Santa Cruz County Prostate Cancer Support Group
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Serving all of SANTA CRUZ COUNTY Santa Cruz PROSTATE CANCER SUPPORT GROUP January 2005 NEWSLETTER Howard Waage (688-0423) -----Editor ______________________________________________________ ___________________________________ When: Tuesday evening, January 25th starting at 7:00 p.m. (The January Steering committee meeting begins at 5:30 p.m., before the regular meeting)
* Please note the change of our meeting location this month
Where: *We’ll be meeting in the MAIN building of Santa Cruz Dominican Hospital. Enter through the Outpatient front door of the hospital and take the elevator down to Conference Room 2
At our January meeting, we will be honored to have J. Talisman Pomeroy M.D., Director of The Cancer Prevention and Treatment Center Of The Central Coast and Joshua Atiba M.D. , speak to our support group and answer any questions you have about prostate cancer and treatment options. Please feel free to contact any of the following steering committee members if you would like to volunteer or if you have any suggestions or questions.
Tony & Beverley Calvo 684-0940 Frank Schmetz 438 4781 Bill McDermott 423-8350 Howard Waage 688-0423 Richard & Tina Koch 761-3577 Ollie Wright 335-3878 Lynn Dreeszen 439-8632 Tim Ryan 476-6550 Our website: http://www.scprostate.org Doug Thornton 724-6446 (Webmaster)
….PROSTATE CANCER IN THE NEWS..…
Men with Prostate Cancer Can Stick to Low-Fat Diet By Anne Harding
NEW YORK (Reuters Health) Dec 22, 2004 - After being diagnosed with prostate cancer, men are capable of adhering to a low-fat diet for at least a year if they receive good counseling and support, a new study shows. There is evidence that dietary fat plays a role in the progression of prostate cancer, Dr. L. H. Lumey of Columbia University Medical Center in New York and colleagues note in the medical journal Urology. However, some doctors have been skeptical about the feasibility putting men with prostate cancer on a low-fat diet. "It was important for us to establish if this indeed was such a complicated matter," Lumey told Reuters Health.
To investigate, he and his colleagues randomly assigned 48 men with prostate cancer to a diet containing 15 percent fat or less, with or without vitamin E and selenium supplements; to a normal diet plus the supplements; or to a "control" group.
All of the men received nutritional counseling at the start of the study, but the men on the low-fat diet and their spouses received more intensive support, with biweekly visits to a nutritionist for the first four months of the study, followed by monthly group sessions.
After three months, men in the low-fat diet group had cut their calorie intake from fat by 8.6 percent and lost an average of 2 kilograms (about 4-1/2 pounds), while men in the control group had increased their fat intake by 2.1 percent and lost 0.8 kg.
One year after the trial began, men on the low-fat diet had lost 2.8 kg and maintained a 9.8 percent lower fat intake, while those on the normal diet had gained 0.5 kg and were eating 1.6 percent less fat. A diagnosis of prostate cancer appears to be a strong motivation for lifestyle change, the researchers note. "These results open the possibility of planning for larger studies to assess the effect of a low-fat dietary intervention on quality of life, disease progression, and survival in men with prostate cancer," they conclude. Page 1
Lumey said he was struck by the commitment to making dietary changes among patients in the study. "People are very involved -- this whole diet thing in prostate cancer patients, it's like a subculture in a way, it generates tremendous involvement and energy," he said. "There's a need to find out what's going on because it's not just an academic issue," he added. "Patients talk about this all the time."
SOURCE: Urology, November 2004. http://www.reuters.co.uk/newsArticle.jhtml?type=healthNews&storyID=7163554§ion=news&src=rss/uk/healthNews
Improving Results From Surgery When Prostate Cancer Comes Back
NEW YORK DEC 15, 2004 (Reuters Health) - Salvage radical prostatectomy offers patients with recurrent prostate cancer after radiation therapy an opportunity for long-term cancer control, and the procedure has an "acceptable morbidity profile," New York- based researchers report in the December issue of the Journal of Urology.
"Salvage radical prostatectomy is technically demanding, but the procedure can be performed safely by an experienced surgeon," senior investigator Dr. James A. Eastham told Reuters Health. "Although rates of urinary incontinence and erectile dysfunction are higher than after standard radical prostatectomy, these outcomes continue to improve."
Dr. Eastham of Memorial Sloan-Kettering Cancer Center and colleagues came to this conclusion after reviewing data from 100 patients who, between 1984 and 2003, underwent the procedure following external beam or interstitial radiotherapy. Between 1993 and 2003, the major complication rate dropped significantly from 33% to 13% and the rectal injury rate fell from 15% to 2%. Moreover, compared with retropubic interstitial radiotherapy, with or without pelvic lymph node dissection, there was a significantly lower risk of complications following external beam radiotherapy or transperineal interstitial radiotherapy (odds ratio, 0.2).
At 5 years, an estimated 68% of patients required one pad daily or less and 39% were not incontinent. Moreover, 23 patients who required three or more pads daily were continent after artificial sphincter placement. Overall, the 5-year potency rate was 28% following unilateral or bilateral nerve-sparing radical prostatectomy. It was 45% in previously potent patients.
Thus, the researchers conclude that the "acceptable morbidity profile of salvage radical prostatectomy following external beam radiotherapy and transperineal radiotherapy should persuade more physicians to consider patients for this potentially curative procedure."
SOURCE: Journal of Urology 2004;172:2239-2243. http://www.cancerpage.com/news/article.asp?id=7818
PSA After Prostate Surgery Not Always Ominous By Megan Rauscher
NEW YORK Dec 27, 2004 (Reuters Health) - Men with prostate cancer who undergo removal of the prostate (i.e., radical prostatectomy) hope to see their PSA fall to zero, but sometimes it remains detectable in their blood. This isn't a good sign, but it bodes worse for some men than others.
"Our study shows that not all people who fail to achieve an undetectable PSA after radical prostatectomy are the same," Dr. Craig G. Rogers told Reuters Health. In particular, how fast the PSA levels rises after surgery may help identify patients who are likely to go downhill rapidly, and would therefore benefit from intensified treatment.
Rogers, in the Department of Urology at Johns Hopkins Hospital in Baltimore, and colleagues assessed the outcome of 160 men with persistently detectable PSA after they underwent radical prostatectomy for localized prostate cancer.
The PSA level is measured in nanograms per milliliter of blood, and 0.1 ng/mL is considered the lowest detectable level. In 75 men (47 percent), the cancer spread to other sites, or "metastasized," an average of five years after surgery, the team reports in the medical journal Cancer. However, Rogers noted, "Some patients remain free of metastatic disease for a prolonged period (7-10 years), whereas others progress rapidly to metastatic disease in less than 3 years."
According to the researchers, the rate of rise in the PSA level -- known as the PSA slope -- after prostatectomy can help identify patients who are at increased risk of having the disease spread.
"In particular, a PSA slope of 0.05 ng/mL per month or greater during the time period of 3-to-12 months after radical prostatectomy was particularly useful in identifying high-risk patients," Rogers told Reuters Health. Summing up, Rogers said "the findings from this study have potential application in identifying those patients at higher risk of metastasis," and this can help doctors figure out who should get additional treatment and when.
SOURCE: Cancer December 1, 2004. http://community.healthgate.com/getcontent.asp?siteid=kumc&docid=/reuters/20041227elin013
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Living longer with prostate cancer
Ivanhoe Newswire 12/21/2004 - Fourteen years ago, Carl Visoky received the grim diagnosis of prostate cancer. "The doctor told me, 'Go home,' cause there's nothing he can do for me. It's too late, and it'll be over," he said. But today, he's doing just fine, thanks to a combination of two drugs, Taxotere and Estramustine. Visoky stated, "There was nothing else available at the time. I heard this drug was doing good, so I said, 'Why not?'"
Taxotere inhibits tubulin, a protein essential to cell division. Basically, it prevents cells from dividing and growing. It's used in patients who have hormone refractory prostate cancer, which means standard treatment has failed and the cancer is progressing.
Dr. Daniel Petrylak explained, "Our study demonstrated that when you treated patients with the combination of Taxotere plus another drug called Estramustine that there was a 20-percent improvement in overall survival. We've had patients who lived three, four, five years with this treatment, where in the past they've only lived about 12 to 15 months."
Fourteen years ago, Carl Visoky received the grim diagnosis of prostate cancer. "The doctor told me, 'Go home,' cause there's nothing he can do for me. It's too late, and it'll be over," he said. But today, he's doing just fine, thanks to a combination of two drugs, Taxotere and Estramustine. Visoky stated, "There was nothing else available at the time. I heard this drug was doing good, so I said, 'Why not?'"
Taxotere inhibits tubulin, a protein essential to cell division. Basically, it prevents cells from dividing and growing. It's used in patients who have hormone refractory prostate cancer, which means standard treatment has failed and the cancer is progressing.
Dr. Daniel Petrylak explained, "Our study demonstrated that when you treated patients with the combination of Taxotere plus another drug called Estramustine that there was a 20-percent improvement in overall survival. We've had patients who lived three, four, five years with this treatment, where in the past they've only lived about 12 to 15 months."
But a prolonged life with this drug mixture has its share of side effects. Doctors say some patients suffer from nausea, fatigue, hair loss, infections from lowered blood counts, and blood clots. But many patients tolerate the drugs just fine. Carl is one of them. He says his quality of life is great. And now, he has more time to do those things.
This drug combination has not yet been approved by the FDA, although each drug is approved when used alone. If you're interested in learning more about the study or how to participate, talk to your doctor.
SOURCE: http://rdu.news14.com/content/headlines/?ArID=61115&SecID=2
Red Wine May Reduce Prostate Cancer Risk
NEW YORK Jan 7, 2005 (Reuters Health) - The results of a new study add to accumulating evidence that consumption of red wine may reduce the risk of prostate cancer in middle-aged men.
Dr. Janet L. Stanford, from the Fred Hutchinson Cancer Research Center in Seattle, and colleagues studied data from 753 newly diagnosed prostate cancer patients between 40 and 64 years of age, and from a comparison group of 703 matched "controls" to assess the association between alcohol consumption and prostate cancer. The men with and without prostate cancer completed in-person interviews about lifetime alcohol consumption and other risk factors for prostate cancer.
No clear associations were observed between the risk of prostate cancer and overall alcohol consumption, the team reports in published in the International Journal of Cancer. However, "each additional glass of red wine consumed per week showed a statistically significant 6% decrease in relative risk" of prostate cancer, they report.
Alcohol alters the balance of hormones, Stanford's group notes, and it "contains chemical substances such as flavonoids (red wine), which may alter tumor cell growth." They say the findings "highlight the need for further research on the biological effects of polyphenol rich foods and beverages," which includes red wine.
SOURCE: International Journal of Cancer January 1, 2005. http://news.yahoo.com/news?tmpl=story&cid=571&u=/nm/20050107/hl_nm/prostate_wine_dc_1&printer=1
Silent risk of osteoporosis in men with prostate cancer
(13-Dec-2004) Men being treated for prostate cancer using hormone therapy maybe under-recognized for their risk of developing osteoporosis, according to a new study. Researchers writing in the January 15, 2005 issue of CANCER (http://www.interscience.wiley.com/cancer-newsroom), a peer-reviewed journal of the American Cancer Society, say few patients get tested for osteoporosis during treatment. Moreover, even men with other risk factors for osteoporosis, such as smoking or receiving the hormone treatment for a long time, are still unlikely to receive prevention or treatment.
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Osteoporosis is a disease characterized by brittle, easily fractured bones that is associated with significant morbidity, mortality, and healthcare cost. It is caused by dysregulation of the hormone-regulated bone remodeling system that leads to a loss of bone mineral density. Risk factors for male osteoporosis include age-associated hormone changes, alcoholism, smoking, some medications, including those used in the treatment of prostate cancer.
Osteoporosis can be prevented and even treated using a wide range of therapies. Common prevention measures include calcium and vitamin D supplements, regular exercise. Screening test such as the dual-energy X-ray absorptiometry (DXA) scan is also available. But, even now, there is no established national consensus guiding doctors of when and what to prescribe. Treatment strategies include bisphosphonates, which have been shown to prevent further bone loss, but it is inconvenient, sometimes expensive, and may cause serious side effects. To find out how clinicians were managing osteoporosis risk in the U.S. in year 2003 and identify factors that might predict who gets treated, Tawee Tanvetyanon, M.D. from Loyola University Chicago Stritch School of Medicine reviewed the sampled records of 184 prostate cancer patients who received androgen deprivation therapy (ADT), which is known to raise the risk of osteoporosis.
Dr. Tanvetyanon found that "the majority of patients undergoing ADT did not receive osteoporosis prevention or treatment," even when they reported other risk factors, as well. Only about one in seven (14.7 percent) eligible patients received any sort of osteoporosis management. Fewer than one in ten (8.7 percent) received at least one DXA scan within three years, and only one in twenty (4.9 percent) was prescribed a bisphosphonate. The only factor that predicted clinical management of osteoporosis risk and disease was the presence of bony metastases (prostate cancers that had spread to the bones). Analysis also showed that primary care physicians were the most aggressive at managing osteoporosis while cancer specialists were the least.
Article: "Physician Practices of Bone Density Testing and Drug Prescribing to Prevent or Treat Osteoporosis during Androgen Deprivation Therapy," Tawee Tanvetyanon, CANCER; Published Online: December 13, 2004 (DOI: 10.1002/cncr.20766); Print Issue Date: January 15, 2005. http://www.eurekalert.org/pub_releases/2004-12/jws-sro120804.php
Like Father Like Son By Howard Waage
We don't like to talk about cancer, and men may be especially reluctant to talk about prostate cancer. But it's important for fathers to talk to their adult sons about prostate cancer. Prostate cancer tends to run in families, so if a man has had prostate cancer, his sons have a greater chance of developing it as well. Brothers of men who have had prostate cancer also face a higher risk. Studies at Fox Chase Cancer Center revealed a 2.9 fold increased risk when the affected relative was a brother. The risk increased 1.8 fold when the affected relative was a second-degree family member (a grandfather or uncle), and 2.1 fold when the relative with prostate cancer was a father.
If your father or brother has prostate cancer, you are more likely to develop the disease six or seven years earlier than men without any history of prostate cancer in the family. The more relatives, the higher the risk. Three or more relatives increase the risk by 35 to 45 percent. If your father was diagnosed younger than age 60, your risk is about 20 percent greater than the general population.
If a man knows he's at higher risk because of a family link, he can take measures to detect the disease earlier. My dad, now age 86 was diagnosed with prostate cancer in 1990, so when was 46 years old I asked for a PSA test. My primary care physician did not want to give me that PSA test..... but how wrong he was. As it turned out, my first PSA was 11.32 and I did have prostate cancer. I was so proud of my son Erik who took the the initiative to have get an exam and have his PSA done this week.
Keep in mind that the first PSA test marks a "baseline value" and it is important to recognize that the real value of the PSA test in early detection is based on establishing a baseline PSA value and regularly, on a yearly basis, measuring the PSA to observe changes from the "baseline value". Incremental changes of 0.75 ng/ml in a year should be investigated. A trend is more important and one must always remember that PSA is not specific for cancer. A high PSA could be caused by infection, prostate enlargement, manipulation or even urine retention. Never react to ONE variance.
Prostate cancer is very treatable with surgery and radiation if it's detected early enough. That's why it's so important for men to know if their risk is higher so they can be extra-vigilant about being screened for the disease. This is one situation where being strong and silent isn't an advantage. You can save your son's life by making sure they're aware of any history of prostate cancer in your family. Sons can also return the favor and remind their dads to continue screenings for prostate cancer. Don't panic if you find out there is a family history of prostate cancer. Remember: prostate cancer grows very slowly compared to other kinds of cancer. Thus, if diagnosed early enough prostate cancer can be cured.
The Santa Cruz County Prostate Cancer Support Group does not endorse any provider, organization, product or individual. All medical decisions should be made with the advice and consultation of medical professionals.
Our newsletter serves over 200 members. Many THANKS to the American Cancer Society for assisting with the printing and mailing of this newsletter.
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