March 07 Newsletter Articles

Hormone Therapy for Prostate Cancer Linked To Diabetes And Heart Disease

Androgendeprivation therapy for prostate cancer may increase the risk for diabetes and heart disease, according to astudy published in the August 2006 issue of the Journal ofClinical Oncology.

The observational study identified 73,196 Medicare enrollees diagnosed with locoregional prostate cancer and studied them ata median of 4.55 years after diagnosis.

Men who took gonadotropinreleasing hormone (GnRH) agionists had hazard ratios of 1.44 for incident diabetes, 1. 6 forincident coronary heart disease, 1.11 for myocardial infarction,and 1.16 for sudden cardiac death, compared with men who didn't take GnRH agonists, after adjustments for numerous socioeconomic and medical variables.

Men treated with orchiectomy had an adjusted HR of 1.34 for incident diabetes, but no increased risk for coronary heart disease, MI, or sudden cardiac death

Given the increasing use of hormone therapy for prostate cancer, the authors urged physicians to weigh its benefits against potential increased risks for diabetes and heart disease.

SPECTRUM ANNOUNCES RESULTS FROM TRIAL OF PROSTATE CANCER DRUG

EARLIER TREATMENT MAY HELP PROSTATE CANCER

Reuters News Service

CHICAGO–Older men with early stage, localized prostate cancer live longer if the disease is treated with radiation or surgery instead of simply waiting and watching as is often recommended, a study said.

Researchers at the University of Pennsylvania in Philadelphia said they found that patients whose cancer was treated had a 31% lower risk of death during the 12 years they were tracked than those who did nothing.

Even though the disease is considered a slow developing one, the study "suggests a reduced risk of mortality associated with active treatment for low and intermediate risk prostate cancer in the elderly ... population examined," concluded the report published in the latest issue of the Journal of the American Medical Association.

The report was based on the medical records of more than 44,000 men 65 to 80 who were diagnosed with the disease in 1991 to 1999 and who had survived more than a year past diagnosis. The study ended at the end of 2002.

In an editorial in the same issue commenting on the study, Mark Litwin and David Miller, two physicians at the University of California, Los Angeles, noted that the findings are preliminary.

PSA BOUNCE AFTER RADIATION DOES NOT PREDICT CLINICAL FAILURE

Transient increases in prostate-specific antigen level (PSA bounce) after radiation therapy for prostate cancer are associated with a higher risk for biochemical failure, but not for clinical failure, according to a report in the October 1st issue of Cancer (2006; 107:1496-1502).

"Do not react quickly if a patient's PSA rises and conclude that their cancer has returned," Dr. Eric M. Horwitz from Fox Chase Cancer Center, Philadelphia, Pennsylvania told Reuters Health. "The PSA bounce is common for all patients treated with radiation and it does not represent treatment failure."

Dr. Horwitz and colleagues sought to determine the biochemical and clinical significance of the PSA bounce

PROSTATE CANCER PATIENT SUPPORT 180080Us TOO

in a pooled analysis of 4,839 patients with prostate cancer treated by external beam radiation therapy (EBRT) alone.

A post treatment PSA bounce was noted in 978 (20%) patients. At 10 years after treatment, 58% of patients with PSA bounce had no biochemical evidence of disease, the results indicate, compared with 72% of patients without PSA bounce. This difference in biochemical failure did not, however, translate into differences in rates of distant failure, cause-specific survival, or overall survival, the researchers note.

"Immediate salvage treatment (specifically hormones) is not necessary until a recurrence has been definitively diagnosed," Horwitz concluded.

Reuters Health, 1 November 2006

CRYOTHERAPY FOR RECURRENT PROSTATE CANCER. . . A PATIENT'S STORY

My Salvage Cryotherapy

By Troy Kee (Bedford, TX)

In 1993 at age 63, a routine physical revealed I had a PSA reading of 8. A second PSA was lower, at 6, so I waited six months. By then it was 12.9, so my doctor referred me to a urologist. He did a biopsy and found malignancies on both sides of the prostate. I decided to see a couple more urologists for second opinions, but they all recommended surgery or radiation. I ended up with a fourth doctor who sent me to a radiation oncologist, who treated me with external radiation.

My PSA dropped to 0.05 right after the radiation treatments, but I developed a pink bloody bowel discharge. It cleared up, but around that time I needed a double hernia repair. The doctor who did it said there was a lot of scar tissue, which I felt was the result of the radiation. Then my PSA started creeping up over a sevenyear period. My urologist said the only thing we could do was watch it and when it got high enough, start hormone shots. His attitude was, "Maybe you'll die of a heart attack before the cancer actually spreads." Sounds kind of cruel, if you're in my shoes. Anyway, my wife and I read an article in the local paper about Dr. David Ellis and the cryoablation procedure. So I made an appointment to see him.

Dr. Ellis did a biopsy and found cancer on both sides. He also did a bone scan, which was negative. He said we could definitely take some positive action instead of waiting until something disastrous happened. I told Dr. Ellis I would think about the cryo procedure. I did a little more research and talked it over with my wife. On September 12, 2001, I went in for cryosurgery.

The recovery was no cakewalk because I had a lot of swelling and soreness. The radiation treatments had done some damage to the tissue (which is why they usually don't attempt surgery after radiation). After 34 days the catheter came out and I was able to urinate normally.

My first PSA reading after the cryo was 0.04. As of September 2005, my PSA was 0.004. I'm 75, and I'm happy to know that, at least for now, the cancer is gone. Cryo is not that big of a jump if you've had radiation before. At least it's an alternative and one that I would have preferred having originally, if it had been available then.

Cryotherapy, or freezing, is a treatment alternative to surgery or radiation therapy for prostate cancer. It is minimally invasive and highly effective. Thousands of patients have undergone cryotherapy. They chose it for its low rate of incontinence, longterm success rates, and rapid return to normal activity. In most cases, cryotherapy can be done on an outpatient basis. For patients with localized prostate cancer recurrence following radiation treatment, cryotherapy is a Medicare approved salvage treatment. For more information, call 1877PCACRYO (8777222796) or visit www.prostatecancer.com.