This is the prostate cancer blog archive page for news stories from 2010. Visit the current blog.
Study Will Evaluate Single Dose Radiation for Prostate Cancer
Radiation oncologists at Beaumont Hospital have launched a research study that will treat men who have low to intermediate risk prostate cancer with a single dose of radiation, according to Medical News Today. This form of treatment is called high-dose rate brachytherapy (HDR). A small radioactive pellet (called a "smart seed") about the size of a grain of rice is temporarily implanted with plastic needles (while a man is under anesthesia) at the prostate cancer tumor site. The procedure takes about three hours, although the actual radiation treatment is only about 15 minutes. No radioactive material is left behind in the man's body. Low and intermediate risk men who qualify for participation in the study include men with T1c through T2b tumors, a Gleason score of 6 or 7, and a PSA that is lower than 15. December 21, 2010.Silymarin and Selenium and Prostate Cancer Progression
In a small study of 37 men, the combination of silymarin (a milk thistle extract) and selenium (a trace mineral) significantly reduced markers of lipid metabolism, which has been associated with prostate cancer progression, low-density lipoprotein (LDL, or bad cholesterol) and total cholesterol, according to a UroToday report. The 37 men received 570 mg of silymarin and 240 μg of selenium daily for six months following radical prostatectomy. No improvements were recorded in the group that did not take the combination (placebo group). In other studies, low dietary selenium has been associated with prostate cancer. December 9, 2010.
Can Soy Save Men’s Lives?
Researchers have found that a new, nontoxic drug made from a natural chemical found in soy (called genistein) may prevent cancer cells from spreading from the prostate to other body areas, according to a news report from Northwestern University. This experimental cancer therapy drug has demonstrated success in preclinical animal studies and now appears to show benefits in men with prostate cancer. In this small phase II randomized study of 38 men with localized prostate cancer, men who took genistein in oral form once a day for one month prior to their prostate cancer surgery had beneficial effects on prostate cancer cells. Specifically, genistein increased the expression of genes that suppress the invasion of cancer cells, and decreased the expression of genes that enhance invasion, in the cancer cells from the prostate that were removed and examined after surgery. While this new therapy is promising, more studies are needed to see if this drug can truly prevent cancer cells from metastasizing. These research findings will be presented at the Ninth Annual American Association for Cancer Research Frontiers in Cancer Prevention Research Conference. November 8, 2010.
Aspirin for Prostate Cancer?
A new study suggests that aspirin may lower the risk of death in men who have localized prostate cancer, as reported by HealthDay News. In 2009, we reported on another retrospective study by Choe et al, which demonstrated that the use of anti-clotting drugs (aspirin, Coumadin, and Plavix) appeared to lower the chance of prostate cancer recurrence in men who also received radiation treatment. This new study, also led by Dr. Kevin Choe, reviewed the records of 5,272 men with localized prostate cancer who had been treated with surgery or radiation and were taking blood thinners (called anticoagulants). Of those men, 1,649 were taking aspirin, 428 were taking warfarin, 287 were taking clopidogrel (Plavix), 26 were taking enoxaparin, and 408 were taking a combination of blood thinners. The risk of dying from cancer was reported to be reduced by more than half. These findings were presented at the annual meeting of the American Society for Radiation Oncology (ASTRO). Choe stated that men taking blood-thinning medications had "better outcomes with regards to prostate cancer death and that this benefit was most prominent in patients who had high-risk disease." After an average follow-up of about seven years, only 1 percent of men who had been taking an anticoagulant had died versus 4 percent of those in the control group. At 10 years, 4 percent of those taking one of these medications had died versus 10 percent in the no-blood thinner group. While encouraging, more stringent clinical trials need to be conducted. Always check with your doctor before starting an aspirin regimen because it has its own risks including bleeding. October 28, 2010.
FDA: New Warnings Needed for Hormone Treatments
Reuters is reporting that health officials have stated that hormone treatments for prostate cancer need new warnings about a small increased risk of diabetes and heart problems including sudden death. The Food and Drug Administration (FDA) stated that the risk of diabetes and heart disease in men treated with the drugs appeared to be low, but that men should be regularly monitored for increased blood sugar or possible signs of heart damage. Doctors should also evaluate a man’s risk for diabetes and heart disease before starting treatment and weigh potential side effects versus benefits. The medications, called gonadotropin-releasing hormone (GnRH) agonists, include Lupron, Zoladex, Eligard, Trelstar, Vantas, and Synarel, as well as generic versions of these drugs. October 21, 2010.Urine Test to Determine Prostate Cancer?
Very preliminary laboratory research conducted by scientists (Whitaker et al) in the UK has demonstrated that a protein in urine could be a reliable marker for prostate cancer risk, according to a report from Medical News Today. Results of the study were published online on October 13 in PLoS ONE . The protein microseminoprotein-beta (MSMB) is produced by normal prostate cells and is then secreted into urine from semen. This protein regulates programmed cell death and is linked to an increased risk of developing prostate cancer. A urine test might be a promising new method for prostate cancer screening because levels of this protein seem to be unaffected by other conditions, such as an enlarged prostate, or by hormones. While there is a long way to go, researchers are hopeful that a simple urine test might be used along with PSA testing to ensure more reliable results. October 20, 2010.
Study: Abiraterone Acetate Significantly Improved Overall Survival for Men with Metastatic Advanced Prostate Cancer
Men treated with the investigational agent abiraterone acetate plus low-dose prednisone/prednisolone had a significant improvement in overall survival (14.8 months vs. 10.9 months; a median gain of 3.9 months) compared to men treated with prednisone/prednisolone plus placebo, according to results from a pre-specified interim analysis of a randomized, placebo-controlled Phase 3 study. This study included 1,195 men with metastatic advanced prostate cancer who were previously treated with one or two chemotherapy regimens (at least one of which contained docetaxel). Read more. October 14, 2010.
Pfizer Stops SUTENT Clinical Trial
The SUN 1120 Phase 3 trial evaluating SUTENT (sunitinib malate) in combination with prednisone for men with advanced castration-resistant prostate cancer that progressed despite treatment with a docetaxel-based chemotherapy regimen has been discontinued, according to a Pfizer Inc. press release. Despite the fact that SUTENT has been shown to be effective for other types of cancers, this trial demonstrated that the combination of sunitinib with prednisone was unlikely to improve overall survival when compared to prednisone alone. October 7, 2010.
Surgery for Aggressive Prostate Cancer
Men with aggressive prostate cancer who had radical prostatectomy were found to have a 10-year cancer-specific survival rate of 92%, and an overall survival rate of 77%, according to researchers from the Fox Chase Cancer Center and the Mayo Clinic, as reported by Medical News Today. The 10-year cancer specific survival rate for men who underwent radiation without surgery was 88% and their overall survival rate was 52%. Between 1988 and 2004, researchers looked at 1,847 men with aggressive prostate cancer. Of these men, 1,238 had radical prostatectomy and 609 received radiation (344 of the men receiving radiation also received androgen deprivation therapy). Men who received radiation plus hormone therapy also had 92% cancer-specific survival rate, but a lower overall survival rate (67%). Men who had radiation alone had an overall survival rate of 52%. The study findings were presented earlier this week at the American Urological Association's 84th Annual Meeting in Chicago. September 29, 2010.
Viagra for Treating Prostate Cancer?
Fox news is reporting that researchers from Virginia Commonwealth University School of Medicine and VCU Massey Cancer Center have demonstrated that Viagra (sildenafil), a popular drug for erectile dysfunction, helped reduce the size of tumors in mice when it was combined with the chemotherapy drug doxorubicin. The combination was also shown to less damage to the heart. Irreversible heart damage is an unfortunate side effect that can occur years after patients receive doxorubicin, which is sometimes used to treat prostate cancer. The next step will be clinical trials to determine the effectiveness of this combination in people with cancer. September 29, 2010.
New Prostate Cancer Treatment Guide for Women
This nonprofit organization Women Against Prostate Cancer launched a new 16-page educational booklet, titled A Woman’s Guide to Prostate Cancer Treatment. The book provides an overview of the different treatment options that are available to men with prostate cancer and discuss some of the factors that go into making a treatment decision. It written to help empower caregivers and loved ones with information to support their friends and family. You can download it here. September 23, 2010.
US Too Launches Program for Men with Advanced Prostate Cancer
Us TOO International has teamed up with Centocor Ortho Biotech Inc. to launch My Prostate Cancer Roadmap, an educational resource that is intended to support men with advanced prostate cancer and their loved ones. Their website states: “Men with advanced prostate cancer have unique needs that differ from men who have earlier-stage prostate cancer, and this site is specifically designed to provide information and insights that address these later-stage needs.” It offers information on a variety of topics, ranging from health and wellness to relationships and intimacy. The resources section provides downloadable questions to ask your doctor about nutrition and exercise, and questions for your doctor or employer. September 1, 2010.
Pain Relievers, Cholesterol Drugs, And Diuretics May Mask True PSA Levels
Men who use nonsteroidal anti-inflammatory drugs (NSAIDS), statins for high cholesterol, and thiazide diuretics may not have accurate PSA test results, according to a study by Chang et al, which appears in the August 2nd online edition of the Journal of Clinical Oncology. This study looked at 1,864 men who were 40 years of age or older who did not have prostate cancer. Five years of NSAID, statin, and thiazide diuretic use was associated with lower PSA levels (by 6%, 13%, and 26%, respectively). The use of statins and thiazide diuretics in combination resulted in the greatest reduction in PSA levels: 36% after 5 years. August 16, 2010.
TroVax Clinical Trial Receives FDA Approval
The US Food and Drug Administration and Recombinant DNA Advisory Committee have approved the initiation of a clinical Phase II study to assess TroVax (MVA-5T4) in men with progressive prostate cancer that does not respond to hormone therapy (hormone refractory prostate cancer or HRPC), according to Oxford BioMedica. Eighty men with HRPC will be enrolled in five U.S. centers. One group of men will receive TroVax with the chemotherapy drug Docetaxel (Taxotere). Another group of men will receive Docetaxel alone. The study is expected to start in the third quarter of 2010. August 7, 2010.
FDA Grants Priority Review Designation to Denosumab
According to a press release from Amgen, the U.S. Food and Drug Administration (FDA) has granted priority review designation to denosumab, the first fully human monoclonal antibody (a subcutaneous RANK Ligand inhibitor), for the treatment of bone metastases to reduce skeletal related events in people with cancer. When cancers like prostate cancer spread to the bone, the growing cancer cells weaken and destroy the bone around the tumor, which can often lead to fractures, spinal cord compression, or even the need to receive radiation or surgery to bone. The priority designation of denosumab appears to be based on positive results from 18 clinical studies involving nearly 6,900 patients, including approximately 5,700 patients with advanced cancer. Amgen has been studying denosumab for its potential to delay bone metastases in prostate cancer. July 22, 2010.
Another Statin Study Related to Prostate Cancer
Men who use statins—drugs commonly used to lower cholesterol—are 30 percent less likely to experience prostate cancer recurrence after surgery compared to men who do not use statins, according to a press release issued by researchers at Duke University Medical Center. Higher doses of the statins were associated with lower risk of recurrence. In the study, the records of 1,319 men who had surgery for prostate cancer were reviewed and 236 men (18 percent) were found to be taking statins at the time of surgery. These men were followed after surgery to evaluate prostate cancer recurrence rates based on rise in PSA. In March, we reported on a study by Banez et al, that suggested that statins may have a potential role in the inhibition of inflammation within prostate cancer tumors. It will be interesting to see what (if any) role statins will play in prostate cancer. More research is needed. In the words of Stephen Freeland, MD, senior author of the Duke study, "Previous studies have shown that statins have anti-cancer properties, but it is not entirely clear when it's best to use them—or even how they work." It is also not clear if the results of this study were due to statin use alone. June 24, 2010.
FDA Approves Jevtana (cabazitaxel) Injection For Metastatic Prostate Cancer
Sanofi-aventis reported today that the FDA has approved its chemotherapy drug, Jevtana (cabazitaxel) injection, in combination with the steroid prednisone for men with metastatic prostate cancer that has not responded to hormone deprivation therapy or treatment with docetaxel. The approval is based on a clinical study, which demonstrated that men who received Jevtana and prednisone in combination experienced a 30% reduction in risk of death. The Associated Press reported on earlier results, stating that survival was prolonged by 10 weeks compared to standard chemotherapy treatment. These men were also more likely to have their tumors shrink; however, the combination regimen was not curative and did not cause a complete remission. June 17, 2010.
Study: Hormone Therapy Plus Radiation Benefits Men with Locally Advanced Prostate Cancer
News from ASCO: Results of a study by Ward et al indicate a substantial overall survival and disease specific survival benefit for men with locally advanced prostate cancer who received a combination of external bean radiation therapy and lifelong androgen deprivation therapy (ADT) versus men who only received ADT. The study included 1205 men (602 had ADT and 603 had ADT plus radiation therapy). Of this number, 1057 men had T3/T4 or T2 tumors, 119 men had a PSA of greater than 40 µg/l or T2 PSA greater than 20 µg/l, and 25 men had a Gleason Score that was greater than or equal to 8, and their cancer had not spread to the lymph nodes or other areas beyond the regional lymph nodes. After a median follow-up of six years, the number of men who died in the group that received combination therapy was 30 less than the group that received ADT alone (175 versus 145). While there is further data to come from this study, the study authors have already concluded that combination therapy should be the standard treatment approach for these men. June 8, 2010.
Dietary Fat and Prostate Cancer
News from AUA: Researchers have shown in animal studies that the type and amount of dietary fat may impact prostate cancer tumor progression, according to a news report on UroToday.com. Mice that were injected with prostate cancer cells were also randomized to a 35% fat Western diet (with either fish oil, olive oil, corn oil or saturated fat). The mice that received fish oil demonstrated significantly improved survival compared to the mice in the other groups. Tumor growth was also inhibited in the fish oil group. While this was only an animal study, it is something to consider when making dietary choices. June 1, 2010.
Nanotechnology May Help Predict Prostate Cancer Cure
More news from AUA: A new ultrasensitive PSA test using nanoparticle-based technology may predict if a man’s prostate cancer is cured after surgery or if he will have a recurrence, according to a Medical News Today report. This new test is claimed to be 300 times more sensitive than current PSA tests and can detect a very low level of PSA, indicating that the cancer has spread beyond the prostate. It may also be helpful in detecting cancer recurrence earlier, which means men can be treated earlier. June 3, 2010.
Men and Their Partners Needed for Online Sexuality Survey
Dr. Jo-an Baldwin Peters (PhD) is the principle investigator of an independent online survey for prostate cancer survivors and their partners. She is also the wife of a prostate cancer survivor. She and her fellow research partners (Dr. Joel Funk and Court Brooker) have been conducting a survey as a follow up to her earlier work on how prostate cancer treatments impinge on the sexuality of both partners as several trends showed up that demand further investigation. She has had more than 600 responses to date, and is hoping to get 1,000 total responses. The survey is available for men as well as their wives/partners. You can find it at http://www.prostaid.org/survey.php until the end of October. May 27, 2010.
Exercise and Hormone Therapy
Fatigue is a common problem with androgen deprivation therapy (ADT). In a paper that will be presented at the American Society of Clinical Oncology (ASCO) meeting, researchers Lau et al suggest that a simple walking program may help improve quality of life for men with prostate cancer who are receiving hormone therapy. While this was a very small feasibility study (only 4 men were in the walking group and 2 men were in the control group), and the results were not statistically significant, there was a positive trend in the group that exercised. Light or moderate exercise is often recommended to help prevent fatigue in men who undergo radiation therapy for prostate cancer. As always, check with your doctor before starting any exercise program, especially if you are undergoing treatment for prostate cancer. May 21, 2010.
Study: Role of Multimedia Education in Prostate Cancer Treatment Decision
A National Cancer Institute-funded study, which is being conducted by The Cancer Information Service Research Consortium, will attempt to determine if receiving a multimedia presentation of medical options helps men make informed treatment decisions. Men who have had a recent diagnosis of prostate cancer (and have not yet chosen any treatment) can participate in the Healing Choices study by calling toll-free, 866-258-7981. If eligible, you will receive one of two information packets, depending on which part of the study you become enrolled in. Some men will receive a free, multimedia program and printed material, while others will receive only printed material. Both groups will receive information that outlines various treatment options. May 11, 2010.
Provenge Finally Approved by FDA
Dendreon Corporation announced on April 29th that the U.S. Food and Drug Administration has approved their drug Provenge (sipuleucel-T) for the treatment of asymptomatic or minimally symptomatic metastatic, castrate-resistant (hormone-refractory) prostate cancer. Provenge is the first U.S. vaccine approved for prostate cancer. It is designed to induce an immune response against prostatic acid phosphatase (PAP), an antigen expressed in most prostate cancers. Dendreon says it will make Provenge available through about 50 centers, all of which were approved Provenge clinical trial sites. The company expects to increase the availability over the next year. April 30, 2010.
Prostate Cancer Surgery More Costly for Obese Men
Radical prostatectomy is more costly for men who are obese, according to a recent study by Bolenz et al, published in the British Journal of Urology. The study authors looked at the charts of 629 men who underwent either robotic-assisted (RALP), laparoscopic (LRP) or open retropubic radical prostatectomy (RRP) between September 2003 and April 2008. Men were considered to be obese if their body mass index (BMI) was greater than or equal to 30. Median direct costs (such as operating room service and anesthesia costs) were about $356 higher for obese men undergoing LRP (median US$5703 vs $5347; P= 0.002) and $508 higher for obese men undergoing RRP (median $4885 vs $4377; P= 0.004). There was no significant difference in direct costs in men who underwent RALP (median $6761 in obese vs $6745 in non-obese; P= 0.64). April 8, 2010.
Study: Hormone Therapy Increases Risk of Blood Clots
Investigators in a Swedish study published in the online edition of The Lancet Oncology (Van Hemelrijck et al) have concluded that men who received hormone therapy for prostate cancer were at a significantly greater risk of developing blood clots (called thromboembolism) than men who do not have prostate cancer. Investigators looked at the records of 30,642 men who received hormone therapy, 26,432 men who received curative treatment, and 19,526 men who opted for active surveillance. Results indicated that men who had received hormone therapy were at greater risk for deep vein thrombosis and pulmonary embolism. The authors also stated that all the men with prostate cancer who were studied were at a slightly greater risk of thromboembolic diseases. They suggest that “prostate cancer itself, prostate cancer treatments, and selection mechanisms all contribute to increased risk of thromboembolic disease.” April 15, 2010.
Weight Gain and Risk of Prostate Cancer Recurrence
Epidemiologists at Johns Hopkins are suggesting that men with prostate cancer who gain five pounds or more close to the time of their surgery may be twice as likely to have a recurrence of prostate cancer than men whose weight stays the same, according to a news report at Medical News Today. The researchers came to this conclusion based on a survey of 1,337 men who had surgery for localized prostate cancer. They also suggest that being physically active reduced the risk of prostate cancer recurrence that is associated with obesity. April 21, 2010.
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. 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.
Always consult a medical professional.