chicagoprostatefoundation.org

Task force rethinks guidelines: recommends men age 55-69 resume prostate cancer screening, with physician input

 

A reversal of 2012 U.S. Preventative Services Task Force (USPSTF) recommendations— that had called for all men to forego prostate cancer screening— was released this week.

Two- tiered recommendations

USPSTF now suggests men age 55 to 69 should resume discussions of prostate cancer screening with their physician.  Screening would include men who do not have any signs or symptoms of prostate cancer.  USPSTF reversed its recommendations  based on new research that demonstrated a negative impact of their 2012 advice against routine PSA blood testing.

The task force furthermore advises men who have reached age 70 should discontinue screening for prostate cancer, rather than age 75 as previously recommended.  USPSTF cites “moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”

Risk groups

According to USPSTF, revised recommendations apply to men in each age group, whether they are at an average risk for prostate cancer, and even men at increased risk, such as African Americans and men with a family history of prostate cancer. USPSTF states there are not enough data to make a different recommendation, even though decision models strongly suggest that African American men have more to gain by screening and may also benefit by starting earlier than the age of 55.

PCFC recommendations

Prostate Cancer Foundation of Chicago (PCFC) champions early detection and concurs in large part with the direction of these recent recommendations.  Yet, we support that men generally begin receiving annual screening at age 50, which is 5 years earlier than recommended by USPSTF.   For men at increased risk for prostate cancer, we recommend screening beginning at age 40, or 15 years earlier than USPSTF advises.

Add DRE for greater detection power

Unlike USPSTF, PCFC also promotes prostate cancer screening that further includes digital rectal examination (DRE).   DRE fell out of favor when many physicians stopped offering their patients routine screening.  In combination with PSA, DRE can uncover abnormalities associated with prostate cancer, even with a normal PSA level.

New evidence of benefits for men age 55 to 69

The USPSTF had previously suggested that PSA testing could lead to unnecessary biopsies and treatment of insignificant cancers.  Task force member Alex H. Krist, MD, MPH, in an interview stated, “There is new evidence to suggest that there is slightly more benefit to screening than we thought before in 2012.  The important thing that we are trying to emphasize is that there is a real close balance between benefits and harms,” he said, but the balance has been tipped slightly toward benefit for the age group aged 55 to 69.”

Less screening led to higher grade tumors when detected

Several studies— and the outcry from many urologists and prostate cancer patients— lead USPSTF to reconsider discouraging men from receiving PSA screening.  Quoting K. Fleshner in Nature Reviews Urology , “Since the 2012 recommendation, rates of PSA screening decreased by 3–10% in all age groups and across most geographical regions of the USA.  Rates of prostate biopsy and prostate cancer incidence have declined in unison, with a shift towards tumours being of higher grade and stage upon detection.”

Results of the European Randomized Study of Screening for Prostate Cancer, demonstrated that slightly more men who are screened would not die from prostate cancer than was the case previously (in 2012).  Also from the European trial, longer-term follow-up shows that three men out of 1000 will avoid advanced prostate cancer because of screening.

Genomic testing of tumors informs treatment decisions

A discussion of a possible limitation of prostate cancer screening points to the difficulty of knowing which cancers will be more likely to advance beyond the prostate.  If a man is found to have a prostate tumor, genomic testing is now available for physicians to understand more about the aggressiveness of a patient’s cancer cells and help men make better prostate cancer treatment decisions.

Education is key

Like the USPSTF, PCFC advocates patient education and shared decision making between doctor and patient.  Discussions of the pros and cons of screening, and available treatment options, will continue to be important for men to have with their family and their physician.

For more information on prostate cancer and screening, contact PCFC at 630-654-2515 or visit the PCFC website.    Prostate Cancer Foundation of Chicago advances patient education, by offering free prostate cancer screening and hosting an Informational Patient Support Group.

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Brachytherapy improves outcomes in men age 60 and younger with prostate cancer

Comparing 8-year survival with LDR brachtherapy (BRT) or with external beam radiation (EBRT)

Life saving advantages of low-dose rate brachytherapy, or seed implant, were demonstrated in a recent study that compared seed implant to external beam radiation treatment (EBRT) eight years after treatment.

Better survival with LDR Brachytherapy

Men who were treated with low-dose rate brachytherapy at ages 60 years and younger survived at twice the rate when compared to men treated with external beam radiation treatment (EBRT) alone.

Men in higher risk groups also benefit

Even for men in subgroups associated with greater mortality risk— high Gleason score, black race, higher Tumor (T) stage and grade— LDR brachytherapy still demonstrated significantly reduced death rate.  Conducted by researchers at New York-Presbyterian Brooklyn Methodist Hospital and Weill Cornell Medicine, the study emphasizes the importance of brachytherapy for men considering a treatment option that provides excellent outcomes.

Read the full article.

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Knowledge is Power

It is thought that Sir Francis Bacon was the first to assert that “knowledge is power.”  At Prostate Cancer Foundation of Chicago (PCFC), we agree that the more you know about prostate cancer and its treatment options, the better you will be able to understand, discuss, and take control of your own health outcome.   

Virtual Support

Not quite ready to join a support group to learn more about coping with prostate cancer?  HealingWell.com is a website that offers educational resources and ‘virtual’ peer support through anonymous patient forums.  The website, launched in 1996, has more than 150,000 community members, over 20,000 newsletter subscribers, and over 175,000 social media followers, for a comprehensive list of diseases, including prostate cancer.  The HealingWell.com prostate cancer forum began in 2006 and has over 28,000 threads on a wide variety of subtopics related to prostate cancer.  The forum’s  ‘read-me-first’ thread is an especially useful starting point for men newly diagnosed with prostate cancer and their caregivers.   

Talk with a prostate cancer survivor

Would you prefer a more low-technology way to converse from someone having first-hand knowledge of prostate cancer?  PCFC can provide you with telephone contact information of a volunteer patient willing to talk about prostate cancer with other men recently diagnosed with prostate cancer who are considering their treatment options. 

Prostate Cancer Foundation of Chicago: Patient Support Group

But if you seek support and information in an informal group setting, PCFC Patient Support Group will be here for you.  Monthly meetings, held at Chicago Prostate Cancer Center, 815 Pasquinelli Dr., Westmont, IL, include survivors, new patients, caregivers, and anyone interested in learning more about prostate cancer and treatment.  A recent PCFC blog cited a study which suggested that, for some men, face-to-face support group attendance could begin with participation in web-based patient support forums.  Several participants of PCFC’s Patient Support Group started learning about prostate cancer through HealingWell.com and other online resources such as the PCFC website, to maintain their anonymity while gathering initial information.

Access HealingWell.com

HealingWell.com forums require free registration to post or chat, but are open to all for browsing.  See HealingWell.com or Prostate Cancer Foundation of Chicago websites for more information, such as the PCFC Patient Support Group meeting schedule.   And as always, check with your doctor before following advice you receive on a website, forum or other resource. 

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African American men may benefit less from hormone therapy added to brachtherapy

Prostate Cancer Foundation of Chicago recently published a study in the journal Cancer in collaboration with Harvard Radiation Oncology Program and Dana-Farber Cancer Institute.  The study assessed the impact of race on the risk of death from all causes and from prostate cancer alone among men actively treated for favorable-risk prostate cancer.

To make prostate cancers shrink or grow more slowly, androgen-suppression hormone therapy (ADT) is often added to brachytherapy radiation therapy as the standard of care for men with intermediate- and high-risk prostate cancer.   Intermediate-risk prostate cancer can be further classified as favorable- or unfavorable-risk disease

African Americans are more likely to be affected by concurrent chronic diseases— diabetes, coronary artery disease, previous myocardial infarction or congestive heart failure—which may interact with hormone therapy and reduce its benefits.  This new research demonstrates that adding hormone therapy to treatment received by African American men for favorable intermediate risk prostate cancer is actually associated with shortened survival, when compared to non-African Americans with the same stage prostate cancer.

These findings will help physicians determine whether to add hormone therapy to radiation therapy for their African American patients, possibly reserving hormone therapy for cases of higher risk prostate cancers.  Read more about the study, Race and mortality risk after radiation therapy in men treated with or without androgen-suppression therapy for favorable-risk prostate cancer.  Further information on prostate cancer risk and detection includes special recommendations for African American men and is available at Prostate Cancer Foundation of Chicago’s educational infographic, The Importance of Prostate Cancer Screening.

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Real Friends Encourage Prostate Cancer Screening

Who convinced me to get screened?

“Originally my wife saw the Prostate Cancer Foundation of Chicago (PCFC) Screening Event in the local paper.  Now I am glad I receive your email reminder.  How can you go wrong? Screening is quick, easy and free!

I know there are pros and cons about the PSA test, that alone it is not 100%.  But since this screening adds the physical examination (DRE), men get more of the facts we need each year.  Some say screening for prostate cancer that might be slow growing is not important, but I am glad to have all the information possible to treat it early and effectively.”    Arnie S.

 

james-l

“I knew about Prostate Cancer Awareness Month and Chicago Prostate Cancer Center through my involvement on the Westmont Park District Board.  One of our longtime leaders was vacationing in Michigan and made several attempts to contact me so I could take the screening time slot he couldn’t keep.  It’s nice when your colleagues watch out for you!”  James L.

 

A third Screening Event participant shared how he turned the loss of a friend into an important life-giving ritual.  According to Martin L., “I had a friend die of colon cancer 17 years ago and it made me start thinking about cancer awareness and prevention.  When I first heard about your prostate cancer screening event on the radio, I decided it was time to act.  Really glad Prostate Cancer Foundation of Chicago and Chicago Prostate Cancer Center provide this screening event every year; I wouldn’t miss it.”

 

PCFC and CPCC thank these three forthcoming participants in the 2016 Free Prostate Screening Event for sharing their motivation for screening.

In observation of National Prostate Cancer Awareness Month the event provided 60 men with PSA blood test, digital rectal examination (DRE) , and consultation.  Contact nonprofit Prostate Cancer Foundation of Chicago at 630-654-2515 to arrange prostate cancer screening.  To learn  more about—or donate in support of—  screening and other PCFC services, please call or click Patient Support Group, Corporate and Community Wellness, research and educational programs.

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National Prostate Cancer Awareness Month: Presidential Proclamation 2016

The White House

Office of the Press Secretary

For Immediate Release   September 01, 2016

Presidential Proclamation — National Prostate Cancer Awareness Month, 2016

NATIONAL PROSTATE CANCER AWARENESS MONTH, 2016
– – – – – – –
BY THE PRESIDENT OF THE UNITED STATES OF AMERICA
A PROCLAMATION

Prostate cancer is one of the leading causes of cancer-related death in American men, and too many men and their families feel the pain and grief it brings. As a country, we must do everything in our power to support men who are battling prostate cancer, deliver the care and treatment they need, and defeat this devastating disease. A cancer-free future is within our grasp — with bold vision and daring optimism, we are pioneering medical breakthroughs in research and seeking to discover a cure for cancer in our time. During National Prostate Cancer Awareness Month, we remember all the men who lost their lives to this disease, and resolve to reach a tomorrow where prostate cancer is no longer a threat to our sons and grandsons.

In 2016, approximately 180,000 men will be diagnosed, and 26,000 men will lose their battle with prostate cancer. Incredible advancements have paved the way for better prevention, detection, and treatment of this disease, and over the past two decades, the incidence of new cases and mortality rates for prostate cancer have been steadily declining. Men who are African American, over the age of 65, or have a family history of prostate cancer are at higher risk and should be aware of risk factors and symptoms. I encourage all men to talk to their health care providers about how prostate cancer can affect them, and to learn more by visiting www.Cancer.gov/Prostate or www.CDC.gov/Cancer/Prostate.

The Affordable Care Act has ensured that more Americans have access to quality, affordable health insurance, and it prohibits insurance companies from denying coverage to someone simply because they have prostate cancer. The Act eliminates annual and lifetime limits on coverage and ensures individuals have the option to participate in clinical trials, which have proven helpful in advancing research of new treatment strategies and improving clinical care for men with prostate cancer.

This year, I asked Vice President Joe Biden to lead our Nation in a new effort to end cancer as we know it. The White House Cancer Moonshot Task Force is striving to make a decade of advances in cancer prevention, treatment, and care in just 5 years through the collaboration of Federal agencies, jumpstarted by a proposed nearly $1 billion investment. Additionally, the Department of Veterans Affairs is helping to introduce a series of pilot programs that will accelerate clinical research and care for veterans with prostate cancer using cutting-edge biotechnologies — they are also working to increase precision oncology research and strengthen personalized medicine for the treatment of prostate cancer among veterans. These efforts build on the goals of our Precision Medicine Initiative, which aims to deliver personalized care and apply medicine more efficiently and effectively based on genetics — and ultimately, to bring us closer to curing diseases like cancer.

This month, let us thank the countless researchers, medical professionals, and advocates who dedicate themselves to supporting survivors and beating cancer. Let us continue raising awareness of prostate cancer and renew our commitment to finding a cure once and for all.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim September 2016 as National Prostate Cancer Awareness Month. I encourage all citizens, government agencies, private businesses, non-profit organizations, and other groups to join in activities that will increase awareness and prevention of prostate cancer.

IN WITNESS WHEREOF, I have hereunto set my hand this first day of September, in the year of our Lord two thousand sixteen, and of the Independence of the United States of America the two hundred and forty-first.

BARACK OBAMA

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PCFC spotlighted by West Suburban Philanthropic Network

Prostate Cancer Foundation of Chicago is proud to participate in West Suburban Philanthropic Network, along with other area nonprofits that work to benefit our shared community.  Read our Spotlight Feature, published in the WSPN Summer 2016 Newsletter.

Prostate Cancer Foundation of Chicago

In his mid-fifties, Eddie shared that “I felt so hopeless and helpless when I found out I had prostate cancer.  I didn’t know what to do, and was very nervous.”  He decided to explore a support group for men and families facing prostate cancer and its many treatment options.  “It really helped having a hands-on physician, available to help answer my questions.  It gives you piece of mind knowing there are different methods of treatment for prostate cancer, and that other men have many of the same concerns.”

Ten years later, Eddie still benefits from a welcoming Patient Support Group, hosted by Prostate Cancer Foundation of Chicago (PCFC).  Since the Westmont nonprofit was established in 2006, PCFC has hosted over 100 monthly support group meetings as one way to fulfill its mission to promote public awareness, cancer prevention, detection and treatment options to prostate cancer patients and families, and medical professionals involved in the diagnosis and treatment of prostate cancer.

According to the American Cancer Society, approximately 250,000 men in the U.S. are diagnosed with prostate cancer every year.  Second to skin cancer, prostate cancer is the most common form of cancer in men, affecting one in seven over their lifespan.  Over the last 20 years, the U.S. has seen a six-fold increase in younger men in the prime of life receiving a diagnosis of aggressive, life-threatening prostate cancer, making early detection even more important for many men.

Prostate cancer is highly treatable, especially when detected at an early stage.  To promote prostate cancer detection, PCFC offers a Prostate Cancer Screening Event each September during national Prostate Cancer Awareness Month.  Free services include a PSA blood test and digital rectal examination for prostate abnormalities with consultation by a physician.

Since initiating the annual event in 2009, PCFC has screened over 450 men, averaging age 63.   The event often bridges the prostate screening needs of underserved men.  Despite current policy debates on whether and when to check for prostate cancer, PCFC advocates screening for all men beginning in their fifties.  Men with a family history of prostate cancer and African American men, for whom prostate cancer tends to be more aggressive, are advised to consider prostate screening starting at age 50 or younger.

Foundation outreach also advances awareness of prostate cancer through employer and corporate wellness programs and community, church, and other organization meetings.  Educational presentations by PCFC director of research and education are tailored to each audience, and can range from general health and cancer awareness to prostate health and prostate cancer.

PCFC works hand-in-hand with Chicago Prostate Cancer Center (CPCC), also of Westmont, which is the only freestanding, full-service medical facility in the world solely dedicated to minimally invasive prostate cancer treatments.  The Center has served over 20,000 men from across the nation.

Together, they conduct clinical research and have trained hundreds of physicians to continually advance best practices in brachytherapy (also known as seed implant), a convenient, effective option for many men seeking to remain productive during prostate cancer treatment.  PCFC has participated in publishing and presenting results for over 35 clinical studies, contributing to prostate cancer treatment advancements for area men and men worldwide.

Among their transformative research studies, PCFC helped pioneer a biopsy mapping technique allowing more precise tumor location and targeting; examined genomic testing to gauge tumor aggressiveness; studied the interaction of diabetes with prostate cancer; and demonstrated patients treated with seed implants have excellent long-term survival rates.

PCFC’s current studies include those designed to: 1) further refine seed implant techniques and better monitor patients with slow growing tumors contained within the prostate; 2) investigate options for men with locally advanced cancer outside the prostate; and 3) analyze outcomes in patients younger than 62— men more likely to have fast-growing prostate cancer and who stand the best chance of survival with early detection.

To learn more, please visit www.chicagoprostatefoundation.org.

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Power of Genomic Testing

Prostate cancer tumor growth rates vary

While men of the same age may have similar PSA (prostate specific antigen blood test results), Gleason score (grading of tumor cell irregularities), and T category (spread of the tumor), they may actually have prostate cancer tumor growth rates that vary widely.  By knowing how aggressively tumor cells are replicating,  physicians may be able to better personalize prostate cancer treatment.

Who benefits from genomic testing?

National Comprehensive Cancer Network (NCCN) Guidelines for Prostate Cancer address staging and risk assessment after an initial diagnosis of prostate cancer, as well as man­agement options for localized, regional, and metastatic disease.  NCCN is currently discussing newly available tests of genes identified in prostate cell function.  Prolaris and Oncotype DX are two molecular assays that NCCN deems may answer the need for a biomarker to predict disease progression.   Genomic testing is typically limited to patients with early-stage prostate cancer contained within the prostate, and is not currently required as the standard of care.  Cost of genomic testing is covered by some insurance plans and can typically be performed with biopsy tissue already submitted for routine pathology.

More information

The predictive power of genomic testing promises to help many men more confidently weigh their prostate cancer treatment options, aligning with the mission of the non-profit organization Prostate Cancer Foundation of Chicago to provide education, support and research on prostate cancer treatment.  For further patient information visit Chicago Prostate Cancer Center;  NCCN also provides a patient guide to prostate cancer.

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The Prostate Gland

1. It keeps sperm healthy

Located just below the bladder, the prostate is a walnut-sized gland found only in men. The urethra, the tube that carries urine from the bladder to the penis, runs through it. Its main role is to produce prostatic fluid to provide nutrients for sperm.

2. STIs can cause prostate infection

Prostatitis, inflammation or infection of the prostate, mainly affects men under 40 and can develop from a urinary tract infection. Symptoms can include pain when urinating and ejaculating and pelvic pain. The cause can be anything from bacteria to sexually transmitted infections (STIs) such as gonorrhoea or chlamydia. It can be treated with antibiotics.

3. Prostatitis may link to cancer

Evidence suggests men who have had prostatitis may be more at risk of developing prostate cancer. The inflammation, especially combined with a lack of vitamin D, may encourage the cancer to develop.

4. Vitamin D is good for prostate health

Good genital hygiene and condoms can help prevent urinary tract infections and prostatitis. There is also increasing evidence that vitamin D promotes resistance to infections.

5. The prostate can enlarge with age

At least 60 per cent of men over 60 have benign prostatic hyperplasia (BPH), or an enlarged prostate. Symptoms include difficulty urinating and needing the toilet often. If symptoms are mild, no treatment is needed, but in severe cases, medication to shrink the gland or surgery can improve quality of life.

6. Prostate cancer is the most common cancer in men

One in nine men develops prostate cancer, about 20,000 are diagnosed annually in Australia and 3300 die from it. Almost two-thirds of those diagnosed are older than 65. Men of Afro-Caribbean descent have an increased risk, as do those who have a close relative with the disease. Having an STI at a young age can also be a risk factor. According to the American Cancer Society, about 238,590 new cases of prostate cancer will be diagnosed in 2013, and about 29,720 will die from it.

7. Genes can play a part in prostate cancer

Up to 10 per cent of prostate cancer cases have an inherited component. For example, the BRCA2 gene, which can cause breast cancer in women, is also associated with prostate cancer.

8. Prostate cancer can be symptomless

Although some men have lower back or hip pain, prostate cancer may have few or no signs in the early stages. A PSA blood test checks whether levels of prostate-specific antigen, a chemical made by the gland, are raised, which may indicate cancer. In advanced prostate cancer the sufferer may experience bone, pelvic or back pain, weight loss and blood in the urine or semen.

9. Diagnosis of prostate cancer is improving

A new test, PCA3, measures a protein only produced by cancer cells and is about 80 per cent accurate. A definite diagnosis can be made with a biopsy.

10. Prostate cancer is often slow-growing

The challenge is to find out whether the cancer is aggressive or slow-growing as treatment can cause serious side effects, including incontinence and impotence. Most cancers are slow-growing. Post mortems show that 80 per cent of men aged 80 have cancer cells in the prostate that may have been present for 20 to 25 years and they have died of other causes.

11. Treatment for prostate cancer varies

Doctors decide on treatment based on a man’s age, how aggressive the cancer appears, PSA test results and the man’s attitude. Out of every 100 men diagnosed, about two-thirds have aggressive treatment. The other third opt for monitoring through regular blood tests, biopsies and digital rectal examinations.

12. There are often no side effects from prostate cancer treatment

Treatment can include removing the prostate, radiotherapy, freezing or heat treatment to destroy the gland. There is little difference in survival rates between treatments, although freezing and heating are quite new. Due to better techniques, serious side effects from treatment are less common.

13. Tomatoes are good for the prostate

Several studies show that men who eat foods containing lycopene, found in tomatoes and tomato-based foods, have a lower risk of developing prostate cancer. Getting enough exercise also appears to reduce the risk. Eat a variety of fruits and vegetables, maintain a healthy weight and don’t smoke.

Information provided by body+soul. http://www.bodyandsoul.com.au/health+healing/mens+health/13+important+facts+about+prostate+health,6971

American Cancer Society

http://www.cancer.org/

 

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