News
PSA Screening cuts cancer deaths by 29%
March 28th, 2012
The European Randomized Study of Screening for Prostate Cancer (ERSPC) reports that PSA screening reduced the risk of dying from prostate cancer by 29%. The ERSPC is the world’s largest prostate cancer screening study involving 182,160 men between the ages of 50 and 74 years of age at entry, followed men for 11 years randomly assigned to PSA screening or no screening.
Tracking PSA Velocity
February 24th, 2012
A new study of 18,214 men screened with PSA confirmed prior data that a PSA rise more than 0.4 ng/ml in consecutive years portends a greater than 8 times risk of prostate cancer and a fivefold greater risk of aggressive disease. Senior author William Catalona, MD states that ” a persistently rising PSA is a harbinger for life-threatening prostate cancer”.
Incontinence and ED after Radical Prostatectomy
January 25th, 2012
A new study just published by Michael Barry of Harvard Medical School and the Massachusetts General Hospital in the Journal of Clinical Oncology reports that radical prostatectomy carries a high risk of post-op adverse effects, most notably incontinence and erectile dysfunction. He surveyed 685 patients who had radical prostatectomies, 406 robotically and 220 open surgeries. Dr. Barry reports that “men should not expect fewer adverse effects following robotic prostatectomy”. The incidence of incontinence and ED were about the same with slightly more problems among patients having robotic surgeries. This is just one more study demonstrating that better results claimed by robotic prostatectomies may be overstated.
PSA Screening Controversy Continues
October 10th, 2011
Screening for prostate cancer has again made the news largely because the new chief medical officer of the American Cancer Society, Dr. Otis Brawly interprets the data as not showing enough benefit for screening. A few personal observations and opinions on the subject: Read more…
Delay of Surgery in Low Risk Prostate Cancer
May 17th, 2011
The June 2011 Journal of Urology has published the findings of Catalona, et al, which report a significantly worse outcome when radical prostatectomy is delayed 6 months or more even among patients diagnosed with clinical low risk (D’Amico criteria) prostate cancer. They found more pathologic upgrading and a higher rate of biochemical progression after delay.
Stress May Play a Role in Treatment Outcomes with Prostate Cancer
May 3rd, 2011
Researchers from the MD Anderson Cancer Center in Houston studied the effect of stress management on patients immune system function in prostate cancer. Men facing treatment decisions for prostate cancer experience profound stress no matter how well they appear to manage it outwardly. The results of this study showed that men who learned stress management had evidence of better immune system function 48 hours after surgery compared to controls.
Higher Local Recurrence Seen with Cryoablation of Kidney Cancer
May 2nd, 2011
A study presented at the ACS meeting showed a higher primary treatment failure rate with cryoablation (freezing) of renal cell cancer as opposed to surgical excision. Tumor persistence/recurrence was observed in 1.7% of patients who underwent a partial nephrectomy compared to 7.8% after cryoablation. The study concluded that “Open partial nephrectomy is the gold-standard treatment for small renal masses…”
Family Likelihood of Prostate Cancer
May 1st, 2011
Prostate cancer incidence within families, referred to as familial prostate cancer, has been increasingly studied. Most prostate cancer occurs sporadically, however observation of prostate cancer clustering within families has led to the study of how certain genes may be the cause in these families. About 25% of all prostate cancers are considered familial based on evidence of a genetic component. Only about 5% of all prostate cancers have strong genetic factors and these cases are referred to as hereditary prostate cancer. Hereditary prostate cancer (HPC) refers to a family with three generations affected, or three first-degree relatives affected, or two relatives affected before age 55. HPC is marked by a pattern consistent with passage of a susceptibility gene via Mendelian inheritance. Early age at diagnosis is a recognized marker of genetic susceptibility for hereditary cancers.
The consensus from expert panels is that men with a family history of prostate cancer should consider PSA testing and digital rectal examination at age 40 years or 10 years younger than the youngest prostate cancer case in a family.
PSA Screening Reduces Prostate Cancer Mortality
April 29th, 2011
Dr. William Catalona recently reports that PSA screening reduces prostate cancer mortality. In the U.S. there has been a 75% reduction in metastatic disease at diagnosis and a 40% decrease in the age adjusted prostate cancer mortality rate during the PSA era. That equates to more than 22,000 fewer men die of prostate cancer each year than in 1992. Dr. Catalona was instrumental in PSA clinical research and in the FDA approval of PSA for prostate cancer screening.
Mayo Clinic Study Favorable to TURP
November 19th, 2010
The Mayo Clinic recently presented the results of a 17 year followup study on the various treatments of BPH at their institution including medical therapy, laser procedures and traditional TURP. The lead investigator of the study, Amy E. Krambeck, M.D., reported that TURP (transurethral resection of the prostate) showed the greatest improvement in both voiding symptoms and incontinence compared with other treatment groups.