Why Some Prostate Cancers Are More Aggressive than Others

Researchers have uncovered a mechanism that determines prostate cancer aggressiveness -- a study published in Cancer Cell (July 13, 2010)

Why is this interesting?  For one thing, if science can determine which prostate cancers are more aggressive and hence life-threatening, physicians may not blanket recommend major interventions -- surgeries and radiation -- that do more harm than good in many men. Watchful waiting may be the more prudent course of action.

Around 15% of prostate cancers are dangerous or life-threatening, regardless of age -- but what makes them dangerous?  Could a guy get a test to see if he is truly at risk instead of having life-altering open or robotic surgery or high dose radiation (see post below on over treatment)?

The research below is focusing in on that question ....

Here's the release from the Sanford Burnham Medical Research Institute:

"How Prostate Cancer Packs A Punch"

Some types of prostate tumors are more aggressive and more likely to metastasize than others. Nearly one-third of these aggressive tumors contain a small nest of especially dangerous cells known as neuroendocrine-type cells. More rarely, some aggressive prostate tumors are made up entirely of neuroendocrine-type cells. The presence of neuroendocrine-type cancer cells is associated with a poor prognosis, but spotting these rare cells can be like finding a needle in a haystack.

More on Over Treatment, Colluding Physicians, PC Putting Medicare at Risk -- A Story of Greed (Docs) and Fear (Patients) -- From WSJ

 A hot topic in The Prostate Storm ... and in the Wall Street Journal this month:

Men with prostate cancer being over-treated (this time with high-dose radiation) and urologists colluding for financial gain ... oh my, could this really be true?  Are the reimbursements Medicare pays out as more Boomers move through their prostate years just too fat to pass up? Apparently...and it could bankrupt the system.

What happened to "do no harm first"?

Here's a couple excerpts from the Wall Street Journal, "A Device to Kill Cancer, Lift Revenue," on December 7, 2010.

"Roughly one in three Medicare beneficiaries diagnosed with prostate cancer today gets a sophisticated form of radiation therapy called IMRT. Eight years ago, virtually no patients received the treatment.

"The story behind the sharp rise in the use of IMRT—which stands for intensity-modulated radiation therapy—is about more than just the rapid adoption of a new medical technology. It's also about financial incentives...."

That's the lead ... later in the story:

"More than 190,000 American men are diagnosed with prostate cancer each year. How—and even whether—to treat the disease has long been controversial because prostate cancer tends to grow slowly. Many victims are more likely to die from other causes.

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