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.
There was an interesting onclive.com article this week by Danielle Bucco discussing the results of the 10-year PROTECT study that was published last year (Hamdy et al). In this study, the survival rate of men with localized prostate cancer was not significantly different between 3 groups, including men on active monitoring, men who had external beam radiation therapy, and men who had radical prostatectomy. The primary outcome was prostate-cancer mortality at a median of 10 years of follow-up. Only 1% mortality was reported in each group. What’s interesting about this study is that the researchers recruited 82,429 healthy men aged 50-69 for PSA screening who were counseled about the uncertainties of early prostate cancer treatment before they were even diagnosed. Of that number, 2,664 were eventually diagnosed and 1,643 of those men agreed to be randomized into 1 of the 3 groups. There were 17 prostate-cancer-specific deaths overall (5 in the surgery group, 4 in the radiation group, and 8 in the active monitoring group). Do these results mean that men can safely defer treatment? It is important to note that metastases developed in more men in the active monitoring group (that would be our biggest fear) and higher rates of disease progression were also noted in the same group. When you look at prostate cancer statistics, a lot of men with localized prostate cancer are still alive 10 years after their diagnosis. What we would like to see is what those numbers are like at 20 or 25 years. What remains is the $100,000 question: how long can a man who will ultimately need treatment defer his treatment to preserve his quality of life without fear of cancer progression? In our opinion, we don’t have the right assessment tools to answer that question yet. January 23, 2018.
Recently, there was a very interesting Washington Post article about immunotherapy and the host of strange side effects that some cancer patients are starting to experience, such as myocarditis, type 1 diabetes, and rashes. My husband and I had a potential PSA-on-the-rise scare recently and his urologist mentioned the hope he has for immunotherapy for prostate cancer. This article certainly gave us some pause about whether he would opt for immunotherapy versus traditional hormone depravation therapy. According to the consensus recommendations from the Society for Immunotherapy of Cancer (SITC) Toxicity Management Working Group, when it comes to immunotherapy for cancer, “Skin, gut, endocrine, lung and musculoskeletal immune-related adverse events [irAEs] are relatively common, whereas cardiovascular, hematologic, renal, neurologic and ophthalmologic irAEs occur much less frequently." Of course, all therapies have potential side effects. That is why it is wise to always do your own research on possible side effects that are related to a prostate cancer treatment. January 5, 2018
Is vasectomy a risk factor for prostate cancer or not? A vasectomy was not associated with high-grade, advanced stage, or fatal prostate cancer, according to a large review study (Bhindi et al) that analyzed 53 different studies. The study authors reviewed 16 cohort studies of 2,563,519 men, 33 case-controlled studies of 44,536 men, and 4 cross-sectional studies of 12, 098,221 men. The primary outcome was any diagnosis of prostate cancer. Secondary endpoints were high-grade, advanced, and prostate cancer that caused death. They concluded that there was a 0.6% absolute increased risk of prostate cancer associated with vasectomy with a population-attributable fraction of 0.5%. No risk at all? No. Small risk? Apparently. The results were published in JAMA Internal Medicine last month. October 5, 2017.
Should men with early prostate cancer wait to have surgery? Results from a new 20-year study (Wilt et al) showed that early surgery (prostatectomy) did not prolong life and often caused complications, including urinary incontinence, erectile dysfunction, and infection. The study included a total of 731 men with prostate cancer. In the group of men who had surgery (366 men), 223 died. In the non-surgery group (367 men) 245 men died. In a nutshell, the study authors state that there was no significant difference in mortality (death) between the two groups. However, surgery was associated with a lower frequency of treatment for disease progression. There are many factors that can influence results from a study like this (for example, all the men were over 60 years of age) that one should not take this as “proof” that waiting is a viable option. Always discuss your options with your healthcare provider. You can find the study in the New England Journal of Medicine. July 18, 2017.
Circulating tumor cells, along with circulating megakaryocytes (large bone marrow cells), analyzed from a simple blood test may be able to target men with aggressive prostate cancer that has spread (metastasized), according to a small study (Xu et al) by researchers at Queen Mary University of London. The researchers looked at blood samples from 81 men with prostate cancer. The results hold promise for determining men with prostate cancer who might benefit from aggressive therapy. The next step will be larger clinical trials. The results of the study were published in Clinical Cancer Research.July 7, 2017.
Liberating Research is looking for men living with prostate cancer (metastatic or recurrent) to help understand their perspective on diagnosis and treatment. There are two ways to participate if you live in New York, Los Angeles, or San Francisco: via telephone or in a face-to-face interview. Your opinions will help improve future educational materials for healthcare practitioners. If eligible, you will be paid for your participation (10% goes to a charity). Time is limited. Make your voice known! May 19, 2017.
Researchers have been able to cure invasive prostate cancer in mice using an existing anticancer drug (cabozantinib). The drug worked by encouraging prostate cancer tumor cells to secrete substances that attracted neutrophils—which are produced in the bone marrow—to enter the tumor and created an immune response that led to an almost complete clearance of tumors, according to a ScienceDaily report. Let’s hope that the drug works just as well in humans some day. Clinical trials are planned to assess using cabozantinib in combination with T-cell immunotherapy for prostate cancer. May 9, 2017.
Researchers (Matthew et al) are hopeful that a triple combination of hormone therapy, surgery, and radiation may be able to eliminate detectable disease in some men with metastatic prostate cancer. In a very small pilot study, 20 men were treated with androgen deprivation therapy, radical prostatectomy, and radiation treatment. Of that number, 14 men who had prostate cancer metastases to the bone had undetectable PSA for up to 46 months following all 3 treatments. While this is optimistic news for men with metastatic prostate cancer, a larger clinical trial is needed to confirm the findings. April 25, 2017.
Researchers at Washington State University are exploring a noninvasive device that analyzes blood and urine to help diagnose prostate cancer and assess extent of disease progression. The device is like a filter that isolates markers of prostate cancer from blood and urine. It uses a mat of tiny glass springs that contain biomarkers that attract exosomes; fatty droplets of proteins and RNA that prostate cancer tumors release into body fluids (like blood and urine) and contain useful genetic information. It is still in the early research phase, but it would be a welcome alternative to biopsy, which can be a very uncomfortable procedure for men. March 28, 2017.
An antidepressant called clorgyline may block an enzyme called MAOA that helps prostate cancer cells spread to the bone, according to a new animal (mouse) study (Wu et al) that was published in Cancer Cell. While clorgyline is no longer used by doctors, researchers will begin studying other antidepressants that have a similar mechanism of action. March 20, 2017.
The green veggie may be good for preventing prostate cancer, according to findings from researchers from Oregon State University, which were published in the Journal of Nutritional Biochemistry. Specifically the compound sulforaphane from broccoli may provide insights on how prostate cancer develops and progresses. The compound appears to affect long, non-coding ribonucleic acids (RNAs), which possibly help “trigger” malignant prostate cancer cells. This may signal the start of more researchers exploring dietary avenues to help prevent or treat the disease. March 17, 2017.
Fewer men are dying from metastatic prostate cancer, according to a poster that was presented at the 2017 Genitourinary Cancers Symposium held in Orlando, Florida. Researchers looked at data from 6,874 men with prostate cancer from the Danish Prostate Cancer Registry, which were divided into 3 groups based on the year they were diagnosed (1995-2000, 2001-2005, and 2006-2011). Mortality related to prostate cancer decreased by about 10% between the 1995-2000 and 2001-2005 groups. New and advanced treatment options may be the reason. February 21, 2017.
Men with recurrent prostate cancer following surgery should combine hormone therapy with radiation treatment, according to results of a new Cedars-Sinai study published in the New England Journal of Medicine that followed 761 men with prostate cancer over a period of 12 years. The group of men who only had radiation therapy had a 13.4% incidence of death while the incidence of death was 5.4% for men who had combined radiation and hormone therapy. Combined therapy may also help lower the chance of cancer spreading (23% incidence of metastasis for radiation alone vs 14.5% for radiation and hormone treatment). This study confirms other studies that have shown that combination therapy is more effective than radiation alone for recurrent prostate cancer. February 7, 2017.
Men everywhere are invited to grow their mo (mustache or moustache outside the US) to save a bro. The charity raises funds to support men's health and to stop men from dying too young. Simply grow and groom your mustache. Mo Sistas can also support the Mo and their men. Visit the charity website to learn more.
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.
Always consult a medical professional.