Prostate Cancer Blog

We're looking for passionate and enthusiastic individual to be the Guide to the Prostate Cancer site on About.com!

What sort of information do we want the new Guide to provide?
Well, we're looking for someone who can help newly diagnosed patients, those living with prostate cancer, and their friends and families understand what the disease does, how it progresses, and how it's treated. Content will discuss diagnosis, prevention, and treatment, and offer resources and support.

What sort of person are we looking for to be the new Guide to Prostate Cancer?
Our ideal candidate:

• a physician, oncology nurse or oncologist who works directly with prostate cancer patients
• a health educator with extensive experience working with prostate cancer

If this sounds like you, and you've got excellent writing skills and the desire to reach and teach a broad audience through your writing, why not go over to our application site to learn more about our hiring program and submit an application?

The Honorable Ralph M. Burnett, Jr., a district court judge in Maryland and tireless advocate for prostate cancer funding and education died of prostate cancer complications at the age of 64 on May 9th, 2007.

He was diagnosed with prostate cancer in 1996, and immediately began advocating funding for a cure for the disease. The following year he was elected to the board of the National Prostate Cancer Coalition, and served as their chair from 1999 to 2001. He is credited with being instrumental in doubling the federal funding for prostate cancer research, and tripling the size of the organization.

Our thoughts and prayers go out to his family, and the NPCC who will surely miss him.

Source: NPCC Mourns Loss of Former Chairman and Friend, Judge Ralph M. Burnett, Jr.. (online article)

Interpreting the numbers when a PSA test comes back can almost be an art. Things such as a man's age, comorbidities, previou test results all have to come into play when making the decision to have a prostate biopsy.

An article in the New York Times, Deciphering the Results of a Prostate Test does a good job of attempting to explain what doctors consider when evaluating this screening tool's results.

Check it out, it is very informative reading.

Men between 40 and 50 years old should be considered for biopsy at lower levels according to research at Duke University.

An article published in the BJU International conclude that lower PSA thresholds for men under 50 are appropriate because norms are lower than in older men.

The research studied just over 12,000 men between the ages of 40 and 96 with at least two PSA tests during a two year period. Of 1622 men diagnosed with prostate cancer, 40 were below age 50. Of the 962 men under 50, the median PSA was 1.3 ng/mL for those with prostate cancer and 0.7 ng/mL for those without.

The researchers are suggesting that for men under 50, biopsies be performed on men with a PSA level of between 2.0 and 2.5 ng/mL. This would adjust the sensitivity of the test at about 74 percent with a 93 percent specificity. They also recommend adjusting the PSA velocity threshold to between 0.2 and 0.6 ng/mL/year.

The researcher opine that PSA screening in men in this age group is more likely to detect men with localized cancer that is easily treated, and PSA level are less affected by BPH which reduces false positives.

Source: BJU Int 2007;99:753-757.

Dr. Fred Cook, 83, and his oldest son Paul, 58, are this year's honorary cancer survivors for the 12th annual Chippewa Relay for Life, planned for July 28th in Chippewa Falls, WI.

According to an article, Father, Son, Share Cancer Victory, in Chippewa.com, the two had both been diagnosed and successfully treated for prostate cancer.

Fred, diagnosed shortly after retiring 18 years ago by the then "new" PSA test had a prostatectomy and 30 radiation treatments has been cancer free for 17 years.

His son, Paul had a spike in his PSA in 2006, underwent a biopsy and chose prostatectomy for treatment. His cancer was localized and is recovering well.

Fred has two other sons who are vigilant at getting their screenings, as they know that they are at much higher risk for the disease due to their close relatives diagnoses.

Analysis: Although the PSA test is a controversial one, here is a story showing how it has saved lives. We wish the Cooks continued health and thank them for sharing their story.

Former cult leader Yahweh Ben Yahweh, linked to nearly two dozen killings during the 1980s and said to have ordered victim's ears cut off as proof they were killed, has died of advanced prostate cancer, his attorney said Tuesday, He was 71.

This according to an article at nbc6.net, published today.

Yahweh, who had served 11 of an 18 year prison sentence for racketeering conspiracy related to those killings had been released from prison in 2001.

He had been released from parole supervision earlier this year due to the advanced disease, even though prosecutors argued that even though he was in frail health he was still a threat.

Source: WTVJ (2007) Cult Leader Yahweh Ben Yahweh Dies of Prostate Cancer.. WTVJ Miami. (online article).

Smoking history is associated with an increased risk of metastatic prostate cancer when patients are treated with external beam radiation therapy (EBRT) according to a retrospective review of about 450 men.

The men, all with PSA levels <100 ng/mL and no evidence of metastasis were categorized as non-smokers, current smokers or previous smokers (>6 months). Information was collected including time from treatment to recurrence, and whether the recurrence was local or distant. Overall and specific survival rates were calculated based on these findings.

Seventy one percent of the men had been smokers at one point in their lives, and 17 percent were current smokers. Non-smokers were 29 percent of the group.

Median age of the men was about 66 years for the smokers, and about 70 years old for previous smokers and those who never smoked. Initial PSA, T stage and Gleason scores were not significantly varied among the groups.

Just under 45 percent had recurrence as detected by biochemical failure, 23 percent had local disease recurrence, and 15.5 percent developed metastasis overall. Local failure reates where similar between groups, but metastatic rates were significantly higher for smokers.

The death rate for the group was 34 percent and 39 percent of these deaths were due to prostate cancer.

It has been theorized that smoking induced hypoxia caused by high serum carboxyhemoglobin levels may contribute to cancer development.

_{Source: J. Pantarotto, S. Malone, S. Dahrouge, V. Gallant, & L. Eapen. (2006). Metastatic Prostate Cancer Incidence of Smokers after XRT. BJU International 99(3): 564-569}

Researchers in the US are confident that a newly discovered protein early prostate cancer antigen-2 (EPCA-2), will become the biomarker for a more reliable blood based prostate cancer test.

Currently, prostate cancer testing relies on a PSA Test. Generally, if PSA levels are greater than 2.5 ng/mL a man is referred for a biopsy. This process is relatively unreliable because of three reasons:

• As high as 80 percent of men who get prostate biopsies due to elevated PSA do not have cancer.
• As high as 15 percent of men who have prostate cancer have negative PSA levels so their cancer goes undetected.
• A PSA test cannot tell if the prostate cancer has spread to other parts of the body.

According to a study published in Urology, The researchers tested the blood of over 300 men for their EPCA-2 and levels, and grouped them as follows:

• Normal PSA with prostate cancer
• Normal PSA without prostate cancer
• Elevated PSA and negative biopsies
• Men with benign prostatic hypertrophy (BPH) without biopsies
• Prostate cancer that has not metastasized
• Prostate cancer than has metastasized
• Men with other types of cancer
• Men with other non cancerous organ conditions

The EPCA-2 levels were tested on these patients, and the following results were found:

• 97 percent of patients who did not have prostate cancer were identified correctly
• Men with negative biopsies (no matter their PSA levels) had EPCA-2 levels considered normal
• Men with other types of cancer or benign organ problems all had EPCA-2 levels considered normal
• 94 percent of men with prostate cancer had alerting levels of EPCA-2
• 90 percent of those with stage I or stage II localized prostate cancer had alerting levels of EPCA-2
• 98 percent of men with metastasized prostate cancer had alerting levels of EPCA-2. These levels were so high, it appears to be able to differentiate between metastatic and non-metastatic prostate cancer
• 77 percent of the men with BPH had non-alarming levels of EPCA-2 which is within the approximate percentage estimated to be prostate cancer free.

This data shows that the EPCA-2 test is more sensitive and specific than the PSA test, and can accurately identify if the prostate cancer has metastasized or not. Larger studies are planned in the very near future, and the EPCA-2 test should be available for use in the US in about 18 months.

Analysis: If the results ot this study should be verified with larger research studies, the test will probably be used in conjunction with a PSA test and DRE for several years in order to completely verify its sensitivity and specificity. Ultimately, it could reduce the number of biopsies that men must endure in order to rule out prostate cancer.

_{Source: E. Leman, G. Cannon, B. Trock, L. Sokoll, et. al. (2007). EPCA-2: A Highly Specific Serum Marker for Prostate Cancer. Urology. 69(4); Apr 2007. 714-720. doi:10.1016/j.urology.2007.01.097}

Researchers have finally done a long-term study about the quality of life for men that have undergone treatment for localized (Stage I or Stage II) prostate cancer.

They have determined that the three most popular treatments: brachytherapy, external beam radiation therapy (EBRT), and prostatectomy, all had very similar survival outcomes, so determining which treatment is the best one for a man should be determined on how each affects his quality of life.

With all three treatments, it was determined that the overall mental and physical well being were not profoundly affected. However, each treatment does negatively affect certain aspects of their quality of life with side effects ranging from urinary incontinence to sexual dysfunction which can be temporary, or permanent.

This study is tracking almost 600 men for five years, and just published the results of the first two years in the journal Cancer.

A summary comparison of the three treatments:

External Beam Radiation Therapy (EBRT)

• Best urinary control outcomes (low obstruction and control problems)
• Sexual function sparing rate high
• Bowel symptoms similar to brachytherapy, much more than prostatectomy
  • diarrhea
  • frequency
  • urgency
  • pain with bowel movements

Brachytherapy

• Shortest recovery times (NOT "Implants on Monday, Golf on Tuesday!")
• Urine obstruction common
• Urine control and irritation higher than with EBRT
• Sexual function sparing rate highest
• Bowel symptoms similar to EBRT, much more than prostatectomy
  • diarrhea
  • frequency
  • urgency
  • pain with bowel movements

Prostatectomy

• Higher rates of urinary incontinence (when sneezing or coughing)
• Higher rate of sexual dysfunction
• Many fewer bowel problems than with EBRT or brachytherapy
• Generally higher rate of sexual dysfunction (now better due to "nerve sparing techniques).

The team will continue to analyze the study data out through the five-year point, but expects little to change as most symptoms will resolve to their final level by two years post treatment.

The researchers stressed that it is important for men to make treatment choices based on their own needs, and to find the best doctor available for the treatment. It was shown that experience of the doctor and the facility do make a significant difference in the quality of the outcomes.

Source: Mark S. Litwin, John L. Gore, Lorna Kwan, Judson M. Brandeis, Steve P. Lee, et. al. (2007). Quality of life after surgery, external beam irradiation, or brachytherapy for early-stage prostate cancer. Cancer. (abstract)

Can tanning lower prostate cancer risk? Well, research has shown that prostate cancer incidence is lower among men diagnosed with skin cancer, according to a study published in the American Journal of Epidemiology, suggesting that ultraviolet (UV) radiation may offer protection against the disease.

Research has shown that exposure to UV radiation causes skin cancer, but some scientists have theorized that it protects against prostate cancer development and progression.

In order to test this hypothesis, researchers in the Netherlands posited that it would be expected that skin cancer patients would have a lower incidence of prostate cancer than the general population and an especially low incidence of advanced (Stage III or Stage IV) prostate cancer.

The researchers followed over 13,500 male skin cancer patients to find their incidence of prostate cancer between the years 1972 through 2004. The team compared the prostate cancer incidence with the reference population of men during this time period.

They found an 11 percent reduction in prostate cancer in the skin-cancer group, and a 27 percent reduction in advanced (Stage III and Stage IV) prostate cancer development.

The researchers feel that this could indicate an anti-progression effect of UV radiation, and supports a growing body of evidence that UV exposure protects against prostate cancer, possibly through the formation of vitamin D by the skin for the body during sun exposure.

If this hypothesis should pan out, it would be important for public health messages to be modified to weigh the increased risk of skin cancer against the decreased risk of prostate cancer due to UV exposure.

Related Articles:

• Vitamin D May Lower Prostate Cancer Risk
• Vitamin D and Sunlight May Reduce Prostate Cancer Risk
• Activated Vitamin D May Help the Sickest Prostate Cancer Patients
• More Evidence: Vitamin D Lowers Prostate Cancer Risk

Source: Esther de Vries, Isabelle Soerjomataram, Saskia Houterman, Marieke W. J. Louwman and Jan Willem W. Coebergh. (2007) Decreased Risk of Prostate Cancer after Skin Cancer Diagnosis: A Protective Role of Ultraviolet Radiation? . American Journal of Epidemiology. 165(8):966-972. (abstract).