Surgery and radiation are the most commonly administered prostate cancer treatments. There are many factors to consider before making a treatment choice. Every man’s prostate cancer case is different, so the same treatment(s) can lead to different outcomes, especially when it comes to side effects. Often, men undergo surgery or radiation (or both) without being...

SpaceOAR is a new rectal protection product for men with prostate cancer undergoing radiation therapy. SpaceOAR reduces the risk of rectal toxicity, also known as radiation enteropathy, a potential side effect of radiation that can be permanent after radiation..

Per the NCCN guidelines, the treatment options for High-Risk prostate cancer are surgery, beam radiation, or a combination of beam radiation plus radioactive seeds. Hormonal therapy (with Lupron for example) is usually given along with the radiation for two to three years. But patients certainly wonder if one of these three treatment options is better than the other two. A study published recently in the October 2016 issue New England Journal of Medicine compared surgery and beam radiation prospectively in men with mostly Low-Risk prostate cancer. It showed equivalent survival rates. A prospective study for High-Risk prostate cancer, however, is unavailable. Only retrospective studies are available.

AUA is an annual meeting of urologists where data from new studies are presented. This data is presented in abstracts, or summaries of the entire peer reviewed articles. In this article, Mark Scholz, MD, analyzes the data and explains the practical implications of these new studies.

In this blog PCRI presents an interview from our contributing partner, Prostatepedia. 

Prostatepedia spoke at length with Dr. Laurence Klotz about why testosterone levels are significant in prostate cancer. Dr. Laurence Klotz is an esteemed Urological Oncologist from the University of Toronto. He is one of the driving forces behind the development of active surveillance as a viable approach for men with slow-growing, non-aggressive prostate cancer. Here is the interview:

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.

While at Pete’s Coffee to write my bi-monthly blog I ran into another regular who occasionally hangs out at Pete’s. Vandana is a professor at Loyola University.  She is an expert in the psychology of learning.  While we were talking I started to bemoan my struggles to educate people about prostate cancer. One of the biggest bugaboos I face is how people overestimate their grasp of the prostate cancer situation. Once I verbalized my complaint, Vandana immediately proposed I create a basic test of prostate cancer knowledge so men could self-assess their level of knowledge.  Thanks Vandana!

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.