The Prostate Cancer Blog for Wives and Partners lets you know when new information has been added to our site. Anytime a new page is created — or we feel there is something worth noting — it will be posted here.
Men who undergo androgen depravation therapy (ADT) may be at increased risk for dementia, according to a new retrospective study (Nead et al) published online in JAMA Oncology. Researchers look at the records of 9,272 men with prostate cancer. They found that after 5 years, 7.9% of men who received ADT had an increased risk of developing dementia vs 3.5% in men who did not have ADT. While some media outlets portray these results as definitive, we would feel more comfortable if similar results were confirmed in more robust randomized clinical trials. But these results are definitely something to discuss with your healthcare provider prior to starting ADT treatment. October 18, 2016.
Authors of a study (Ciu et al) published in Current Medical Research and Opinion suggest that digital rectal exam (DRE) screening may add little benefit. Researchers found that only an additional 2% of men who had normal PSA levels had abnormal DREs when analyzing data from 5,064 men from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial. Only 99 of those men who had normal PSA levels were diagnosed with clinically significant prostate cancer (CSPC). When looking at men who had both abnormal PSA and DRE, 20% were diagnosed with CSPC. It should be noted that the PLCO has been criticized for several factors, including low numbers of African-American men and lack of (or inconsistent) biopsies. September 30, 2016.
In 2012, the U.S. Preventive Services Task Force issued a final guideline recommending that men should not be routinely screened for prostate cancer. As a result, the number of men who are being diagnosed in the US with early prostate cancer declined by 19% in 2012 and fell another 6% in 2013, according to a HealthDay News report. We predict that this trend will continue until our government comes to its senses and the pendulum swings back again. September 27, 2016.
Men with localized prostate cancer may be just as likely to survive without treatment after 10 years as men who opt for surgery or radiation, according to a new UK study published in the New England Journal of Medicine (Hamdy et al). The study followed 545 men with prostate cancer who had active monitoring, 533 men who had radical prostatectomy, and 545 who had radiation (median age was 62 years). The majority of men (77%) had a Gleason sore of 6. Researchers found that death due to prostate cancer at 10 years was low (about 1%) regardless of the type of treatment. September 23, 2016.
African American (AA) men with prostate cancer had an increased likelihood of dying after receiving androgen deprivation therapy (ADT) for an average of 4 months than non-AA men, according to a new study (Konstantin et al), as reported by Brigham and Women’s Hospital that was published in the August 4 issue of Cancer. First, this was a retrospective study that analyzed the medical records of 7,252 men with low or favorable-intermediate risk of prostate cancer (20% of those men had ADT prior to brachytherapy). A lot of factors can come into play in a retrospective study. But it is noteworthy to report that the AA men had a 77% higher risk of death. Randomized clinical trials are needed to confirm these results. August 9, 2016.
Researchers have linked inherited mutations in DNA-repair genes (such as BRCA2) with a greater risk of lethal prostate cancer. But men with localized prostate cancer (cancer that is confined to the prostate gland) usually do not undergo routine genetic testing because the incidence of having DNA-repair gene mutations is low (1.2% to 1.8% for BRCA2 alone). In a recent study (Pritchard et al), however, researchers found that these DNA-repair gene mutations were present in 12% of 82 men with metastatic cancer, prompting the suggestion that “it may be of interest” to routinely examine all men with metastatic prostate cancer for genetic testing. But the researchers admit there were multiple limitations with this study, which appeared online first last week in the New England Journal of Medicine. July 12, 2016.
Focal laser ablation is a new type of treatment for prostate cancer that involves the application of heat, using a laser, to destroy cancerous tissue inside a tumor (guided by magnetic resonance imaging). While it has not yet been approved for use by the U.S. Food and Drug Administration, early Phase I study results are promising with no reported serious adverse effects or changes in urinary or sexual function six months after the procedure, according to results published in the Journal of Urology (Natarajan et al), as reported by UCLA Health. This was a very small study of 8 men and much larger studies will need to be conducted to verify both the safety and efficacy of this new approach before it becomes widely available. June 21, 2016.
Every inch on a man’s waist counts with prostate cancer, according to a new University of Oxford study (Perez-Cornago et al) that followed more than 140,000 men (mean age of 52) across 8 countries over a period of 14 years. Of the 7,000 men who developed prostate cancer, those men with a 37-inch waist had an 18% higher risk of fatal prostate cancer than men with a 33-inch waist, as reported by British media outlets, including The Telegraph and The Guardian. Adding another 4 inches (41-inch waist) increased the risk of fatal prostate cancer by 36% (compared to men with a 33-inch waist). We have reported about BMI and prostate cancer before, and this study reported increased risk when BMI was measured. High-grade prostate cancer, which is more aggressive, was also associated with being overweight. What can a man do about it? Try to maintain a weight that your doctor says is healthy for you. June 6, 2016.
While not surprising, patient-physician communication is critical for the health of prostate cancer survivors who have had their prostates surgically removed, according to a new study (Ernstmann et al) published in BJU International. At least 3 years after prostatectomy, patient-physician communication was associated with helping men cope with their disease and for improving their health-related quality of life. The authors of the study, which involved 1,772 men, suggest that a “trustful relationship” should be part of long-term follow-up care for prostate cancer patients and survivors. May 16, 2016.
A new and novel test can detect malignancies and differentiate between high-grade and low-grade prostate cancer, according to an interim analysis of a six-center clinical trial of 132 patients, as reported by the Cleveland Clinic at the American Urological Association annual meeting. The new test identifies molecular changes in the prostate specific antigen (PSA) protein. We all know that current PSA testing is not ideal, but it’s the only game in town. This IsoPSA test identifies prostate cancer differently and demonstrated improved diagnostic accuracy in early clinical trial results. We look forward to seeing the complete findings of the clinical trial when they are released. May 13, 2016.
We already know that men may experience a rise in PSA after sexual activity (it is suggested to avoid sex a few days prior to testing). Now men who are sexually active following radiation treatment for prostate cancer may experience a small rise and fall in PSA level, according to a new study by Japanese researchers (Matsushima et al) that was published in the International Journal of Urology. These “bounces,” which may go on for years, have only been noted in men who have had radiation therapy. Younger men appear to have a greater risk of experiencing them. In the study, researchers looked at data from 154 men who had been treated with brachytherapy for localized prostate cancer and were followed for a minimum of 24 months. Thirty-eight men (24.7%) experienced PSA bounce. May 4, 2016.
We’ve always known that depression is a potential negative side effect with androgen deprivation therapy (ADT) for prostate cancer. Now a study (Dinh et al) published in the Journal of Clinical Oncology has determined that men are at a “significantly increased risk” of developing depression with ADT and that risk increases with the length of therapy. Researchers reviewed a database of about 79,000 men older than age 65 (from 1992 to 2006) who had stage I to stage III prostate cancer. Overall, men who had ADT had a 23% increased risk of depression. Researchers also found that the longer a man had ADT, the greater his risk of developing depression. Twelve percent of men developed depression from with ≤ 6 months of ADT treatment; 26% of men developed depression with 7 to 11 months of ADT treatment, and 37% of men developed depression with ≥ 12 months of ADT treatment. May 2, 2016.
Another study is touting the benefits of moderate to high-level physical activity to help improve a man's chance of surviving prostate cancer. A reduced risk of prostate cancer specific mortality (death) has already been associated with vigorous physical activity, both before and after a man is diagnosed, according to research by Wang et al, which was presented at the American Association for Cancer Research Annual Meeting this week. Now, researchers say that “sitting time” (watching television, reading, sitting or driving in a car, etc.) is not associated with a reduced risk of prostate cancer specific mortality. The researchers looked at data from more than 10,000 men (ages 50 to 93) who did not have metastatic prostate cancer. Men who exercised the most had a 35 percent lower risk of dying from prostate cancer than men who exercised the least. April 19, 2016.
One of the challenges of active surveillance (sometimes called watchful waiting) is that there is no way to predict if — or when — cancer may spread. Now researchers are telling us that more than three percent of men who are on active surveillance had prostate cancer metastasis, according to a new study (Yamamoto et al) published in the The Journal of Urology. In this single center, prospective cohort study, 30 of 980 men experienced prostate cancer metastasis. The median age of men was 70 years, median PSA was 6.2 ng/ml, and median time to metastasis was 8.9 years. Median follow up was 6.3 years. The study authors conclude that active surveillance may be safe in men at low risk and certain patients at intermediate risk (Gleason score 6 and PSA > 10 ng/ml). April 16, 2016
Men with low-risk prostate cancer who receive a slightly higher dose of radiation for 5.6 weeks may be able to control their prostate cancer as well as men who receive standard radiation for 8 weeks, according to a new study (Lee at al) published in the Journal of Clinical Oncology. At five years, overall survival and disease-free survival were the same between both groups. April 13, 2016.
Always consult a medical professional.