an infection of the urinary tract or difficulties with the kidneys, both of which can lead to symptoms which are similar to the symptoms experienced in cases of a swollen prostate.

In some cases the doctor may also order additional tests such as an ultrasound examination to determine the size of the prostate gland and measure the volume of urine in the bladder, or a cystoscopy (an exam making use of a thin and flexible scope) to evaluate the condition of the urethra and bladder.

When none of these tests produce clear results a doctor may order a prostate biopsy in which a number of tiny samples of tissue are taken from the prostate gland for microscopic examination.

Source: http://www.ArticleBiz.com

HIFU : Prostate Cancer’s Breakthrough

2007-09-06T07:54:00.000-07:00

By: Varna Andrews

Cancer is a frightening word. But prostate cancer doesn’t mean the end.
There is a breakthrough that is giving men diagnosed with prostate cancer their lives back, and next to painlessly!

When I was diagnosed with Prostate cancer in 2002, I honestly felt that my world was rapidly coming to an end. Fortunately, I discovered HIFU. My roommate at the Indiana University Hospital had undergone a standard prostatectomy two days before me…and was in considerable pain…while I was walking laps around the perimeter of the 6th floor within four hours of regaining consciousness! My progress has been steadily upward ever since. Thank you for giving me my life back!"

Norman
West Chester, Ohio

What is HIFU treatment?
HIFU treatment, which is short for High Intensity Focused Ultrasound, is a state-of-the-art technology acoustic ablation technique that utilizes the power of ultrasound to destroy deep-seated tissue with pinpoint accuracy for treatment of prostate cancer. HIFU focuses sound waves in a targeted area which rapidly increases the temperature in the focal zone causing tissue destruction.

The control and precision of HIFU treatment reduces the risk of common side effects such as impotence and incontinence.

HIFU is a 1-3 hour, one-time procedure preformed on an out-patient basis under spinal or epidural anesthesia. Unlike radiation, HIFU is non-ionizing so it can be repeated if necessary without damaging healthy tissue! This means that HIFU can also be used as a salvage technique if other prostate cancer treatments fail.

What is the HIFU treatment like?
It is very important that you do not move during the HIFU procedure, therefore, after arriving at the treatment facility, you will be given an epidural anesthesia that will numb you from the waist down. You will also be given light intravenous sedation.

During HIFU treatment, the prostate specialist uses continuously updated real-time images of the prostate to map out and execute the entire treatment plan. These images show treatment progression and permit the prostate specialist to customize treatment for maximum safety and effectiveness.

The patient experiences no pain during treatment! A small probe that emits ultrasound waves directly to the prostatic tissue is inserted into the rectum. First, the prostate specialist captures real-time images of the prostate and the surrounding area. Treatment time varies depending on the size of the prostate, but generally lasts one to three hours. You may experience swelling in the abdomen as a result of the destruction of tissue, therefore a catheter is inserted and is typically worn for 2-3 weeks to make sure that the bladder can empty properly as your body heals. Most patients are able to resume a normal diet and lifestyle almost immediately! No hospital stay is required and the procedure involves no incision and no scalpel.

Immediately after HIFU there is a one to two hour recovery period at the treatment facility and then you are discharged to recover comfortably at your hotel. Your prostate specialist will prescribe some antibiotics and other medications for after HIFU, but most people don’t experience any pain after the procedure. You may experience some discomfort or body aches which is normal and is temporary. Additionally, in the first one to two weeks after HIFU, you may experience very mild urinary symptoms such as frequency and/or urgency to void, which are also normal and temporary.

What are the benefits of HIFU?
•HIFU is "clean" energy; there is no radiation exposure to the patient, so there is no risk for weakening or damaging of cells and tissue surrounding the prostate.
•HIFU is non-surgical; therefore there is minimal blood loss and it is less invasive than other treatments for Prostate cancer.
•HIFU treatment is preformed under spinal anesthesia, thus eliminating risk associated with general anesthesia.
•It is an out-patient procedure; no overnight hospital stay is required.
•HIFU can be repeated, if necessary.
•After HIFU treatment, if needed, patients may pursue other treatment options.
•HIFU can be used as a salvage treatment for local prostate cancer recurrence.
• Studies show that HIFU preserves patient quality of life by minimizing side effects such as impotence and incontinence.

for more information, visit www.drlotenfoe.com
Source: http://www.ArticleBiz.com

Pre-surgical Preparation and its Effect on Recovery After Prostate Cancer Surgery

2007-09-02T07:46:00.000-07:00

By: Matt Murren

Even though the prostate is notoriously difficult to remove, there are some things you can do beforehand to speed up recovery after prostate cancer surgery. Over the years, doctors have come to recommend these preparations more and more. If your doctor does not discuss these things with you, it is still important to ask about them.

For many years, meditation has been considered the arena of quacks and charlatans. Nevertheless, new studies reveal that the ability to relax plays a crucial role in speeding up recovery after prostate cancer surgery. In addition, patients that learn to focus also develop the ability to manage their pain more effectively. This is especially important in assisting with recovery after prostate cancer, as well as from the procedure itself.

Along with fears of the blood banks harboring contaminated blood, there is also an overall growing shortage of blood available for transfusion. As small and unimportant as the prostate is in the overall scheme of things, a great deal of blood may be lost during the surgery. If you have two pints of blood drawn prior to the procedure, you will effectively be donating to yourself. This will make it much easier for your body to adapt to the new blood, and thus speed up recovery after prostate cancer surgery.

As may be expected, your health condition prior to undergoing surgery will either help or hinder your recovery after prostate cancer surgery. While you may not have enough time to take up weight lifting and high impact aerobics; Pilates exercises, Tai Chi, and walking can all boost your sense of well being, as well as speed up your recovery after prostate cancer surgery. In addition, before surgery, it is also important to eat foods that will supply your body with the proteins and other nutrients that will help you heal faster. You may want to check with your doctor to learn about which foods will work best.

It may also be helpful to you to understand what side effects you will have to contend with during your recovery after prostate cancer surgery. As an example, the last thing you want to do is wind up with constipation, and not have stool softeners available. Since urinary incontinence is often a part of recovery after prostate cancer surgery, you will also want to get some undergarments and pads designed to manage this effectively. By having an open and frank discussion with your doctor about this, and other concerns, you will be able to purchase whatever supplied and medications you need before the surgery. This will help you have peace of mind, as well as reduce stress after you get home from the hospital.

Today, doctors are becoming more aware that their treatments occur at a specific point in time. This time point is not at all divorced from all that goes on beforehand. Thus, pre-surgical preparations are becoming a vital aspect of determining speed and completeness of recovery after prostate cancer surgery. If your doctor does not initiate a discussion about these things, you may want bring them up on your own.

Source: http://www.ArticleBiz.com

Is The Prostate Cancer Biopsy An Effective Diagnostic Tool?

2007-08-20T07:41:00.000-07:00

By: Donald Saunders

Though there are various different tests which can be carried out when you suspect the possible presence of prostate cancer, the only certain way to diagnose the disease is the prostate biopsy. But precisely how successful is the biopsy when it comes to diagnosing this disease?

In the United States alone annually there are about one million prostate biopsy procedures carried out of which around 25 percent indicate the existence of cancer. Of the remaining 75 percent of biopsies however roughly 33 percent indicate false negative results. This means that about a quarter of those men undergoing a prostate biopsy are cleared by their biopsy, despite the fact that they actually have prostate cancer.

At first sight therefore it could seem that the biopsy is not a very good test but these results do not mean that there is anything wrong with the prostate biopsy procedure as a tool for diagnosing the presence of cancer. What it does mean however is the need to detect those patients who, in spite of they have returned a negative result, are nonetheless at considerable risk from cancer and ought therefore to undergo a second follow-up biopsy.

The problem is that until very recently there has not been an easy method of determining patients at risk. Fortunately, a recent study of more than five hundred men being investigated for the possible presence of prostate cancer might now provide an answer.

All of the men investigated in the study had already had a negative biopsy result but researchers discovered that when they studied the patient's prostate specific antigen (PSA) test results and these were adjusted to take account of the size of the prostate gland they could identify those patients who were more likely to produce positive results on a follow-up biopsy.

Additionally, the researchers found that patients who had a Gleeson score of 7 or above were at greater risk from life-threatening cancer and were once again more likely to record a positive result on a second biopsy. The Gleeson score runs on a scale between 2 and 10 and the score is derived from a microscopic investigation of biopsy tissue. Low scores show a cancer with a relatively small risk of spread while high scores show a cancer which is much more likely to spread.

There are various different biopsy procedures in use now but perhaps the most frequently performed procedure is known as the core needle biopsy. Here a number of very small tissue samples are removed from different areas of the prostrate gland using a biopsy gun which shoots a needle into the selected area and removes the sample within a fraction of a second. These samples are then sent off for laboratory analysis to ascertain whether or not cancer is present and, if so, to determine precisely how much of the prostate gland is affected.

The prostate biopsy is a costly procedure and is a test which can be quite nerve-racking for the patient. It can also be a fairly painful test which can be accompanied by bleeding and a risk of infection. For these reasons it is in everyone's interest to identify those men for whom a follow-up biopsy would be advisable and to reduce as far as possible the number of needless follow-up biopsies being carried out each year.

Source: http://www.ArticleBiz.com

Medical Treatments for Prostate Cancer

2007-08-15T04:46:00.000-07:00

By: Ian Dasilva

There are many different medical treatments for prostate cancer that involve the clinical care of a healthcare professional. These treatments include expectant therapy, surgery, radiation therapy, hormone therapy, and chemotherapy. Expectant therapy is to carefully observe and monitor the prostate cancer. Because prostate cancer cells often spread very slowly, many older men who have the disease may not need more extensive treatment. However, expectant therapy usually includes routine physician examinations, including digital rectal exams and PSA tests.

The different types of surgery for prostate cancer are radical prostatectomy - an open-surgery procedure in which the entire prostate gland and surrounding tissue are removed. Transurethral resection of the prostate (TURP) - surgery to remove part of the prostate gland that surrounds the urethra. Cryosurgery - this procedure involves killing the cancer cells by freezing them with a small metal tool placed in the tumor. Side effects of prostate cancer surgery include incontinence and impotence. Incontinence is the inability to control urine and may result in dribbling of urine, especially immediately after surgery. Normal control usually returns within weeks or months after surgery. Impotence is the inability to achieve an erection. For a month, or so, after surgery, most men are not able to get an erection. Eventually, approximately 40 to 60 percent of men will be able to get an erection sufficient for sexual intercourse, but without ejaculation of semen, since removal of the prostate gland prevents that process.

Radiation therapy uses high energy rays to kill or shrink cancer cells, and to decrease their ability to divide. Radiation is often used to treat prostate cancer that is still confined to the prostate gland, or has spread only to nearby tissue. If the disease is advanced, radiation may be used to reduce the size of the tumor and to provide relief from symptoms. Possible side effects of radiation for prostate cancer may include diarrhea, with or without blood in the stool, and colitis, problems associated with urination, a degree of impotence (inability to get an erection), which may occur within two years of radiation therapy

The goal of hormone therapy is to lower the level of male hormones in the body, particularly testosterone. Hormone therapy does not cure the cancer, and is often used to treat persons whose cancer has spread or recurred after treatment. Produced mainly in the testicles, testosterone causes prostate cancer cells to grow. Thus, reduced testosterone levels can make the prostate cancer shrink and become less active. Most studies show that hormone therapy works better if it is started early. Chemotherapy is the use of powerful, anti-cancer medications to kill cancer cells.. Hospitalization may be needed to monitor treatment and chemotherapy's side effects. Common side effects of chemotherapy include: nausea and vomiting, hair loss, anemia, reduced ability of blood to clot, mouth sores, increased likelihood of developing infections, fatigue. Most side effects disappear once treatment is stopped.

For more information visit: http://prostate-treatment.last-long.com

PSA Test Scores Provide An Excellent Indication Of An Aggressive Prostate Cancer

2007-08-05T05:14:00.000-07:00

By: Donald Saunders

The PSA test is a blood test that is Often carried out as a screening test to detect the presence of a swollen prostate and of prostate cancer. Though the test cannot in itself be used for diagnosis it is a good indicator and, in combination with other tests, PSA test can point to the need for additional investigation.

The PSA test is usually recommended for men in high risk groups (like those with a family history of the condition) once they reach the age of about 40 to 45 and for men in general after they reach the age of 50.

A single PSA test in isolation will give a snapshot of prostate specific antigen levels in the blood and might indicate a problem immediately if you have particularly high psa numbers. However, in most cases, and when a prostate problem may be in its early stages of development, a single PSA test result will prove to be inconclusive and a further test will normally be suggested in a few weeks time. In fact, ideally PSA testing should be carried out at regular intervals 2 or 3 times each year so PSA levels may be viewed over time.

Provided that you have a normal PSA score then all is well, but when your PSA levels begin to rise they must be monitored closely. The speed at which PSA levels rise is normally called the 'PSA velocity' and providing the rise is steady and the velocity slow then it is once again frequently sufficient simply to watch the situation as numerous things can influence levels of PSA and seemingly increasing levels will frequently fall back to normal given time.

However, when PSA levels begin to increase rapidly and the velocity is said to be high then further investigation is certainly necessary.

This pattern of PSA testing and monitoring has been performed for some time but, although the test has always been considered to be a good indicator of the need for additional investigation, it was not until quite recently that we have been in a position to link specific PSA velocity to prostate cancer in a way that can indicate how aggressive prostate cancer is.

In a study conducted recently data concerning 950 men with prostate cancer who had undergone either surgery of radiation treatment at four hospitals between 1988 and 2004 was carefully scutinized.

In all cases each patient had been diagnosed with aggressive prostate cancer on the basis of an isolated very high PSA score, a noticeable rise in PSA velocity during the year before diagnosis, an advanced stage tumor, a biopsy showing signs of an aggressive cancer at cellular level or a combination of two or more of these signs.

This study also looked at the post-treatment outcomes for all of the patients and found that a rapidly increasing PSA level that rose by 2 points or more in a twelve month period was the best indicator or an aggressive cancer.

Up until now we have been able to connect increasing PSA levels with the possible presence of prostate cancer but it has been necessary to guess to a fair degree about whether or not such a cancer might be aggressive and require correspondingly aggressive treatment.

However, now we are able to say with reasonable certainty that where a PSA level rises by 2 or more points in a twelve month period then prostate cancer is almost certainly aggressive and requires speedy and vigorous treatment.

Source: http://www.ArticleBiz.com

Prostate Cancer: Warning Sign

2007-07-30T20:36:00.000-07:00

There are no early warning signs or symptoms of prostate cancer. It usually grows very slowly, and due to its location, many men do not have any physical symptoms. However, if the prostate grows large enough, you may experience some symptoms.

Still, there are some symptoms, while not specific to prostate cancer, that should be reported to your physician for further study. These include urinary frequency and urgency, or obstructive urinary symptoms such as slowing of the urinary stream or difficulty emptying the bladder.

That's why many cases of prostate cancer aren't detected until it has spread beyond the prostate.

When signs and symptoms do occur, they may include the following:

Dull pain in your lower pelvic area
Urgency of urination
Difficulty starting urination
Pain during urination
Weak urine flow and dribbling
Intermittent urine flow
A sensation that your bladder doesn't empty
Frequent urination at night
Blood in your urine
Painful ejaculation
General pain in your lower back, hips or upper thighs
Loss of appetite and weight
Persistent bone pain

In fact, men who have a family history of prostate cancer are at least three times more likely to develop prostate cancer in their lifetime. If they have two or more relatives with prostate cancer, such as a brother, uncle or father, they are five times more likely to develop the disease, and if they have three or more relatives afflicted by prostate cancer, they are 11 times more likely to develop it themselves.

What causes prostate cancer and why some types behave differently are unknown. Research suggests that a combination of factors may play a role, including heredity, ethnicity, hormones, diet and the environment.

Diagnosed

Prostate cancer is diagnosed from the results of a biopsy of the prostate gland. If the digital rectal exam of the prostate or the PSA blood test is abnormal, a prostate cancer is suspected. A biopsy of the prostate is usually then recommended. The biopsy is done from the rectum (trans-rectally) and is guided by ultrasound images of the area. A small piece of prostate tissue is withdrawn through a cutting needle. The TRUS-guided Tru-Cut biopsy is currently the standard method to diagnose prostate cancer. Classically a 6-core set is taken by sampling the base, apex and mid gland on each side of the gland. More cores may be sampled to increase the yield, especially in larger glands. A pathologist then examines the tissue under a microscope for signs of cancer in the cells of the tissue.

When prostate cancer is diagnosed on the biopsy tissue, the pathologist will then grade each of two pieces of the tissue from 1 to 5 on the Gleason scale. The scale is based on certain microscopic characteristics of the cancerous cells and reflects the aggressiveness of the tumor. The two scores are then added together. Sums of 2 to 4 are considered low, indicating a slowly growing tumor. Sums of 5 and 6 are intermediate, representing an intermediate degree of aggressiveness. Sums of 7 to 10 are considered high, signaling a rapidly growing tumor with the worst prognosis (outcome). Gleason scores can be helpful in guiding treatment that is based, at least in part, on the aggressiveness of the tumor.

Prostate Cancer Symptoms And The Key Prostate Nutrients

2007-07-26T21:04:00.000-07:00

by BRETT SEAGROTT

If a man is experiencing recognizable prostate cancer symptoms, normally the disease has spread beyond the prostate gland. The deadliest, as well as most common cancer among men, prostate cancer only has a cure rate of only 20 to 30 percent.

One in six men will develop prostate cancer in his lifetime with the likelihood increasing as they age (two thirds of prostate cancers are diagnosed in men over the age of 65). Because of the slow development of prostate cancer symptoms, it is vitally important that men begin preventative health-care measures early in life - preferably starting in the early 30's. Among the key measures is a diet and sensible supplementation rich in clinically proven prostate and anti-cancer nutrients.

Prostate Cancer Symptoms

In order to have a better chance in fighting the disease, it is important to be aware of the symptoms associated with prostate cancer. The most common prostate cancer symptoms include a decrease in the size or force or an interrupted urine flow, painful or burning urination, frequent urination (especially at night) and blood in urine or semen. These symptoms are also associated with an enlarged prostate gland (BHP). In its advanced stages, these prostate cancer symptoms include frequent nagging pain in the hips, back, ribs, and pelvis. This is usually because the disease has spread to the bones in the pelvis or back.

Causes Of Prostate Cancer

While the exact causes of prostate cancer are not known, there are many risk factors that can add to the likelihood of contracting the disease. Genetics is believed to play a role because prostate cancer symptoms appear to run in some families. Having an immediate family member (father or brother) with prostate cancer more than doubles a man's risk of developing this disease. Diet and lifestyle can also play a role. Eating five or more servings of red meat and / or high fat diary products, in conjunction with substandard amounts of fruits and vegetables, have shown a link to prostate cancer.

Natural Prevention Methods

Without a clear understanding of the causes, it is hard to know how to prevent prostate cancer. However, since you have no influence over genetics, it is best to start with the factors you can control. Diet and nutrition are the first factors to consider when looking at natural cures for prostate cancer. Your diet should be based on a wide range of foods from plant sources, including, fruits and vegetables containing powerful phytonutrients, which often contain anti-cancer properties.

Research studies on phytonutrients have also shown success in preventing and relieving enlarged prostate (BPH) and prostate cancer symptoms. In addition, an anti-cancer diet comprised of brown rice, fresh raw fruits and raw vegetables will not only promote good health, it will give your body the building blocks it needs to fight prostate cancer and other diseases.

Supplements For Prostate Health

Most supplements designed for prostate health are comprised of several key herbs and nutrients. Since your diet is likely to have insufficient amounts of many of these nutrients you need to get them through a multi-nutrient supplement that balances the dose amounts and takes into account the synergistic reactions they have with one another.

The key players for prostate health are: • Beta Sitosterol • Turmeric • Corn Silk • Lycopene • Saw Palmetto • Zinc Citrate and Zinc Aspartate • Grape Seed • Quercetin • Omega 3 • Green Tea • Resveratrol (high potency) NOTE: Most supplements contain Zinc in the Citrate form which is good but it is crucial that additional Zinc is included in the Aspartate form because this travels directly to the prostate where it is needed!

To learn more about these prostate nutrients and how they specifically target different aspects of prostate health please follow this link: prostate cancer symptoms and prostate nutrients

Let’s Sum Up

As an older male, it is crucial to have a strong understanding of good prostate health as well as being able to recognize any and all possible prostate cancer symptoms.

Equally important for young men is to adopt preventative health-care measures early in life by eating responsibly, and investing in your long-term health with a quality, science-based nutritional supplement containing a high number of established anti-cancer nutrients. This must include all the key prostate nutrients listed above. (Less omega 3 which can be purchased separately in a soft gel).

Prostate Cancer In African American Genes

2007-07-16T20:54:00.000-07:00

There is clear evidence that the African American male is nearly twice as likely to develop prostate cancer compared to the white male. Indeed the highest rate of prostate cancer in the United States is found in African American men.

Additionally, African American men are also most likely to suffer from drug side effects from prostate cancer treatment than seen in white men such as incontinence. It has also been documented that African American men with prostate cancer are most likely to be dissatisfied with their doctor’s support compared to white men.

There are a number of reasons why the African American male community have a higher prevalence of prostate cancer disease. Researchers have suggested some of the following reasons for this:

* African American men's negative attitudes and distrust of the prostate cancer screening tests together with health care may contribute to the fact that when prostate cancer is diagnosed, it will be in the more advanced and inoperable stage in the African American men.

* They have limited or less access to health care and this is also believed to be a contributory factor. A large number do not have health insurance and this means that African American men do not always receive the preventative health care assessments that they require.

* Nutritional and environmental factors are also thought to play an important role. Although black men in Africa do have a high rate of prostate cancer, they do not appear to have as high a rate of prostate cancer compared to that of black men in the United States. It is also thought that lower levels of vitamin D and a difference in genetics may also contribute to higher rates of prostate cancer in African American men.

It is recommended that African American men aged over 40 years should undergo prostate cancer screening test on an annual basis. This screening should include a Prostate specific Antigen Blood test, commonly known as PSA. A Digital Rectal Examination or DRE should also be performed. This involves a gloved finger being inserted into the rectum to feel for any unusual growths on or around the prostate gland.

Those men who have prostate cancer in their family are at a greater risk of developing prostate cancer. It is advisable that African American men ascertain how many family members have suffered with prostate cancer before passing this information onto your doctor. Prostate cancer that is caught early provides men with greater chances of survival and living a normal life.

It is essential that African American men receive regular prostate health check-ups as these can save lives. Men should eat a healthy diet which includes ample fruit and vegetables. Exercise is also essential, although one should seek professional advice before embarking on an exercise regime. About The Author: Sharon Evans owns the prostate health website where you can get a most informative ebook that tells you all you need to know about prostate cancer. she also offers other great downloadable ebooks on a vast variety of health issues.

Prostate Symptoms and Treatment Tips

2007-07-06T20:43:00.000-07:00

Author: Joe Bella

The prostate is a glandular organ present only in males. It surrounds the neck of bladder & the first part of urethra and condributes a secretion to the semen. The gland is conical in shape and measures 3 cm in vertical diameter and 4 cm in transverse diameter.It has got five lobes anterior, posterior, two lateral and a median lobe. Since the first part of the urethra pass through it any lesion in the prostate will produce difficulty in passing urine.

Some diseases of the prostate gland include the following:

1) Prostatitis:-

This is the inflamation of the prostate gland due to bacterial infection.

2) Benign enlargement of the prostate:-

This is a non cancerous tumour of the prostate seen after the age of 50. 3, Cancer of the prostate:-This is the 4th most common cause of death from malignant diseases in males.

Cancer of the prostate.

Cancer of the prostate is directly linked with the male sex hormones(androgens). If the levels of sex hormone increases the growth rate of cancer also increases. It is found that after the removel of testes there is marked reduction in the size of tumour.

Site of tumour:-

Prostate cancer is seen mainly in the posterior lobe. Non cancerous enlargement is seen in other lobes.

Changes in the gland in cancer:-

The gland becomes hard with irregular surface with loss of normal lobulation. Histologically prostate cancer is an adeno carcinoma(cancer of the epithelial cells in the gland)

Growth :-

Growth rate is very fast in prostate cancer. The tumour compresses the urethra and produce difficulty in urination.

Spread of tumour:-

Metastasis in cancer of prostate is very early.

1) Local spread:-

From the posterior lobe the cancer cells go to the lateral lobes and seminal vesicles. Tumour cells also move to the neck and base of the urinary bladder.

2) Lymphatic spread:-

Through the lymph vessels cancer cells reach the internal and external illiac group of lymph nodes. From there cells move to retroperitonial(Behind the peritonium) and mediastinal lymph nodes(in the chest)

3) Spread through the blood:-

Spread of cancer cells takeplace through the periprostatic venous plexus and reaches the vertebral veins while coughing and sneezing and finally enders the vertebral bodies of the lumbar vertebrae.

Signs and symptoms of prostate cancer:--

Signs and symptoms depend upon the stage of the cancer. The following symptoms may be seen.

1) No symptoms:-

Tumour is small and only in the posterior lobe. This is diagnosed accidentely.

2) Slight difficulty in urination:-

Here the tumour is enlarged and urethra is slightly compressed. Shortly there will be frequent urge for urination with difficult urination.

3) When the tumour spread to all nearby areas including neck of bladder and urethra there will be painful urination with bleeding.Urine comes drop by drop.

4) Retention of urine:-

When the urethra is completely compressed there will be retention of urine. This can lead to hydronephrosis, renal failure ect.In this condition patient may get convulsions due to renal failure and finally coma.

5) Signs of metastasis:-

Some patients come with the signs and symptoms of metastasis.

a) Lumbo sacral pain due to spread of cancer cells to lumbar and sacral vertebrae.

b) Fracture of spine due to cancerous growth in the spine.

c) Swelling, pain and fluid collection in the abdomen due to lesion in the abdomen.

d) Respiratory complaints due to cancer of mediastinal lymphnodes and lungs.

e) General weakness due to spread of cancer to different parts of the body.

f) Anaemia due to involment of bone marrow and increased destruction of RBCs.

Clinical examination :-

Includes per rectal examination to feel the prostate gland, palpation of abdomen to feel the swelling in kidneys and any tumours. Patient is examined from head to foot to find out any lesions.

Investigations:-

1) Complete blood investigations;-

RBC, WBC, Platlets, ESR, bleeding time , clotting time ect.

2) Urine analysis:-

Microscopic examination to detect pus cells, occult blood, casts, Crystals ect.

3) Renal function tests:-

Blood urea level, creatinine level, electrolyte level ect.

4) Serum acid phosphatase:-

Increased in cancer of prostate.

5) x-ray of the spine:-

To detect any tumour or fracture.

6) Ultra sonography;-

Gives idea about prostate, bladder, kidney ect.

7) C T scan:-

More detailed information about organs and tumour.

8) MRI of the spine:-

Gives detailed information about spine , disc and nearby soft tissues.

9) Lymphangiography:-

Gives idea about lymphatic spread of cancer.

10) Biopsy to confirm cancer:-

Biopsy is taken from the tumour and is send for histopathological examination under the microscope. This will detect the presence of cancer cells.

Treatment:-

1) If there is retention of urine catheterisation is needed.
2) Dialysis if kidney failure.
3) If there is coma monitoring of all vital functions along with parentral nutrition and electolyte supply.
4) Specific treatment is prostatectomy(removal of prostate)

Partial prostatectomy :-

Here only the affected lobe is removed.

Radical prostatectomy :-

Total removal of prostate along with nearby lymphnodes.

5, Hormone therapy :-

Stilbestrol is given to reduce tumour growth.Since this treatement increases the chance for cardiovascular disease phosphorylated diethyle stilbesterol is used nowadays.

6) Chemotherapy:-Drugs like cyclophosphamide, cisoplatim ect are given.

7) Radiotherapy is also done for some cases.

8) Homoeopathy:-

Homoeopathic drugs like carcinocin, conium, sabal, crotalus, thuja, iodum, selinium, staphysagria, sulphur ect can be given according to symptoms. Constitutional homoeopathic medicine will give great relief and can increase the life span.

Source: http://www.articlesbase.com/non-fiction-articles/prostate-symptoms-and-treatment-tips-43015.html

How Do you Know you Have an Acid Reflux Disease Symptoms

2007-07-02T20:38:00.000-07:00

Author: Arturo

If you have been experiencing some strange sensations that you can ' t explain, you may be having an acid reflux disease symptom. This may be especially true if you are experiencing these things at night or after eating certain foods.

What is Acid Reflux?

Acid reflux disease is a condition where acidic gastric juices travel from the stomach back into your esophagus. There are those who experience acid reflux disease symptom regularly and there are those who experience acid reflux disease symptom only when they eat certain foods. Acid reflux disease is not a life threatening condition, but those who suffer with acid reflux disease symptom live with the discomfort and pain that this condition can bring.

Acid reflux disease can become more serious if your symptoms are not addressed, as the acid from your stomach can cause damage to the lining of your esophagus. There are many over the counter medications that a person can take that will address most acid reflux disease symptom you may have.

You may need to see a doctor if over the counter medication is not working for you. They will often prescribe a lifestyle change as well as stronger medication than what you can get over the counter. Many times a simple change in eating habits can alleviate an acid reflux disease symptom.

What is an Acid Reflux Disease Symptom?

For those who are unfamiliar with acid reflux disease symptom, they make include the most common of all symptoms; heartburn. Heartburn is an acid reflux disease symptom that sends many people running to the doctor. What heartburn is is a burning sensation that rises from your stomach into your throat. It can make swallowing difficult or painful. You may also experience an acid reflux symptom that includes hoarseness or dental erosion. You may even contract asthma from acid reflux disease because the acid from your digestive juices can make their way into not only your mouth and throat, but into the air passages of the lungs as well.

Don't hesitate to talk to a health care professional if you are experiencing any kind of acid reflux disease symptom. Once you get your signs and symptoms under control, you will increase the quality of your life.

Prostate Cancer

2007-05-17T20:12:00.000-07:00

The prostate is a small gland found only in men. It is the size of a walnut and surrounds the first part of the tube (urethra) which carries urine from the bladder to the penis.
What Is The Prostate?

The prostate makes part of seminal fluid। During ejaculation, seminal fluid helps carry sperm out of the man's body as part of semen. Male hormones (androgens) make the prostate grow. The testicles are the main source of male hormones, including testosterone. The adrenal gland also makes testosterone, but in small amounts.

Prostate cancer

Prostate cancer generally affects men over the age of 50, and is rarely found in men under that age. It differs from most other cancers in the body, because small areas of cancer within the prostate are very common and may stay dormant for many years.

One in six men will get prostate cancer, but if caught early, nearly 100% survive.
Early prostate cancer has a symptoms, that's why screening is so important.

It often doesn't produce any symptoms in its early stages. That's why many cases of prostate cancer aren't detected until it has spread beyond the prostate.When signs and symptoms do occur, they may include the following:

Having theses symptoms do not necessarily mean you have prostate cancer. However you should have your symptoms checked by a doctor.

What doctors and other health professionals will I see?

Your general practitioner will refer you for initial tests to confirm whether or not you have cancer. He or she may later refer you to a specialist who will advise you about treatment options.

You should be cared by a team of health professionals from the relevant major disciplines (e.g. surgery, medical oncology, radiotherapy and endocrinology).

Specialists and other health professionals who care for people with prostate cancer include:

· Urologists/urological surgeons who specialise in diseases of the urinary system

· Radiation oncologists: who are responsible for radiotherapy

· Dietitians: who will recommend the best diets to follow

How prostate cancer is diagnosed
If your doctor thinks you have prostate cancer, a number of tests can be done to find out for certain. These tests will also check the size of the cancer and find out if it has spread. You may have some or all of the following tests:

Blood Test (PSA)
A blood test may be done to check the level of prostate specific antigen (PSA). PSA is usually found in the blood in larger amounts when prostate cancer is present. A high level of PSA does not mean you have prostate cancer but you will have a biopsy to know for certain. It is very common for BPH to cause a high level of PSA.

Digital rectal examination
An examination of the prostate through the back passage (rectum) is called a digital rectal examination. The doctor places a gloved finger into your rectum and feels the prostate through the rectum wall. If your doctor feels anything suspicious, such as an enlarged prostate or an odd shape, a biopsy may be arranged.

Biopsy
In a biopsy, samples of tissue are removed from the body. For a biopsy of the prostate, a small needle is directed – by an ultrasound probe in the rectum – into the prostate (this is called transrectal ultrasound or TRUS). The probe is the size and shape of a middle finger. It shows the shape and condition of the prostate on a screen like a television. Six to eight samples of tissue are taken from different parts of the prostate and sent for examination under a microscope.

The biopsy is important to help you and your doctor male a treatment decision. The doctor will take into consideration how many of the tissue samples, if any show cancer, and how the malignant cells appear under the microscope. This is graded by what is known as the Gleason score. A Gleason score between 1 and 4 probably indicates a very good outlook (prognosis). A score between 4 and 7 is moderate, and in general treatment is needed. A score from 8 to 10 means are more aggressive (quickly growing) cancer.

Bone scan
A bone scan may be used to see if the prostate cancer has spread to your bones.

A radioactive tracer (like a dye) is injected into a vein, usually in your arm. You will need to wait for the tracer to make its way through your body. You will be asked to undress and put on a gown, then lie on a table under the scanning machine. The machine will detect rays from the tracer and turn these into pictures, which can be seen on a computer. The tracer will show any “hot spots" in your bones, which may be cancer.
The test will take about one hour. It is painless and has no side effects.

X-ray
An x-ray of the chest may be done to find out whether or not the cancer has spread to the area

Intravenous pyelogram (IVP)
This is a special type of x-ray used to find blockages in the urinary system.

A dye is injected into a vein, usually in your arm. It moves through the blood stream to the kidneys, the ureters (the tubes that take the urine from the kidneys to the bladder) and the bladder. The doctor can watch the dye move around the body on an x-ray screen and see anything unusual.
The dye can make you feel ht and flushed for a few minutes, but this feeling goes away. You may feel some discomfort in your abdomen, but this will not last. You should be able to go home as soon as the test is over. It takes about an hour.

Computerised tomography (CT) scan
The CT scan is a special type of x-ray, which gives a three-dimensional picture of the organs and other structures (including any tumours) in your body. It usually takes about 30-40 minutes to complete this painless test.

To ensure that the pictures taken by the scanner are clear, you may drink or have injected a dye or ‘contrast fluid’. This will mean that you do not eat or drink for about four hours before the scan. The dye injection can cause a burning sensation.

You will be asked to lie flat on a table while the CT scanner, which is large and round like a doughnut, rotates around you. Most people are able to go home as soon as their scan is over.

Magnetic resonance imaging (MRI)
This test is similar to a CT scan (see above), but it uses magnetism instead of x-rays to build up a series of very clear and detailed pictures of your body.

Like a CT scan, MRI is painless, and the magnetism is harmless. You will be asked to lie very still on a couch inside a metal cylinder, which is open at both ends. The whole test may take up to an hour to complete. The cylinder makes some people feel quite claustrophobic, but you can usually take someone into the room with you to keep you company.

This test will help your doctor decide whether the cancer has spread beyond the prostate, which will help you both decide which treatment will be best for you.

Staging the disease
The previous tests show whether you have cancer. They will also show where the primary cancer is and whether the cancer has spread to other parts of your body. This helps your doctor "stage" the disease so they can work out the best treatment for you.

The staging system used for prostate cancer is the ‘TMN system’, where T=tumour, N=nodes and M=metastases.

· T followed by a number between 1 and 4 shows whether and how far the cancer has spread. A higher number after the T (e.g. T3 or T4) means it has spreads beyond the prostate into the tissues around the prostate, or to nearby organs (the bladder or rectum)

· N1 means the cancer has spread to a lymph node or nodes near the prostate. N0 means the cancer has not spread to nay lymph nodes

· M followed by 1a, b or c shows that the cancer has spread to bones or other sites

Treatment

Sometimes, the best thing to do is ‘watch and wait’. Regular check ups will tell you and your doctor if treatment is needed. Prostate cancer can be treated by surgery, radiotherapy or hormone therapy. Treatment will depend on where the cancer is, what type of cancer it is, its size and how far it has spread. Your specialist will also consider your age, general health and your preferences. You may see a number of different specialists at this stage to help decide the best treatment for your particular cancer.

Watchful waiting
Sometimes, for example, if you are over 70 years of age and the cancer is at a very early stage, your doctor will advise treatment is not needed. This may not be the case for some younger men. However, you will need to be examined regularly to check the cancer is not growing.

Surgery
If the cancer has not spread beyond the prostate, the whole prostate and some tissue around it may be removed. This is called a radical prostatectomy. It is done to cure the cancer.

You will need to stay in hospital for 5 to 7 days. You will be able to get back to normal activities within six weeks.

If it is not possible to remove the prostate, surgery may be used to remove the blockages in the urinary tract. This operation is called a transurethral resection of the prostate. This should relieve symptoms such as the need th pass urine more often than normal. A telescope like instrument is passed up the urethra through the penis. An instrument inside the telescope is then used to remove the blockage. This type of operation is also used to treat BPH.

Men with advanced prostate cancer may be advised to have an orchidectomy. This is surgery, which removes the testicles, to lower the level of testosterone and slow the growth of prostate cancer cells. Refer to ‘hormone treatment’, late in this section, for more information.

Side effects of surgery
A radical prostectomy will cause some degree of urinary incontinence (loss of bladder control) in many men. This will be temporary in most men and less than 5% will have any significant permanent incontinence. Virtually all men will have a change in their sexual function and most men will have erectile dysfunction (also known as impotence). Some men will improve but more than 70% will have ongoing problems. Urethral operations will be necessary in some men to correct strictures (narrowing) in the urethra.

Radiotherapy
Radiotherapy treats cancer with high-energy rays that damage or destroy cancer cells. The treatment is planned careful to ensure that the rays are targeted precisely onto the cancer, and do as little harm as possible to healthy tissues nearby. It may be used as an alternative or an additional treatment to surgery.

Radiotherapy can be given as external radiotherapy or internal radiotherapy.

External radiotherapy
In external radiotherapy, rays from a large machine are directed towards the part of the body where the cancer is located. You will need to go to the hospital or clinic for treatment.

To make sure that exactly the same area is being treated each time, the radiation therapist will make a number of marks on your skin. These marks consist of lines, crosses and dots applied with special inks. Sometimes they will be redone during the course of treatment.

External radiotherapy may be given five days a week for four to six weeks or more. This will depend on the size and type of cancer and on your general health. It takes a few minutes each time. Having radiotherapy in a number of small doses helps reduce the side effects.

Radiotherapy may also be used to relieve pain caused by secondary cancers in the bone, or to shrink obstructions in your lymphatic or urinary systems.

The treatment is not painful. You will not see, hear or feel the rays. External radiotherapy does not make you radioactive. It is quite safe for you to be with other people.

Side effects of external radiotherapy
External radiotherapy can cause a number of temporary side effects that will gradually disappear after the treatment has finished.

Short –term effects: You may experience tiredness, cystitis and diarrhoea. Less common side effects include a reddening or burning sensation of the skin or nausea.

Long-term effects: Radiotherapy for prostate cancer can cause erectile dysfunction (impotence), urinary incontinence, diarrhoea and bowel urgency. This can improve over time. Bowel problems may be experiences during or after treatment, resulting in diarrhoea with or without cramping. A small number of men will continue top experience bowel problems after treatment has ended. Bleeding from the bowel affects some men treated with radiotherapy.

It is estimated that for every man who has radiotherapy for prostate cancer, 40 to 80 will suffer erectile dysfunction and a small number will have urinary incontinence.

Brachytherapy (Internal radiotherapy)
Internal radiotherapy (also called implant therapy or brachytherapy) is a type of radiotherapy where the source is placed in an area being treated. Two types of brachytherapy are used to treat prostate cancer.

One is the use of tiny permanent radioactive ‘seeds’. These seeds are put in the prostate, where they treat the cancer. The seeds lose their radioactivity over time. It usually requires an overnight stay in hospital. This type of brachytherapy is used instead of external radiotherapy. It is considered a good treatment for small tumours with a low Gleason score and with a low PSA.

The other type of brachytherapy is a temporary implant. In this case, hollow needles are places inside the prostate. Radioactive sources can be places in the hollow needles temporarily. After a few treatments, these temporary needles are removed. It usually requires an overnight stay in hospital. This type is used with external radiation, for men with higher PSA, higher Gleason score and large tumours.

Side effects of brachytherapy
There can be discomfort from inserting the needles or seeds. Otherwise the side effects of permanent and temporary brachytherapy are different.

With permanent seeds, painful urination, poor urine flow and bladder irritation are common side effects. These can start a month after treatment and last up to one year. Some men also have urinary incontinence. Erectile dysfunction (impotence) and rectal problems can also occur with brachytherapy. If you are resuming sexual intercourse, condoms should be used for the first two weeks after the seeds are implanted. This is in case a seed is accidentally moved or ejaculated in semen.

Temporary needles are usually used with external radiotherapy. The side effects from temporary needle are very similar to those of external radiation alone.

Hormone treatment
Prostate cancers need the male hormone, testosterone (produced by testes), for their growth. It is possible to slow down or shrink the cancers by reducing the body’s testosterone levels. Hormone treatment can help with symptoms such as pain caused by the cancer spreading. It can also help symptoms such as urinary frequency. It is often given for some months before radiotherapy or surgery to increase the effectiveness of treatment.

The two main ways of reducing testosterone levels are by surgery or by injections.

Hormone treatment with surgery
Two operations can e done to reduce testosterone levels. The first removes the testes. This operation is known as an orchidectomy or orchiectomy. Inserting a plastic prosthesis into the scrotum to keep its shape and appearance may follow this. A smaller operation involves the removal of the inner part of the testes (a ‘subcapsular orchidectomy’). In this case a prosthesis is not needed.

Hormone injections
Injections of luteinising hormone releasing hormone (LHRH) area used to control the production of testosterone. LHRH is given as a monthly or 3 monthly injection. Hormone injections will not cure the cancer but often slow down its growth for some years.

Side effects of hormone treatment
Hormone treatment for prostate cancer can cause loss of libido (sex drive), weight gain, erectile dysfunction (impotence), hot flushes, swelling of breast, fluid retention and progressive hardening of arteries.

Palliative treatment
If the cancer has spread and it is not possible to cure it, then your doctor will discuss various treatments for problems caused by the cancer.

Palliative treatment is treatment that relieves or soothes pain and other distressing symptoms of illness. Palliative care is available for all people who experience pain and distress associated with cancer, whatever their stage of cancer treatment. It is a particularly important type of treatment for people with advanced cancer, who cannot be cured but can expect to live without undue pain and distress.

Palliative care includes pain relief using painkilling drugs and other measures. Pain is usually well controlled with oral medication.

General practitioners, specialist and specialist palliative care teams in hospital all play important roles in palliative treatment for people with early and advanced cancer.

Prognosis
Prostate cancer can be treated best when the cancer is found early and is still confined to the prostate.
In many cases, the cancer does not go away after treatment but stops growing or shrinks in size. Men usually return to normal or near normal good health. This may last for months or years.

After your treatment is finished, your doctor may recommend regular check ups. If you have any new symptoms, you should see your doctor.

Making decisions about treatment
Sometimes it is difficult to make decisions about what is the right treatment for you. You may feel that everything is happening so fast that you do not have time to think things through. Some people find that waiting for test results and for treatment to begin is very difficult.

While some people feel they are overwhelmed with information, other may feel that they do not have enough. You need to make sure that you understand enough about your illness, the possible treatment and side effects to make your own decisions.

If you are offered a choice of treatments, you will need to weigh up the advantages and disadvantages of each treatment. If only one type of treatment is recommended, ask your doctor to explain why other treatment choices have not been advised.

Some people with more advanced cancer will always choose treatment, even if it only offers a small chance of cure. Others want to make sure that the benefits of treatment outweigh any side effects. Still others will choose the treatment they consider offer them the best quality of life. Some may choose not to have treatment but to have their symptoms managed as they arise in order to maintain the best possible quality of life.

Talking with doctors
You may want to see your doctor a few times before making a final decision on treatment. The first consultation when you are told you have cancer is usually stressful and you may not remember very much. It is often difficult to take everything in, and you may need to ask the same question more than once. You always have the right to find out what a suggested treatment means for you, and the right to accept or refuse it.

Before you see the doctor, it may help to write down your questions. There is a list of questions to ask your doctor at the end of this section which may assist you. Taking notes during the session can also help. Many people like to have a family member or friend to go with them, to take part in the discussion, take notes, or simply listen. Some people find it is helpful to tape-record the discussion.

Talking with others
Once you have discussed treatment options with your doctor, you may want to talk them over with family or friends, or your own religious or spiritual adviser. Talking it over can help to sort out what course of action is right for you.

A second opinion
You may want to ask for a second opinion from another specialist. This is understandable and can be a valuable part of your decision-making process. Your specialist or local doctor can refer you to another specialist and you can ask for you records to be sent to the second-opinion doctor. You can still ask for a second opinion even if you have already started treatment or still want to be treated by your first doctor.

Taking part in a clinical trial
You doctor may suggest that you consider taking part in a clinical trial.

Clinical trials are a vital part of the search to find better treatments for cancer. Doctors conduct clinical trials to test new or modified treatments and see if they are better than existing treatments. Many people all over the world have taken part in clinical trials that have resulted in improvements to cancer treatment. However the decision to take part in a clinical trial is always yours.

If your doctor asks you to take part in a clinical trial, make sure that you fully understand the reasons for the trial and what it means for you. Before deciding whether or not to join the trial, you may wish to ask your doctor:

What treatments are being tested and why?

What tests are involved?

What are the possible risks or side effects?

How long would the trial last?

Will I need to go into hospital for treatment?

What will I do if any problems occur while I am in the trial?

If you decide to join a randomised clinical trial, you will be given either the best existing treatment or a promising new treatment. You will be chosen at random to receive one treatment or the other, but it will always be the best treatment available.

If you do join a clinical trial, you have the right to withdraw at any time. Doing so will not jeopardise your treatment for cancer. It is always your decision to take part in a clinical trial. If you do not want to take part, your doctor will discuss the best current treatment choices with you.

Coping with side effects
The side effects of prostate cancer treatment include erectile dysfunction (impotence), changes in bowel habit, urinary incontinence and infertility. These can be hard to cope with. Below is some information that may be useful to you.

Erectile dysfunction (impotence)
Erectile dysfunction means not being able to get and maintain an erection firm enough for penetration. This can happen as men get older. It can also happen to men who have radiotherapy or surgery for prostate cancer, because these treatments can damage key nerves. Your doctor will try to avoid damaging these nerves, but sometimes, because the cancer can grow very close to them, it is not possible.

Erectile dysfunction can be treated by:
· Injections to the penis, that you can learn to do yourself, can help you have an erection These injections can cause a dull pain for a little while ins some men and scarring if used too often.

· Tablets can increase blood flow to the penis, helping you have an erection. These tablets can cause headaches and a hot flushing feeling

· Other methods include implants in the penis and pumps

Bowel habit changes
Some men have diarrhoea or bowel urgency after treatment. A small number of men have bleeding from bowel after radiotherapy. For most men, bowel problems improve over time

Urinary incontinence
Urinary incontinence is not being able to control; the flow of urine. It is a common side effect of prostate cancer treatment, caused by damage to the nerves or other parts that control urination.

In some men it can be minor, just a few drops when they, for example, cough or sneeze. In others it can be more severe, so that men need to use incontinence pads several times a day. It usually gets worse straight after treatment and gets better within a year of treatment.

Men can be concerned about odour or ‘having an accident’ in public. It is important that you do not withdraw from your friends or social situations because of such fears. You can prevent or disguise odours and accidents.

Exercising the muscles of your pelvis can help. You may need to use pads. There are also clamps and other devices you may wish to try. If your incontinence does not improve with time, surgery may be an option.

Infertility
Most men become infertile after treatment, which means the sperm they produce are not able to penetrate an egg.

Seeking Support
When you are first diagnosed with cancer, you may feel a variety of emotions, such as fear, sadness, depression, anger or frustration. It may be helpful to talk about your feelings with your partner, family members or friends or with a hospital counsellor, social worker, psychologist or your religious or spiritual advisor.

Sometimes you may find that your friends and family do not know what to say to you: they may have difficulty with the feelings as well. Some people may feel so uncomfortable that they avoid you. They may expect you to ‘lead the way’ and tell them what you need. This can be very difficult to bear and can make you feel very lonely. You may feel able to approach your friends directly and tell them what you need. You may prefer to ask a close family member or a friend to talk with other people for you.

Diet
A balanced nutritious diet will help you to keep as well as possible and cope with the cancer and any side effects if treatment. Depending on the kind of treatment you have had, you may have special dietary needs. A dietician can help to plan the best foods for your particular situation – ones that you find tempting, easy to eat and nutritious.

The Resource and Wellness Centre has a resident dietitian. For an appointment please call 03 2698 7300 or email contact@cancer.org.my

Relaxation techniques
Some people find relaxation or meditation helps them to feel better. The Resource and Wellness Centre offers relaxation and meditation classes. Telephone 03 2698 7300 or email contact@cancer.org.my for further information.

Sexuality and cancer
We are all sexual beings and intimacy adds to the quality of our lives. Cancer treatment and the psychological effects of cancer may affect you and your partner in different ways.

Some people may withdraw through feelings of being unable to cope with the effects of chemotherapy and radiotherapy on themselves or their partner. Others may feel an increased need for sexual and intimate contact for reassurance.

Communication is essential in addressing any concerns or problems, which may arise. Talk about your feelings with your partner. Try different positions and practices to find out what feels right and is satisfactory for both of you. If you have difficulties in continuing with your usual sexual activities, discuss this with your doctor or with a trained counsellor so that you may obtain the best advice.

2007-04-26T08:42:00.000-07:00

Adult cancer Prostate Cancer Symptoms Cancer Information on Prostate Cancer and Cancer Links – Guide to useful resources on. Adult Acute The National Cancer .

Learn About adult cancer: Prostate Cancer Learn About prostate cancer, medical tests, treatments, and other topics surrounding .

Adult cancer-Prostate cancer is the most commonly diagnosed cancer in men in the United States. Cancer Clinical Trials · Pediatric Cancer Clinical Trials

about prostate cancer. PSA Velocity Indicates the Presence of Life Threatening Prostate Cancer Urology Director,.

Risk Of Dying From Prostate Cancer Increased
That obesity did not impact the incidence of prostate cancer is consistent with findings from most other studies. However, that "BMI and adult weight gain

Prostate Cancer Is the Most Common Cancer in Men adult cases of prostate cancer (29 percent of all adult male cancers)

Growth Inhibition of Human Prostate Cancer Cells in Human Adult. This is the first report of an IGF ligand-specific inhibitory antibody that suppresses the growth of human prostate cancer cells in human adult

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2007-01-04T20:25:00.000-08:00

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Tag: Prostate cancer - Signs, Symptoms and Treatment

2006-10-18T05:53:00.000-07:00

Signs and Symptoms of Prostate Cancer

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In this issue, learn the facts about colorectal cancer, including risk factors, signs and symptoms and available treatment options

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