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October 11, 2007, 10:29 PM CT

Why some prostate cancer recurs after treatment

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.........

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October 10, 2007, 5:10 AM CT

Prostate cancer more likely to return in blacks

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.........

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September 17, 2007, 10:35 PM CT

Does black men have more aggressive prostate cancer?

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.........

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August 28, 2007, 9:26 PM CT

More prostate cancer screening has little effect

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.........

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August 15, 2007, 6:08 AM CT

First biomarker for prostate cancer outcome

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.........

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July 25, 2007, 5:19 AM CT

Success rates for prostate cancer depend on experience of surgeon

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%).........

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June 5, 2007, 0:12 AM CT

African-American men understimate risk of prostate cancer

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.........

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May 17, 2007, 5:21 AM CT

No magic tomato? No benefit to prostate cancer prevention

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.........

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April 23, 2007, 5:19 PM CT

Prostate Cancer Treatments Impact On Quality Of Life

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.........

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March 29, 2007, 4:38 AM CT

Biopsy for prostate cancer in obese men

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."........

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Prostate cancer
The prostate is located just below the bladder and in front of the rectum in male. The tube that carries urine runs through the prostate. The prostate contains cells that make some of the seminal fluid. This fluid protects and nourishes the sperm. Prostate cancer usually starts in the gland cells of the prostate. This kind of cancer is known as adenocarcinoma. Prostate cancer is usually a slow disease, but sometimes it can grow fast and spread quickly to other organs. Archives of prostate-cancer-blog

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