The Prostate Cancer Information Source

From JAMA

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The Physicians’ Health Study II Randomized Controlled Trial

J. Michael Gaziano, MD, MPH; Robert J. Glynn, ScD; William G. Christen, ScD; Tobias Kurth, MD, ScD; Charlene Belanger, MA; Jean MacFadyen, BA; Vadim Bubes, PhD; JoAnn E. Manson, MD, DrPH; Howard D. Sesso, ScD, MPH; Julie E. Buring, ScD

JAMA. 2009;301(1):52-62. Published online December 9, 2008 (doi:10.1001/jama.2008.862).

Context Many individuals take vitamins in the hopes of preventing chronic diseases such as cancer, and vitamins E and C are among the most common individual supplements. A large-scale randomized trial suggested that vitamin E may reduce risk of prostate cancer; however, few trials have been powered to address this relationship. No previous trial in men at usual risk has examined vitamin C alone in the prevention of cancer.

Objective To evaluate whether long-term vitamin E or C supplementation decreases risk of prostate and total cancer events among men.

Design, Setting, and Participants The Physicians’ Health Study II is a randomized, double-blind, placebo-controlled factorial trial of vitamins E and C that began in 1997 and continued until its scheduled completion on August 31, 2007. A total of 14 641 male physicians in the United States initially aged 50 years or older, including 1307 men with a history of prior cancer at randomization, were enrolled.

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January 8th, 2009 | Tags: Announcements, Clinical Trials, Food, Research | Category: Announcements, Clinical Trials, Food, Research | Leave a comment

From Irish Times

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Reliable screening techniques for men’s cancers have yet to be found, writes Michael Kelly

A RECURRING theme that pops up whenever we discuss men’s health is that men don’t take their health seriously enough.

We are told that we don’t visit our doctors as regularly as we should and, as a result, diseases and illnesses go unchecked often until it’s too late. It is interesting in this context that there are no screening programmes in Ireland which are accessible to men.

The National Cancer Screening Service’s (NCSS) current programmes are exclusively focused on women – BreastCheck, which provides free breast X-rays to women aged 50-64, and CervicalCheck, which will provide free screening for women aged 25-60.

Prostate screening is not available from the NCSS, despite the fact that more cases of prostate cancer are diagnosed each year than breast cancer (2,352 cases of breast cancer and 2,407 cases of prostate cancer in 2005).

It would be easy for men to look at this situation and feel slightly confused – if the powers-that-be want us to engage with the health service, surely it would be worth making a screening programme available for us to engage with?

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January 8th, 2009 | Tags: Awareness, Diagnosis, Editorial, Government, Legal, Medical | Category: Awareness, Diagnosis, Editorial, Government, Legal, Prevention | Leave a comment

From the JHU Gazette

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By Christen Brownlee
Johns Hopkins MedicineThe hormone deprivation therapy that prostate cancer patients often take gives them only a temporary fix, with tumors usually regaining their hold within a couple of years. Now, researchers at Johns Hopkins have discovered critical differences in the hormone receptors on prostate cancer cells in patients who no longer respond to this therapy. The findings, reported in the Jan. 1 issue of Cancer Research, could lead to a way to track disease progression, as well as to new targets to fight prostate cancer.

Prostate cancer cells rely on androgens, male hormones that include testosterone, to survive and grow. Since 1941, doctors have taken advantage of this dependency to battle prostate cancer by depriving patients of androgens, either by castration or chemical methods. For most patients, this hormone deprivation therapy causes tumors to shrink, sometimes dramatically. However, it’s never a cure; tumors eventually regrow into a stronger form, becoming resistant to this and other forms of treatment.

Seeking the reason why this therapy eventually fails, Jun Luo, an assistant professor at Johns Hopkins’ James Buchanan Brady Urological Institute, and his colleagues at the Johns Hopkins University School of Medicine and the University of Washington and Puget Sound VA Medical Center looked to a key player: the androgen receptors on prostate cancer cells.

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January 8th, 2009 | Tags: Cures, Medications, Research, Treatment | Category: Cures, Medications, Research, Treatment | Leave a comment

From hot100.com

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Aberrant Ras and Wnt signaling are emerging as key events in the multistep nature of prostate tumorigenesis and progression. Here, we report the generation of a compound model of prostate cancer to define the synergism of activated K-ras (K-ras+/V12) and dominant stabilized β-catenin (Catnb+/lox(ex3)) in the murine prostate. Recombination of floxed alleles and subsequent expression of oncogenic transgenes was mediated by Cre recombinase expression governed by the composite Probasin (PB) promoter (termed PBCre). Concomitant with elevated mitogen-activated protein kinase (MAPK) signaling, PBCre+K-ras+/V12 mice developed AH at 100 days (100% incidence) and low-grade prostate intraepithelial neoplasia and adenocarcinoma (60% and 7% incidence) by 500 days. PBCre+Catnb+/lox(ex3) mice showed reduced longevity (average 428 days) and were predisposed to PIN-like keratinized squamous metaplasia at 100 days (100% incidence) and adenocarcinoma (100% incidence) at end-point. These lesions displayed elevated Wnt signaling and basal levels of MAPK signaling. Synchronous activation of K-ras and β-catenin significantly reduced survival (average 189 days), reflecting accelerated tumorigenesis and the development of invasive carcinoma that displayed activated Wnt and MAPK signaling. Notably, expression of the basal cell marker p63 negatively correlated with tumor grade, resembling human prostate adenocarcinoma. Taken together, our data show that combinatorial oncogenic mutations of K-ras and β-catenin drive rapid progression of prostate tumorigenesis to invasive carcinoma, characterized by the synergistic elevation of androgen receptor, cyclooxygenase-2, and c-Myc. [Cancer Res 2009;69(1):94–101]

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January 8th, 2009 | Tags: Prevention, Research, Treatment | Category: Prevention, Research, Treatment | Leave a comment

From TheDay

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New treatments available locally; evidence needed to determine which are preferable
By Judy Benson Published on 1/4/2009

Dr. Franklin Friedman assists Dr. T. Casey McCullough (not in photo) during a prostate cancer procedure at The William W. Backus Hospital in Norwich last month. McCullough is operating the DaVinci Surgical System, a robotic device, from a console in the operating room.

In the past year, southeastern Connecticut’s two hospitals both purchased expensive new equipment employing the latest technologies to treat prostate cancer, a disease diagnosed in about 218,000 men across the country in 2007.The acquisition by Lawrence & Memorial Hospital of the Calypso image-guided radiation therapy system and by The William W. Backus Hospital of the DaVinci robotic surgery system, promoted by both with advertising and videos and on their Web sites, gives southeastern Connecticut’s prostate cancer patients new treatment options locally.

They add to the already ample – and perhaps confusing – array of choices offered close to home and in larger hospitals in New Haven, Hartford, New York City and Boston all competing for their business. Ultimately, decision makers at both hospitals believe, patients benefit from having more choices available at their local as well as out-of-town hospitals.

”When hospitals in a region purchase different equipment,” said L&M spokesman Kelly Anthony, “the advantage clearly goes to the patient…”

For nonprofit, small-to-medium-sized community hospitals such as Backus and L&M, the decision to acquire the new equipment is also a major investment hospital officials consider necessary to sustain and increase patient numbers, keep and attract

doctors and maintain a positive public image as up-to-date institutions.

”I can’t deny those pressures exist,” said Dr. David Kalla, acting chairman of the Division of Surgical Services at Backus.

But whether these investments will translate into improved patient outcomes compared to existing remedies remains unclear, regardless of what the hospitals’ marketing and advertising campaigns may assert. That’s the conclusion of a February report by the Agency for Healthcare Research and Quality, an arm of the U.S. Department of Health & Human Services.

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January 8th, 2009 | Tags: Cures, Medical, Risks, Treatment | Category: Cures, Research, Treatment | Comments (1)

From eFluxMedia

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Researchers said that men with advanced prostate cancer will have the chance to follow a new treatment that might help slow disease progression

Degarelix, a novel gonadotrophin-releasing hormone blocker, lowers the level of testosterone, in a different way than other medicines do it, as well as levels of prostate-specific antigen (PSA), according to Professor Hein Van Poppel of the Department of Urology at the University of Gasthuisberg.

The Food and Drug Administration said that treatment with degarelix doesn’t result in temporary spurt in the male hormone and tumor growth that most drugs do.

“The reason we want to lower testosterone in prostate cancer is because it is a hormone-dependent cancer, and if you lower testosterone, you can stop it from growing,” said Dr. E. David Crawford, a nationally recognized expert in prostate cancer, head of the Urologic Oncology at the University of Colorado-Denver.

But although results from clinical trials showed a substantial reduction in testosterone levels within days in most of the participating patients, the FDA said that the drug was as effective as leuprolide (Lupron) at maintaining hormone levels down. Lupron is also used to treat advanced prostate cancer in men, by reducing the production of testosterone levels.
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January 8th, 2009 | Tags: Medications, Research, Treatment | Category: Medications, Research, Treatment | Comments (2)

From Forbes Health Highlights

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January 3, 2009

The outcomes of prostate cancer patients treated with brachytherapy (seed implants) were not affected by patients’ family history, a new study finds.

Researchers from the Departments of Radiation Oncology and Urology at New York City’s Mount Sinai School of Medicine tracked 1,738 prostate cancer patients, of which 187 had a family history of the disease. The scientists found that among all risk groups, family history had no significance on outcome among prostate cancer patients treated with brachytherapy.

Study results were reported in the Jan. 1 issue of the International Journal of Radiation Oncology *Biology* Physics.

Prostate cancer is the second-most common cancer in men, next to skin cancer. The American Cancer Society estimates that 186,320 new cases of prostate cancer were diagnosed in the United States in 2008, and some 28,660 men died of the disease.

While family history does increase a man’s risk of developing prostate cancer, “there is conflicting data on how family history impacts treatment outcomes,” the researchers wrote in a news release.

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January 8th, 2009 | Tags: Genetics, Research, Risk Factors, Treatment | Category: Awareness, Genetics, Prevention, Research, Risk Factors | Leave a comment

From suite101.com

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Drink Tea for a Healthier Prostate

© Angela Wilson

Jan 2, 2009

Multiple studies have shown promising results. According to the Prostate Cancer Foundation, prostate cancer is the second leading cause of cancer-related death in American males. Men with prostate cancer have to make personal decisions about treatment options and diet and lifestyle changes. Huge efforts are being made in the scientific community to discover new ways of preventing prostate cancer. One hopeful prevention may be Green Tea.

The following studies have showed promising results regarding the use of green tea as a method for preventing prostate cancer.

Pandey, M. & Gupta, S. (2009). Green tea and prostate cancer: From bench to clinic, Frontiers in Bioscience, E1, 13-25.

This comprehensive review provides an in-depth overview of various biochemical and signaling pathways affected by green tea in various models of prostate cancer.

A decade of research with green tea polyphenols in cell culture system, pre-clinical models like mouse tumor xenograft and transgenic mouse models have proven that green tea polyphenols can influence a number of molecular pathways that has relevance to tumor growth, proliferation and metastasis.

Although green tea polyphenols inhibit and reverse tumorigensis in the post-initation stages, they also hold therapeutic potential through their ability to specifically kill cancer cells without affecting the growth of normal cells. It is only now with the development of sophisticated investigational techniques that the various molecular signaling pathways modulated by them are being understood.

Adhami, V.M, Ahmad, N., & Mukhtar, H. (2003). Molecular targets for green tea in prostate cancer prevention, Journal of Nutrition, 133, 2417-2424.

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January 3rd, 2009 | Tags: Awareness, Diet, Food, Prevention, Research, Treatment | Category: Awareness, Food, Prevention, Research | Leave a comment

From EurekAlert

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Contact: Beth Bukata
bethb@astro.org
703-839-7332
American Society for Therapeutic Radiology and Oncology

In a first of its kind study, a first-degree family history of prostate cancer has no impact on the treatment outcomes of prostate cancer patients treated with brachytherapy (also called seed implants), and patients with this type of family history have clinical and pathologic characteristics similar to men with no family history at all, according to a January 1 study in the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology.

“This information is relevant for both physicians and patients with new diagnoses as they embark on complex treatment decisions,” Christopher A. Peters, M.D., lead author of the study and a radiation oncologist at Northeast Radiation Oncology Center in Dunmore, Pa. (chief resident at Mount Sinai School of Medicine at the time of the study), said. “Now patients with a family history of prostate cancer can be confident that they have the same outcomes as patients with sporadic disease, regardless of the treatment modality they chose.”

According to the American Cancer Society, prostate cancer is the most common cancer in men behind skin cancer. Many patients diagnosed with prostate cancer have some type of family history of the disease and men with a family history do have an increased risk of developing the disease, but there is conflicting data on how family history impacts treatment outcomes.

In the study, researchers at the Departments of Radiation Oncology and Urology at the Mount Sinai School of Medicine in New York sought to determine if having a familial history of prostate cancer, which is defined as a clustering of prostate cancer cases within a family, had an impact on the prognosis of men treated with brachytherapy for clinically localized prostate cancer patients.

Researchers followed 1,738 prostate cancer patients, of which 187 had a family history of prostate cancer in a first-degree relative, for a median follow-up time of 60 months. They found that in the low-, intermediate- and high-risk groups, a family history of prostate cancer had little to no prognostic significance in men treated with brachytherapy. Previous studies done with prostate cancer patients receiving external beam radiation therapy or radical prostatectomy had similar findings.

ASTRO is the largest radiation oncology society in the world, with more than 10,000 members who specialize in treating patients with radiation therapies. As the leading organization in radiation oncology, biology and physics, the Society is dedicated to improving patient care through education, clinical practice, advancement of science and advocacy. For more information on radiation therapy, visit www.rtanswers.org. To learn more about ASTRO, visit www.astro.org.

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January 3rd, 2009 | Tags: Clinical Trials, Genetics, Research, Risks, Treatment | Category: Clinical Trials, Diagnosis, Genetics, Research, Risk Factors, Treatment | Comments (1)