Shorter course of radiation therapy effective in treating men with prostate cancer


 

Lead author Dr. Amar Kishan, assistant professor of radiation oncology at the David Geffen School of Medicine at UCLA and researcher at the UCLA Jonsson Comprehensive Cancer Center.

A new UCLA-led study shows that men with low- or intermediate-risk prostate cancer can safely undergo higher doses of radiation over a significantly shorter period of time and still have the same, successful outcomes as from a much longer course of treatment.

This type of radiation, known as stereotactic body radiotherapy, is a form of external beam radiation therapy and reduces the duration of treatment from 45 days to four to five days. The approach has been in use since 2000, but has not yet been widely adopted because of concerns over how safe and effective this approach would be in the long term.

“Most men with low- or intermediate-risk prostate cancer undergo conventional radiation, which requires them to come in daily for treatment and takes an average of nine weeks to complete,” said lead author Dr. Amar Kishan, assistant professor of radiation oncology at the David Geffen School of Medicine at UCLA and researcher at the UCLA Jonsson Comprehensive Cancer Center. “That can be very burdensome on a patient and be a huge interruption in their life. With the improvements being made to modern technology, we’ve found that using stereotactic body radiotherapy, which has a higher dose of radiation, can safely and effectively be done in a much shorter timeframe without additional toxicity or compromising any chance of a cure.”

The UCLA research team analyzed data from 2,142 men with low- or intermediate-risk prostate cancer across multiple institutions who were treated with stereotactic body radiotherapy for prostate cancer between 2000 and 2012.

The men were followed for a median of 6.9 years. Just over half of the men had low-risk disease (53 percent), 32 percent had less aggressive intermediate-risk disease and 12 percent had a more aggressive form of intermediate-risk disease.

The recurrence rate for men with low-risk disease was 4.5 percent, the recurrence rate for the less aggressive intermediate-risk was 8.6 percent, and the recurrence rate for the more aggressive intermediate-risk group was 14.9 percent. Overall, the recurrence rate for intermediate-risk disease was 10.2 percent. These are essentially identical to rates following more conventional forms of radiation, which are about 4 percent to 5 percent for low-risk disease and 10 percent to 15 percent for intermediate-risk disease.

“What is remarkable about this very large study is how favorably stereotactic body radiotherapy compares to all other forms of radiation treatments, both in terms of effectiveness and side effects,” said senior author Dr. Christopher King, professor of radiation oncology and scientist at the UCLA cancer center. “With such long-term follow-up data, we can now offer this approach to patients with full confidence.”

The research team at UCLA had previously found that stereotactic body radiation therapy was more cost effective because of the fewer treatments involved. Other research has also suggested psychological benefits such as less regret about undergoing treatment. The current study now provides long-term data regarding the safety and clinical efficacy of this approach.

Kishan said the data show that the majority of the men followed are free of prostate cancer seven years after treatment. He added that there was no evidence that this therapy caused worse toxicity in the long term. “In fact,” Kishan said, “we not only confirm that this method is both safe and effective, but we provide significant evidence that this could be a viable treatment option for men with low- and intermediate-risk of prostate cancer.”

Focal Therapy of Prostate Cancer


Abstract

Purpose of review: The aim of this study was to summarize the latest evidence, as well as the rationale behind using focal therapy for the treatment of prostate cancer. With patients becoming more educated, knowledge of the available evidence is key when discussing treatment.

Recent findings: In older works, the natural history of prostate cancer has been described as being multifocal, driven by one index lesion. This represents the key argument for most experts, why focal therapy is feasible in prostate cancer. Most modalities have similar results. For high-intensity focussed ultrasound (HIFU), a pooled data analysis with a median follow-up of 2.2 years showed a negative biopsy rate of 77% with a salvage therapy free rate of 92%. A matched pair analysis comparing irreversible electroporation with robot-assisted radical prostatectomy showed a better side effect profile for focal therapy in evenly matched groups, yet with worse disease-free survival. Interestingly, the better outcomes concerning continence and erectile function did not translate into better patient-reported outcomes.

Summary: Focal therapy modalities are generally well tolerated and show good results in terms of continence and potency. Long-term follow-up is not available, and inclusion criteria for trials are not yet uniform. Newer technologies, such as photodynamic therapy, are being developed, as well as improvements to older techniques, such as HIFU.

A Daily Dose of Viagra Gave Test Subjects a Valuable Health Benefit


By sustaining erections where limpness once prevailed, Viagra has vastly improved the sex lives of many people. But the little blue pill, it turns out, may be useful outside the bedroom as well. In March, researchers discovered that the popular erectile dysfunction drug can play a potentially life-saving role in another body part — the colon.

The scientists, publishing their findings in the journal Cancer Prevention Research, showed that a small daily dose of Viagra played a role in preventing colon cancer, at least in mice.

Using mice engineered to be predisposed to growing colon polyps — abnormal cell clumps that can sometimes become cancerous — the scientists tested whether a small daily dose of Viagra could prevent the development of colon cancer in the mice. Specifically, they were looking at the effect of sildenafil, the active ingredient in Viagra, on the rate of polyp formation. The daily dose, administered through the drinking water of the mice, reduced polyp formation and colon inflammation by 50 percent.

viagra
When administered to mice in small doses, Viagra reduced the rate of formation for polyps, cell clumps that could become cancerous.

The study built upon previous work suggesting that Viagra inhibits an enzyme in colon cells that boosts cell proliferation. The more that cells multiply, the more opportunities they have to pick up mutations that can lead to cancer, so suppressing cell proliferation. While the researchers don’t know exactly how Viagra is working its magic in these mice just yet, they know that reducing the rate of polyp formation is one promising way to prevent the development of colon cancer (and prevent the painful rectal bleeding that colon polyps cause, whether they’re cancerous or not).

Viagra, for its part, has proven to be useful in solving other medical problems. It’s used to treat premature babies with pulmonary hypertension, a deadly condition in which blood pressure rises in the lungs, and its been shown to help treat prostate cancer when used in tandem with another cancer-fighting drug.

Not that everything went well for Viagra in 2018. An ongoing problem for United States public health experts is the ongoing popularity of vape liquids that contain erectile dysfunction drugs and the danger they pose to users. Not regulated by any medical authority, these widely available vape liquids contain unknown amounts of sildefanil and taladafil (the active ingredient in the erectile dysfunction drug Cialis), which themselves may be counterfeit. One account even claimed it gave a user a two-day erection.

Radiotherapy to the Primary Tumor for Newly Diagnosed Metastatic Prostate Cancer


TAKE-HOME MESSAGE


abstract

This abstract is available on the publisher’s site.

Docetaxel for Prostate Cancer: ‘Win-Win-Win’


Adding the chemotherapy docetaxel to standard hormone therapy for both metastatic and nonmetastatic prostate cancer is a win-win-win because it improves patients’ overall quality of life (QoL), reduces the need for subsequent therapy, and is cost-effective, according to a new modeling study from the investigators of a major clinical trial.

That trial, known as STAMPEDE (Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy), helped establish that docetaxel was an effective option in the treatment of metastatic prostate cancer (Lancet. 2016;387:1163-1177). The study showed a 10-month overall survival benefit when the drug was added to androgen deprivation therapy (ADT) for hormone-sensitive metastatic prostate cancer compared with ADT alone.

However, use of docetaxel in nonmetastatic disease has been considered controversial  because the difference in survival was not as pronounced in this earlier stage of disease as it was in metastatic disease and did not reach statistical significance, as reported at the time by Medscape Medical News.

Now, the lead author of STAMPEDE, Nicholas D. James, MD, PhD, professor of clinical oncology, University of Birmingham, United Kingdom, is championing the idea.

“Results suggest use of docetaxel in selected nonmetastatic patients should be considered,” he said in a presscast ahead of the Genitourinary Cancers Symposium (GUCS) 2018, which will be held later this week in San Francisco.

The triple benefit (QoL, less need for more therapy, cost-effectiveness) seen in nonmetastatic disease is “somewhat surprising and may cause clinicians to rethink how and when they use docetaxel to treat prostate cancer,” he said.

Dr James will be presenting results from the new modeling study, which  calculated lifetime predictions of costs, changes in predicted survival duration, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The researchers used data on both men with metastatic (M1) and nonmetastatic (M0) disease, as the trial included both populations.

Health outcomes and costs in the UK National Health Service were modeled by using EuroQol (EQ-5D), which is a standardized self-reporting tool, and resource-use data collected within the STAMPEDE trial. In the trial, standard of care was ADT for at least 2 years and, in some patients, radiotherapy. Docetaxel (75 mg/m2) was administered alongside standard of care for six 3-weekly cycles with prednisolone 10 mg daily.

The team reported that docetaxel was estimated to extend predicted survival by an average of 0.89 years for M1 patients and 0.78 years for M0 patients, compared with patients receiving standard of care.

Docetaxel was also estimated to extend QALYs by 0.51 years in M1 patients and 0.39 years in M0 patients — and the findings for this measure had a “high degree of certainty,” Dr James commented. QALY gains in M0 patients were driven by the “beneficial effect of delayed and reduced relapse,” the authors said.

Compared with standard of care, docetaxel was cost-effective in both M1 patients and M0 patients. A sensitivity analysis indicated a “very high probability” (>99%) that docetaxel is cost-effective in both M0 and M1 patients, the authors also stated. Docetaxel remained cost-effective in M0 patients because of reductions and delays in relapse; this held true even when no survival advantage was assumed.

How Does This Compare to Abiraterone?

The new data prompted Sumanta K. Pal, MD, an American Society of Clinical Oncology (ASCO) expert and urologic oncologist at City of Hope, Duarte, California, and moderator of the GUCS presscast, to think about another drug used in this setting, abiraterone (Zytiga, Janssen).

“I will be interesting to assess these results [ie cost and QoL for docetaxel] against recent data for abiraterone, an oral hormonal therapy for prostate cancer, which has similar benefit in the same settings in prostate cancer,” he told reporters.

“Abiraterone may have the benefit of improved tolerability over a short course vs chemotherapy but does require a much more extensive duration of use and further mandates concomitant intake of prednisone, a steroid,” Dr Pal said.

Understanding the cost and quality of life associated with abiraterone may help in selecting either it or docetaxel for these patients with prostate cancer, he summarized.

Press materials from ASCO further pointed out that docetaxel is much less expensive: For the average patient with prostate cancer in the United Kingdom, a course of docetaxel costs £5000 (approximately $6000) per year, compared with £24,000 ($28,800) for abiraterone.

Apalutamide Slows Metastasis in Prostate Cancer


Two-year delay in metastatic progression with apalutamide

Action Points

  • Note that this study was published as an abstract and will be presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

Men with non-metastatic castration-resistant prostate cancer (nmCRPC) had a 2-year delay in the time to metastatic progression when treated with the new-generation androgen-receptor inhibitor apalutamide, a large randomized trial showed.

Patients randomized to apalutamide had a median metastasis-free survival (MFS) of 40.5 months versus 16.2 months for placebo treatment. The difference represented a 72% reduction in the hazard for metastatic progression or death, according to Eric Small, MD, of the University of California San Francisco, and colleagues.

Time to metastasis (TTM), progression-free survival (PFS), symptomatic progression, and PFS after subsequent therapy (PFS2) all favored apalutamide, Small reported at a press briefing prior to the Genitourinary Cancers Symposium (GUCS).

“Apalutamide was associated with a reduced risk of death, but that was not significant at this early interim analysis and will continue to be followed. The trend was certainly encouraging,” he said. “Treatment with apalutamide was generally well tolerated with no impact on quality-of-life [QoL] scores and with low rates of discontinuation due to treatment-related adverse events. Overall, these data suggest that apalutamide should be considered as a new standard of care for men with nonmetastatic castration-resistant prostate cancer.”

The results were consistent with those of the randomized PROSPER trial with enzalutamide (Xtandi), which also will be reported at GUCS, said press briefing moderator Sumanta Pal, MD, of City of Hope in Duarte, California. The abstract for the PROSPER trial showed a median MFS of 37 months for men treated enzalutamide (Xtandi) versus 15 months with placebo. Patients in both groups continued existing androgen deprivation therapy (ADT) after randomization.

“Until the results of studies presented at this meeting, there’s really been no obvious standard of care for these patients,” said Pal.

Noting that enzalutamide already has approval for more advanced prostate cancer, Pal added, “The familiarity that oncologists already have with enzalutamide may help with clinical adoption.”

However, the patient population targeted by the SPARTAN and PROSPER studies could be shrinking, Pal continued. SPARTAN investigators used conventional imaging modalities (CT and technetium bone scan) to assess patients’ status at enrollment and during the trial. Some newer forms of PET imaging may improve the ability to detect disease spread earlier, leading to early changes in clinical management, he said.

Metastatic CRPC remains uniformly fatal, associated with a median survival of about 2.5 years, Small noted. The condition arises in two way: metastatic hormone-sensitive prostate cancer and nmCRPC. Both conditions afford opportunities for interventions that delay or prevent progression to mCRPC, although as Pal noted, nmCRPC currently has no standard of care.

The primary objective of the SPARTAN trial was to determine whether treatment with apalutamide could delay development of metastases and the transition from nonmetastatic to metastatic CRPC. Apalutamide has a three-fold mechanism of action that could help accomplish the objective:

  • Prevention of androgen binding to receptor
  • Prevention of androgen receptor translocation to the nucleus
  • Blocking androgen receptor-mediated DNA transcription

Investigators at 332 centers worldwide enrolled 1,207 patients who had a baseline PSA doubling time of less than 5 month. The patients were randomized 2:1 to daily apalutamide or placebo, in addition to continuous ADT. The primary endpoint was MFS. Treatment continued until disease progression, and then patients had the option to switch to abiraterone (Zytiga) plus prednisone.

The trial ended prematurely after a planned interim analysis showed the trial had met the primary endpoint. The results showed that treatment with apalutamide was associated with a significant reduction in the hazard for MFS (95% CI 0.23-0.35, P<0.001). Small did not report results for secondary endpoints (TTM, PFS, and symptomatic progression) but said all were significantly improved in the apalutamide group versus the placebo group.

After a median follow-up of 20.3 months, the survival data remained immature to determine whether apalutamide treatment would lead to improved survival, said Small. However, the interim analysis showed a favorable trend in favor of apalutamide (P=0.07).

Apalutamide was generally well tolerated, as adverse events rates were similar in the two groups. Rates of discontinuation because of adverse events were 10.7% in the apalutamide group and 6.3% in the placebo group. Baseline health-related QoL scores were similar in the two groups and maintained throughout the study.

PET/CT differentiates prostate cancer from healthy tissue by new method


https://speciality.medicaldialogues.in/pet-ct-differentiates-prostate-cancer-from-healthy-tissue-by-new-method/

Complete Mediterranean diet may protect against aggressive prostate cancer


https://speciality.medicaldialogues.in/complete-mediterranean-diet-may-protect-against-aggressive-prostate-cancer/

Men Who Have this Popular PSA Prostate Cancer Screening Have a Staggering 4-Fold Increase in Serious Blood Infections


Men Who Have this Popular PSA Prostate Cancer Screening Have a Staggering 4-Fold Increase in Serious Blood Infections

Story at-a-glance

  • The benefits of PSA prostate cancer screening has been repeatedly shown to be minimal at best and detrimental at worst. Overall, PSA screening barely has any impact on mortality rates from prostate cancer. As a result, the U.S. Preventive Services Task Force will soon recommend that men not get screened for prostate cancer.
  • According to Stanford University researchers, the PSA test indicates nothing more than the size of your prostate gland. . The false positive rate is high, and the bulk of the harm is a result of subsequent unnecessary treatments.
  • Canadian researchers have raised the alarm over prostate biopsies, citing a four-fold increase in serious blood infections over the past decade from the procedure. Researchers are also questioning the conventional treatments of prostate cancer, which include surgical removal of the prostate gland and radiotherapy, as they may not be necessary for most men.
  • Your diet can greatly impact your prostate health and help prevent enlarged prostate and prostate cancer. Ideally, you’ll want to eat as much organic (preferably raw) food as possible, and limit sugar/fructose and grains from your diet. Highly processed or charcoaled meats, pasteurized dairy products, and trans fats correlate with an increased risk for prostate cancer and should also be avoided. Other specific nutritional therapies are discussed.

Prostate cancer is one of the most common cancers in men, but it is not  as deadly as breast cancer.

According to the latest statistics from the American Cancer Society, an estimated 240,890 men will be diagnosed with prostate cancer this year, and just over 33,700 men may die from it, so only one in seven diagnosed with it will die from it.

Overall, American men have a one in six chance of being diagnosed with prostate cancer at some point in their lives, or one in 42 chance of dying from it..

Most cases of prostate cancer do not occur until after men turn 50, but in recent years there has been a steady rise in the percentage of men in their 30s and 40s with both prostate problems and prostate cancer, primarily as a result of poor diet and increasing environmental pollution.

Unfortunately, investigations over the years have discovered serious flaws with the PSA test used to diagnose prostate cancer.

And the U.S. Preventive Services Task Force—which has also declared women in their 40s don’t need mammograms—may soon recommend that men not get screened for prostate cancer using the PSA test.

Researchers are also questioning the conventional treatments of prostate cancer, which include surgical removal of the prostate gland and radiotherapy, as they may not be necessary for most men.

All in all, I think this really highlights the necessity to employ preventive strategies, which I will discuss at the end of this article.

Moderate to High Certainty PSA Test Does More Harm than Good, Task Force Says

The prostate-specific antigen test (PSA test), analyzes your blood for prostate-specific antigen (PSA), a substance produced by your prostate gland.  When higher-than-normal levels of PSA are detected, it is believed that cancer is present.

However, the PSA test has been criticized as useless for a number of years now. For example, back in 2004, Stanford University News reported:

“The most commonly used screening tool for detecting prostate cancer – the PSA test – is virtually worthless for predicting men’s risk of contracting the disease, medical school researchers have determined. Stanford scientists studied prostate tissues collected in the 20 years since a high PSA test result became the standard for prostate removal. They concluded that as a screen, the test indicates nothing more than the size of the prostate gland.”

The U.S. Preventive Services Task Force is now planning on recommending a “D” rating for PSA testing, meaning that “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”  A review of studies has shown that the PSA blood test yields “small or no reduction” in prostate cancer deaths.

As reported by CNN:

“The report adds that PSA testing is ‘associated with harms related to subsequent evaluation and treatments.’ … The problem is that many of the cancers that get detected are so small and slow-growing, they’ll never be harmful, and doctors have a difficult time discerning the quick, harmful cancers from the slow, harmless ones.”

The PSA Test for Prostate Cancer is Deceptive

Today, many experts agree that PSA testing is unreliable at best and useless at worst for accurately diagnosing prostate cancer. Many also agree that routine PSA blood tests often lead to over-diagnosis of prostate cancer, resulting in unnecessary treatments. Similar to mammograms, the PSA screen has become little more than an up-sell technique. The false positive rate is high, and the bulk of the harm is a result of subsequent unnecessary treatments.

According to the American Cancer Society: “There can be different reasons for an elevated PSA level, including prostate cancer, benign prostate enlargement, inflammation, infection, age, and race,” all factors that make PSA test results confusing, leading to potential for unnecessary treatment and suffering when tests are elevated.  Getting a PSA test reduces your lifetime risk of dying from prostate cancer from three percent to just 2.4 percent, so the difference is negligible.

Drs. Boyle and Brawley of the International Prevention Research Institute, Lyon, France have said,

“The real impact and tragedy of prostate cancer screening is the doubling of the lifetime risk of a diagnosis of prostate cancer with little if any decrease in the risk of dying from this disease.”

Complications of ill advised prostate cancer treatments include urinary incontinence and erectile dysfunction. Both of these conditions are difficult to reverse and can significantly decrease your quality of life.

Prostate Biopsies Can Result in Dangerous Infections

A positive PSA test will typically lead to a biopsy—which has also come under increasing scrutiny and criticism in recent years. On the one hand, the procedure itself may cause acute or long-term harm, and on the other, the rate of false negatives is high.

There are over one million prostate cancer tissue biopsy procedures performed annually in the U.S. Approximately 25 percent of these tissue biopsies are reported “positive,” indicating the presence of prostate cancer. The remaining 75 percent are reported “negative.” One-third of the men with initial “negative” results for prostate cancer actually do have prostate cancer that was missed by the biopsy.

A prostate biopsy involves inserting fine needles into the prostate gland. But specialists have begun to worry about a recent, significant increase in the risk of complications from the procedure. In particular, they are concerned about hard-to-treat bloodstream infections that can require weeks of treatment. Over the past decade, the rate of hospital admissions in Ontario, Canada, for serious infections caused by prostate biopsy increased four-fold.

Earlier this summer, the NPR reported:

“Doctors all over the world are increasingly concerned about post-biopsy infections. At last week’s annual meeting of the American Urological Association, there were 10 reports on the phenomenon … The underlying problem, many say, is the spread of antibiotic-resistant microbes.”

Prostate biopsies inherently pose a risk for infection because:

  • The needles that collect a tiny piece of prostate tissue can transport bacteria through your rectal wall into the prostate and bloodstream, and/or
  • The needles can spread harmful bacteria present in your gut into your bloodstream

Many Cancer Screenings Don’t Save Lives and May Cause Cancer

A recent article featured on PreventDisease.com brings up yet another problem with the PSA test:

“Perhaps most concerning, the PSA test frequently identifies something that qualifies as cancer under a microscope but acts nothing like cancer in real life. That is to say, the large majority of PSA-discovered “cancers” would never cause any problem whatsoever if they went undetected. Finding something through screening invariably leads to treating it through conventional means which cause cancer themselves.”

An underlying issue that needs to be addressed is that both breast- and prostate cancer screenings (mammography and PSA testing respectively) fail to address prevention. Although they are commonly viewed as “preventive” measures, they’re nothing of the sort.  Furthermore, they both appear to result in increased risk of mortality.

The article on PreventDisease.com also includes the following shocking statistics about breast- and prostate cancer screening:

“In a Swedish study of 60,000 women, 70 percent of the mammographically detected tumors weren’t tumors at all. These “false positives” aren’t just financial and emotional strains, they may also lead to many unnecessary and invasive biopsies. In fact, 70 to 80 percent of all positive mammograms do not, upon biopsy, show any presence of cancer.

When it comes to prostate cancer, a 20-year study from Sweden suggests that screening for prostate cancer does not reduce the risk of death from the disease. In fact, many men receive false-positive results and overtreatment, adding an element of risk to widescale screening, researchers report in the March 31 online issue of the BMJ.

“In the light of our findings, I would say that the benefit from screening is not sufficient to support mass screening,” said study author Dr. Gabriel Sandblom, an associate professor at the Karolinska Institute in Stockholm.”

http://www.afcomponents.com/flv/swf/flv_demo.swf

Screens and Treatments Involving Radiation Promote Cancer

Cancer screens like mammography and radiation treatment of either breast- or prostate cancer are not benign tests and treatments. It’s important to understand that radiation exposure causes genetic mutations in cells, and is also known to switch off a tumor suppressing gene. According to PreventDisease.com:

“[N]ew research from the Lawrence Berkeley National Laboratory in America (a US Government facility) has shown that radiation both changes the environment around breast cells, and increases the risks of mutation within them; a mutation that can be passed on in cell division. Four to six weeks after exposure to radiation at a level below that of a screening mammogram, breast cells started to prematurely age.

This results in their inability to send certain chemical messages into their immediate environment, which then filled with pre-cancerous mutated cells also from the radiation.

Paul Yaswen, a cell biologist and breast cancer research specialist with Berkeley Lab’s Life Sciences Division says “our work shows that radiation can change the microenvironment of breast cells, and this in turn can allow the growth of abnormal cells with a long-lived phenotype that have a much greater potential to be cancerous.”

Yawsen stated that radiation specialists have been slow in understanding these concepts. “Many in the cancer research community, especially radiobiologists, have been slow to acknowledge and incorporate in their work the idea that cells in human tissues are not independent entities, but are highly communicative with each other and with their microenvironment.”

Despite the Evidence, Many Cling to the PSA Test

Shannon Brownlee, author of Overtreated, recently wrote an insightful article for Time Magazine on this topic as well.  Many men are responding with outrage at the news that the PSA test will no longer be recommended. Many prostate cancer survivors credit the PSA test with saving their lives.

“The trouble is most men who get treated didn’t have a cancer that needed treating,” Brownlee writes. “So while a given man may believe fervently that early treatment saved his life, there’s a better than even chance that he would have been fine even if his cancer had been left well enough alone.

We never hear from the men who died from their prostate cancer treatment or biopsy. And there have been plenty of them. The mortality rate during or shortly after prostate surgery is estimated to be 1 in 200, according to a study published in the Journal of the National Cancer Institute. We also don’t hear much from the men who are suffering from incontinence, impotence, or both, the devastatingly common side effects of treatment.”

This is probably to be expected. If it was you, how willing would you be to tell the world that you’re now incontinent and impotent as a result of opting to get tested for prostate cancer? These are personal details that few men are willing to share.

How to Maintain Optimal Prostate Function and Help Prevent Prostate Cancer

Men over 70 have a 50/50 chance of developing an enlarged prostate, known as benign prostate hyperplasia (BPH). This is not the equivalent of prostate cancer. However, you do need to address this issue, and unfortunately, the conventional route includes drugs. It’s important to know that some of these drugs actually carry a warning label that if you have benign prostate hyperplasia, the drug may increase your cancer risk, and/or may promote a much more aggressive form of cancer.

For more information about this, please review this previous article on prostate health, which includes an informative interview with Dr. Rudi Moerck. Diet is a factor that can greatly impact your prostate health and help prevent enlarged prostate and prostate cancer.

You’ll want to eat as much organic (preferably raw) food as possible, and liberally include fresh herbs and spices, such as ginger. Make sure to limit carbohydrates like sugar/fructose and grains as much as possible to maintain optimal insulin levels, which will help reduce your cancer risk in general. Highly processed or charcoaled meats, pasteurized dairy products, and trans fats correlate with an increased risk for prostate cancer and should also be avoided.

There are also a number of more specific nutritional therapies that are particularly beneficial for avoiding and/or treating prostate cancer.

  • Include prostate-healthy foods in your daily diet: Foods that support prostate health include vegetables and fruits rich in antioxidants, vitamins, cartenoids like astaxanthin, and lycopene. One 2009 study identified tomatoes, cauliflower, broccoli and green tea as being particularly beneficial against prostate cancer
  • Try saw palmetto: The medical literature contains about 100 clinical studies on saw palmetto for prostate health and reduced incidence of prostate cancer. Trying saw palmetto before you resort to a drug is well worth it, considering the stern warnings that accompany some of these drugs. According to Dr. Moerck, saw palmetto in combination with pumpkin seed or lycopene may be an even more potent combination.

    Beware that quality is very important when selecting a saw palmetto supplement. Most brands on the market are ineffectual because they use the inactive form of the plant.

    The highest quality products are the organic supercritical-extracted saw palmetto oils, which are very dark green in color. Only one or two out of every 20 brands will be of this high quality. Dr. Moerck recommends a daily dose of 320 mg of saw palmetto oil (supercritical CO2 extract). Keep in mind that saw palmetto is a fat soluble supplement, so it will not absorb well unless you take it in conjunction with a little bit of fat. I recommend taking it with eggs, which contain phospholipids that enhance absorption of fat soluble nutrients.

  • Optimize your vitamin D levels, ideally by exposing your bare skin to natural sun light on a regular basis. (Your skin also synthesizes vitamin D sulfate, which may account for many of vitamin D’s potent health benefits, so sun exposure is really the ideal way to optimize your levels and get the greatest overall health benefits.) Evidence suggests that vitamin D may be one of the most potent variables associated with a lower risk of prostate cancer.

    There are well over 800 scientific studies confirming the link between vitamin D deficiency and multiple types of cancers, including prostate cancer. For example, according to a 2005 study, men with higher levels of vitamin D in their blood were half as likely to develop aggressive forms of prostate cancer as those with lower amounts. Another study published two years ago found that men with higher levels of vitamin D in their blood were seven times less likely to die from prostate cancer than those with lower amounts.

    Testing your vitamin D levels is done by a simple blood test. Anything below 20 ng/ml is considered a serious deficiency state, which will increase your risk of breast- and prostate cancers.

    The optimal value that you’re looking for is between 50-70 ng/ml. However, research has suggested that maintaining a slightly higher level of 70-100 ng/ml may be optimal for cancer prevention. If you can’t get regular sun exposure, you may want to consider using a safe tanning bed (one that uses electronic rather than magnetic ballasts and has less, not more, UVA than the sun produces). If these are unavaialble you can opt for an oral vitamin D3 supplement. Keep in mind that when using a supplement, regular testing becomes even more important to make sure you’re staying within therapeutic range.

  • Consider a vitamin K2 supplement: Another nutrient that has been found to offer significant protection against prostate cancer is vitamin K2. For more information about that, please refer to this previous article. Although I don’t typically recommend taking a lot of supplements, vitamin K is one you may want to seriously consider because many people don’t get nearly enough of it on a daily basis through the foods they eat.
  • Exercise your body, and your prostate: Having a well-rounded exercise regimen is essential for overall health, and is now becoming more widely accepted as a critical piece of cancer prevention and treatment. Having sex on a regular basis, which exercises your prostate specifically, is also important.
  • Check your testosterone levels: Contrary to popular belief, restoring testosterone levels in aging men does not appear to promote prostate cancer—on the contrary! According to meticulous research by Dr. Abraham Morgentaler, MD, author of Testosterone for Life, men with low testosterone are the ones at greater risk. For an interesting article that contains a lot more information about this, read Dr. Morgentaler’s report Destroying the Myth About Testosterone Replacement and Prostate Cancer.

    It explains how unfortunate assumptions have led to a dogmatic belief that testosterone replacement increases your risk of prostate cancer—a belief that might now be preventing many men from being optimally healthy. If you are low you can consider trans rectal DHEA cream. I personally use about 50 mg twice a day, and it has done wonders to optimize my testosterone levels as DHEA is converted to testosterone in your body.

Ideally, you’ll want to pay close attention to your prostate health early on—avoid waiting until you’re in your 60’s. Incorporating the lifestyle recommendations discussed above can help you prevent prostate problems from developing in the first place.

Source:mercola.com

New treatment based on ocean bacteria shown to stop the spread of prostate cancer.


“A huge leap forward.”

Scientists just completed a trial of a new, non-surgical prostate cancer treatment that uses a tumour-killing drug based on ocean bacteria, and the procedure saw almost half the patients go into complete remission.

The treatment is known as vascular-targeted photodynamic therapy (VTP), and is made possible by a drug called WST11, which is derived from bacteria that live at the bottom of the ocean. These light-sensitive organisms convert photons into energy, and when the same trick is mimicked by WST11, the compound kills cancer cells.

In a broad clinical trial at 47 treatment sites across 10 different European countries, 49 percent of patients with early prostate cancer that were treated with VTP went into complete remission, compared with 13.5 percent in the control group.

“These results are excellent news for men with early localised prostate cancer, offering a treatment that can kill cancer without removing or destroying the prostate,” says lead researcher Mark Emberton from University College London.

“This is truly a huge leap forward for prostate cancer treatment, which has previously lagged decades behind other solid cancers such as breast cancer.”

Men diagnosed with early or low-risk prostate cancer are usually monitored via regular testing to make sure the cancer isn’t spreading.

But if it does begin to spread, patients face a dilemma, as traditional treatments such as surgery or radiation therapy can cause lifelong erectile problems and incontinence.

For these reasons, a non-surgical treatment that doesn’t come with such negative side effects has long been a goal of researchers, and VTP with WST11 could be it.

In the study, the procedure only caused short-term urinary and erectile problems, which had resolved within three months, and all other side effects disappeared within two years.

“This changes everything,” Emberton told James Gallagher at the BBC.

“Traditionally the decision to have treatment has always been a balance of benefits and harms. … To have a new treatment now that we can administer, to men who are eligible, that is virtually free of those side effects, is truly transformative.”

The treatment involves injecting WST11 into the bloodstream, and inserting optical fibres into the prostate gland.

When the optical fibres are turned on, light beams activate the drug in the patient’s blood, causing it to release high-energy free radicals that destroy tumour tissue while leaving surrounding tissue unharmed.

Of the individuals who took part in the trial, cancer progressed in 58 percent of men in the control group, who maintained regular monitoring during the study. But for the men who received VTP, only 28 percent saw tumours spread.

According to Emberton, these results would be even stronger today, as the researchers in the trial didn’t have access to the latest MRI technology when they began their study in 2011.

“We can now pinpoint prostate cancers using MRI scans and targeted biopsies, allowing a much more targeted approach to diagnosis and treatment,” Emberton said in a press release.

“This means we could accurately identify men who would benefit from VTP and deliver treatment more precisely to the tumour. With such an approach, we should be able to achieve a significantly higher remission rate than in the trial and send nearly all low-risk localised prostate cancers into remission.”

There’s also scope to extend the procedure to other cancers, including breast and liver cancer, but first the researchers need to continue monitoring the patients who took part in this trial and see if the remission rates hold up over time.

Meanwhile, the European Medicines Agency (EMA) is currently reviewing the treatment, but it could be years before it’s made available to patients in the broader population.

It’s important to note that there’s still a lot we don’t know about this treatment, and despite its early promise, it’s not necessarily more effective than surgery or radiation therapy at removing the danger of cancer.

That said, it also doesn’t seem to offer the same kinds of complications, so depending on how further research pans out, it could be a valid avenue of treatment in the future.

One man who hopes the wait isn’t too long is Gerald Capon, a 68-year-old from West Sussex in the UK, who took part in the study.

“[T]he trial changed my life. I’m now cancer-free with no side effects and don’t have to worry about needing surgery in future,” he says.

“I feel so lucky to be in this position… I hope that other patients will be able to benefit from this treatment in future.”

Source: The Lancet Oncology.