April 22, 2008, 9:40 PM CT

Protein that helps predict prostate cancer survival

An Oregon Health & Science University Cancer Institute researcher has identified a protein that is a strong indicator of survival for men with advanced prostate cancer. The C-reactive protein, also known as CRP, is a special type of protein produced by the liver that is elevated in the presence of inflammation.

"This could mean that a simple blood test that is already available could help in clinical decision making and patient counseling. Patients and doctors would know better what to expect from the prostate cancer they are facing," said Tomasz Beer, M.D., director of the Prostate Cancer Research Program at the OHSU Cancer Institute, associate professor of medicine (hematology/medical oncology), OHSU School of Medicine.

Beer's research will be published online in the journal Cancer on Monday, April 21.

Past research has shown that cancer causes an inflammatory response. This research also suggests that inflammation may play an important role in driving prostate cancer progression and resistance to treatment. Inflammatory cells are attracted to cancer sites and this local inflammation can lead to a release of inflammatory markers, like CRP.

"While inflammation may sometimes slow the progression of the cancer, an increasing body of evidence suggests that cancer can actually take advantage of the inflammatory response, and the reaction of the immune system may fuel cancer progression. To the extent that our hypothesis proves true, C-reactive protein may be reflecting the overall intensity of the inflammation," Beer said......... Posted by: Mark      Read more         Source

April 13, 2008, 8:56 PM CT

Exercise may lead to faster prostate tumor growth

Prostate tumors grew more quickly in mice who exercised than in those who did not, leading to speculation that exercise may increase blood flow to tumors, as per a new study by scientists in the Duke Comprehensive Cancer Center (DCCC) and the Duke Prostate Center.

Our study showed that exercise led to significantly greater tumor growth than a more sedentary lifestyle did, in this mouse model, said Lee Jones, Ph.D., a researcher in the DCCC and senior investigator on this study. Our thought is that we may, in the future, be able to use this finding to design better drug delivery models to more effectively treat patients with prostate cancer, and those with other types of cancer as well.

The findings were presented in a poster session at the American Association for Cancer Research annual meeting on April 13 in San Diego, Calif. The study was funded by the United States Department of Defense, the Prostate Cancer Foundation and the American Urological Association Foundation, Rising Star in Urology Award, given to Stephen Freedland, one of the studys investigators.

The scientists implanted prostate tumors subcutaneously in the flanks of 50 mice and then put half of the mice in cages with exercise wheels and half in cages with no wheels. All mice were fed the same diet. On average, the exercising mice ran more than half a mile each day......... Posted by: Mark      Read more         Source

January 30, 2008, 9:20 PM CT

Links between prostate cancer, cadmium, and zinc

Cadmium exposure is a known risk factor for prostate cancer, and a new University of Rochester study suggests that zinc may offer protection against cadmium.

In an article reported in the February 2008 journal, The Prostate, epidemiologist Edwin van Wijngaarden, Ph.D., reports that PSA levels were 22 percent higher among American men who had zinc levels below the median (less than 12.67 mg/daily) and cadmium levels above the median. (PSA is a protein produced by the cells of the prostate gland. The higher a mans PSA level, the more likely cancer is present.) .

In contrast, among men with a greater than median zinc intake, little evidence of an association between cadmium and PSA was found.

The way zinc and cadmium interact within human organs is significant and provides interesting leads for study, van Wijngaarden said. Zinc stimulates production of a protein that binds cadmium thereby taking it out of circulation and reducing its toxic effects.

However, it is too early to recommend zinc supplements for those whore worried about prostate damage, he added.

Your health is based on the complex interplay of a number of factors, said Van Wijngaarden, an assistant professor in the Department of Community and Preventive Medicine at the University of Rochester Medical Center. Environmental exposures play out differently in people. Its important to identify those subpopulations that may be more sensitive to toxicities......... Posted by: Mark      Read more         Source

January 21, 2008, 7:59 PM CT

Pros, cons of drug to prevent prostate cancer

Findings by UT Southwestern Medical Center scientists encourage men to weigh both the potential benefits and side effects of the drug finasteride before taking it to prevent prostate cancer.

In todays online issue of Cancer, UT Southwestern doctors analyzed data gathered by the National Cancer Institutes Prostate Cancer Prevention Trial, or PCPT. The trial, which began in October 1993, was designed to test whether finasteride could prevent prostate cancer in men 55 years of age and older. It was stopped early in June 2003 when an analysis showed that finasteride reduced the risk of developing prostate cancer by 25 percent.

UT Southwesterns analysis of the PCPT data indicates that cost effectiveness and quality of life issues linked to taking the drug are not clear cut, said Dr. Yair Lotan, assistant professor of urology and the Cancer studys senior author. The PCPT data show that in addition to preventing prostate cancer, finasteride also reduces urinary-tract symptoms linked to non-malignant prostatic hyperplasia. It also decreased sexual desire and caused impotence in 5 percent of the trial participants. Some PCPT participants who did develop prostate cancer also had high-grade tumors, eventhough there is ongoing debate whether this result might have been due to sampling bias......... Posted by: Mark      Read more         Source

November 13, 2007, 10:03 PM CT

A low-carb diet may stunt prostate tumor growth

A diet low in carbohydrates may help stunt the growth of prostate tumors, as per a new study led by Duke Prostate Center researchers. The study, in mice, suggests that a reduction in insulin production possibly caused by fewer carbohydrates may stall tumor growth.

This study showed that cutting carbohydrates may slow tumor growth, at least in mice, said Stephen Freedland, M.D., a urologist at Duke University Medical Center and lead researcher on the study. If this is ultimately confirmed in human clinical trials, it has huge implications for prostate cancer treatment through something that all of us can control, our diets.

Freedland conducted most of the research for this study while doing a fellowship in urology at Johns Hopkins Brady Urological Institute under the tutelage of William Isaacs, Ph.D., a molecular geneticist there.

The scientists published their results on November 13, 2007 in the online edition of the journal Prostate. The study was funded by the Department of Veterans Affairs, the Department of Surgery and the Division of Urology at Duke University Medical Center, the Prostate Cancer Foundation, and the Department of Defense Prostate Cancer Research Program.

The scientists hypothesized that since serum insulin and a related substance known as insulin-like growth factor (IGF) had been linked with the growth of prostate tumors in earlier research in mice, a reduction in the bodys levels of these substances might slow tumor growth, Freedland said......... Posted by: Mark      Read more         Source

October 29, 2007, 10:33 PM CT

Can statins make radiation more effective?

Prostate cancer patients who receive high-dose radiation therapy and also take statin drugs usually used to lower cholesterol have a 10 percent higher chance of being cured of their cancer at 10 years after diagnosis (76 percent), in comparison to those who dont take these medications (66 percent), as per a research studypresented at a scientific session October 31, 2007, at the American Society for Therapeutic Radiology and Oncologys 49th Annual Meeting in Los Angeles.

The study demonstrated that the greatest benefit of statin medications was observed in patients who had more aggressive or advanced forms of prostate cancer. The research also showed that men who took statins during high-dose radiation treatment had a lower rate of the cancer spreading to distant parts of the body.

We were, indeed, surprised by the findings that statins used by these patients for other conditions was shown to improve the effectiveness of radiation therapy in killing prostate cancer cells, said Michael J. Zelefsky, M.D., the senior author of the study and a radiation oncologist at Memorial Sloan-Kettering Cancer Center in New York. The use of statins during radiation may also be effective in the therapy of other types of cancer. However, more studies are necessary to explore the association between statins and radiation therapy in curing cancers......... Posted by: Mark      Read more         Source

October 29, 2007, 10:18 PM CT

Radiation seeds effectively cure prostate cancer

Radiation seed implants (brachytherapy) are just as effective at curing prostate cancer in younger men (aged 60 and younger) as they are in older men, as per a research studypresented at a scientific session on October 31, 2007, at the American Society for Therapeutic Radiology and Oncologys 49th Annual Meeting in Los Angeles.

Brachytherapy is a minimally invasive procedure where a radiation oncologist places small radioactive seeds into the prostate in order to kill the cancer cells. It is an attractive therapy option for prostate cancer patients because it has a much shorter recovery time than surgery and studies have shown brachytherapy to be just as effective as surgery. However, surgeons have commonly advised younger men to undergo surgery to remove all or part of the prostate (prostatectomy) over other therapys like seed implants because they believed younger men could physically tolerate surgery, plus they believed surgery was more effective than brachytherapy at curing prostate cancer long term. This meant that a number of younger men would undergo surgery without ever learning about other therapy options, like brachytherapy or external beam radiation treatment.

These results suggest that brachytherapy is extremely effective in curing localized prostate cancer for men aged 60 and younger. When younger men are diagnosed with localized prostate cancer, they should be presented with all viable therapy options, including brachytherapy, said Alice Ho, M.D., the lead author of the study and a radiation oncologist at Memorial Sloan-Kettering Cancer Center in New York. Every man with prostate cancer, regardless of his age, should have access to the therapy that is best for his cancer and lifestyle......... Posted by: Mark      Read more         Source

October 28, 2007, 2:01 PM CT

Walking prevents bone loss caused from prostate cancer treatment

Exercise may reduce, and even reverse, bone loss caused by hormone and radiation therapies used in the therapy of localized prostate cancer, thereby decreasing the potential risk of bone fractures and improving quality of life for these men, as per a research studypresented on October 28, 2007, at the American Society for Therapeutic Radiology and Oncologys 49th Annual Meeting in Los Angeles.

Patients with prostate cancer are not routinely advised to exercise. Walking is one tool that patients with prostate cancer can use to improve their health and minimize the side effects of cancer and cancer therapys, said Paula Chiplis, PhD., RN, the lead author of the study and a clinical instructor and senior research assistant at Johns Hopkins Hospital in Baltimore. Walking has no harmful side effects, if done moderately, but it can dramatically improve life for men suffering from side effects from some prostate cancer therapys.

Men with localized prostate cancer frequently receive radiation treatment followed by months of hormone treatment to treat their cancer. Radiation is used to kill the cancer cells, while hormone treatment decreases testosterone and estrogen that feed the cancer cells, thereby keeping the tumor from growing. Men undergoing hormone treatment lose between 4 to 13 percent of their bone density on an annual basis, in comparison to healthy men who lose between.5 to 1 percent per year, beginning in middle age. Men are typically not believed to be at risk for osteoporosis and bone fractures; however, their rate of bone loss is greater than that of post-menopausal women......... Posted by: Mark      Read more         Source

October 28, 2007, 1:57 PM CT

Image Guided radiation therapy for prostate cancer

Oregon Health & Science University Cancer Institute scientists have observed that highly targeted radiation treatment for prostate cancer can ensure that the majority of persons with this tumor will not have any long-term rectal damage.

A group of 231 study participants received a combination of intensity-modulated radiation and seed marker-based image-guided radiation therapies (IM-IGRT) for prostate cancer then were tracked for 1.4 years. Nearly 98 percent of these participants had no rectal damage, as per Todd Scarbrough, M.D., principal investigator, associate professor, radiation medicine, OHSU School of Medicine; and an OHSU Cancer Institute member. This combination allows for millimeter targeting accuracy of the tumor.

If these outcomes hold over time and the results can be reproduced by others, then this combination of radiation therapies for prostate cancer will yield some of the lowest toxicity rates of any definitive therapys for prostate cancer. This would be the therapy for prostate cancer. A patient could cruise through therapy with no side effects, explained Scarbrough who also serves as director of the MIMA Cancer Center, Melbourne, Fla.

A poster of this study will be presented Monday, Oct. 28, at the 2007 annual American Society of Therapeutic Radiology and Oncology (ASTRO) meeting in Los Angeles......... Posted by: Janet      Read more         Source

October 11, 2007, 10:29 PM CT

Why some prostate cancer recurs after treatment

Cancer scientists have long worked to understand why some prostate cancers recur after the use of therapies designed to stop the production of testosterone and other androgens that fuel cancer cell growth. New research has now detected that androgen-synthesizing proteins are present within cancer cells, which suggests that cancer cells may develop the capacity to produce their own androgens.

The presence of these proteins may explain why some prostate cancers become resistant to these widely-used therapies, and offers new directions for research into future therapys that could block the development of androgens in the cancer cells. The study, funded by the Prostate Cancer Foundation and the National Cancer Institute, was presented today at the Foundations annual Scientific Retreat.

Androgen-deprivation treatment is routinely used in the therapy of advanced (metastatic) prostate cancer, in order to deprive cancer cells of these hormones that fuel their growth. However, over time cancer cells can become androgen independent, and grow even in the presence of these medications. This type of the cancer is a lethal form of the disease, with most patients dying 18 to 24 months after becoming resistant to hormone suppression. Research in the field has focused on understanding the mechanisms used by these cancer cells to become castration resistant......... Posted by: Mark      Read more         Source

October 10, 2007, 5:10 AM CT

Prostate cancer more likely to return in blacks

African-American men are more likely to have their prostate cancer return after therapy, but their disease is no more aggressive when it does recur than that of their white counterparts, as per a research studyled by Duke Prostate Center researchers.

Our study observed that African-American men have a slightly higher risk of what is known as PSA recurrence, which is a blood test that indicates the presence of cancer based on the levels of a certain biomarker known as prostate-specific antigen, said Stephen Freedland, M.D., a urologist at Duke and senior researcher on the study. We were encouraged, however, to see that their disease is not necessarily more aggressive than that of white men, once it has recurred.

African-American men tend to have higher PSA levels at initial diagnosis of prostate cancer, as well, despite being diagnosed at younger ages. This suggests that there may be an underlying genetic and biologic component that predisposes African-American men to prostate disease, Freedland said, highlighting the need for black men to have prostate screening early and often.

The team's findings would be reported in the November 15, 2007 print edition of the journal Cancer, but also appeared early in the journals September 17, 2007 online edition. The study was funded by the U.S. Department of Defense, the Prostate Cancer Research Program, the Department of Veterans Affairs, the National Institutes of Health, the Georgia Cancer Coalition and the American Urological Association Foundation......... Posted by: Mark      Read more         Source

September 17, 2007, 10:35 PM CT

Does black men have more aggressive prostate cancer?

A University of Minnesota study of prostate cancer tumors from Caucasian and African-American men has shown no evidence that the cancer is more aggressive in black men. Lead investigator Akhouri Sinha, a professor of genetics, cell biology, and development and research scientist at the Minneapolis VA Medical Center, said the belief that black mens tumors are more aggressive is based on studies that failed to match patients properly and used only indirect means to measure tumor aggressiveness. The work will be published in Anticancer Research Sept. 21 (vol. 27, issue 5A, pp. 3135-3142).

In prior studies of prostate tumors, those in black patients tended to be larger and at a more advanced stage, and black men had higher blood levels of prostate specific antigen (PSA), a substance produced by the prostate that, at high levels, points to the possibility of prostate cancer. But all these criteria are interrelated and could be the result of delayed diagnosis or medical care, Sinha said.

Prior studies showing differences in prostate cancers among races require re-evaluation because inconsistent criteria were used in selection of patients, he said. Our data shows that for patients receiving similar therapy, African-American patients are not following up with their doctors as opposed to Caucasians, and this difference is highly significant. Also, Caucasian patients are four times as likely to receive additional therapy after prostatectomy. Cancer does not discriminate on the basis of race, religion, national origin, or caste system, like people do. Invasiveness of prostate cancer is not race-dependent......... Posted by: Mark      Read more         Source

August 28, 2007, 9:26 PM CT

More prostate cancer screening has little effect

More prostate cancers were detected among men who were screened every two years than men screened every four years, as per a research studypublished online August 28 in the Journal of the National Cancer Institute But the shorter time between screenings did not reduce the number of aggressive cancers found between the scheduled screening tests.

Since the introduction of PSA (prostate specific antigen) testing in the late 1980s, the occurence rate of prostate cancer has risen dramatically. The rise is mainly due to widespread screening of asymptomatic men. Screening for prostate cancer is a controversial issue because evidence is lacking that PSA screening prevents prostate cancer deaths. Looking at the rate of interval cancerscancers diagnosed based on symptoms during the years between screening testsmay give an indication of how well a screening program is working.

Monique Roobol, Ph.D., of Erasmus Medical Centre in Rotterdam, The Netherlands, and his colleagues conducted a study to determine whether the time between PSA screenings influenced the occurence rate of prostate cancer. They analyzed data collected at two European medical centers that participated in the European Randomized Study of Screening for Prostate Cancer. At a center in Gothenburg, Sweden, 4,202 men were screened every two years, and in Rotterdam, The Netherlands, 13,301 men were screened every four years. The scientists compared both the number and characteristics of the interval prostate cancers diagnosed in these men. Serious, potentially life threatening interval cancers were analyzed separately......... Posted by: Mark      Read more         Source

August 15, 2007, 6:08 AM CT

First biomarker for prostate cancer outcome

Mayo Clinic scientists have identified the first immune molecule that appears to play a role in prostate cancer development and in predicting cancer recurrence and progression after surgery. The report on the B7-H3 molecule by Mayo Clinic Cancer Center appears today in Cancer Research.

This discovery will allow physicians to individualize therapy and observation plans for patients with prostate cancer, says Timothy Roth, M.D., a Mayo Clinic urology resident and lead author of the study. Being able to tell a patient his specific risk after surgery, and perhaps even previous to surgery, will be a huge step forward.

Until now there were no strongly-predictive molecules for prostate cancer. The most notable other prostate biomarkers, prostate-specific antigen (PSA), and prostate-specific membrane antigen (PSMA) are useful to diagnose prostate cancer. However, PSA tends to leave prostate cancer cells and migrate throughout the body, making it a poor target for treatment.



Todays Research

In this study, Mayo scientists demonstrate that nearly all normal, pre-cancerous and malignant prostate cells have B7-H3 on their surface. Unlike PSA, B7-H3 stays attached to the surface of prostate cancer cells and does not appear to migrate, thus making B7-H3 a especially attractive target for treatment. The scientists think that B7-H3 kills or paralyzes immune cells that are trying to attack the cancer. Their findings indicate that B7-H3 may prove useful as a diagnostic, prognostic and even therapeutic tool because it is stably or increasingly displayed by tumor cells as prostate cancers develop -- even after initiation of anti-hormone treatment, which is the most common therapy for advanced prostate cancer......... Posted by: Mark      Read more         Source

July 25, 2007, 5:19 AM CT

Success rates for prostate cancer depend on experience of surgeon

Surgeons performing operations to remove patients prostate glandsthe primary therapy for prostate cancergo through a steep learning curve, as per a research studypublished online July 24 in the Journal of the National Cancer Institute As the surgeons gain more experience performing the operation, called a radical prostatectomy, the chance that patients prostate cancer will reoccur goes down.

The idea that more experienced surgeons perform more successful surgeries is a widely held belief. But there have been few data to support this idea, and it has not been previously shown whether a surgeons experience makes a large or small difference on their patients outcome.

Andrew Vickers, Ph.D., of Memorial Sloan-Kettering Cancer Center in New York and his colleagues analyzed data from 72 surgeons at four institutions and 7,765 of their patients with prostate cancer treated with radical prostatectomies between 1987 and 2003. They measured surgeons experience by the number of times they had performed the procedure before each operation.

More surgical experience was linked to a greater likelihood that the patients cancer would not return after their operation. The learning curve for this procedure was very steepthere was dramatic improvement in patient outcomes as surgeons experience increased up to 250 operations, after which increasing experience had little influence on cancer recurrence. Patients treated by inexperienced surgeons (for example, those with 10 previous operations) were nearly 70% more likely to have evidence of recurrence of their prostate cancer within five years than those whose surgeons had performed 250 operations (17.9% vs. 10.7%)......... Posted by: Mark      Read more         Source

June 5, 2007, 0:12 AM CT

African-American men understimate risk of prostate cancer

A number of African-American men radically underestimate the likelihood that having a needle biopsy for suspected prostate cancer will result in a cancer diagnosis, as per a research studyfrom the University of Chicago Medical Center.

The researchers, who presented their results at the American Society of Clinical Oncology annual meeting in Chicago, say this is alarming. African-American men have a higher incidence rate, are diagnosed later, and have a higher mortality rate from prostate cancer than Caucasians.

"A group that underestimates the risk of having cancer is likely to underestimate the value of early detection and thus skip the whole process," said study author William Dale, MD, PhD, assistant professor of medicine/geriatrics at the University of Chicago, "which may explain, in part, why African-American men are so often diagnosed later and thus have worse outcomes".

Dale and his colleagues collected data on what 243 patients expected from their biopsies and their anxiety levels while waiting in a urology clinic. The average age of these patients was 63. Almost 40 percent of the men were African-American. Fifty-six percent had at least a college education level.

Despite being referred for biopsy because they were known to be at increased risk for prostate cancer, commonly due to a blood test, 55 percent of the African-American men at the time of prostate biopsy said they had a zero percent chance of having prostate cancer (i.e. that it was impossible). Only 20 percent of the Caucasian men said this......... Posted by: Mark      Read more         Source

May 17, 2007, 5:21 AM CT

No magic tomato? No benefit to prostate cancer prevention

Tomatoes might be nutritious and tasty, but dont count on them to prevent prostate cancer. In the recent issue of Cancer Epidemiology, Biomarkers & Prevention, scientists based at the National Cancer Institute and Fred Hutchinson Cancer Research Center report that lycopene, an antioxidant predominately found in tomatoes, does not effectively prevent prostate cancer. In fact, the scientists noted an association between beta-carotene, an antioxidant correlation to lycopene, and an increased risk for aggressive prostate cancer.

As per the researchers, the study is one of the largest to evaluate the role of blood concentrations of lycopene and other carotenoid antioxidants in preventing prostate cancer. Study data were derived from over 28,000 men enrolled in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, an ongoing, randomized National Cancer Institute trial to evaluate cancer screening methods and to investigate early markers of cancer.

"It is disappointing, since lycopene might have offered a simple and inexpensive way to lower prostate cancer risk for men concerned about this common disease," said Ulrike Peters, Ph.D., M.P.H., of the Fred Hutchinson Cancer Research Center. "Unfortunately, this easy answer just does not work."

Prior studies suggested that a diet rich in lycopene protected against prostate cancer, spurring commercial and public interest in the antioxidant. Antioxidants protect against free radicals, highly reactive atoms and molecules that can damage DNA and other important molecules in the cell. Since free radical damage increases with age, there has been a long-held suspicion in the scientific community that free radical damage could increase the risk of prostate cancer, a disease that has been clearly linked to age......... Posted by: Mark      Read more         Source

April 23, 2007, 5:19 PM CT

Prostate Cancer Treatments Impact On Quality Of Life

A rigorous, long-term study of quality of life in patients who underwent one of the three most common therapys for prostate cancer observed that each affected men's lives in different ways. The findings provide invaluable information for men with prostate cancer who are facing vital therapy decisions.

Scientists studied quality of life in men who either underwent radical prostatectomy, implantation of radioactive seeds in their prostate gland or had external beam radiation treatment. The three therapy options rank about equally in survival outcomes for most men, so specific impacts on quality of life become paramount in making therapy decisions, said Dr. Mark Litwin, the study's lead author and a researcher at UCLA's Jonsson Cancer Center.

"The good news is that overall mental and physical well-being were not profoundly affected by any of the three therapy choices," Litwin said. "That's good news for men with the sword of prostate cancer hanging over their heads. In general, they'll be OK no matter which of the three options they choose".

However, each of the three options did negatively affect quality of life, at least temporarily, with problems ranging from erectile dysfunction and minor incontinence to urinary and bowel irritation.

The study tracked 580 men for five years. The study results, reported in the June 1, 2007 issue of the peer-evaluated journal CANCER, represent data from the first two years of the study. Those years, Litwin said, are when most of the negative impacts surface and resolve......... Posted by: Mark      Read more         Source

March 29, 2007, 4:38 AM CT

Biopsy for prostate cancer in obese men

Obese and overweight men who are diagnosed with prostate cancer by biopsy are more likely than healthy weight men to actually have a more aggressive case of the disease than the biopsy results would indicate, as per a research studyled by a Duke University Medical Center researcher.

The finding suggests that misleading biopsy results may be causing a number of obese and overweight men to receive inadequate or inappropriate therapy that is not aggressive enough to combat the true nature of their disease, said study leader Stephen Freedland, M.D., an assistant professor in the Division of Urology and the Duke Prostate Center.

"We already know that it's more difficult to diagnose prostate cancer in obese men because they have lower levels of prostate-specific antigen, or PSA, a common blood marker for prostate cancer, and because their larger-sized prostates make it more likely for a biopsy to miss the cancer," he said. "These findings further suggest that we could be missing even more high-grade disease among obese men".

Gaining a better understanding of links between biopsies and prostate cancer also may help physicians improve patient therapy, said Freedland, who also holds an appointment in surgery at the Durham Veterans Affairs Medical Center.

"If we can determine through additional biopsies that an obese or overweight man has more aggressive prostate cancer, we can discuss whether the cancer should be treated with more than one approach, such as combining hormonal treatment with radiation, to reduce the risk of the cancer spreading and improve the chances of cure," Freedland said. "We must also keep in mind that even if a well-done biopsy shows low-grade cancer in an obese patient, there is still a reasonable likelihood that the patient may have high-grade disease."........ Posted by: Mark      Read more         Source