Prostate Cancer

[mlk_man]

Radiation treatment is a common form of prostate cancer therapy. But those who undergo external-beam radiation may be creating more health problems than they solve.

In the April 2005 issue of the journal Gastroenterology, researchers from the University of Minnesota (UM) report on a study examining the secondary effects of external-beam radiation for localized prostate cancer. The UM team used data from the medical records of more than 85,000 men with prostate cancer who participated in the SEER (Surveillance, Epidemiology and End Results) Program, an ongoing data collection project maintained by the National Cancer Institute.

About 30,500 of the men received radiation treatment between 1973 and 1994. When researchers compared the rates of subsequent colorectal cancer cases to the two groups (men who received radiation and men who did not), risk of developing colorectal cancer was 70 percent higher for men in the radiation group.

The UM researchers noted that although today's radiology methods are more advanced than they were in 1994, parts of the rectum are still exposed when external beam radiation is used. Their recommendation: When prostate cancer is treated with radiation, patients should be closely monitored for colorectal cancer.





Two key prostate cancer facts: 1) Most prostate cancer patients are diagnosed after the age of 60, and 2) In most cases, prostate cancer grows so slowly that men who develop the cancer are more likely to die of other causes.

That second point is confirmed by a new study that appeared in the January 2005 issue of the Journal of Clinical Oncology.

Two researchers at the German Center for Research on Aging used the SEER database to assess the five- and 10-year survival rates for more than 183,000 men with prostate cancer. They found that 99 percent of the men survived for at least five years, and 95 percent survived for at least 10 years. Furthermore, when these rates were compared to all-cause-mortality in men of the same age in the general population, the survival rates were nearly the same.

So treatment is a dilemma. Should radiation be used, increasing the risk of colorectal cancer? Should the prostate be removed, increasing the risk of incontinence and impotence?

These questions can only be answered on a case-by-case basis, but it underlines the importance of proceeding with caution or getting a second opinion when a doctor recommends a therapy that may have dire consequences.

[Rod]

If your family has a history of prostate cancer, as does mine-

- Grandfather died

- Uncle died

- 2 uncles terminal

- Dad survived (with surgery)

Then it's extrememly important that you get your PSA (Blood test)along with a DRE (Digital rectal exam)at least annually- even if you are in your 30's, as I am. But if you have no family history, start when you turn 50 or if you begin to show signs of prostate cancer.

The doctor who operated on my Dad, Dr. William Catalona (he also operated on Joe Torrey), told my brothers & I that we need to keep an eye on our PSA's. Ifit ever reaches 3.0, then we should have a biopsy.

One important factor in tracking your PSA is to be on the look-out for rising levels. For instance, let's say your PSA this year was .05, then next year it was 1.5, then the next it was 2.0, then the next 2.5, this could be an indication of something going on and would probably warrant a biopsy once and if it reached 3.0 or higher.

If, at your*FIRST*PSA test, you have a reading of 3.0 or higher, don't panic. But get tested again a few months later because different things can elevate your PSA. If you still test at 3.0 or higher after a few tests, then you want to get a biopsy.

Tip- avoid ejaculation for at least 72 hours prior to a PSA. It is known to elevate your PSA.

God Bless:^

[mlk_man]

Planting The Seeds

Options. They can be a very good thing indeed, but they can also be daunting and confusing. When diagnosed with prostate cancer, men are faced with a plethora of choices, from surgery to radiation to hormones. Which is best?

According to new research involving about 1,500 Long Island prostate cancer patients, radioactive seeds were as effective as surgery or external radiation in treating localized disease (prostate cancer that has not spread to other parts of the body), and with fewer side effects. The study was conducted by Louis Potters, MD, medical director of the New York Prostate Institute at South Nassau Communities Hospital in Oceanside, New York.

What Are Radioactive Seed Implants?

These tiny seeds or pellets are a form of brachytherapy -- radiation treatment in which radioactive material is placed directly on cancer to destroy it. To distinguish it from more traditional external beam radiation, brachytherapy is often referred to as internal radiation. Under ultrasound guidance, a needle is used to implant radioactive seeds as close as possible to the prostate tumor.

Seed-implant therapy is most effective in cases of small, well-contained cancers. Accessibility is a concern -- if a tumor is not reachable with an ultrasound-guided needle, radioactive seeds are not an option.

Dr. Potters adds that although the risks of incontinence and impotency are low with brachytherapy, there are risks. Potential complications include increased urinary frequency and urgency, which are usually short-term.

Advantages Over Other Approaches

While radioactive seeds have only been around since 1985, the results are encouraging. Their advantages include...


In comparison with external beam therapy, a more traditional approach in which radiation is directed through the body area from an outside source, brachytherapy permits a greater concentration of radiation on the tumor itself, so damage to adjacent healthy tissue is minimized. It also allows for a more intense, up-front dose of radiation than possible with external radiation.
In contrast with surgery, brachytherapy is minimally invasive. There is no cutting or suturing, and you can be back at home or work with no physical restrictions two hours after the procedure. Surgery is more likely to cause incontinence or impotence.
Like radiation and surgery, hormone therapy is a common approach to treating prostate cancer. However, Dr. Potters believes that this approach is grossly over-utilized in prostate cancer. He notes that there is scant data to support hormonal therapy as adjuvant treatment to radiation, except in men with very high-risk disease. Moreover, side effects can be considerable, and may include impotence, weight gain, muscle loss, fatigue, sweating and flushing.

If you are diagnosed with prostate cancer, be sure to ask your primary care provider to refer you to a radiation oncologist as well as a surgeon, so that you can weigh the pros and cons of all options. Understanding all your available choices is the key to making an informed decision about prostate cancer treatment.

Note: Radioactive seed implants are not for prostate cancer alone. They also may be used to treat small, well-contained tumors in the breast, cervix, uterus, thyroid, head and neck.

Another key consideration: As with any surgery, it is better to have an experienced doctor perform the procedure. According to Dr. Potters, the more practice a doctor has with implanting seeds, the greater the chance of treatment success. He recommends that you ask your physician how long he/she has performed the procedure and what his outcomes have been.