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Serving all of  SANTA CRUZ COUNTY

Santa Cruz  PROSTATE CANCER SUPPORT GROUP

March 2005                                           NEWSLETTER

                                                                                                                                                        Howard Waage  (688-0423) -----Editor ______________________________________________________ ___________________________________

  When:    Tuesday evening, March 29th starting at 7:00 p.m.

               (The March Steering committee meeting begins at 5:30 p.m., before the regular meeting)

  Where:   Our meeting will be downstairs in two-story redwood Education Building behind

                the Santa Cruz Dominican Hospital.  We’ll meet in the Bennett & Suzy Katz Cancer Resource

                Center on the 1st  Floor.

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..…

Prostate Cancer Drug Has Lifesaving Potential

FOX NEWS February 28, 2005 --The drug Proscar (search) helps prevent prostate cancer and could lengthen the lives of many men, researchers say. This is true even though the drug appears to increase the likelihood that some men will get more advanced prostate cancer (search), they say.

Prostate cancer is the most common type of cancer for U.S. men after skin cancer, says the American Cancer Society. The ACS estimates that one in six men will develop prostate cancer. However, many fewer men -- one in 33 -- will die of prostate cancer, and prostate cancer death rates are dropping, says the ACS.

Lifesaving Effects: Prostate cancer grows in response to the male hormone testosterone. Proscar inhibits testosterone. It has already been approved by the FDA to treat men with enlarged prostates. It's also sold under the name Propecia to treat male pattern baldness.The drug entered the spotlight in the recent Prostate Cancer Prevention Trial, where it cut prostate cancer prevalence by nearly 25 percent. The trial's results were so strong that the study of almost 19,000 men was stopped a year early.

But the news wasn't all rosy. The testosterone-lowering drug was linked to a greater incidence of advanced prostate cancer. Of men diagnosed with prostate cancer, nearly 12 percent of those taking Proscar had advanced prostate cancer, compared with 5 percent who took a placebo. (***SEE DR. MYERS COMMENT BELOW)

Was Proscar worth it for men to take on a large scale? Yes, says the new study, which appears in the April 1 edition of the journal Cancer. The researchers crunched the numbers from the Prostate Cancer Prevention Trial, applying them to all men aged 55 or older from 1993 to 1997. They calculated Proscar's lifesaving potential.

If every man in the U.S. age 55 or older took Proscar, more than 316,000 person-years would be saved in a decade, the researchers estimate. For example, more than 316,000 men would live a year longer than without the drug. Even if advanced cancers increased by about 7 percent, Proscar would still allow more than 262,000 men to live a year longer, write Joseph Unger, MS, and colleagues. Unger works at the Fred Hutchinson Cancer Research Center in Seattle.

(page 1)

Proscar's potential shouldn't be overlooked out of fear, the study suggests. The researchers point out again that prostate cancer would be prevented in 25 percent of men that take Proscar.

By Miranda Hitti, reviewed by Michael W. Smith, MD   SOURCES: Unger, J. Cancer, April 1, 2005; vol 103.

 http://www.foxnews.com/printer_friendly_story/0,3566,148988,00.html

***The authors of the study concluded, "even if finasteride is found to potentiate the growth of high-grade tumors, this analysis shows that the potential detrimental effects of an increased rate of cases with high grade Gleason score would be substantially outweighed by a reduction in incidence."

However quite a different opinion was posted by Dr. Myers on the Prostate Problems Mailing List (Internet) writing that Proscar may NOT potentiate the growth of high-grade tumors as reported.

Charles Myers Jr., M.D. wrote:

The National Prostate Cancer Conference  is now done………There were a number of highlights. One issue of great importance was addressed by Dr. Bostwick and it is the recent trial of Proscar vs placebo for PC prevention. As you remember, while there was close to a 25% reduction in the risk of prostate cancer, Gleason 7 or above was found in 6.4% of the proscar patients and in 5.1% of the control patients. Drs. Bostwick and Gleason (of the Gleason score fame) showed us how Proscar can distort the Gleason scoring system. The move to a Gleason 7 means a move from a pattern 3 to a pattern 4. In pattern 3, you see donut shaped gland like structures. With pattern 4, these collapse into a more uniform sheet of cells. It turns out that this same collapse happens during hormonal therapy by castration, lupron/zolodex or casodex. Proscar also does this, but to a more variable degree. Rather than indicate more aggressive disease, this actually signals a partial hormonal response. For this reason, both Drs. Bostwick and Gleason state that the Gleason scoring system is not valid in men on hormonal therapy and/or proscar. Thus, the increase in Gleason 7 or above seen in this recent study may well be an artifact.

After the presentation, I talked with Don Coffey from Johns Hopkins about this and he said that Epstein, the lead prostate pathologist at Hopkins also says that Gleason  scoring system was not designed to handle changes induced by hormonal therapy, but that Epstein thinks he has a system that can get around this problem.

In any case, three of the top prostate pathologists, Bostwick, Gleason and Epstein, have serious reservations about the nature of the prostate cancer seen in the patients on proscar.

>From this, I have two conclusions:

1) In the Proscar vs placebo study, we do not know what proportion of the 6.4% with apparent Gleason 7 or above actually have more aggressive disease and what proportion are undergoing a hormonal response. If the latter is significant, the patients with apparent Gleason 7 or above may well be patients whose cancer is responding to mild hormonal therapy and who will therefore do very well long term. The only real resolution to this issue may be to look at the survival of that 6.4%.

2) If you are on proscar or avodart and you have a biopsy, you need to let the pathologist know. Also, reading these slides will be very difficult and should only be done by one of the top pathologists.

It is also true that radiation therapy can markedly alter the pathology, making the cancer hard to grade using the Gleason scoring system.

Charles Myers Jr., M.D.

Director

American Institute for Diseases of the Prostate

690 Bent Oaks Drive, Earlysville, VA 22936

Phone 434-964-0212

(page 2)

Prostate Cancer Vaccine Is First To Increase Survival

February 17, 2005 - For the first time, researchers have found that a novel immunologic therapy increases survival by nearly 18 percent in men with advanced prostate cancer that no longer responds to hormone therapy.

The therapeutic cancer vaccine, called APC8015 (Provenge), is likely to become a new standard of care for patients with metastatic prostate cancer. The UCSF-led study is the first to demonstrate a survival benefit from immunologic therapies or vaccines in patients with advanced prostate cancer.

"We’re very pleased with the results. A therapy that prolongs life yet avoids the side effects of other therapeutic approaches is clearly attractive to patients and physicians alike," said Eric Small, MD, UCSF professor of medicine and urology and lead investigator of the study.

The study was presented in Orlando, Florida, on Saturday, Feb. 19, at a prostate cancer symposium sponsored by the American Society of Clinical Oncology, the Prostate Cancer Foundation, the American Society for Therapeutic Radiology and Oncology, and the Society of Urologic Oncology.

Although the new agent is called a vaccine, it is not designed to prevent cancer. Rather, it uses the patient’s own immune system to recognize and attack existing cancer cells. APC8015 is designed to stimulate the immune system to attack cells that express prostatic acid phosphatase (PAP), a protein found on approximately 95% of prostate cancer cells.

APC8015 is produced by collecting blood from each patient, isolating the relevant immune cells, and stimulating those cells so that they recognize PAP as "foreign." The resulting product, APC8015, is administered as an intravenous infusion.

In this study, investigators randomized 127 men with asymptomatic metastatic prostate cancer that no longer responded to hormone therapy to receive the vaccine (82 men) or a placebo (45 men). Patients received three doses of the vaccine at two-week intervals, and were followed for three years. Overall survival among patients receiving the vaccine was 25.9 months, compared to 22 months in the placebo group. Three years later, more than three times as many vaccine patients (34 percent) were still alive, compared to the placebo group (11 percent). Treatment was well-tolerated – fever and shaking were reported as the most common side effects, and generally disappeared within two days of vaccine administration.

Therapeutic vaccines are being studied in the treatment of other types of cancer including lymphoma, leukemia, and cancers of the brain, breast, lung, kidney, ovary, pancreas, colon, and rectum.

Source: University Of California, San Francisco     http://www.sciencedaily.com/releases/2005/02/050222111915.htm

High Levels of Vitamin E Cut Prostate Cancer Risk

NEW YORK (Reuters Health) Mar 2, 2005 - High blood levels of the major vitamin E components, alpha- and gamma-tocopherol, seem to cut the risk of prostate cancer by about 50 percent each, a study shows.

The findings are based on an analysis of 100 individuals with prostate cancer and 200 cancer-free "controls" participating in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study, which included nearly 30,000 Finnish men.

Men with the highest levels of alpha-tocopherol in their blood at baseline were 51 percent less likely to develop prostate cancer than those with the lowest levels, report investigators in this week's Journal of the National Cancer Institute (NCI).

Similarly, men with the highest levels of gamma-tocopherol were 43 percent less likely to develop the disease compared with men with the lowest levels. Further analysis showed that the link between high tocopherol levels and low cancer risk was stronger among subjects using alpha-tocopherol supplements than among non-users.

(page 3)

This supports the original findings from the ATBC study, which showed that daily vitamin E supplementation reduced the risk of prostate cancer by 32 percent.

Dr. Demetrius Albanes, from the NCI in Bethesda, Maryland, and colleagues believe that the antioxidant activity of vitamin E may be particularly important to the associations they observed in the current study because oxidative stress has been tied to the development of prostate cancer. However, alpha-tocopherol has other non-antioxidant properties, such as enhancement of the immune response, which may also play a role in the benefits seen, they add.

SOURCE: http://www.reuters.com/newsArticle.jhtml?type=healthNews&storyID=7787319

A New Urine Test For Prostate Cancer?

PSA Rising, February 19, 2004. Test for thymosin beta-15 may improve on PSA screening, reduce unnecessary biopsies and help find more aggressive disease.

Men middle-aged and older routinely get blood tests for prostate-specific antigen, or PSA, to screen for prostate cancer. But PSA testing has shortcomings: many men with elevated PSAs don't have prostate cancer and undergo unnecessary biopsies.

Other men do have prostate cancer, but have normal PSAs, allowing the cancer to spread undetected. A preliminary study from Children's Hospital Boston, led by Dr. Bruce Zetter, shows that a simple urine test may improve upon PSA screening. Results appear in the Jan. 21 online edition of the journal Prostate.

Zetter, a researcher in the Vascular Biology Program at Children's, is interested in the role of cell motility -- cells' ability to move and travel -- in helping cancers to metastasize. He became especially interested in thymosin beta-15, a protein that stimulates cell migration and promotes metastasis in prostate cancer. Unlike PSA, it is produced almost exclusively by cancer cells, and is detectable in urine.

In this study, Zetter and colleagues compared thymosin beta-15 levels in urine samples from 121 men with prostate cancer, 15 men with other genitourinary cancers (kidney or bladder cancer), 81 men with non-malignant prostate disease (such as prostatitis), 73 men with other non-malignant urologic diseases (such as urinary tract infection), and 52 healthy men who served as controls.

Thymosin beta-15 levels were elevated in men with aggressive or untreated prostate cancer, but normal or near-normal in healthy men and men with other genitourinary diseases. Men with aggressive prostate cancer were 12 times more likely than the healthy controls to have elevated thymosin beta-15.

Notably, nearly half of cancer patients whose PSA levels were considered normal tested positive for thymosin beta-15. Conversely, many men with other genitourinary diseases had elevated PSAs, but normal thymosin beta-15 values. When PSA and thymosin beta-15 were combined, the combination detected prostate cancer more often than PSA testing alone, with far fewer false-positives.

Zetter, who is also Children's Chief Scientific Officer, is now following the long-term outcomes of men with prostate cancer to determine thymosin beta-15's usefulness as a prognostic predictor in combination with PSA testing.

The Vascular Biology Program at Children's is also actively studying urinary markers for other cancers. In a small pilot study, Dr. Marsha Moses and postdoctoral fellow Dr. Roopali Roy recently found that a compound called ADAM 12, when detected in urine, is an early marker of breast cancer. Another group of markers will soon enter formal clinical trials in adults with prostate, breast, bladder, lung, and colon cancer.

A urine test for genetic signs of prostate cancer, the UPM3 test, is already in use by Bostwick Laboratories.

For more information about this test, go to their website at:  http://www.bostwicklaboratories.com

Source:   http://www.psa-rising.com/med/info/thymosin-beta-15.htm

(page 4)

Vitamin D may ward off prostate cancer By MARILYNN MARCHIONE

AP MEDICAL WRITER SEATTLE POST-INTELLIGENCER February 18, 2005

ORLANDO, Fla. -- Getting a little sunshine may be one way for men to cut their risk of prostate cancer. A large study presented at a cancer conference Thursday found that men with higher levels vitamin D in their blood were half as likely to develop aggressive forms of the disease than those with lower amounts.

Doctors are not ready to recommend the "sunshine vitamin" without more study, but many see little harm in getting the 15 minutes a day that the body needs to make enough of this nutrient. "When you were little and your mother said, `Go outside and play,' it wasn't just to get you out of her hair," but may have been instinctive advice about something good for health, said Dr. Eric Klein, a prostate cancer specialist from the Cleveland Clinic.

He had no role in the research, which involved nearly 15,000 men in the Physicians' Health Study at Brigham and Women's Hospital and Harvard Medical School in Boston. Five years ago, this study found that men who consumed a lot of calcium had modestly higher rates of prostate cancer.

The new findings fit with that notion, because too much calcium lowers vitamin D, and are especially believable because researchers got them by measuring blood samples rather than relying on what men said they ate - an imprecision that has hurt past studies of food and cancer risk. Blood samples were taken in 1982, when the study began. Eighteen years later, 1,082 of the men had developed prostate cancer. Their levels of two common forms of vitamin D in the stored blood samples were compared with those of 1,701 men in the study who did not get cancer.

Levels of one or the other vitamin D derivative did not make much difference in prostate cancer risk. However, men with higher levels of both had roughly half the risk of developing aggressive tumors - the kind most likely to kill - than men with lower levels, said Dr. Haojie Li, who led the study. That is in keeping with what previous studies have shown about prostate cancer, Klein noted.

Men in northern latitudes have higher cancer death rates, and vitamin D levels are lower in older men, who are most prone to prostate cancer.

Melanin, which gives skin its color, blocks ultraviolet light that spurs vitamin D production. Blacks, who have a lot of melanin, also have the highest rates of prostate cancer. Experiments also suggest vitamin D inhibits cell growth. "So there is some lab evidence that vitamin D may be anti-cancer," Klein said.

It could be that the risk comes from too little vitamin D, and that consuming lots of vitamin D is not helpful, doctors say. How much should people get? The recommended daily amount is 400 international units, but most scientists think that is probably low, Li said.

Most milk is fortified with vitamin D, but drinking a lot of it might raise the risk of prostate cancer because of its calcium content. Getting enough vitamin D from food is difficult, but doctors do not recommend supplements because they can cause unsafe levels of calcium to build up. "If you start overloading on vitamin D you're going to cause other problems," said Dr. Durado Brooks, chief of prostate cancer research at the American Cancer Society.

Hence the advice to get a little sunlight - but not too much, because that can raise the risk of skin cancer.

Researchers presented two other studies from the same group of 15,000 doctors. One found that men who were overweight were 30 percent more likely to die of prostate cancer than normal-weight men. Those who were obese were nearly twice as likely to die.

The second study examined a protein in the blood, acid-labile subunit or ALS, that blocks the effects of a hormone that spurs cells to grow and has been linked to many types of cancer.

Compared with men with low levels of ALS, men with higher amounts of it were 40 percent to 60 percent more likely to develop prostate cancer, and their chances of having advanced cancer more than doubled, said Lorelei Mucci, a Harvard epidemiologist who led the study.

ALS needs more study, but may be a new marker for predicting cancer risk and may be a target for developing new treatments, Klein said.           Source: http://abcnews.go.com/Health/wireStory?id=509120

(page 5)

Celebrex provides a two pronged attack against prostate cancer

(Pharmaceutical News) 1-Mar-2005 -- Celecoxib, a selective COX-2 inhibitor with promising anti-cancer properties, has now been found to attack prostate cancer cells in a second way that differs from Vioxx (rofecoxib), another anti-inflammatory drug that also inhibits COX-2.

In studies published in the March 1 issue of the journal Clinical Cancer Research, scientists at the Weill Medical College of Cornell University revealed that celecoxib, marketed under the name Celebrex, not only targets COX-2, but also reduces levels of a key protein, cyclin D1, that's critical for cell replication. "It is well established that COX-2 is a significant and rational target for anti-cancer therapy," said Andrew Dannenberg, M.D., director of cancer prevention at the Weill Medical College of Cornell University and senior author of the paper.

"These studies suggest that celecoxib exerts a second mode of action independent of its known anti-inflammatory mechanism that imposes further restrictions on the proliferation of prostate cancer cells. The results provide potentially important insights into our understanding of the overall anti-tumor activity of selective COX-2 inhibitors."

Dannenberg and a team of investigators discovered this new mechanism by applying celecoxib to prostate cancer cells that failed to express COX-2. Here, the scientists observed that the celecoxib-treated cancer cells did not replicate as rapidly as untreated cells. After further analysis, they found the drug worked by suppressing amounts of cyclin D1, a protein that's essential if cells are to grow, divide and spread. The scientists also attempted to replicate the experiment with Vioxx substituting for celecoxib. In this case, the prostate cancer cells continued to flourish.

"These results support the notion of a unique action by celecoxib that is independent of COX-2, and that's different from Vioxx," said Dannenberg.

"These beneficial effects were observed at concentrations of celecoxib that occur in humans," added Dannenberg. "This increases the likelihood that our findings are clinically relevant."

Dannenberg and his colleagues then demonstrated that celecoxib worked in animals that served as hosts for human prostate tumors. In this animal model, celecoxib not only was shown to reduce proliferation of cancer cells, but also reduced the growth of blood vessels at the tumor sites. As a result, tumor mass and blood vessel density in the treated animals was about half that observed in the untreated animals.

Contributing to the studies, along with Dannenberg, were Kotha Subbaramaiah, Baoheng Du and Mindy Chang from Weill Medical College of Cornell University, New York, N.Y.; Manish Patel, Carlos Cardon-Cardo, and Howard Thaler, Memorial Sloan-Kettering Cancer Center, New York, N.Y.; and Peiying Yang and Robert Newman, UT M.D. Anderson Cancer Center, Houston, Texas.         Source: http://www.news-medical.net/?id=8066

DO YOU HAVE A NEWS ITEM TO CONTRIBUTE?

We want to hear from you! Members of the support group are welcome to contribute any items of interest to the group at large. Updates on your status, news about prostate cancer treatments, or anything you feel would be of interest to the group are all welcome. Contact Howard Waage, 688-0423 with your story.  

Heads Up For Our Special Event Speaker for The May 31^st Meeting:

Topic: “Getting Back to Intimacy After Prostate Cancer Treatment", and it's specifically about sexual intimacy.

Our Speaker: Maren Martin is a Licensed Clinical Social Worker with a psychotherapy practice in Pacific Grove as well as a Certified Sex Therapist and  specializes in sex and couple therapy.  She has a special interest in helping cancer survivors have emotional intimacy and fulfilling sexual relationships.

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.