Guest Column: Q&A with a Radiologist on Prostate Cancer

How does radiation kill  prostate cancer cells—and leave healthy cells to recover? What is the difference between proton therapy and high-dose radiation? What is the future of radiotherapy in treating prostate cancer?

Radiologist Lisa Livingston

Radiologist Lisa Livingston tackles these and other questions, as our first guest columnist. Lisa has created the online site, Radiation Technician Schools, a good resource for radiation technicians on schools, career options, scholarship opportunities and more. Plus, you can find interesting articles on the history of the pharmaceutical industry in America, how mobile computing is changing health care delivery, and many other health care topics that interest everyone.  Check out her website and blog — and if you have additional questions about radiation and prostate cancer, send them to The Prostate Storm blog, and we’ll get them answered. (SV)

How does radiation kill cancer cells?

Radiation stops or slows the growth of cancer cells. It kills the genes (DNA) in cancer cells so that they can no longer grow and divide. Cancer cells tend to divide quickly and grow out of control, but radiation can impede this growth. It can also shrink a tumor and keep it from spreading to other parts of the body.

Radiation therapy does not always kill cancer cells immediately. Sometimes it can take days or weeks of treatment to kill cancer cells, and they may even continue to die after treatment ends. Tissues that grow quickly such as skin and bone marrow are generally affected right away, while nerve, breast, prostate and bone tissue will take longer to show affects.

The final debunking of Vitamin E: Now it raises prostate cancer risk

Vitamin E -- No longer miracle supplement for PC.

Tough week for guys trying to deal with the threat of prostate cancer:  First the PSA screen came under attack (previous post), now vitamin E.

Once believed to be a super supplement that could reduce the risk of prostate cancer, vitamin E (and selenium) were  shown to have no benefit at all several years ago. That was about the time of my diagnosis, years after I'd begun taking vitamin E.

Natually, this came as disappointing news. Since the early 2000s, men had been popping high doses of vitamin E, thinking this was an easy over-the-counter antidote to the second most deadly cancer among American men. 

I was among the poppers. Since the late '90s, I'd been besieged by urinary tract issues and an enlarged prostate, so I tried everything — including buying bottles of vitamin E at the local GNC and trying high doses, believing vitamin E was good for prostate health and would relieve my symptoms.  It didn't seem to help much. But I took vitamin E off and on for years, adding it to a cocktail of other so-called "miracle" supplements.

Interestingly, the researchers who revealed vitamin E and selenium had no benefit in 2008, continued to study the 35,000 men in the trial.  Now, three years later, they're reporting high doses of vitamin E actually increase the risk of prostate cancer.

They found an increased risk of 17 percent in men who took 400-unit capsule of vitamin E every day for about five years.  Look, that's a lot of vitamin E — about 20 times more than the recommended amount. But that wasn't unusual for guys who believed they might be preventing prostate cancer, or at least improving prostate health — like me.

Just goes to show you, if you wait long enough, all common wisdom will eventually be upended by another study.

PSA test not recommended by Task Force — but have they gone too far (again)?

The PSA test is an unreliable test that has led to serious overtreatment of prostate cancer. Few argue it's anything but a lousy screen for the second deadliest cancer among American men.

Grading cancer from 1 to 5, the least to the most aggressive

But the U.S. Preventative Services Task Force's recommendation (released next Tuesday, Oct. 11th) that the screen should no longer be given to healthy men is going way too far. (Reuters--PSA Test for prostate cancer not recommended: panel.)  Also read Prostate cancer test under fire.)

They may've over-reached in trying to protect men from the "collateral damage" of radiation and surgical treatments — i.e., varying degrees of impotence and incontinence.

I understand giving guys a "warning" that the test is not cracked up to what everyone may think — but hey, it's still the only game in town for early detection.