Posts Tagged ‘prostate cancer treatment’

Takeaways from the Prostate Cancer Live Chat at Winship

prostate-chat-cil638Thanks to everyone who joined us Tuesday, November 24th for the live online prostate cancer program chat at Winship Cancer Institute of Emory University hosted by Drs. Pattaras & Rossi.

Drs. Pattaras & Rossi answered several of your questions about prostate cancer risk factors, symptoms and therapy. Check out the conversation by viewing the chat transcript! Here are just a few follow up questions we didn’t get to from the chat:

Question: What preventive measures are most effective for improving urinary function and quality of life?

Answer: Preventative measures include exercise, weight loss and a healthy low fat diet. Unfortunately there are genetic predispositions for prostate enlargement and bladder dysfunction including spinal disorders that even prevention will not help. See a urologist if there is a noticeable change in urination.

Question: Conventional wisdom is that if you have prostate cancer you should no take testosterone. Dr. Abraham Morgantaler has written a number of articles in JAMA and NEJM challenging that conventional wisdom. Are doctors Pattaras and Rossi familiar with his research, and if so, any thoughts?

Answer: Though specifically not familiar with his publications there are numerous studies which suggest that men with low testosterone could be supplemented to normal levels if watched carefully. Testosterone itself does not cause prostate cancer but can feed advanced cases. Chemical castration is a therapy for advanced prostate cancer but is not done for localized treated cancer so testosterone supplementation is feasible but does have risks. We have placed men on testosterone replacement after therapy as long as they are compliant.

If you missed this chat, be sure to check out the full list of questions and answers on the web transcript. For more information go to the Prostate Cancer at Winship Cancer Institute website or 404-778-7777 to learn more from a registered nurse.

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If you have additional questions for Drs. Pattaras & Rossi, feel free to leave a comment in our comments area below.

Prostate Cancer: Risk Factors, Screenings, Symptoms & Therapy Live Chat on November 24th

prostate-chatAccording to the American Cancer Society (ACS), about 1 man in 7 will be diagnosed with prostate cancer during his lifetime. If detected early and depending on the type and stage of the disease, prostate cancer can be treated.

Join John G. Pattaras, MD and Peter Rossi, MD, two physicians with Winship Cancer Institute of Emory University’s prostate cancer team, on Tuesday, November 24th at 12pm EST for a live chat where they will answer your questions about prostate cancer risk factors, screenings, symptoms and therapy. All are welcome to attend an online open-forum discussion about prostate cancer with Dr. Pattaras and Dr. Rossi. Sign up for this live chat here.

Chat Sign Up

Prostate Cancer: Is Active Surveillance an Option?

guys (1)For many years, most men with prostate cancer were given the option of either surgery or radiation. Over time, doctors saw many men had prostate cancer that was less aggressive and unlikely to spread to other parts of the body or shorten lifespan. Doctors were also learning that many of these men were experiencing the downsides of prostate cancer treatment (e.g. difficulty with erections, leakage of urine) without benefit.

In response to “over treatment”, some centers offered men with low-risk prostate cancer prognosis were enrolled in a clinical trial of “active surveillance”. After 15 years of follow-up, half of the patients were able to avoid prostate cancer treatment. Today, these studies—with nearly 20 years follow-up—show excellent results of active surveillance for low-risk prostate cancer.

Men with low prostate-specific antigen (PSA) test results, low-grade tumors, and minimal abnormalities on the prostate exam are considered for the newer protocols. Active surveillance programs usually involve repeat biopsies every one to two years and PSA tests every three to six months. Treatment is recommended if the patient is found to have higher-risk disease.

It is difficult to hear a cancer diagnosis and then be presented with surveillance as an option to avoid treatment. Yet, cancer patients can trust that active surveillance is a process that can delay or avoid cancer treatment side effects with rare risk of death from prostate cancer. Newer technologies, like multiparametric magnetic-resonance imaging and molecular biomarkers, may identify more prostate cancer patients who would benefit from active surveillance.

In the end, among selected patients on active surveillance, death or progression of cancer is rare. There is no evidence that prostate cancer patients who undergo delayed prostate cancer treatment fare worse than those treated immediately. In fact, they avoid the side effects of cancer treatment over that time. If newly diagnosed with prostate cancer, active surveillance may be an option worth discussing with your urologist or radiation oncologist.

Additional Resource:
The Prostate Cancer Support Group meets the 1st Wednesday of every month from 11:00 AM – 12:30 PM at the Clifton Campus. If you’re interested in further details visit: https://winshipcancer.emory.edu/about-us/events/

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PSA Screening for Prostate Cancer – A Healthy Debate
Questions on Validity of PSA Test as Prostate Cancer Screening Tool
Prostate Cancer, To Screen or Not?
Winship’s Approach to Prostate Cancer Treatment

About Dr. Filson

filsonChristopher Filson, MD, MS, is an assistant professor of urology at Emory University School of Medicine. Dr. Filson started practicing with Emory Healthcare in July 2015. His main clinical specialties include robotic surgery, laparoscopic surgery, cystectomy, urinary diversion, prostatectomy and nephrectomy. Dr. Filson received his Medical Degree from University of Michigan in Ann Arbor MI. His postdoctoral training included a surgery internship and urology residency also at University of Michigan and a Fellowship in Urologic Oncology at University of California Los Angeles.

New Tests to Improve Decision Making in Prostate Cancer Treatment

This blog was originally posted June 3, 2015 AACR Press Office.

Prostate Cancer Cells

Prostate Cancer Cells

A diagnosis of prostate cancer can often result in difficult choices for both patients and physicians. Prostate cancer is the most common non-skin cancer diagnosed in American men, with over 200,000 diagnosed cases and almost 28,000 deaths per year. A major reason why prostate cancer is diagnosed so frequently is that the FDA-approved blood test for prostate-specific antigen (PSA) is widely used and is highly sensitive. However, the PSA test cannot distinguish prostate cancers that are aggressive from indolent cases that will not spread if left untreated.

It has been estimated that about 50 percent of men who are diagnosed with prostate cancer as a result of PSA testing would remain asymptomatic if left untreated. Furthermore, the side effects of surgery or radiation therapy can be significant, and include urinary incontinence and sexual dysfunction. These side effects from overtreatment without clear survival benefit led the U.S. Preventive Services Task Force (USPSTF) to recommend against PSA screening. As a result, there is a pressing clinical need for new prostate cancer biomarkers that can discriminate aggressive from indolent disease to prevent overtreatment of indolent cases and undertreatment of aggressive cases. This is one example of how precision medicine can both improve cancer care and reduce overall health care expenditures.

While single biomarkers can be useful, quite often using a panel of many genes is more robust, predictive, and informative than a single biomarker such as PSA. Moreover, RNA is generally much easier to detect and quantitate than protein, even at low amounts, and RNA-based assays can test many targets simultaneously. RNA-based approaches to prostate cancer biomarker discovery include the analysis of which genes are switched on and off in a cancer cell, as well as measurement of previously unappreciated RNAs that do not code for proteins, and detection of known genetic mutations.

Biopsies themselves carry some risk of infection, discomfort, and expense. Consequently, less invasive biomarkers that can use blood or urine samples are more desirable, and likely to be adopted more broadly, resulting in better patient compliance and follow up. Many researchers are thus looking for prostate cancer biomarkers that can be readily measured from biofluid specimens.

There are several different clinical questions that new biofluid biomarkers for prostate cancer could potentially address. First, if I have a high PSA, do I really need a biopsy? Second, if my biopsy looks indolent, am I a good candidate for active surveillance, or do I really need surgery or radiation? And third, if I do need surgery or radiation, will it be curative, or should I think about enrolling in clinical trials? These are all important questions that many scientists and physicians are currently pursuing in their biomarker research.

Recent research in our lab has identified a gene panel that can predict whether a patient is likely to have a recurrence after surgery, and we are currently working on determining if this panel can also identify good candidates for active surveillance. This research is using advanced sequencing technologies on both urine and biopsy samples, and could make it easier for patients and their doctors to safely decide that surgery or radiation are unnecessary, reducing side effects and unnecessary treatments. A number of other commercially available panels are already in use including Prolaris, Oncotype Dx, and Decipher, though none are currently FDA approved. Hopefully, with additional research to determine the best biomarkers of cancer aggressiveness and approval of such tests, patients and physicians can be confident in the treatment decisions that they make, leading to the best possible health outcomes.

About Dr. Moreno

carolos moreno, phdCarlos S. Moreno, PhD, is an associate professor in the Departments of Pathology & Laboratory Medicine, and Biomedical Informatics at the Emory University School of Medicine. He is a member of the Cancer Genetics and Epigenetics research program at Winship Cancer Institute. Moreno specializes in cancer bioinformatics and systems biology, cancer genomics, cancer biomarkers, and transcriptional networks. He is the informatics project leader for the Emory Molecular Interaction Center for Functional genomics (MicFG) as part of the Cancer Target Discovery and Development (CTD²) Network to identify protein-protein interaction networks.

Moreno has been a member of the American Association for Cancer Research since 2003 and received an AACR Minority Scholar Award in 2006.

Related Resources

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

New Treatment for Prostate Cancer: Saint Joseph’s Hospital First in State to Treat Patient with Xofigo

Xofigo new prostate cancer treatment medicationA double bass player in the Atlanta Symphony Orchestra, Doug Sommer claims he was just “in the right place at the right time with the right doctors,” when he was offered the opportunity to be the first in the state to receive a new treatment option for his prostate cancer.

Doug is the first patient in Georgia to receive a new FDA-approved radioactive therapeutic drug for advanced metastatic prostate cancer. He received the treatment, a single injection of radium Ra 223 dichloride, (brand name Xofigo) at Saint Joseph’s Hospital. This was the first of six injections. Xofigo has been shown to reduce bone pain and improve quality of life.

“Patients with a type of cancer called castration-resistant prostate cancer (CRPC) with metastatic bone disease, who have failed hormone suppression therapy, now have a new treatment option for their disease.”

Peter Rossi, MD, medical director of radiation oncology at Saint Joseph’s Hospital and assistant professor of radiation oncology at Emory University School of Medicine & Winship Cancer Institute

Read more about this new treatment for prostate cancer on the Saint Joseph’s Hospital blog >>