Prostate Treatment
Heart Risk For Some

The standard treatment for prostate cancer --- shutting off the body's production of androgen hormones --- can chop 2 1/2 years off the lives of men who are at high risk of developing heart disease, Boston researchers reported Friday.

The drugs used for suppressing the hormones produce anemia, weight gain and insulin resistance, a constellation of factors known as metabolic syndrome.

These effects sharply can increase the risk of a fatal heart attack, especially in men who are at high risk, Dr. Anthony D'Amico of Brigham and Women's Hospital in Boston reported in the Journal of Clinical Oncology. Because the drugs can slow or halt the progression of a prostate tumor, researchers are not advocating that physicians stop using them.

Instead, they recommend that prostate cancer patients be screened for cardiovascular risk, and that those with risk factors be treated aggressively for their potential heart disease before cancer therapy is begun.

DETECTION OF LIFE-THREATENING PROSTATE CANCER WITH PROSTATE-SPECIFIC ANTIGEN VELOCITY DURING A WINDOW OF CURABILITY

Carter HB, Ferrucci L, Kettermann A, et al
J Nati Cancer Inst 98(21): 1521-7, 2006

Background: Prostate-specific antigen PSA) level is typically used as a dichotomous test for prostate cancer, resulting in overdiagnosis for a substantial number of men. The rate at which serum PSA levels change (PSA velocity) may be an important indicator of the presence of life-threatening disease.

Methods: PSA velocity was determined in 980 men (856 without prostate cancer, 104 with prostate cancer who were alive or died of another cause, and 20 who died of prostate cancer) who were participants in the Baltimore Longitudinal Study of Aging for up to 39 years. The relative risks (RRs) of prostate cancer death and prostate cancer-specific survival stratified by PSA velocity were evaluated in the three groups of men by Cox regression and Kaplan-Meier analyses. Statistical tests were two-sided.

Results: PSA velocity measured 10-15 years before diagnosis (when most men had PSA levels below 4.0, ng/mL) was associated with cancer-specific survival 25 years later; survival was 92% (95% confidence interval [CI] = 84% to 96%) among men with PSA velocity of 0.35 ng/mL per year or less and 54% (95% CI = 15%

Continued in the right-hand column.

PROSTATE CANCER PATIENT SUPPORT 1 800 80 Us TOO

Prostate Cancer Risk Linked to DNA Finding May Lead to Genetic Test

New York - Scientists have identified a common genetic marker that signals a 60 percent heightened risk of prostate cancer in men who carry it, and it may help explain why black men are unusually prone to the disease, a new study says.

The DNA variant may play a role in about 8 percent of prostate cancers in men of European extraction and 16 percent of the cancers in blacks, researchers said.

The study was published online Sunday by Nature Genetics and will appear in the journal's June Issue. The work, drawing on study populations in Michigan, Illinois, Iceland and Sweden, was reported by Kari Stefansson and colleagues at deCode genetics in Reykjavik, Iceland, and scientists elsewhere.

The variant is about twice as common in blacks as whites, so that may contribute to the higher incidence of prostate cancer in blacks, the researchers said.

Stefansson said deCode planned to use the discovery to develop a genetic test that might help doctors decide how closely to follow men at high risk and how to treat prostate cancer cases. The study indicated the variant might be associated with more aggressive forms of the disease.

It is not clear whether the heightened risk comes from the variant or from another that lies nearby on chromosome 8.

In general, men run a 1-in-6 chance of developing prostate cancer. The risk is greater for those who are older, black or have a brother or father who has had the disease. More than 230,000 new cases are expected this year in the United States, with about 27,000 deaths.

Originally printed in The Grand Rapids Press May 8, 2006 - The Associated Press

to 82%) among men with PSA velocity above 0.35 ng/ mL per year (P < 0.001). Furthermore, men with PSA velocity above 0.35 ng/mL per year had a higher relative risk of prostate cancer death than men with PSA velocity of 0.35 ng/mL per year or less (RR = 4.7, 95% Cl = 1.3 to 16.5; P = 0.02); the rates per 100,000 person-years were 1240 for men with a PSA velocity above 0.35 ng/mL per year and 140 for men with a PSA velocity of 0.35 ng/mL per year or less.

Conclusions: PSA velocity may help identify men with life-threatening prostate cancer at a time when their PSA levels are associated with curable disease.

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