At the first ever Active Surveillance Convention, a conference I attended back in 2007, many experts openly bemoaned that the word “CANCER” profoundly overstates the significance of Gleason 6 type of prostate cancer. The pathologists at the conference, however, shot down the idea of a name change saying, “Under the microscope it looks like a cancer, so it is cancer.” No one at the conference had    a rebuttal so the proposal for a name change was dropped.

Interpreting a Pathology Report By Jonathan Epstein, MD | Johns Hopkins University

Patients should personally review their pathology report; the expert description of the information obtained from the needle biopsy. In this article, Dr. Epstein answers 15 common questions about understanding a pathology report.

"This video is intended for the wives, husbands, partners and loved ones of men who may be at risk of having prostate cancer or who have been diagnosed with the cancer. Our aim is to help you help him navigate through what can be a complicated, confusing and anxiety ridden time.

"If you are looking about information about Prostate cancer for yourself or someone you love, you are going to encounter the Gleason Score. OK so what is it? At it’s simplest the Gleason score is a measure of how aggressive or nonaggressive a prostate cancer tumor is. 

This summary is from the 2015 Prostate Cancer Conference where in his lecture, Matthew Cooperberg, MD, spoke on Active Surveillance. Dr. Cooperberghas has been invited to present his research findings at many national and international conferences. 

In 2013, the American actress Angelina Jolie made a life-altering decision that fascinated the public and made the cover of Time magazine [1].  Based upon her family history and a genetic blood test for the BRCA1 gene, she was counseled that she had an 87% chance of developing breast cancer.  This led to her decision to undergo a preventive double mastectomy.  The Time article was titled “The Angelina Effect” and focused on the power of genomic medicine to guide clinical decision making.  A family history can be considered part of “clinical information” and would certainly increase the odds of developing breast cancer, but only the genomic test increased those odds such that a preventive procedure became a reasonable strategy.

New prostate cancer drugs come to market quite rarely because the studies mandated by the FDA cost hundreds of millions of dollars. The FDA requires these studies to randomly allocate men into two comparison groups. One group receives the new medicine being tested. The other group gets an ineffective fake, called a placebo. Assuming the study is performed in an acceptable manner, the FDA will approve a new drug for commercial use, only if the men who are receiving the new medicine outlive those treated with the placebo by a specified margin without excessive toxicity.

Studies designed to evaluate the effectiveness of surgery for prostate cancer take a long time to perform because prostate cancer grows much slower than other cancers.  Since it is primarily in older men, mortality from unrelated causes—other cancers, heart disease and simply old age—frequently occurs before the prostate cancer progresses enough to impair health. 

Selecting a treatment for prostate cancer is increasingly complex. In an effort to help my prostate cancer patients navigate the complexities of this process, I routinely frame the discussion around these three rules:

Rule #1: If you listen to enough people you will hear just about anything.