Smoking linked to more aggressive prostate cancer

Smokers, if you're sweating lung cancer or heart disease or stroke, put prostate cancer on your list of diseases now stalking you.  The bad news...

• If smoking when diagnosed with prostate cancer, you're 61% more likely to die from it than a nonsmoker
• Smoking might directly affect the aggressiveness of cancer
• Smokers are 61% more likely to experience a recurrence of prostate cancer after treatment
• Men who smoked a pack a day for 40 years (or the equivalent of two packs over 20 years) were 82% more likely to die of prostate cancer than non-smokers
• Even former smokers who kicked the habit are more likely to succomb to PC than nonsmokers.

This from a new study, published in the Journal of American Medical Association, that

Prevention: Coffee, green tea lower risk of prostate cancer

Men who regularly drink coffee – caffeinated or decaf – are significantly less likely to develop prostate cancer.  And the more java, the better.

According to a Harvard study published online on May 17 in The Journal of the National Cancer Institute, Harvard scientists followed 47,911 men who periodically described their coffee intake. The researchers found that those who consumed six or more cups a day were almost 20 percent less likely to develop prostate cancer over two decades than those who drank none. The study was part of the Health Professionals Follow-Up Study.

Controversy? FDA warns hair loss, BPH meds increase prostate cancer risk. Or not...

The FDA now warns that Proscar, Propecia, Avodart and Jalyn increase the risk of high-grade prostate cancer. But not every expert agrees, including the chief medical officer of the American Cancer Society.

Bloomberg reports: Merck and GlaxoSmithKline Plc (GSK)’s drugs for hair loss and enlarged prostate will carry new U.S. warnings about a low risk of being diagnosed with a more serious form of prostate cancer.

Study: Little evidence radiation is superior to watchful waiting for "early prostate cancer"

If you're in the throes of making a treatment decision on prostate cancer, the choices can seem bewildering.  Radiation (and all the different flavors), surgery (robotic and open), and watchful waiting -- what to do?  You don't want to risk your life, on the other hand, if you don't need an aggressive treatment, why risk the collateral damage, i.e. incontinence and ED? I'm posting the following story by HealthDay, because it's worthwhile reading if you're weighing those risks.  The article Jury Still Out on Radiation for Early Prostate Cancer cites a new Tufts University study funded by the Agency for Healthcare Research and Quality that says there's little evidence radiation is more likely to save your life than watchful waiting, if you have early prostate cancer.  I'm assuming "early prostate cancer" means the low-grade (Gleason 6 and under), nonlethal, slow-growing variety, although it's not clear. The Tufts study is yet another reminder that treatment for low-grade prostate cancer still has the medical experts baffled.  Best advice: Do your homework, consider all your options, talk to multiple physicians, and don't rush into a decision.

In another article this week from Reuters Health, Prostate Cancer: Is it safe to skip radiation?, a review of many recent studies reveals there is no clear picture of what works best for the majority of men when comparing different radiation treatments.  Interestingly, last year a research group in the article found that among 466 patients who chose active surveillance rather than immediate treatment, those with tumors at intermediate risk for progression fared as well as men with low-risk prostate cancer over four years.  Granted, most of us are looking for no cancer beyond four years, but it's an interesting comparison and something to keep in mind ... especially if you have a Gleason of 6 or under.

Prostate Cancer Survival Rates Up Dramatically with Exercise

Run, walk, bike, sweat a little — if you’re a guy treated for prostate cancer, you can reduce your risk of the cancer reoccurring by over 60% with three hours a week of vigorous exercise compared to men who got less than one hour per week of vigorous exercise.     These findings came from the Health Professionals Follow-Up Study, of 2705 men observed every two years over 18 years. "Vigorous" simply means "a very brisk pace" — in other words, work up a sweat for 30 minutes a day, six days a week.       For anyone who has gone through surgery or radiation and all that anxiety about how things are gonna turn out, a little exercise every day is a small price to pay (and a cheap insurance policy). Why the positive outcomes from all that exercise?  The study's authors suggest physical activity might influence cancer survival by modulating insulin activity and inflammation and/or by altering the immune system's behavior. More research is required, according to an article in The Washington Post.

'Magic Mushroom' Prevents Prostate Cancer - New Study with Mice

This is no joke.  What would you think if researchers stumbled onto a compound that (a) cured existing prostate cancer 100% of the time, (b) prevented the development of prostate cancer, (c) produced no side effects, and (d) could be found in huge quantities in mushrooms that grew in forests all over the world?

Turkey Tail mushrooms grow on  bark

Wow is right. A cure.

Well, mice ain't people, and more study is warranted ... but this one is worth keeping an eye on. So here are some facts:

Incredible new research out of Australia last month has shown that a compound called polysaccharopeptide (PSP), which comes from a type of mushroom called "Turkey Tail," is 100 percent effective at targeting prostate cancer stem cells and suppressing tumor formation in mice. The research, which has been published in the online journal PLoS ONE, represents the first to show that a natural substance is totally and completely effective in every single trial, according to an article in NaturalNews.com (June 1, 2011).

Survivor Story posted on Prostate.net

Photo credit to my son Nick

Last month, Craig Cooper, the founder of Prostate.net contacted me, wondering if I'd like to contribute my story to his Survivor series.

Today, that story got posted -- and it's all great, I'm thrilled to get the message out to Craig's readers, and I thank him for helping putting it all together.

Prostate.net is fantastic site and has a huge presence on Facebook.  It's filled with great information for anyone with prostate disease, those recently diagnosed with cancer and wondering what's next, or guys looking for a smarter approach to prostate health and healthy living. 

My thanks, again, to Prostate.net and Craig for sharing the stories and information that hopefully will help others.

Second Edition Just Released!

NEW EBOOKS ... I just updated The Prostate Storm with new studies, research and post-treatment experiences — now available in multiple ebook formats:  PDF, Sony Reader, Kindle, RTF, Plain Text (viewable as web page), and Epub for Stanza Reader and iPads.  Only $5.95 ... with a portion of proceeds going to Zero—The Project to End Prostate Cancer. Once you buy an ebook on Smashwords, you are entitled to download future updated versions FOR FREE!

NEW PAPERBACK edition ... Now available on Amazon (and Kindle version).  Take a "Look Inside" now....

My goal with all proceeds is to support researchers who are looking for a better screen that will discern between lethal and nonlethal prostate cancer. The hope is that this better screen will help men with lower-grade prostate cancer (and their advising doctors) make smarter treatment decisions ... thereby, reducing the risk of collateral damage (i.e., incontinence, impotence and rectal issues) from treatment ... and also reducing unnecessary biopsies.

A better screen is desperately needed -- and an important step toward a cure!

Prostate Cancer Statistics

Boomer guys are in the crosshairs of a prostate cancer explosion.  The number of new cases and deaths of prostate cancer is expected to increase dramatically over the next decade as baby boomer men age into the target zone for prostate cancer. If there is no change in prevention or treatment strategies, by 2015, there will be approximately 3 million men battling prostate cancer. If there are no better treatments or a cure for prostate cancer, by 2015, 45,000 men will die from the disease each year.

A man is 35% more likely to develop prostate cancer than a woman is to develop breast cancer.

Rockers Who Took On Prostate Cancer

I get more hits on my blog entry, Famous Guys with Prostate Cancer, than all the other serious stuff about PC overtreatment,  unnecessary biopsies, lethal vs nonlethal PC, recurrence anxiety, exercise and prostate health, the alarming PC money tree, and so on....

Zappa

No, most people wanna know whose famous prostate went to hell just like theirs.  Why the fascination?  I suppose, we find a new and real way to relate to those icons we grew up, strange as it is.

As a runner, for instance, when I read Bill Rogers had PC and survived, no I can't relate to him breaking the tape four times in the NY marathon, or dropping the field on Heartbreak Hill to win four Bostons — but I sure can relate to "Boston Billy" running down prostate cancer, his probable peeing problems, biopsies, catheters, PSA anxiety, and all the other fun stuff. 

...Stills

I'm not a rock star but I love rock music — I'm a boomer, grown up on Zappa, CSNY, Grateful Dead, Dan Fogelberg. These guys or bands all got rocked by PC, and for some odd reason, especially for me with Stephen Stills, who laid the soundtrack on my wonderfully misguided youth ... surviving it with the guy who ripped Sweet Judy Blue Eyes makes me feel a tad better.

Me and Stephen. PC survivor sympatico. 

Then there's cranky Frank Zappa, music weirdness legend, founder of The Mothers of Invention ... some of these stony songs followed me for 40 years to my iPod. 

In looking for famous rockers with PC, I came across this interview on The Today Show with  Zappa, talking about the surprise of PC and testing back in 1992 ... and worth dropping in here:

"Well," the iconic innovator said, "I think it’s worthwhile being examined to find out whether or not you got it but on the other hand I had urinary problems over a period of years and was examined and they didn’t find it, and so that’s why it came as such a shock to me that I had it, because I had urinary problems for years…you can imagine how irate a person might be when informed, 'yeah, you got it but we can’t operate on it' ... so yeah, go have a a test but get another test, have a few tests....”

...Lesh

Zappa was quietly pissed at how things were turning out; recall that the PSA test had only been around a few years by 1990, and testing wasn't as widespread as it is today. To Zappa's anguish, PC ended up not being an old man's disease after all. He died in 1993, three years after being diagnosed. He was 52.

Grateful Dead bassist and composer Phil Lesh underwent successful prostate cancer surgery in 2006.

...Fogelberg

Singer/songwriter Dan Fogelberg, part of the “soft rock” movement of the 1970s, wasn't as lucky, and apparently had an aggressive strain of prostate cancer like Zappa.  He died from it in 2007, at 56.   

The following day, Crosby, Stills and Nash band member Graham Nash mentioned in a Larry King interview that his 62-year-old bandmate Stephen Stills had been diagnosed with PC and was planning to seek treatment. Stills underwent surgery for prostate cancer in 2008.

How 'bout Johnny Ramone—guitarist for The Ramones? He died of PC, at age 55, in 2004.  

So, what do rock stars have to do with prostate cancer?  Nothing at all, really.  Except we (the freshly diagnosed and/or curious survivors) seem to like to know about the famous who share our diseases, all the better and more relate-able if they riffed on our life's soundtrack back in the day ....

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.

The Lure of the Robot

Robotic surgery is the preferred choice of men today to pluck out there cancerous prostates.  But is it any better than traditional surgery?  Is the promise of fewer side effects living up to the hype?  Is there a financial incentive for physicians and providers to recommend the robot? 

From New York Times, March 11, 2011 ... "Hospitals With Robots Do More Prostate Cancer Surgery"

"Hospitals that buy surgical robots end up performing more prostate cancer operations, suggesting that technology has become a driving force behind decisions about men’s cancer care, new research shows..."

But is it better than any other treatment or doing nothing at all?  There's no evidence to say one way or the other....  

"But," the article continues, "that hasn’t stopped hospitals from conducting intense marketing campaigns that imply surgery using the high-tech robot gives prostate cancer patients a better result."

Ben Org, author of All About The Prostate, put a finer point on the issue and financial incentives in the general promotion of robotic surgery, when he wrote in the following email.... 

"Follow the money. From 2001-06, use of the da Vinci system — the only robot available for this operation — rose from one per cent to 40 per cent of all radical prostatectomies. During that time, the stock price of da Vinci’s maker, Sunnyvale, California-based Intuitive Surgical Inc., increased 11-fold.

A PROSTATE CANCER MONEY TREE

Reposted here from Wall Street Journal, December 2010.  It's worth a second look because the whole idea behind the story is so outrageous, i.e. financial gain is driving overtreatment (with new forms of radiation) of prostate cancer patients ... and it's so easy because Medicare is paying the tab.

A Device to Kill Cancer, Lift Revenue
By John Carreyrou and Maurice Tamman

"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...."