Posts Tagged ‘prostate cancer screening’

Takeaways from Dr. Sanda’s Chat on Prostate Cancer

Thank you for attending the live chat with Dr. Martin Sanda on prostate cancer. (Link to: ) Your questions and participation were terrific. Below are additional Q&As that we didn’t have time to get to during the live chat portion.

As you know, prostate cancer is the second most common cancer in men, second only to skin cancers. Emory Healthcare is privileged to partner with you in your health and is ready and able to assist if needed. Please use the resources on this page and this website to contact us if we can help in any way.

Question: What are today’s best prostate cancer diagnosis methodologies?
Answer: Despite a lot of advances in imaging tests such as MRI or higher-resolution ultrasound, there is still a need to biopsy the prostate in order to determine whether or not prostate cancer is present. The biopsy provides important information, not only as to whether there are cancer cells, but if so, how aggressive or how fast-growing those cancer cells appear to be. Bone scans and CT scans are useful to look for spread of prostate cancer elsewhere. Also, new PET (positron emission tomography) scans or other diagnostic studies that image molecules which are taken up by cancerous tissue and not by normal tissue are emerging. But, their role in standard care is not yet sorted out. MRI can provide valuable information about the size and configuration of tumors in the prostate itself and the immediate vicinity, as part of a watchful waiting monitoring plan, or as a guide for treatment planning.

Question: What are the dangers of conventional biopsy?
Answer: The main risk of prostate cancer biopsy is infection, which can be seen in approximately one out of 50 to one out of 100 cases and can require hospitalization for treatment. More commonly, some men may feel faint after a biopsy and should plan on taking the day off or taking it easy if they undergo a prostate biopsy procedure. Rarely, men might experience bleeding from where the needle is inserted into the prostate and this, too, can require hospitalization. Common after prostate biopsy is having blood in the semen or ejaculate; however, this does not pose any danger or risks and will typically resolve in a matter of a few weeks.

Question: Are there new drugs and and prostate cancer treatments on the near horizon?
Answer: Major scientific discoveries have taken place over the past five to 10 years and many more are underway. This has led to a half-dozen new treatments for advanced prostate cancer that have become available in the past several years. A broad range of new treatments are being developed, including more refined types of hormonal therapy, including immune therapies or therapeutic vaccines and also targeted therapies that are aimed at molecular differences between the cancer cell and normal tissue.

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About Dr. Martin Sanda

Dr. Martin SandaMartin G. Sanda, MD, an internationally recognized prostate cancer surgeon and scientist, was appointed chair of the Department of Urology at Emory University School of Medicine and service chief for Emory Healthcare. He also serves as director of the Prostate Cancer Center, which will be established within Emory’s Winship Cancer Institute.

Sanda joins Emory from Harvard Medical School, where he was professor of surgery in urology, and from Beth Israel Deaconess Medical Center, where he served as director of the Prostate Cancer Center. He was also the co-leader of the Prostate Cancer Program at the Dana Farber Cancer Center.

 

Though Common, Prostate Cancer is Often Very Treatable – Join Our Q&A Chat for Details

Prostate Cancer Q&A ChatDid you know that prostate cancer is the second most common cancer experienced by men, after skin cancer? The good news is that, when caught early, it can often be treated with great success.

Millions of men are living today as survivors of prostate cancer. Being armed with good information in advance is a key ingredient in protecting yourself or your loved ones from this disease.

Join Emory Chairman of the Department of Urology, Dr. Martin Sanda, on Tuesday, September 24, for an online web chat to discuss “Prostate Cancer.”

Prostate Cancer Chat Sign Up

A More Precise Blood Test Outperforms PSA Screening in Detecting Aggressive Prostate Cancers

Martin Sanda, MDMartin Sanda, MD, a member of the Winship Cancer Institute, chairman of the Emory Department of Urology and internationally recognized prostate cancer scientist, recently delivered big news about better prostate cancer diagnosis, at the American Urological Association’s 2013 Annual Meeting.

As corresponding and presenting author of the abstract “Prostate Health Index (phi) for Reducing Overdetection of Indolent Prostate Cancer and Unnecessary Biopsy While Improving Detection of Aggressive Cancers,” Sanda presented findings that represent a significant step towards better detection and diagnosing of fast-growing prostate cancers, and fewer unnecessary biopsies of indolent cancers.

The Prostate Health Index (phi), a blood test used to evaluate the probability of prostate cancer diagnosis, outperformed commonly used prostate-specific antigen (PSA) and free/total prostate-specific antigen (%fPSA) tests in predicting the presence of clinically significant prostate cancer and in improving prostate cancer detection, according to the new study. The phi test focuses on measuring a subtype of PSA, called pro-PSA, that unlike the rudimentary total PSA, is preferentially made by aggressive prostate cancers and less so by normal prostate or slow-growing cancers. Sanda and his collaborators found that among men being considered for prostate biopsy due to abnormal results on the traditional “total” PSA test, one in four had phi test results that indicated no aggressive cancer would be found and unnecessary biopsy could be averted.

To learn more about this exciting new screening test, read the full story in the Emory News Center. For more prostate cancer and PSA screening related articles, check out our related resources at the end of this post.

About Martin Sanda, MD

Martin G. Sanda, MD is chair of the Department of Urology at Emory University School of Medicine and Urology service chief for Emory Healthcare. Before joining Emory in 2013, Sanda was Professor of Surgery in Urology at Harvard Medical School, Director of the Prostate Cancer Center at Beth Israel Deaconess Medical Center and co-leader of the Prostate Cancer Program at the Dana Farber Cancer Center.

As a urological surgeon specializing in cancers of the prostate and bladder, Sanda focuses on developing new surgical and non-surgical approaches to cancer care and to improving the quality of life among cancer survivors.  Currently, he is spearheading studies that seek to develop urine tests for detecting prostate cancer; develop benchmarks for improving quality of life among cancer survivors; and develop innovative prostate cancer vaccines.

Sanda has served as chair of the Prostate and Genito-Urinary Collaborative Group of the National Cancer Institute’s Early Detection Research Network (2007-2010), has led two nationwide, NCI Cooperative Group prostate cancer clinical trials, and has served on the Research Council of the American Urological Association since 2011.  Dr. Sanda will also serve as Director of the Prostate Cancer Center, being established within the Winship Cancer Institute of Emory University.

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Questions on Validity of PSA Test as Prostate Cancer Screening Tool?

Prostate Cancer PSA ScreeningViraj Master, MD Prostate cancer is the second leading cause of cancer death among American men.  Nearly 250,000 men will be diagnosed with prostate cancer this year.  More than 32,000 men will die from prostate cancer this year.  In Georgia, 7,360 men will be diagnosed and 1,080 will die.  With statistics like that, we want every advantage possible in our fight with this disease.

Since the early 1990s, the Prostate Specific Antigen (PSA) test has been the primary screening tool used to detect prostate cancer. The PSA is a simple blood test, non-invasive and easy to administer and process.  The US Preventive Services Task Force has recently recommended, however, that the PSA test no longer be offered to men as a screening tool.

This task force is a federally funded independent panel of experts in prevention and evidence-based medicine.  It is comprised of primary care providers such as internists, family practitioners and pediatricians, but not oncologists or urologists.  Their job is to evaluate the benefits of preventive services like screening and make recommendations about which services should be routinely incorporated into primary medical care.

Screening, or early detection, for prostate cancer is a complicated issue.  Unlike the colonoscopy, which provides clear evidence of early detection and has been determined to have saved lives in multiple studies, the PSA test has been contradictory, with some studies showing a benefit, while others did not.  There are many reasons, including the fact that most forms of prostate cancer are relatively slow-growing cancers.  Generally, a man with prostate cancer may live for many years without ever having the cancer discovered.  In fact, many men with prostate cancer will not die from it, but with it.  In addition, high or increasing levels of PSA can indicate an increased risk for prostate cancer, but can also indicate an infection or an enlarged prostate.  So, the USPSTF determined that because of these uncertainties, the risk of over treatment is greater than the benefit, and their recommendation states that PSA tests should no longer be offered as a screening tool.

The biggest issue in prostate cancer that confronts patients, their families and their healthcare providers is to delink screening with treatment.  Not all forms of prostate cancer require active therapeutic interventions, but some do.

While the PSA test is imperfect, it is – at this time – the best tool we have at our disposal for early detection of prostate cancer.  The Winship Cancer Institute of Emory University aligns with the American Urological Association, the American Cancer Society, American College of Physicians and the American College of Preventive Medicine and recommends informed decision-making.  Our recommendation is that men at average risk should receive information, including a PSA test if they want it, at an appropriate middle age, although African American men or men with a family history of prostate cancer should receive information at an earlier age, such as 40, or 45 years.

So, what do we mean when we say “informed decision-making”?  This means that doctors should discuss the potential benefits and harms of PSA screening with their patients and consider their patients’ preferences, overall health, and family history when making decisions regarding screening with a PSA test.

Unfortunately, there is no easy answer.  Each patient comes to us with his own distinctive characteristics, and those characteristics must be taken into consideration when deciding whether to have the PSA test.

About Dr. Viraj Master
Dr. Master specializes in the treatment of adrenal cancer, bladder cancer, kidney cancer, prostate cancer, testicular cancer. He is also an expert in laparoscopic surgery. Dr. Master received his Medical Degree in the University of Chicago in Chicago, Illinois, in 1997. He completed his Internship at University of California, San Francisco in 1999, where he also completed his Fellowship in 2003.