Prostate Cancer

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Prostate Cancer

NIH - Medical Encyclopedia Prostate cancer

"The cause of prostate cancer is unknown, although some studies have shown a relationship between high dietary fat intake and increased testosterone levels. … Prostate cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75 years old. Prostate cancer is rarely found in men younger than 40. … Men at higher risk include black men older than 60, farmers, tire plant workers, painters, and men exposed to cadmium. The lowest incidence occurs in Japanese men and vegetarians. Prostate cancers are classified or staged based on their aggressiveness and how different they are from the surrounding prostate tissue. There are several different ways to stage tumors, a common one being the A-B-C-D staging system, also known as the Whitmore-Jewett system: A: Tumor is not palpable (not felt on physical examination), and is usually detected by accident after prostate surgery done for other reasons. B: Tumor is confined to the prostate and usually detected by physical examination or PSA testing. C: Tumor extends beyond the prostate capsule without spread to lymph nodes. D: Cancer has spread (metastasized) to regional lymph nodes or other parts of the body (bone and lungs, for example)."

Highlighted Articles

Body Mass Index, Weight Change, and Risk of Prostate Cancer in the Cancer Prevention Study II Nutrition Cohort (Cancer Epidemiology Biomarkers & Prevention 2007)

" Conclusion: Obesity increases the risk of more aggressive prostate cancer and may decrease either the occurrence or the likelihood of diagnosis of less-aggressive tumors. Men who lose weight may reduce their risk of prostate cancer."

Meat Consumption among Black and White Men and Risk of Prostate Cancer in the Cancer Prevention Study II Nutrition Cohort (Cancer Epidemiol Biomarkers Prev 2006)

"No measure of meat consumption was associated with risk of prostate cancer among White men. Among Black men, total red meat intake (processed plus unprocessed red meat) was associated with higher risk of prostate cancer … this increase in risk was mainly due to risk associated with consumption of cooked processed meats (sausages, bacon, and hot dogs … This study suggests that high consumption of cooked processed meats may contribute to prostate cancer risk among Black men in the United States."

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Prostate Cancer

Daily Treatment Report

Cognitive Therapy-CBT-Psychotherapy

Device Therapy

Drug Side-Effects and Interactions

Prostate Cancer Treatment Ups Cardiovascular Mortality "In men who undergo radical prostatectomy for localized prostate cancer, the use of androgen deprivation therapy (ADT) appears to increase the risk of death from cardiovascular causes, new research shows."

Prostate Cancer Increases Hip Fracture Risk By Eight Times In 50 To 65 Year-olds " 'Medical advances are improving survival rates, but the downside is that treatment can lead to osteoporosis, where the bone loses density and becomes more fragile. This is turn increases the risk of fractures.' "

Hormone Therapy for Prostate Cancer Linked to Heart Risks "Prostate cancer patients receiving androgen-deprivation therapy, a common form of hormone treatment proven to slow tumor growth and prolong life, may face a nearly threefold higher risk of dying from heart disease, a new study suggests. The apparent danger results from a drop in testosterone levels that is central to androgen-deprivation therapy's (ADT) effectiveness at curbing prostate cancer, the study authors said. This drop in testosterone can provoke insulin resistance, leading to type 2 diabetes, as well as a gain in body mass, body fat and so-called bad cholesterol. Collectively, this group of problems is called the "metabolic syndrome," a condition long-associated with cardiac complications. "

Physical Function in Men With Prostate Cancer on Androgen Deprivation Therapy. (Phys Ther. 2007) "The results suggest that ADT has a significant effect on walking speed and physical performance in men with prostate cancer."

Osteonecrosis of the jaw in prostate cancer patients with bone metastases treated with zoledronate: A retrospective analysis. (Acta Oncol. 2007)

What's good for prostate cancer may be bad for heart, study finds "The standard treatment for prostate cancer — shutting off the body's production of androgen hormones — can chop 2 ½ years off the lives of men at high risk of developing heart disease, Boston researchers reported Friday. The drugs used for suppressing the hormones produce anemia, weight gain and insulin resistance, a constellation of factors known as metabolic syndrome. The effects can increase substantially the risk of a fatal heart attack, especially in men at high risk, Dr. Anthony D'Amico, of Brigham and Women's Hospital in Boston, reported in the Journal of Clinical Oncology. Because the drugs can slow or halt the progression of a prostate tumor, researchers are not advocating that physicians stop using them. "

Prevalence of osteoporosis during long-term androgen deprivation therapy in patients with prostate cancer. (Urology. 2007) "CONCLUSIONS: The prevalence of osteoporosis seemed high in hormone-naive patients with prostate cancer, and it increased to more than 80% after 10 years of ADT. Because of the increased risk of bone fractures in those patients, clinicians should be aware of the impact of ADT on BMD to prevent bone mass loss."

Effect of 1 mg/day finasteride on concentrations of serum prostate-specific antigen in men with androgenic alopecia: a randomised controlled trial. (Lancet Oncol. 2007) " INTERPRETATION: In men aged 40-60 years, 1 mg/day finasteride for 48 weeks lowers serum PSA concentration. Therefore, the existing recommendation for the adjustment of serum PSA concentration in prostate-cancer screening in men taking 5 mg/day finasteride should also apply to men taking the 1 mg/day preparation for male-pattern hair loss. Research is needed to assess the effect of 1 mg/day finasteride preparation beyond 48 weeks of treatment."

Drugs

Chemotherapy for the treatment of hormone-refractory prostate cancer. (Int J Clin Pract. 2007)

Survival in Men With Nonmetastatic Prostate Cancer Treated With Hormone Therapy: A Quantitative Systematic Review (Journal of Clinical Oncology 2007)

Adjuvant androgen deprivation therapy augments cure and long-term cancer control in men with poor prognosis, nonmetastatic prostate cancer. (Prostate Cancer Prostatic Dis. 2007)

Gabapentin Helps Hot Flashes from Prostate Cancer Treatment

The role of hormonal treatment in prostate cancer. (Recent Results Cancer Res. 2007) "In 1941 Huggins and Hodges published for the first time the favorable effects of surgical castration and estrogen treatment on the progression of metastatic prostate cancer."

Adjuvant Androgen Deprivation Can "Cure" Nonmetastasized Prostate Cancer

Neoadjuvant therapy and prostate cancer: what a urologist should know. (Curr Opin Urol. 2007)

Androgen deprivation therapy in the treatment of advanced prostate cancer. (Rev Urol. 2007) "Adverse events associated with LHRH agonists include the flare phenomenon, hot flashes, loss of libido, erectile dysfunction, depression, muscle wasting, anemia, and osteoporosis. Intermittent therapy has been advocated to reduce morbidity of treatment. The addition of an antiandrogen provides maximum androgen blockade. There remains controversy regarding the timing of the addition of an antiandrogen."

Predictors of overall and cancer-free survival of patients with localized prostate cancer treated with primary androgen suppression therapy: results from the prostate cancer outcomes study. (J Urol. 2007) "CONCLUSIONS: The use of primary androgen suppression therapy in the Prostate Cancer Outcomes Study data set resulted in 91% 5-year cancer specific survival. Advanced age, and factors that reflect tumor burden and biology were predictive of overall survival, while cancer specific survival was predicted by tumor factors and the burden of comorbid conditions. A nomogram for predicting overall survival at 5 years was constructed."

Population Based Study of Hormonal Therapy and Survival in Men With Metastatic Prostate Cancer. (J Urol. 2007) "CONCLUSIONS: Hormonal therapy is associated with improved prostate cancer specific and overall survival in men with poorly differentiated cancer. Improved survival does not appear evident in men with well differentiated disease."

Early effects of pharmacological androgen deprivation in human prostate cancer. (BJU Int. 2007) "CONCLUSIONS Pharmacological AD induces significant involution within prostatic tissues over 7-28 days, but allows the persistence of some viable tumour cells capable of proliferation."

Exercise

Walking prevents bone loss caused from prostate cancer treatment "Exercise may reduce, and even reverse, bone loss caused by hormone and radiation therapies used in the treatment of localized prostate cancer, thereby decreasing the potential risk of bone fractures and improving quality of life for these men, according to a study presented on October 28, 2007, at the American Society for Therapeutic Radiology and Oncology’s 49th Annual Meeting in Los Angeles."

Exercise can prevent and even reverse adverse effects of androgen suppression treatment in men with prostate cancer. (Prostate Cancer Prostatic Dis. 2007)

General Information

Low risk prostate cancer in men under age 65: The case for definitive treatment. (Urol Oncol. 2007)

Active surveillance for favorable risk prostate cancer: what are the results, and how safe is it? (Semin Radiat Oncol. 2008) “Active surveillance for favorable risk prostate cancer has become increasingly popular in populations in which prostate cancer screening is widespread because of evidence that prostate cancer screening results in the detection of disease that is not clinically significant in many patients (ie, untreated, would not pose a threat to health). The approach is supported by data showing that patients who fall into the category of clinically insignificant disease can be identified with reasonable accuracy and that patients who are initially classified as low risk who reclassify over time as higher risk and are treated radically are still cured in most cases.”

Is it necessary to cure prostate cancer when it is possible? (Understanding the role of prostate inflammation resolution to prostate cancer evolution). (Clin Interv Aging. 2007)

Will focal therapy become a standard of care for men with localized prostate cancer? (Nat Clin Pract Oncol. 2007) "The current treatment choice for men with localized prostate cancer lies between active surveillance and radical therapy. The difference between these two extremes of care is 5% in terms of cancer-related absolute mortality at 8 years. It is generally accepted that this small difference will decrease for men diagnosed in the prostate-specific-antigen era. Radical therapy is associated with considerable adverse effects (e.g. incontinence, impotence, rectal problems) because it treats the whole gland, and damages surrounding structures in up to half of men."

Routine use of magnetic resonance imaging in the management of t(1c) carcinoma of the prostate: is it necessary? (J Endourol. 2007) "Conclusions: The role of MRI in the management of clinical stage T(1c) prostate cancer is limited, as it altered the management of only 1.3% of our patients. The cost v the value of this study should be discussed with the patient before MRI is prescribed."

Short- and Long-term Mortality With Localized Prostate Cancer. (Arch Intern Med. 2007)

Encourage Diet and Lifestyle Interventions in Low-Risk Prostate Cancer "Men with low-risk prostate cancer who opt for active surveillance should be encouraged to make dietary and lifestyle changes that improve their overall quality of life, such as reducing calories and exercising …"

[Metastatic prostate cancer treatment in the elderly] (Bull Cancer. 2007)

Failure to Achieve a PSA Level (Int J Radiat Oncol Biol Phys. 2007) "CONCLUSIONS: The results of our study have shown that patients with a PSA level >1 ng/mL at the beginning of external beam radiotherapy after >/=2 months of neoadjuvant luteinizing hormone-releasing hormone agonist therapy have a significantly greater rate of biochemical failure and lower survival rate compared with those with a PSA level of

[Treatment of hormonal refractory metastatic prostate cancer.] (Ugeskr Laeger. 2007)

[Treatment of localised prostate cancer.] (Ugeskr Laeger. 2007)

[Rising Prostate Specific Antigen following treatment with curative intention.] (Ugeskr Laeger. 2007)

Effect of androgen deprivation therapy on quality of life in Japanese men with prostate cancer. (Int J Urol. 2007)

Adjuvant Androgen Deprivation Can "Cure" Nonmetastasized Prostate Cancer

[Optimal treatment for elderly high-risk prostate cancer patients.] (Gan To Kagaku Ryoho. 2007)

Lack of survival benefit of post-operative radiation therapy in prostate cancer patients with positive lymph nodes. (Prostate Cancer Prostatic Dis. 2007)

A Cure for Prostate Cancer? " A new study reveals some exciting news for men with prostate cancer. Investigators say 74 percent of men treated with a combination of radiation seed implants and external beam radiation therapy for prostate cancer are cured of their disease 15 years later."

Guidelines

NGC - Guideline for the management of clinically localized prostate cancer: 2007 update. (2007)

ASCO 2007 Guideline Update: Recommendations for the Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer (2007)

ASCO Patient Guide: Hormone Therapy for Advanced Prostate Cancer (2007)

ASCO Treatment Algorithm for the Initial Hormonal Management of Androgen-Sensitive Advanced Cancer: 2007 Update (2007)

The AUA Prostate Cancer Guideline: What's New? (2007)

NGC - Initial hormonal management of androgen-sensitive metastatic, recurrent, or progressive prostate cancer: 2006 update of an American Society of Clinical Oncology practice guideline. (2007)

NGC - External beam radiation therapy treatment planning for clinically localized prostate cancer. (2006)

NGC - Postradical prostatectomy irradiation in prostate cancer. (2006)

New Guidelines for Prostate Cancer " … • Men should be informed that in comparing options of "watchful waiting" and surgery, surgery may reduce the risk of cancer recurrence and improve survival. (In watchful waiting, the decision is made to hold off on treatment but to closely monitor the cancer to see if it progresses and then decide on treatment.) • Men at intermediate risk who choose external beam radiation as their treatment should be informed that adding hormone therapy improves survival. • Men at high risk should know that adding hormone therapy to external beam radiation may prolong their life. Among the recommendations: • Men should know that for localized prostate cancer, using hormone therapy as an initial treatment is seldom indicated. • Patients with localized cancer should be offered the chance to enroll in clinical trials if they qualify. Among the options: • High-risk men should be told that recurrence rates are high even with treatments … Patients with localized prostate cancer need to know that "no one treatment is right for all," Thompson says. "Two patients with precisely the same tumor may come to two different conclusions [about treatment] based on the evidence." "

NGC - Docetaxel for the treatment of hormone-refractory metastatic prostate cancer. (2006)

Immunotherapy

Internet Sites

Treatment Information

DrugBank (drug structure)

FDA - MedWatch (Drug Alerts)

NCI - Dictionary of Cancer Terms

NCI - Drug Dictionary

NCI - Overview of Nutrition in Cancer Care

NCI - Prostate Cancer (PDQ®): Treatment

Drug-Food-Supplement Information

Drug Information Online

Drug Interaction Checker

DrugDigest (drug interactions)

FDA - Drug Interactions: What You Should Know

NIH - Botanical Dietary Supplements: Background Information

NIH - Drug, Supplements, and Herbal Information

NIH - Herbal Supplements: Consider Safety, Too

NIH - Medicines

NIH - Vitamin and Mineral Supplement Fact Sheets

Nutrition

Pomegranate Juice vs. Prostate Cancer? "Natural chemicals in pomegranate juice may slow the growth of prostate cancer, according to scientists at the University of California at Los Angeles (UCLA). The key pomegranate chemicals, called ellagitannins, are also found in foods including strawberries, raspberries, and muscadine grapes, note Navindra Seeram, PhD, and colleagues. Their theory is that when someone drinks pomegranate juice, the juice releases ellagitannins, which get digested into chemicals called urolithins, which may fight prostate cancer."

Flaxseed May Prevent Growth of Prostate Cancer

Tomato-Broccoli Combo May Protect Against Prostate Cancer: Study with rats found the foods eaten together led to tumor reduction "Broccoli and tomato -- two vegetables known to help fight cancer -- are more effective against prostate cancer if they're eaten together as part of a daily diet than if they're eaten alone, a new study with rats suggests."

Other

Radiation-Chemotherapy

Other Treatments

Dissolving Prostate Cancer

Prostate brachytherapy: A descriptive analysis from CaPSURE. (Brachytherapy. 2007)

Recto-urethral fistula following brachytherapy for localized prostate cancer. (Colorectal Dis. 2007)

[Functional outcome after laser vaporisation of the prostate with the KTP laser.] (Urologe A. 2007)

"Excellent Results" With Implanted Radiation Seeds in Early Prostate Cancer "A technique that implants radiation seeds the size of a grain of rice directly into the prostate yields "excellent long-term results" in the treatment of early prostate cancer, concludes a new analysis of pooled data."

Long-term followup of a randomized study of locally advanced prostate cancer treated with combined orchiectomy and external radiotherapy versus radiotherapy alone (Urol Oncol. 2007) " CONCLUSIONS: Immediate androgen deprivation should be considered instead of deferred endocrine treatment started at clinical progression for prostate cancer with spread to regional lymph nodes. While awaiting evidence from randomized trials, one should consider full dose radiotherapy for local control of locally advanced prostate cancer even when it is lymph node positive."

Radiotherapy combined with hormonal therapy (RT-HT) in prostate cancer patients with low, intermediate, and high risk of biochemical recurrence: perspective and therapeutic gain analysis. (Neoplasma. 2007)

Experimental

Saw Palmetto induces growth arrest and apoptosis of androgen-dependent prostate cancer LNCaP cells via inactivation of STAT 3 and androgen receptor signaling. (Int J Oncol. 2007)

Lycopene and lutein inhibit proliferation in rat prostate carcinoma cells. (Nutr Cancer. 2007)

Oral Grape Seed Extract Inhibits Prostate Tumor Growth and Progression in TRAMP Mice. (Cancer Res. 2007)

Radiotherapy

10-Year Survival and Quality of Life in Patients with High-Risk (P)N(0) Prostate Cancer Following Definitive Radiotherapy. (Int J Radiat Oncol Biol Phys. 2007) "CONCLUSIONS: Despite surgically proven (p)N(0), RT with dosage <70 Gy as monotherapy does not give satisfactory CSS rates after 10 years in patients with T(3-4) or GS >/=7B."

Lack of survival benefit of post-operative radiation therapy in prostate cancer patients with positive lymph nodes. (Prostate Cancer Prostatic Dis. 2007)

Supplements-Vitamins-CAM

Lycopene and soy isoflavones in the treatment of prostate cancer. (Nutr Cancer. 2007)

Plasma carotenoids and prostate cancer: a population-based case-control study in arkansas. (Nutr Cancer. 2007)

Curcumin enhances the apoptosis-inducing potential of TRAIL in prostate cancer cells: molecular mechanisms of apoptosis, migration and angiogenesis. (J Mol Signal. 2007)

Fish Oil Might Slow Prostate Cancer "According to Chen, the study suggests that diets high in long-chain omega-3 fatty acids might give men an edge against prostate cancer. But not everyone is convinced. 'Recent large reviews and meta-analyses tend to suggest no major effects of fish [intake] on cancer risk,' said Paul Terry, assistant professor in the department of epidemiology at the Emory University School of Public Health, in Atlanta. … For his part, Chen said it's important that consumers realize that not all omega-3s are created equal in terms of their potential health benefits. 'In this study, we are only referring to the long-chain form' found in oily fish, such as mackerel, herring, albacore tuna and salmon, he said. Other, shorter-chain varieties can be found in flaxseed and plant sources, but their impact, if any, on cancer is even less clear."

Cancer Treatments From the Kitchen: New research shows that flaxseed and ginseng have something to offer patients. Shark cartilage, however, comes up short. "Nutritionists and alternative-medicine practitioners alike are enamored of flaxseed. High in omega-3 fatty acids, it also has "800 times more lignan than anything else you could stick in your mouth," says Duke University cancer researcher Wendy Demark-Wahnefried. Lignan, a chemical found in the cell walls of plants, binds to testosterone in the body—and in many prostate-cancer patients, testosterone is what fuels tumor growth. Researchers have often suspected that lignan might stop prostate tumor cells from multiplying out of control. Before starting her most recent research, Demark-Wahnefried says, her team "put a man with rising [prostate-specific antigen or PSA] levels on flaxseed, and in three months his PSA had halved and his cancer cells were shrinking."

The relationship between daily calcium intake and bone mineral density in men with prostate cancer. (BJU Int. 2007) "CONCLUSIONS DCI seems to be related to BMD; a low DCI was an independent risk factor for osteoporosis in men with prostate cancer. In the study population overall the DCI was inadequate. Urologists should recommend a DCI of >1000 mg in patients with prostate cancer, especially in those under ADT."

Curcumin May Treat Prostate Cancer "The ingredient curcumin -- found in the common curry spice, turmeric -- may help treat prostate cancer. In the most recent issue of Cancer Research, researchers from the Comprehensive Cancer Center of the University of Alabama in Birmingham report curcumin has anticancer effects. "

Surgery

The Short-Term and Long-Term Effects of Radical Prostatectomy on Lower Urinary Tract Symptoms. (J Urol. 2007)

Surgery Best Bet for Prostate Cancer Survival "Surgery may offer the best chance of long-term survival for prostate cancer patients, a Swiss study suggests. Researchers at Geneva University found that prostate cancer patients who had surgery were less likely to die of the disease within 10 years than men who had other types of treatment. Surgery seemed especially beneficial for younger patients or those who had prostate cancer with certain tumor cell characteristics."

[Clinicopathological study of prostate cancer patients who had a serum PSA level of more than 20 ng/ml and were treated by a radical prostatectomy] (Nippon Hinyokika Gakkai Zasshi. 2007) "CONCLUSION: Based on our findings, the prognosis of TZ cancer cases was better than that of PZ cancer cases among the radical prostatectomy cases with PSA greater than 20 ng/ml. Radical prostatectomy might be one of the effective treatment option for TZ cancer even if the PSA shows greater than 20 ng/ml. It seems to be important to detect TZ cancer properly based on DRE and TRUS findings."

Exercises reduce urine leak after prostate surgery "Men with urinary incontinence after prostate surgery may benefit from exercises designed to strengthen the pelvic floor muscles, a group of muscles that surround the urethra and rectum, according to a report in BJU International."

The Surgical Learning Curve for Prostate Cancer Control After Radical Prostatectomy (Journal of the National Cancer Institute 2007) "Results: The learning curve for prostate cancer recurrence after radical prostatectomy was steep and did not start to plateau until a surgeon had completed approximately 250 prior operations. The predicted probabilities of recurrence at 5 years were 17.9% (95% confidence interval [CI] = 12.1% to 25.6%) for patients treated by surgeons with 10 prior operations and 10.7% (95% CI = 7.1% to 15.9%) for patients treated by surgeons with 250 prior operations (difference = 7.2%, 95% CI = 4.6% to 10.1%; P<.001). This finding was robust to sensitivity analysis; in particular, the results were unaffected if we restricted the sample to patients treated after 1995, when stage migration related to the advent of PSA screening appeared largely complete. Conclusions: As a surgeon's experience increases, cancer control after radical prostatectomy improves, presumably because of improved surgical technique. Further research is needed to examine the specific techniques used by experienced surgeons that are associated with improved outcomes. "

Quality of life, sexual function and decisional regret at 1 year after surgical treatment for localized prostate cancer. (BJU Int. 2007)

[Urinary incontinence after prostatic surgery.] (Ugeskr Laeger. 2007)

Natural History of Biochemical Recurrence after Radical Prostatectomy: Risk Assessment for Secondary Therapy. (ur Urol. 2007)

Retropubic versus perineal radical prostatectomy in early prostate cancer: Eight-year experience. (J Surg Oncol. 2007)

Transplantation

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