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Senior Health Week: Prostate Cancer
Health News You Can Use •

Latest Prostate Cancer News:

Treatment for Advanced Prostate Cancer May Impair Memory: Researchers say luteinizing hormone-releasing hormone (LHRH) analogues used to decrease testosterone may cause memory impairment.


Recent Prostate Cancer News:

Fat, Calcium Increase Risk of Aggressive Prostate Cancer: Researchers say a diet high in fat and calcium may not boost the risk of prostate cancer, but could fuel its development into a more aggressive disease.

Mayo Model Helps Predict If Brachytherapy Is Sufficient: The model based on Gleason score, prostate specific antigen (PSA) level and tumor staging can help determine if addition of external beam radiation is needed.

Patients Get "Little Encouragement" for Watchful Waiting Approach: British researchers found men often get pressure from family members, doctors and support groups to seek active treatment.

Funds Set for Research on Spread of Prostate Cancer to Bone: Researchers will seek to learn why some of cells turn into deadly metastatic cancer and spread to human bone, while others remain dormant or die.

Antioxidants in Red Wine Inhibit Growth of Prostate Cancer Cells: Researchers say gallic and tannic acid and rutin in particular encouraged apoptosis, or cell death, in prostate cancer cells.

PSA Test Leads to "Considerable" Overdiagnosis: Researchers say a"considerable" number of men over age 60 diagnosed with prostate cancer after taking the prostate specific antigen (PSA) test are receiving treatments for a disease that never would have affected them in their lifetimes.

Number Cured by Salvage Cryotherapy "Seems to Be Small": While use of the surgical procedure that destroys cancer tumors by freezing can benefit some patients with locally recurrent prostate cancer, researchers say "patient selection is important."

Vasectomy Does Not Appear to Increase Prostate Cancer Risk: A study in New Zealand, which has the world's highest vasectomy rate, found no evidence that a vasectomy increases the risk of prostate cancer even after 25 years.

New Test Can Help Identify Patients With Aggressive Prostate Cancers: Researchers report that a simple test can be used to help identify patients with the most aggressive prostate cancers, even among patients whose tumors have the same Gleason grade.

Balding at Crown of Head Linked to Higher Risk of Prostate Cancer: A study of almost 3,000 men under 70 years of age found that those with vertex baldness had a 50 percent greater risk of prostate cancer than those with no balding.

Number of Men in 50s Being Biopsied for Prostate Cancer Rising: Researchers report the number of biopsies that detected prostate cancer in men aged 50 to 59 increased from 11 percent in 1995 to 16 percent in 2001 -- a 45 percent increase in this age group.

Annual PSA Tests May Be Unnecessary for Many: Men whose screening tests for prostate cancer detect a very low prostate specific antigen (PSA) level may safely opt not to be retested every year, and may be able to go up to five years between screenings.

Maker of Herbal Supplement PC SPES to Go Out of Business: The maker of the controversial treatment, once taken by as many as 10,000 men for prostate cancer, has announced it will go out of business June 1.

Initial Biopsies Appear to Miss One-Quarter of All Prostate Cancers: Researchers say initial biopsies of men with elevated prostate specific antigen (PSA) levels or suspicious digital rectal examination results appear to miss prostate cancer almost one-quarter of the time.

Men Treated With Hormonal Blockade Often Have Osteoporosis: Researchers say therapies designed to block production of the male hormone (androgen) can result in osteoporosis, "an important and debilitating side effect."

Lymph Node Removal Beyond Conventional Area Recommended: Researchers say "extended pelvic lymphadenectomy" is particularly useful in detecting lymph node cancer in patients with high prostate specific antigen (PSA) levels and high Gleason scores.

Low-Fat Diet, Exercise, Stress Reduction May Combat Early Prostate Cancer: A California researcher reports that a study of 84 men suggests that a low-fat diet, plus lifestyle changes, may slow or reverse the progression of prostate cancer in patients with early-stage disease.

PC SPES Contained 3 Prescription Drugs Including DES: Researchers report the herbal supplement widely used until recently by prostate cancer patients also contained the blood thinner warfarin and the anti-inflammatory drug indomethacin.

New Coffee Roasting Process May Aid Fight Against Prostate Cancer: Scientists report developing a new way of roasting green java coffee beans designed to preserve the disease-fighting antioxidants which may provide some prostate cancer protection.

Nerve-Sparing Surgery Does Not Increase Risk of Recurrence: Men who have nerve-sparing surgery for localized prostate cancer -- a technique that enhances their chances of having erections again following the operation -- are not at increased risk of cancer recurrence, according to University of Miami researchers.

Blacks With Normal DRE More Likely Than Whites to Have Prostate Cancer: University of Mississippi researchers report that black American men who have a normal digital rectal exam but a prostate specific antigen (PSA) level of 4.0 or greater are more likely than their white counterparts to in fact have prostate cancer.

Aspirin-a-Day May Cut Risk of Prostate Cancer: Mayo Clinic researchers report that a daily dose of aspirin or other nonsteroidal anti-inflammatory drug (NSAID) can reduce the risk of prostate cancer by as much as 83 percent in older men.

Prostate Cancer Primer:

The prostate is a gland in a man's reproductive system. It makes and stores seminal fluid, a milky fluid that nourishes sperm. This fluid is released to form part of semen. The prostate is about the size of a walnut. It is located below the bladder and in front of the rectum. It surrounds the upper part of the urethra, the tube that empties urine from the bladder.

The causes of prostate cancer are not well understood. Studies have found that the following risk factors are associated with prostate cancer:

  • Age. In the United States, prostate cancer is found mainly in men over age 55. The average age of patients at the time of diagnosis is 70.
  • Family history of prostate cancer. A man's risk for developing prostate cancer is higher if his father or brother has had the disease.
  • Race. This disease is much more common in African American men than in white men. It is less common in Asian and American Indian men.
  • Diet and dietary factors. Some evidence suggests that a diet high in animal fat may increase the risk of prostate cancer and a diet high in fruits and vegetables may decrease the risk.

A man who has any of the risk factors may want to ask a doctor whether to begin screening for prostate cancer (even though he does not have any symptoms), what tests to have, and how often to have them. The doctor may suggest either of the tests described below.

  • Digital rectal exam--the doctor inserts a lubricated, gloved finger into the rectum and feels the prostate through the rectal wall to check for hard or lumpy areas.
  • Blood test for prostate-specific antigen (PSA)--a lab measures the levels of PSA in a blood sample. The level of PSA may rise in men who have prostate cancer, BPH, or infection in the prostate.

Early prostate cancer often does not cause symptoms. But prostate cancer can cause any of these problems:

  • A need to urinate frequently, especially at night;
  • Difficulty starting urination or holding back urine; Inability to urinate;
  • Weak or interrupted flow of urine;
  • Painful or burning urination; Difficulty in having an erection;
  • Painful ejaculation;
  • Blood in urine or semen; or
  • Frequent pain or stiffness in the lower back, hips, or upper thighs.

If a man has symptoms or test results that suggest prostate cancer, the doctor may order exams to learn more about the cause of the symptoms. These may include:

  • Transrectal ultrasonography--sound waves that cannot be heard by humans (ultrasound) are sent out by a probe inserted into the rectum. The waves bounce off the prostate, and a computer uses the echoes to create a picture called a sonogram.
  • Intravenous pyelogram--a series of x-rays of the organs of the urinary tract.
  • Cystoscopy--a procedure in which a doctor looks into the urethra and bladder through a thin, lighted tube.
  • Biopsy--If test results suggest that cancer may be present, the man will need to have a biopsy. During a biopsy, the doctor removes tissue samples from the prostate, usually with a needle. A pathologist looks at the tissue under a microscope to check for cancer cells.

If cancer is found in the prostate, the doctor needs to know the stage, or extent, of the disease. Staging is a careful attempt to find out whether the cancer has spread and, if so, what parts of the body are affected. These are the main features of each stage:

  • Stage I or Stage A--The cancer cannot be felt during a rectal exam. It may be found by accident when surgery is done for another reason, usually for BPH. There is no evidence that the cancer has spread outside the prostate.
  • Stage II or Stage B--The tumor involves more tissue within the prostate, it can be felt during a rectal exam, or it is found with a biopsy that is done because of a high PSA level. There is no evidence that the cancer has spread outside the prostate.
  • Stage III or Stage C--The cancer has spread outside the prostate to nearby tissues.
  • Stage IV or Stage D--The cancer has spread to lymph nodes or to other parts of the body.

Decisions about prostate cancer treatment involve many factors. Before making a decision, a man may want to get a second opinion by asking another doctor to review the diagnosis and treatment options. A short delay will not reduce the chance that treatment will be successful.

Treatment for prostate cancer depends on the stage of the disease and the grade of the tumor (which indicates how abnormal the cells look, and how likely they are to grow or spread). Other important factors in planning treatment are the man's age and general health and his feelings about the treatments and their possible side effects.

Treatment for prostate cancer may involve watchful waiting, surgery, radiation therapy, or hormonal therapy. Some patients receive a combination of therapies.

Watchful waiting may be suggested for some men who have prostate cancer that is found at an early stage and appears to be slow growing. Also, watchful waiting may be advised for older men or men with other serious medical problems. For these men, the risks and possible side effects of surgery, radiation therapy, or hormonal therapy may outweigh the possible benefits.

Surgery is a common treatment for early stage prostate cancer. The doctor may remove all of the prostate (a type of surgery called radical prostatectomy) or only part of it. In some cases, the doctor can use a new technique known as nerve-sparing surgery. This type of surgery may save the nerves that control erection. However, men with large tumors or tumors that are very close to the nerves may not be able to have this surgery.

Radiation therapy (also called radiotherapy) uses high-energy x-rays to kill cancer cells. Like surgery, radiation therapy is local therapy; it can affect cancer cells only in the treated area. In early stage prostate cancer, radiation can be used instead of surgery, or it may be used after surgery to destroy any cancer cells that may remain in the area.

Radiation may be directed at the body by a machine (external radiation), or it may come from tiny radioactive seeds placed inside or near the tumor (internal or implant radiation, or brachytherapy). Men who receive radioactive seeds alone usually have small tumors. Some men with prostate cancer receive both kinds of radiation therapy.

There are several forms of hormonal therapy. :Prostate cancer that has spread to other parts of the body usually can be controlled with hormonal therapy for a period of time, often several years. Eventually, however, most prostate cancers are able to grow with very little or no male hormones. When this happens, hormonal therapy is no longer effective, and the doctor may suggest other forms of treatment that are under study.

It is hard to limit the effects of treatment so that only cancer cells are removed or destroyed. Because healthy cells and tissues may be damaged, treatment often causes unwanted side effects. The side effects of cancer treatment depend mainly on the type and extent of the treatment.

  • Watchful Waiting. Although men who choose watchful waiting avoid the side effects of surgery and radiation, there can be some negative aspects to this choice. Watchful waiting may reduce the chance of controlling the disease before it spreads. Also, older men should keep in mind that it may be harder to manage surgery and radiation therapy as they age.
  • Surgery. Patients are often uncomfortable for the first few days after surgery. Their pain usually can be controlled with medicine, and patients should discuss pain relief with the doctor or nurse. The patient will wear a catheter (a tube inserted into the urethra) to drain urine for 10 days to 3 weeks. It is also common for patients to feel extremely tired or weak for a while. Surgery to remove the prostate may cause long-term problems, including rectal injury or urinary incontinence. Some men may have permanent impotence. Nerve-sparing surgery is an attempt to avoid the problem of impotence.
  • Radiation Therapy. Radiation therapy may cause patients to become extremely tired, especially in the later weeks of treatment. Some men may have diarrhea or frequent and uncomfortable urination. When men with prostate cancer receive external radiation therapy, it is common for the skin in the treated area to become red, dry, and tender. External radiation therapy can also cause hair loss in the treated area. The loss may be temporary or permanent, depending on the dose of radiation. Both types of radiation therapy may cause impotence in some men, but internal radiation therapy is not as likely as external radiation therapy to damage the nerves that control erection. However, internal radiation therapy may cause temporary incontinence. Long-term side effects from internal radiation therapy are uncommon.
  • Hormonal Therapy The side effects of hormonal therapy depend largely on the type of treatment. Men who receive total androgen blockade may experience more side effects than men who receive a single method of hormonal therapy. Any method of hormonal therapy that lowers androgen levels can contribute to weakening of the bones in older men.

During and after treatment, the doctor will continue to follow the patient. The doctor will examine the man regularly to be sure that the disease has not returned or progressed, and will decide what other medical care may be needed. Followup exams may include x-rays, scans, and lab tests, such as the PSA blood test.

Background information provided by: National Cancer Institute, National Institutes of Health, Bethesda, MD 20892

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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