With PSA screening, men are being diagnosed with prostate cancer (CaP) at younger ages. In the online issue of the BJU International, Dr. Steinsvik and colleagues address the issues of fertility as related to prostate cancer therapies. In Norway, the percentage of patients aged <60years has increased from 4% in 1986 to 11% in 2006.
Patients experience scattered testicular irradiation during pelvic external beam radiotherapy with short-term androgen-deprivation therapy that causes transient azoospermia. However, data on sperm counts following radiotherapy are lacking. Brachytherapy may preserve spermatogenesis but reduce seminal fluid volume. Options for infertility following these treatments or radical prostatectomy include semen cryopreservation prior to therapy or sperm extraction from the epididymis or testes afterwards. This can then be used for intracytoplasmic sperm injection.
The authors present two cases of prostate cancer patients desiring fertility following therapy. One was a 57 year old man with intermediate risk CaP. He and his partner had failed to conceive for the previous 8 years. ICSI has resulted in 7 spontaneous abortions. He underwent brachytherapy with a radiotherapy boost. Incredibly, he impregnated his partner 2 days following brachytherapy and prior to the onset of radiotherapy. His testicular dose after brachytherapy was estimated to be 0.1Gy based upon the treatment planning scheme. The second patient was 56 years old with high-risk prostate cancer. He underwent radiotherapy with 3 months of ADT. He remained sexually active and had a sperm count 4 years after therapy of 225x106/ml sperm cells with a semen volume of 1.7ml. Five years post-therapy he fathered a child without use of cryopreserved sperm cells. His testicular dose was estimated to be 1.2-2.3Gy.
Despite these remarkable outcomes, the authors recommend that younger patients be advised of the option to cryopreserved sperm prior to CaP therapies.
Monday, July 14, 2008
Virus helps flush cancer cells out of hiding
A GENETICALLY engineered version of the cold virus helped flush dangerous prostate cancer cells out of hiding in mice, making them easier to see on imaging equipment, United States researchers said on Friday.
If the same approach works in humans, it could offer a way to catch prostate cancer as it begins to spread, they said.
Ultimately, the hope is to use the approach to kill cancer cells as part of a highly targeted, image-guided therapy.
'If we can catch the cancer before it invades other organs, we have a better chance to change the outcomes for these patients,' Dr Lily Wu of the University of California, Los Angeles, whose study appears in the journal Nature Medicine, said in a statement.
The finding offers an example of a much-anticipated new use of imaging technology known as molecular imaging, in which advanced diagnostic equipment can be used to target and treat cancers on the cellular level.
Conventional scans known as computed tomography or CT scans have a hard time spotting the earliest stages of prostate cancer as it spreads, or metastasises, to hard-to-reach lymph nodes in the pelvis.
To help get a better look, Dr Wu's team tinkered with the common cold virus so that it would only target prostate cancer cells.
Once inside the cancer cell, genes in the virus trick the cancer into making a protein that can be seen using positron emission tomography, or PET scans. The protein serves as a sort of a flare signal identifying the location of the cancer.
'The virus happens to be lymphotropic, which means it favours the lymph nodes. We were able to exploit its natural capability for this particular function,' Dr Wu said in a telephone interview.
Using genetic engineering, Dr Wu said her team deleted all of the parts of the cold virus that make people sick. Next, they spliced in genes that make proteins that can be seen on PET scans, and they added in other genes that target prostate cancer cells.
'It's a prostate cancer-specific control switch,' she said.
The result was a virus that specially looked for prostate cancer cells in the lymph nodes, which is typically the first stop cancer makes before it spreads to other organs.
When Dr Wu and her team injected the engineered virus into tumours in mice with prostate cancer, PET scans picked up signals only from lymph nodes with cancer cells in them, suggesting the virus was able to target and tag prostate cancer cells.
Dr Wu and her colleagues are now working to develop a toxic agent they can add in that would find and kill the cancer cells at the same time, watching it all on a PET scanner.
She said the team plans to start testing the technique in dogs with prostate cancer. Her team is working to perfect the technique so that it can be tested in humans within the next two years, she said.
Prostate cancer occurs usually in older men. With an estimated 254,000 deaths annually, prostate cancer is the sixth leading cause of cancer death in men worldwide.
If the same approach works in humans, it could offer a way to catch prostate cancer as it begins to spread, they said.
Ultimately, the hope is to use the approach to kill cancer cells as part of a highly targeted, image-guided therapy.
'If we can catch the cancer before it invades other organs, we have a better chance to change the outcomes for these patients,' Dr Lily Wu of the University of California, Los Angeles, whose study appears in the journal Nature Medicine, said in a statement.
The finding offers an example of a much-anticipated new use of imaging technology known as molecular imaging, in which advanced diagnostic equipment can be used to target and treat cancers on the cellular level.
Conventional scans known as computed tomography or CT scans have a hard time spotting the earliest stages of prostate cancer as it spreads, or metastasises, to hard-to-reach lymph nodes in the pelvis.
To help get a better look, Dr Wu's team tinkered with the common cold virus so that it would only target prostate cancer cells.
Once inside the cancer cell, genes in the virus trick the cancer into making a protein that can be seen using positron emission tomography, or PET scans. The protein serves as a sort of a flare signal identifying the location of the cancer.
'The virus happens to be lymphotropic, which means it favours the lymph nodes. We were able to exploit its natural capability for this particular function,' Dr Wu said in a telephone interview.
Using genetic engineering, Dr Wu said her team deleted all of the parts of the cold virus that make people sick. Next, they spliced in genes that make proteins that can be seen on PET scans, and they added in other genes that target prostate cancer cells.
'It's a prostate cancer-specific control switch,' she said.
The result was a virus that specially looked for prostate cancer cells in the lymph nodes, which is typically the first stop cancer makes before it spreads to other organs.
When Dr Wu and her team injected the engineered virus into tumours in mice with prostate cancer, PET scans picked up signals only from lymph nodes with cancer cells in them, suggesting the virus was able to target and tag prostate cancer cells.
Dr Wu and her colleagues are now working to develop a toxic agent they can add in that would find and kill the cancer cells at the same time, watching it all on a PET scanner.
She said the team plans to start testing the technique in dogs with prostate cancer. Her team is working to perfect the technique so that it can be tested in humans within the next two years, she said.
Prostate cancer occurs usually in older men. With an estimated 254,000 deaths annually, prostate cancer is the sixth leading cause of cancer death in men worldwide.
Friday, July 11, 2008
Hormone therapy for prostate cancer does more harm than good
A new study today's Journal of the American Medical Association suggests that older men who have early stage prostate cancer should not be advised to receive hormone therapy, which can do more harm than good to older men.
The review study of almost 20,000 older men over 65 with early stage prostate cancer showed forgoing the treatment and having their condition monitored would be a better option for the patients.
Researchers from the Robert Wood Johnson Medical School in New Jersey found that although the hormone therapy did increase survival from advanced prostate cancer, but also increased the rate of deaths from other causes such as heart disease, negating any benefit.
Dr. Patrick Walsh, an urologist at the Johns Hopkins School of Medicine was cited as saying studies have shown that the treatment itself through the increased risk of cardiovascular disease and worsened diabetes kills a significant number of older men.
The therapy that aims to suppress the male hormone testosterone helps patients with their cancer spreading beyond the prostate gland, but is ineffective at treating patients with the early stage prostate cancer.
The severe adverse effects associated with the hormone therapy include cardiovascular disease, diabetes, bone fractures, fatigue and other conditions, Grace Lu-Yao, lead author and an epidemiologic at Johnson and colleagues said.
Walsh said there has never been any evidence that hormonal treatments help older men with early stage disease. Rather its causes many side effects including weight gain, hot flashes, loss of muscle mass, and a decrease in mental acuity.
Oder men with early stage prostate cancer are not advised to receive the treatment although the treatment helps those with advanced disease.
But why do urologists do it anyway?
Urologists reportedly have found treating patients with the useless drugs, they could make tens of thousands of dollars a year by just marking up the price they pay to obtain the hormone-suppressing medications.
Prostate cancer is diagnosed in 186,000 people each year in the United States and 8,600 are expected to die from the disease. The disease is the second leading cancer killer, only behind lung cancer.
However, the disease is often not as aggressive as many others. About 80 patients have a survival of 10 years with or without the hormonal therapy. Many studies have showed that many alternative treatments may be used to effectively treat the disease.
The review study of almost 20,000 older men over 65 with early stage prostate cancer showed forgoing the treatment and having their condition monitored would be a better option for the patients.
Researchers from the Robert Wood Johnson Medical School in New Jersey found that although the hormone therapy did increase survival from advanced prostate cancer, but also increased the rate of deaths from other causes such as heart disease, negating any benefit.
Dr. Patrick Walsh, an urologist at the Johns Hopkins School of Medicine was cited as saying studies have shown that the treatment itself through the increased risk of cardiovascular disease and worsened diabetes kills a significant number of older men.
The therapy that aims to suppress the male hormone testosterone helps patients with their cancer spreading beyond the prostate gland, but is ineffective at treating patients with the early stage prostate cancer.
The severe adverse effects associated with the hormone therapy include cardiovascular disease, diabetes, bone fractures, fatigue and other conditions, Grace Lu-Yao, lead author and an epidemiologic at Johnson and colleagues said.
Walsh said there has never been any evidence that hormonal treatments help older men with early stage disease. Rather its causes many side effects including weight gain, hot flashes, loss of muscle mass, and a decrease in mental acuity.
Oder men with early stage prostate cancer are not advised to receive the treatment although the treatment helps those with advanced disease.
But why do urologists do it anyway?
Urologists reportedly have found treating patients with the useless drugs, they could make tens of thousands of dollars a year by just marking up the price they pay to obtain the hormone-suppressing medications.
Prostate cancer is diagnosed in 186,000 people each year in the United States and 8,600 are expected to die from the disease. The disease is the second leading cancer killer, only behind lung cancer.
However, the disease is often not as aggressive as many others. About 80 patients have a survival of 10 years with or without the hormonal therapy. Many studies have showed that many alternative treatments may be used to effectively treat the disease.
Wednesday, July 09, 2008
Treating Prostate Cancer Naturally
Uncover what you must know about prostate cancer… and what you can do NOW to reduce your risks and stay healthier longer.
Prostate cancer is a stop-you-dead diagnosis. Every horror story you've ever heard comes back to you in vivid detail. Treatments have terrible side effects, and mean trips to doctor's offices and hospitals (not my favorite places, or yours either). Still, you're not sure which is worse, treating the cancer that has invaded your body, or leaving it there to grow quietly, hoping it won't get any bigger, and more dangerous. It seems like a no-win situation.
For a good many of us, there are no signs at all, for others there are any number of painful, embarrassing symptoms like these...
Instead, you'll be loosing your chance at an early detection (and nearly 100% survival rates), and leaving a dangerous condition to go unchecked. And, it's entirely possible that even if you have one of more of these terrible symptoms, another treatable condition besides prostate cancer could be the culprit. Find out.
Prostate cancer is a stop-you-dead diagnosis. Every horror story you've ever heard comes back to you in vivid detail. Treatments have terrible side effects, and mean trips to doctor's offices and hospitals (not my favorite places, or yours either). Still, you're not sure which is worse, treating the cancer that has invaded your body, or leaving it there to grow quietly, hoping it won't get any bigger, and more dangerous. It seems like a no-win situation.
For a good many of us, there are no signs at all, for others there are any number of painful, embarrassing symptoms like these...
- You're in the middle of something and you find that you "need to go" again. If you stop to think about it, you're in the restroom much more often than you used to be.
- Your sleep is disrupted by the need to go to the bathroom - it's been happening for long enough now that you've come to expect the nightly wake up call.
- Once you get to the bathroom, you have trouble getting urine to flow - either you can't start a stream, or the flow is interrupted before getting going again.
- You grit your teeth while you pee, trying to tough out the intense burning or searing pain - it gets so you dread going to the bathroom, but there's no escaping the terrible discomfort.
- You've just come from the restroom, and you feel like you could go right back - your bladder never quite feels emptied, even though you know you've just gone.
- Suddenly it's really hard to hold urine back, and you cringe if you feel a leak, hoping no one noticed. Even if they didn't you see the evidence - the tell tale stains in your underwear that have gotten bigger and more noticeable.
- Your intimate relationship isn't what it was... either because of a humiliating inability to get an erection, or because you've had your pleasure abruptly turn to pain during ejaculation - making sex the last thing on your mind.
- You're startled to catch sight of bright, red blood in either your urine or semen - a place you're sure it does not belong, and that frankly scares the life out of you.
Instead, you'll be loosing your chance at an early detection (and nearly 100% survival rates), and leaving a dangerous condition to go unchecked. And, it's entirely possible that even if you have one of more of these terrible symptoms, another treatable condition besides prostate cancer could be the culprit. Find out.
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