The American Society of Clinical Oncology (ASCO) has come up with an updated recommendation based on the latest research. Results: In one randomized trial, PSA testing in menwho would not otherwise have been screened resulted in reduced death rates from prostate cancer, but it is uncertain whether the size of the effect was worth the harms associated with screening and subsequent unnecessary treatment. Although there are limitations to the existing data, there is evidence to suggest that men with longer life expectancy may benefit from PSA testing. Adverse events associated with prostate biopsy are low for the majority of men; however, several population-based studies have shown increasing rates of infectious complications after prostate biopsy, which is a concern. Provisional Clinical Opinion: On the basis of identified evidence and the expert opinion of the panel:
In men with a life expectancy<10 years,* it is recommended that general screening for prostate cancer with total PSA be discouraged, because harms seem to outweigh potential benefits.
In men with a life expectancy>10 years,* it is recommended that physicians discuss with their patients whether PSA testing for prostate cancer screening is appropriate for them. PSA testing may save lives but is associated with harms, including complications, from unnecessary biopsy, surgery, or radiation treatment.
It is recommended that information written in lay language be available to clinicians and their patients to facilitate the discussion of the benefits and harms associated with PSA testing before the routine ordering of a PSA test.
A low-fat diet with fish oil supplements eaten for four to six weeks prior to prostate removal slowed down the growth of prostate cancer cells -- the number of rapidly dividing cells -- in human prostate cancer tissue compared to a traditional, high-fat Western diet.
Done by researchers at UCLA's Jonsson Comprehensive Cancer Center, the short-term study also found that the men on the low-fat, fish oil supplement diet were able to change the composition of their cell membranes in both the healthy cells and the cancer cells in the prostate. They had increased levels of omega-3 fatty acids from fish oil and decreased levels of omega-6 fatty acids from corn oil in the cell membranes, which may directly affect the biology of the cells, though further studies are needed, said Dr. William Aronson, the study's first author and a researcher with UCLA's Jonsson Comprehensive Cancer Center.
This is a limited study. A longer term study is being done with patient that doing "Waitful Watching" of their PC rather than active treatment.
I got an email from US Too. It is prostate cancer support and resource group.
Are you a man with advanced prostate cancer (or his wife, partner or caregiver) who is treating advanced prostate cancer with some of the newest treatment options available? If so, please consider sharing your experiences with the new treatments. This research will be used to improve support services for other patients and their families. The Frankel Group, a life science focused consulting firm, is seeking participants for a 30-minute telephone discussion. Your identity will be kept completely confidential at all times. For your time, they will offer you a $50 honorarium.
Two researchers from Roswell Park Cancer Institute (RPCI) have opened a clinical trial that will assess the impact of dietary change to control prostate cancer . The Men's Eating and Living (MEAL) study led by co-investigators James Mohler, MD, and James Marshall, PhD, is both the first to assess the effects of radical dietary intervention on men with prostate cancer and the only current clinical investigation involving men placed on active surveillance in lieu of active treatment for low-risk prostate cancer.
This multisite trial will test the results of assigning men with small, low-grade prostate tumors to an intervention designed to encourage a diet low in animal products. The MEAL trial is now open at RPCI and other sites through several cooperative oncology groups sponsored by the National Cancer Institute. Dr. Mohler is Senior Vice President for Translational Research and Chair of the Department of Urology, and Dr. Marshall is Senior Vice President for Cancer Prevention and Population Sciences.
Their team will identify 450 men with prostate cancer from across the country, all considered to be at low risk for developing advanced prostate cancer. All participants will change their dietary intake, but half will more significantly change their diet, assisted by a telephone intervention.
Research has shown that a diet low in animal products like meat and dairy and high in fruits and vegetables is associated with lower incidence of prostate cancer. Drs. Marshall and Mohler and colleagues led a similar six-month pilot study launched in 2004.
"The MEAL trial promises to be a very strong study based in biological and behavioral changes," said Dr. Marshall, who is also Roswell Park Alliance Foundation Endowed Chair in Cancer Prevention. "We've shown very convincingly with our pilot study that we can change men's diets we can see the progress in diet records but, more importantly, by means of blood-based nutritional biomarkers."
The research is supported by the National Cancer Institute, the Department of Defense and The Prostate Cancer Foundation. The MEAL trial will have two important collaborators: J. Kellogg Parsons, MD, MHS, and John Pierce, PhD, both researchers with the Moores Center, UC San Diego.
"The most common question that a urologist gets from a patient who has low-risk prostate cancer is, 'Is there anything I can do to slow or stop its growth should I change my diet?' And this trial should give us much clearer and perhaps even definitive answers," notes Dr. Mohler.
Source: Roswell Park Cancer Institute [a name="ratethis">View Thread
Insulin-like growth factor pathway: A link between androgen deprivation therapy (ADT), insulin resistance, and disease progression in patients with prostate cancer? - Abstract Division of Hematology/Oncology, Department of Medicine, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA 94143, USA.
Androgen deprivation therapy (ADT) is standard of care for patients with metastatic hormone-sensitive prostate cancer (HSPC), yet through its induction of a hypogonadal state leads to metabolic perturbations, including insulin resistance (IR) and obesity. IR and obesity have been associated with an increased risk of progression to castrate-resistant prostate cancer (CRPC) and ultimately increased prostate cancer-specific mortality. On a molecular level, this association between obesity/IR and prostate cancer progression may be mediated by alterations in the insulin-like growth factor (IGF) axis, which has been shown to be up-regulated upon disease progression to CRPC. Targeting the IGF axis, either by anti-IGF therapy or via enhancement of peripheral insulin sensitivity, represents a viable therapeutic target in patients with prostate cancer. Using the development of IR and/or obesity may represent a clinically available biomarker that may predict those patients most likely to respond to such therapy, and warrants testing in future prospective clinical trials. Written by: Aggarwal RR, Ryan CJ, Chan JM. Are you the author? Reference: Urol Oncol. 2011 Jun 7. Epub ahead of print. doi: 10.1016/j.urolonc.2011.05.001 [a>PubMed Abstract PMID: 21658978 UroToday.com Prostate Cancer SectionView Thread
"Many men have some degree of incontinence after prostate surgery, but few are significantly bothered by it, according to a poll at one U.S. hospital.
Of 315 patients who'd had their prostate removed due to cancer, only a quarter said a year or more after surgery that they never experienced any leakage.
Still, more than three-quarters of the men said they didn't use pads in their underwear and only about one in 20 said they were significantly bothered by incontinence.
"The bottom line is that many men, after having their prostate removed, will have some impact on the way they urinate," said Dr. Erik Castle, an associate professor of urology at the Mayo Clinic in Phoenix, who led the new work. "But the degree of the impact is minimal.
According to the American Cancer Society, one in six men gets prostate cancer at some point in his life and one in 36 men in the U.S. will die from it.
While there is controversy over how to treat low-risk tumors, some of which may never cause any harm if left untreated, surgery and radiation are common options when the disease is more advanced. But men considering these treatments also face possible side effects like becoming incontinent or impotent. And getting useful information about how common these problems are is difficult, Castle said, because there are so many different ways of defining them. "There is a lot of miscommunication," he told Reuters Health. "The goal of the study was to come up with a more detailed analysis of what men should expect after their prostate is removed."
The researchers sent out questionnaires to 600 men, from 42 to 82 years old, who'd had robot-assisted prostate surgery at their hospital. The surveys focused on incontinence, asking a wealth of questions, including how the patient's sex life, physical activity and social life were affected.
Just over two-thirds of the men responded. At least one year after their surgery, 78 percent said they didn't use pads in their underwear, while only 26 percent said they never leaked. "The outcomes are actually pretty darn good," said Castle, adding that some of the older men might already have been leaking before they underwent surgery.
Men who used more than one pad a day -- 17 percent -- most often leaked during exercise or when coughing and sneezing, and said their incontinence was most bothersome in relation to their sex life. Overall, five percent of men said they were significantly bothered by their incontinence, and less than one percent reported leaking all the time.
"We just wanted to get the message across that, 'Look, the vast majority of patients had some kinds of changes in their lifestyle but are still very happy,'" Castle said, adding that less than one percent of patients have any major complications at Mayo Clinic.
Prostate removal is usually only recommended for men who are expected to live at least 10 to 15 more years. And even then, the decision should be based on individual preferences, Castle said.
For instance, if a man already has some incontinence and impotence, Castle would encourage surgery. But if he is very worried about impotence, radiation treatment might be a better way to go, because its effect on continence and potency are delayed a few years, he added.
"This study armed us with the information to be able to explain to patients what to expect when we are counseling them," Castle told Reuters Health. "We end up getting patients who say, 'Doctor, I'm very happy.'"