Prostate Cancer Blog Archive

Welcome to the Prostate Cancer Blog Archive, the place to find older posts to the The Prostate Cancer Blog for Wives and Partners. This blog provides information, helpful tips, and coping strategies for wives and partners of men with prostate cancer.

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Infertility Linked to Prostate Cancer Risk

Reuters Health is reporting on a study by Walsh et al that suggests that infertile men may have an increased risk of developing aggressive prostate cancer. Researchers in California looked at records of 22,562 men who were evaluated for infertility between 1967 and 1998. After accounting for age, men who were infertile were 2.6 times more likely to be diagnosed with aggressive prostate cancer tumors. You can find the abstract of the study in the online version of Cancer at http://www3.interscience.wiley.com/journal/123325171/abstract. March 23, 2010.

What Motivates Women To Encourage Their Men to Seek Help for ED?

Closeness and intimacy in a relationship may be more important to women than sex, and it may motivate them to encourage their partners to seek treatment for erectile dysfunction (ED), according to a study by McCabe et al, which was published in the March/April issue of the International Journal of Impotence Research. The study authors conducted interviews with 100 women who were seeking medical treatment for their loved one's ED. The hopes that women had related to the medication, particularly their hope that it would increase their partner's confidence and reduce his sexual frustration, was the second major theme in the study. Enhancement of the relationship, as well as improving the women's own feelings of self-doubt and sexual frustration, were also cited. March 31, 2010.

What Does Continence Really Mean?

A study by Liss et al, which was published in the February issue of Urology, raises an interesting question about defining what "continence" means following radical prostatectomy. The study authors state that "After radical prostatectomy continence is commonly defined as no pads except a security pad or 0 to 1 pad." After reviewing data of 500 men who underwent robot assisted radical prostatectomy from October 2003 to July 2007, the study authors suggest that there was a significant decrease in quality of life between no pads, a security pad, and 0 or 1 pad. They also conclude that their findings "do not support defining continence with a security pad or 0 to 1 pad. Continence should be strictly defined as 0 pads." More reason to ask a surgeon what his/her definition of continence is prior to your loved one's radical prostatectomy! March 16, 2010.

Hold the Supplements When Undergoing Radiation for Prostate Cancer

Men who are undergoing radiation therapy for prostate cancer should not take herbal or dietary prostate-specific supplements without first talking to their doctor, according to a study published in the March issue of the International Journal of Radiation Oncology*Biology*Physics, as reported by Medical News Today. Researchers at Michigan's William Beaumont Hospital found that three widely used supplements increased the radiosensitivity of normal prostate cell lines, leading to normal tissue complications. Previous studies have shown that some supplements can interfere with chemotherapy for prostate cancer. March 10, 2010.

American Cancer Society Issues New Prostate Cancer Screening Guideline

Highlights of the new American Cancer Society (ACS) Guideline for the Early Detection of Prostate Cancer (Update 2010), which appears in the online edition of CA: A Cancer Journal for Clinicians, include:

Asymptomatic men (men who do not have any symptoms of prostate cancer) who have at least a 10-year life expectancy "should have an opportunity to make an informed decision with their health care provider about whether to be screened for prostate cancer, after receiving information about the uncertainties, risks, and potential benefits associated with prostate cancer screening." The guideline also states that prostate cancer screening should not occur without an informed decision-making process. Men at average risk should receive this information starting at age 50.

Men at higher risk should receive this information beginning at age 45. This includes African American men and men who have a first-degree relative (father or brother) diagnosed with prostate cancer before age 65.

Men at appreciably higher risk should receive this information beginning at age 40. This includes men who have had multiple family members diagnosed with prostate cancer before age 65. Asymptomatic men who have less than a 10-year life expectancy based on age and health status should not be offered prostate cancer screening.

The ACS guideline also states that "men should either receive this information directly from their health care providers or be referred to reliable and culturally appropriate sources." March 4, 2010.

Another Study Suggests Success of Statins

Studies have shown that inflammation is associated with advanced prostate cancer. A recent study by Banez et al, which was published in the February 16 online edition of Cancer Epidemiology, Biomarkers & Prevention, suggests that statins (which are commonly prescribed for reducing high cholesterol) may have a potential role in the inhibition of inflammation within prostate cancer tumors. In this study of 236 men undergoing radical prostatectomy from 1996 to 2004, the men who took 20 mg of simvastatin daily for a year prior to their surgery had a significantly lower risk for inflammation within their tumors. There have been a number of studies about statins and their potential role in preventing progression of prostate cancer. This does not mean, however, that men should rush to ask their doctors for a prescription for a statin. More studies are needed before such a recommendation can be made. But if your man is already taking a statin, it may be an added plus. March 1, 2010.

Soy Bread for Prostate Cancer

Health News Digest reports that Ohio State cancer researchers and food scientists have baked a new soy bread that they hope will help fight prostate cancer. Dozens of men have been enrolled in a study, which is being conducted at Ohio State's James Cancer Hospital and Solove Research Institute. The men will get a daily dose of soy-packed bread, which was inspired by the Asian diet, which is rich in soy. The rate of prostate cancer in men living in Asia is very low. The bread that is being used in the study is equal to the amount of soy Asian men consume in a typical day. February 4, 2010.

Sexual Bother is Big for Men Following Prostate Cancer Surgery

"Sexual bother" increases after radical prostatectomy, even in men who can have "good" erections after their surgery, according to a recent study by Nelson et al, which was published in the January issue (Part 1) of the Journal of Sexual Medicine. This sexual bother includes shame, embarrassment, and a reduction in general life happiness. In the study, 183 men who had surgery for prostate cancer completed inventories (like a questionnaire) 12 and 24 months following their treatment. The inventories included information about erectile function and sexual bother. The mean scores for erectile function decreased from the beginning of the study to the 24-month time point. The mean sexual bother scores increased from the baseline to the 12-month time point, but stayed stable from the 12-month time point to the 24-month time point (whether a man had erectile dysfunction [ED] or not). The average age of the men studied was 58 (plus or minus 7 years). Only 7% of men with ED moved from being "bothered" at 12 months to "no bother" at 24 months. The study authors suggest that men do not seem to "adjust" to ED following surgery for prostate cancer. February 9, 2010.

Nitroglycerin for Prostate Cancer

Medical News Today is reporting on results of a very small clinical study that suggests that a very low dose of nitroglycerin may slow and even halt the progression of prostate cancer.

Twenty-nine men with rising PSA levels following prostate surgery or radiation were treated with a low-dose, slow-release nitroglycerin skin patch in the study, which was conducted by Queen's University researchers. Of the 17 patients who completed the study, all but one showed a stabilization or decrease in the rate of cancer progression, as measured by their PSA doubling time.

While much larger studies are needed to confirm the efficacy of nitroglycerin, this is an interesting development in the treatment of prostate cancer. February 18, 2010.

Study: Sexual Decline Following Radiation Therapy

A man's sexual function following external beam radiation therapy for prostate cancer declines in the first two years, but then stabilizes, according to a small study by Siglin, et al, which was published in the January issue of the International Journal of Radiation Oncology Biology Physics. The study followed 143 men following radiation treatment (mean follow-up time was four years) and used questionnaires to assess their sexual function. The mean age of the men studied was 69 and their mean Gleason score was 6. The questionnaires included questions about sex drive, erectile function, ejaculatory function, and overall satisfaction. January 10, 2010.

Vaccine Shows Promise for Metastatic Prostate Cancer

According to the Dana-Farber Cancer Institute, a newly published National Cancer Institute-sponsored clinical trial has demonstrated that men with metastatic prostate cancer who received the PROSTVAC-VF vaccine (a harmless combination of two weakened poxviruses that was engineered to cause an immune system attack on prostate tumor cells), lived "substantially longer" than men who did not receive the vaccine (called placebo vaccine). The trial findings will be published online and in the print edition of the Journal of Clinical Oncology. The double-blinded trial (which means that the men did not know whether they were receiving the vaccine or the placebo vaccine, and the study investigators did not know what they were giving the men) included 125 men with metastatic prostate cancer who did not respond to standard hormone therapy. Eighty-two men received PROSTVAC-VF and 40 men received a placebo vaccine. After three years, 30 percent of the men who received PROSTVAC-VF were alive, versus 17 percent of the men who got the placebo vaccine. The median survival (which is the middle value of given numbers, and should not be confused by mean or average, which is the sum of all given numbers divided by the total number of men in the group) of the men who received the vaccine was 24.5 months, compared to 16 months for the group of men that received placebo vaccine. January 26, 2010.

Study: Regular Exercise and External Beam Radiation

A small, randomized, controlled single-center study (Kapur et al) of 66 men in the United Kingdom reports that men receiving external beam radiation who exercised regularly had significantly less severe acute rectal toxicity. One study group of 33 men walked aerobically for 30 minutes at least three times a week during a 4-week course of radiation. The other group (called the control group) did not. There was no significant difference in bladder toxicity scores between the two groups. The study authors concluded that keeping active, and being asked to adhere to a well-defined exercise schedule, appears to reduce the severity of rectal toxicity during radiotherapy to the prostate. The study appeared in the December 17, 2009 online edition of the European Journal of Cancer Care. January 20, 2010.

Study: Couple’s Perspective on Sexual Side Effects after Prostate Cancer Treatment

Researchers are finally realizing that prostate cancer is often a "couple's disease." A recent study by Tsivian et al, which was published in International Brazilian Journal of Urology, reports that men and their female partners may view sexual side effects following prostate cancer surgery differently. Twenty-eight couples completed a Retrospective Sexual Survey that contained questions about physiological changes in libido, foreplay, erection and arousal, orgasm and ejaculation in addition to perceived psychological impact. Only about 40% of men and women were happy with their levels of sexual interest with 82% concordance (which means the level of agreement between the couples surveyed). While greater than 70% of couples stated they utilized more or the same foreplay after prostate cancer treatment, the concordance was only 48%. Out of all men and women, less than 40% declared being happy with their partner's level of desire (concordance 86%). Urine loss during orgasm was reported by 43% of men and the majority of study participants were bothered by it. Ejaculation changes were observed by 96% of men (concordance 96%) with most reporting anejaculation (which means they were unable to ejaculate). A change in orgasm experience was noted by 86% of men (and 36% of their female partners). Despite the change, the majority of men and women reported being satisfied with their ability to climax. January 15, 2010.

Study: Suicide Risk Greater in Men with Advanced Prostate Cancer

Depression is common after a diagnosis of prostate cancer, but a Swedish study by Bill Axelson et al, showed that the risk of suicide was twice as high among men with locally advanced or metastatic disease, compared with an age-matched male population. No increased risk of committing suicide was observed among men diagnosed with early prostate cancer (nonpalpable T1c prostate tumors diagnosed after PSA testing). The study reviewed data from the Swedish National Prostate Cancer Register, including the number of reported suicides (128 among 77,439 prostate cancer cases). Risk of increase in suicide was not noted for 22,405 men with PSA-detected T1c tumors. But among the 22,929 men with locally advanced nonmetastatic tumors, and 8,350 men with distant metastases, there was a significantly higher number of suicides. January 7, 2010.

Study: Robotic Surgery vs. Open Radical Prostatectomy

In October of 2009, we wrote about a study that reported that while men who undergo minimally invasive approaches (like robotic-assisted surgery) may experience shorter hospital stays and fewer respiratory problems, surgical complications, and strictures, they experience more genitourinary complications, erectile dysfunction, and incontinence. Now a study by Carlsson et al, which was published in the December issue of Urology (online edition), reports that men who undergo robot-assisted radical prostatectomy (RARP) have less risk of surgical complications, such as bladder neck contractures, blood transfusions, and postoperative wound infections than men who undergo open retropubic radical prostatectomy (RRP). The study looked at a total of 1,738 men. Of that number, 1,253 had RARP and 485 had RRP for clinically localized prostate cancer. Surgery-related complications were assessed using a hospital-based complication registry. In the RRP group, 112 men (23%) needed blood transfusions, compared with 58 men (4.8%) in the RARP group. Complications caused by infections occurred in 44 men (9%) in the RRP group, compared with 18 men (1%) in the RARP group. Bladder neck contracture was treated in 22 (4.5%) men who had RRP compared with 3 men (0.2%) in the RARP group. As with any surgery for prostate cancer, the skill and experience of the surgeon is paramount. It has been reported that it takes longer for a surgeon to become proficient in performing robotic surgery than traditional radical prostatectomy. It is important to ask how many of these surgeries a surgeon has performed, and what the success rate of those surgeries were (i.e., number of men who had positive surgical margins, incontinence and impotence rates, prostate cancer recurrence rate). If a doctor throws statistics at you, ask where those statistics come from. Are the numbers based on the surgeon's personal practice, or is the surgeon quoting from a clinical study that involved highly skilled surgeons (like this one)? January 15, 2010.

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