Are you a good candidate for active surveillance?

This first video is from September 2007, but the issues Dr. Klotz discusses are more important than ever. Half of all newly diagnosed patients, he says, are being treated with surgery or radiation yet their cancers are considered low grade (small volume cancer on biopsy, PSA in the low to intermediate range).  In Dr. Klotz's group of 500 patients monitored through active surveillance, he found that 75% never need to have a radical treatment, and 25% end up having surgery or radiation.


The second video gives new guidelines from the NCCN regarding managing early-stage PC through active surveillance (from March 2010). 

Can you detoxify for a healthy prostate?

Just prior to my cancer diagnosis, I was a reading an interesting book by Dr. Larry Clapp, 90 Days to Prostate Health Without Radiation or Surgery, in which he advocates colon cleanses as a critical component to good prostate health.

Dr. Clapp claims to have cured his own prostate cancer not once but twice (yeah, it returned) through an holistic approach that included colon cleanses, natural foods, select supplements and herbs, de-stressing his life and even dental care.

His argument for cleanses goes something like this: Over a 70-year lifetime, the average American eats nearly 70 tons of solid food that is over processed, filled with pesticides and hormones, lacking in fiber, and hard to digest. Consequently, many suffer from slow bowel transit time and/or constipation.

Study: 90% of men with low-grade prostate cancer choose risky, aggressive treatments

It's truly unbelievable: Nine out of 10 men with low grade, NON-LETHAL prostate cancer choose aggressive treatments, risking incontinence, erectile dysfunction and rectal problems — UNNECESSARILY.   The major surgeries and radiation treatments that these men are having are NOT saving their lives, according to a Johns Hopkins study of 769 men across the U.S. and published in the Journal of Clinical Oncology.  Worse still, 80% of those choosing treatments are over age 75, an age group with a shortened lifetime horizon and thought to be ideal candidates for active surveillance....

When 'Waiting' Is The Smart Treatment Option

Overtreatment of prostate cancer is a serious issue. Men with low-grade prostate cancer (Stage 1, Gleason scores 6 and under) are getting radiated or going under the knife unnecessarily. Not only are these aggressive treatments not saving lives, they're causing irreparable damage to the lifestyles of tens of thousands of men every year.

Yet because of the anxiety that "having prostate cancer" causes men, the compliance of  many urologists, and the enormous financial benefits to providers—overtreatment is now commonplace. "It's embarrassing that this is going on," one of my doctors told me.

Fact is, men with slow-growing prostate cancer are not at high risk. They can live with prostate cancer as a chronic and often asymptomatic condition. Many experts now see 'watchful waiting' as the smart treatment choice and new studies are supporting this view. 

Just this week....
Once under the radar, the epidemic of overtreatment for PC is getting more and more attention from major news outlets. Here's a couple this week ... the first from Reuters Health, citing a study published in the Journal of Clinical Oncology....More evidence for waiting to treat prostate cancer, by Leigh Krietsch Koemer, April 13, 2011.  And another from Medical News Today, April 12, 2011....Slow-Growing Prostate Cancer: "Active Surveillance" May Be Better Option Than Treatment For Older Men
  

Older men overly screened?

From the New York Times
Screening Prostates at Any Age, by Gina Kolata
April 11, 2011

When, if ever, are people just too old to benefit from cancer screening? 

The question keeps arising and has never been satisfactorily answered. Now it has come up again, in the context of a provocative new study on the popular P.S.A. test for prostate cancer. The paper, published in The Journal of Clinical Oncology, finds that men in their 70s are being screened at nearly twice the rate of men in their 50s — and men ages 80 to 85 are being screened as often as those 30 years younger.

“That is mind-boggling,” said the lead author, Dr. Scott E. Eggener, a University of Chicago urologist. “What we were hoping was that young, healthy men who were most likely to benefit would be screened at higher rates and that screening would tail off in older men.”

Myths, the male and prostate cancer video

 

From xtranormal, the education movie maker -- Debunking myths and 

misconceptions about prostate cancer, treatments and risks.

Prostate cancer doesn’t mean no sex life

Good OVERVIEW story about the risks of treatment choices on your sex life  ...

April 7 2011 at 11:15am
By Anna Hodgekiss 
Lifestyle

Composer Andrew Lloyd Webber last week revealed he’d been left impotent following prostate cancer surgery. He is one of 37,000 men who are diagnosed with the disease each year in the UK. 

There are various treatment options available, but which is best and what are the implications for your sex life? 

“There are three considerations when it comes to treatment,” says David Neal, professor of surgical oncology at Addenbrooke’s Hospital in Cambridge. “We need to remove the cancer, prevent urinary incontinence and preserve sexual function - and the majority of patients agree this is the order of importance. 

“However, the key indicator of what your sex life will be after the operation is what it was like before. Remember also that sexual function may begin to wane naturally once a man reaches his 50s and 60s.” 

Why the PSA test sucks, you still gotta get it, and a new gene screen could change everything

There are two kinds of prostate cancer —one will kill you, one won't.  Most of it won't. But doctors generally will recommend surgery and radiation for most cancer they see, even the non-lethal forms.  Why?  Because they don't know the difference.

"The biggest challenge we face in managing prostate cancer currently is determining whether someone with a newly diagnosed tumor will die or not," says Dr. Eric Klein, of The Cleveland Clinic, in an article in the Cleveland Plain Dealer, Cleveland Clinic researchers hopeful about study findings, promise of future prostate cancer test.

So what's the problem?  Why can't we separate the non-lethal from the lethal, and spare men unnecessary biopsies and life-altering treatments?

It starts with the PSA test—which sucks (non-medical term). Yes, it is the best indicator for prostate cancer that science has produced and every guy needs to get tested regularly. But it is terribly unreliable at identifying aggressive and non-aggressive forms of prostate cancer ... which, in an ideal world, should be the key to a treatment decision. Even biopsies, with their Gleason scores and in combination with PSA scores, can't predict better than 30-40% of the time which cancers are lethal.