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Serving all of SANTA CRUZ COUNTY

Santa Cruz PROSTATE CANCER SUPPORT GROUP

November 2008 NEWSLETTER

Howard Waage ----Editor

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Where: Our meeting will be in the Bennett & Suzy Katz Cancer Resource Center on the 1st Floor of the
two-story redwood Education Building behind Santa Cruz Dominican Hospital.

When: Tuesday, November 25th, 2008 7:00 PM. For more information: Please call-The Bennett and Suzy Katz Cancer Resource Center at Dominican Hospital (831) 462-7770

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.

Joe Ferrara 426-7724 ¥ Frank and Janet Schmetz 438 4781 ¥ Bill McDermott 423-8350 ¥ Howard Waage 688-0423
Michael & Julie Batz 724-2701 ¥ Tim Ryan 476-6550 ¥ Our website: http://www.scprostate.org

...PROSTATE CANCER IN THE NEWS...

Study: When/if to start hormones for prostate cancer patients whose PSA rises after radiation
Findings also provide guidance on when to forgo hormone therapy

BOSTON (Sept. 23, 2008) -- A new Fox Chase Cancer Center study suggests men with early stage prostate cancer treated with radiation therapy should begin hormone therapy immediately if their PSA level rises quickly and doubles within six months at any time after treatment. The study also supports foregoing hormones if the PSA doesn't rise as quickly. Both findings suggest a change in the practice of prescribing hormones is warranted.

After treatment for prostate cancer, many men will experience fluctuations or bounces in their PSA level, but for some the PSA continues to rise and doesn't return to its lowest point immediately after treatment. Knowing if or when to recommend hormone treatment (androgen deprivation therapy) depends on how much and how quickly the PSA rises - called the PSA doubling time. Hormone therapy has been shown to kill cancer cells and improve survival, but it carries a risk of side effects.

"We've been using PSA doubling time to help guide our decision about when to begin hormone therapy, but this study gives us new and critical information that suggests we should start therapy sooner than previously thought for some patients and delay treatment for others," explains Eric Horwitz, M.D., acting chairman and clinical director of the radiation oncology department at Fox Chase, who led the study. "While hormone therapy can have side effects such as hot flashes, decreased libido and osteoporosis, it can help prevent the cancer from spreading to the bones, causing pain and leading to an earlier death from the disease."

Previous studies indicated an increased likelihood that the cancer had spread if the PSA doubling time occurred within 12 months, and thus a potential benefit from receiving hormone therapy. But recently, a newly validated formula, known as the Phoenix definition, used by physicians demonstrates a more accurate way of determining biochemical failure, a term used to describe a significant rise in PSA. Using the new formula, the Fox Chase team was able to determine when earlier action needs to be taken.

"What we now know is that when the PSA rises and doubles within 6 months, versus 12 months, we need to act," explains Horwitz. "Our study suggests that these are the men who will benefit most from hormone therapy." Horwitz's research was presented today at the 50th annual meeting of the American Society for Therapeutic Radiology and Oncology.

Also, Horwitz says the study helps identify who is less likely to benefit from hormone therapy which may indicate a necessary change in current practice. "Men whose PSA rises, but does so over a longer period of time may not benefit from hormones.

"These results further refine the role of PSA doubling time in predicting which patients may benefit from hormone therapy and which patients may be observed expectantly and spared the toxicity of the hormones," Horwitz concludes.

Fox Chase Cancer Center is one of the leading cancer research and treatments centers in the United States. Founded in 1904 in Philadelphia as the nation's first cancer hospital, Fox Chase became one of the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, treatment, and community outreach. For more information, call 1-888-FOX-CHASE or 1-888-369-2427.

Source: http://www.eurekalert.org/pub_releases/2008-09/fccc-swt091208.php#

Increased Survival For Men With Prostate Cancer By Adding Radiation To Hormone Therapy

Sept. 23, 2008 - For men with locally advanced prostate cancer the addition of radiation treatment to anti-androgen hormone therapy reduces the risk of dying of prostate cancer by 50 percent compared to those who have anti-androgen hormone treatment alone, according to a randomized study presented at the American Society for Therapeutic Radiology and Oncology's 50th Annual Meeting in Boston.

"This randomized trial is the first to show that men with locally advanced prostate cancer will survive substantially longer when radiation is added to their treatment plan," Anders Widmark, M.D., lead author of the study and a professor in radiation oncology at Umea University in Umea, Sweden, said. "I would encourage men with locally advanced prostate cancer to talk to their doctor to see if they would be a good candidate for radiation therapy in addition to hormone treatment."

Locally advanced prostate cancer is cancer that has grown close to the border or outside the prostate gland and into neighboring tissue, but has not spread into the lymph nodes or to other organs. In this study, anti-androgen hormone therapy is used to treat prostate cancer by blocking the stimulating effect of testosterone on the prostate cancer cells, to shrink the prostate cancer and slow down the growth of prostate cancer. External beam radiation therapy (also called radiotherapy) involves a series of daily treatments to accurately deliver radiation to the prostate.

The study involved 880 patients with locally advanced prostate cancer who were randomly assigned to receive three months of intense hormone therapy (temporary castration) called total elimination of androgens in the body (total androgen blockade) followed by continuous anti-androgen therapy, allowing the testosterone to come back or the same hormonal treatment combined with radiation therapy between February 1996 to December 2002.

Findings show that 18 percent of patients who underwent hormone therapy alone died of prostate cancer, compared to nine percent of those who had both hormone and radiation treatment. The quality of life at four years after treatment was similar between the two groups, with the exception of decreased social function in the patients who had the combined treatment.

The abstract, "A Randomized Trial Comparing Antiandrogens With Or Without Radiotherapy in the Treatment Of Locally Advanced Prostate Cancer: Survival and Qol Outcome," was presented on Monday, September 22, 2008. Source: http://www.medicalnewstoday.com/articles/122609.php

New Tool Helps Physicians Tailor Hormone Therapy For High-risk Prostate Cancer Patients

ScienceDaily (Sept. 27, 2008) - Using one of the largest databases of prostate cancer outcomes in the United States, Fox Chase Cancer Center researchers have developed a prediction tool that uses a patient's clinical information to estimate the benefit of adding androgen deprivation therapy of various durations to radiation therapy.

Such hormone therapy has been shown to help radiation kill prostate cancer cells and improve survival in men at a high risk of recurrence, but it is associated with significant side effects. Even when the cancer has been characterized as high-risk, the degree of benefit from the addition of androgen deprivation can be quite variable.

"Studies have generally lumped patients into three levels of risk, and physicians have recommended hormone therapy based on these studies," says Niraj H. Pahlajani, a resident in the radiation oncology department at Fox Chase Cancer Center in Philadelphia.

"Our experience tells us that prostate patients can't be lumped together into broad categories and expected to respond the same way to treatment even when they fall into similar risk-categories.

Fortunately, we've been able to generate a nuanced prediction tool that incorporates disease burden and individualizes treatment recommendations. We can enter each patient's clinical information and estimate the probability of the cancer coming back using different durations of hormone therapy to determine the best course."

Pahlajani says other similar tools exist to predict cancer treatment outcomes, but none is as personalized and none has yet been used to estimate the gains from different lengths of hormone therapy. The Fox Chase researchers used two key factors derived via biopsy to identify subtle differences among those at intermediate to high-risk of recurrence. The two factors were the percent of cancer-positive tissue identified and the percent of that positive tissue with a Gleason grade of four or five. "With this information, we're able to personalize each man's treatment by quantifying the optimal duration of hormones based on his individual factors," Pahlajani says.

Pahlajani presented the study supporting the tool at the 50th annual meeting of the American Society for Therapeutic Radiology and Oncology. Source: http://www.sciencedaily.com/releases/2008/09/080923140635.htm

Mutant gene found in 70 percent of prostate cancer

WASHINGTON (Reuters) Oct. 24, 2008 - A mutated gene previously linked to breast cancer has been found in 70 percent of prostate tumors as well, U.S. researchers reported on Friday. They found the gene BP1 was overactive in samples of prostate tumors removed from patients and said their finding suggests the gene may underlie other cancers too.

"We have previously published that it is active in 80 percent of (ductal) breast cancer (samples tested) and 63 percent of acute myeloid leukemia, and now we are finding it in prostate cancer," Dr. Patricia Berg of the George Washington University Medical Center, who led the study, said in a telephone interview.

Berg said the BP1 gene also appeared overactive in prostatic intraepithelial neoplasia, or PIN, a pre-cancerous change in prostate tissue. Berg and colleagues tested 50 prostate tumor samples from the Armed Forces Institute of Pathology and 123 from the National Cancer Institute. They compared these to samples of healthy prostate tissue.

Writing in the journal Modern Pathology, they said BP1 was overactive in 70 percent of the tumors. BP1 is a so-called homeobox gene -- one of a family of transcription factors involved in early development. A transcription factor turns other genes on and off and these are supposed to be turned off in mature tissue. Cells that are improperly switched back on may proliferate out of control, and this process, at least in part, underlies many cancers.

BP1 may be active early in the process of developing cancer, Berg said. She believes it may be possible to target drugs to turn down BP1's effects. Prostate cancer is the second-leading cause of cancer death among men in many countries, and is diagnosed in 679,000 men every year, killing 221,000.

In 2003, Berg's team reported finding that BP1 was overactive in 80 percent of the samples of tissue from breast cancer patients, and in 89 percent of samples from black women. (Reporting by Maggie Fox)

Source: http://news.yahoo.com/s/nm/20081024/hl_nm/us_cancer_prostate_gene_1

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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.