Actively monitoring prostate cancer can be safe alternative to surgery or radiation, study says

Good news has been released for men seeking to avoid prostate cancer treatment-related sexual and incontinence problems.

According to an Associated Press story by Carla K. Johnson a while back, it appears that most men can hold off on treatments because actively monitoring the disease is a safe alternative to surgery or radiation.

Dr. Stacy Loeb

Long-term evidence supporting that conclusion was confirmed, the piece notes, by Dr. Stacy Loeb, prostate cancer specialist at NYU Langone Health who was not involved in the research. 

It has long been known that most prostate cancer grows very slowly.

The story quotes Loeb as saying that a recent study's findings indicate that "there was no difference in prostate mortality at 15 years" between those who had surgery to remove tumors, those who had radiation treatment, and those who monitored.

The survival rate for all three groups was 97% — "also very good news," Loeb says.

Results of the study, funded by Britain's National Institute for Health and Care Research, were published in the New England Journal of Medicine.

The lead author of the study, Dr. Freddie Hamdy of the University of Oxford, was quoted to the effect that men diagnosed with localized prostate cancer should "consider carefully the possible benefits and harms caused by the treatment options" — and not rush their decisions or panic, despite the fact that a small number of men with high-risk or more advanced disease do need urgent treatments.

Dr. Freddie Hamdy

Researchers, Johnson's story says, "followed more than 1,600 U.K. men who agreed to be randomly assigned to get surgery, radiation, or active monitoring."

The study began on 1999, a time when monitoring practices were not as good as now (when MRI imaging and gene tests can be employed before informed decisions are made). 

"We have more ways now to help catch that the disease is progressing before it spreads," the AP story quoted Loeb as saying.

More information about the multiple facets of research can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Hereditary cancers are problem for males as well as for females, says head of genetic risk program

Breast cancer is not just a female problem. It strikes 2,500 men in the United States every year and kills about 500 of them.

Dr. Robert Sidlow

Those statistics come from Dr. Robert Sidlow, director of the Male BRCA Genetic Risk Program at New York's Memorial Sloan Kettering Cancer Center, in a recent Jewish Telegraphic Agency story by Larry Luxner.

Ashkenazi Jews, those of Eastern European descent, are particularly susceptible to the perils caused by a BRCA mutation that elevates the risk to men "not only of breast cancer, but also of melanoma and prostate, ovarian and pancreatic cancer," the article says.

Hundreds "of other mutations in the BRCA gene are just as dangerous, but they're not specific to Ashkenazim," Sidlow is quoted as saying.

The story notes that about "1 in 40 Ashkenazi Jews… carries the harmful mutation, compared to about 1 in 400 in the general population."

Roughly 1-2% of men "with the BRCA1 mutation and 6-7% of men with the BRCA2 mutation will develop cancer by age 80," Sidlow contends.

Luxner's piece also quotes Elana Silver, CEO of Sharsheret (Hebrew for "chain"), to the effect that "it's crucial that men with a family history of cancer undergo genetic counseling screening — via a standard blood or saliva sample — for BRCA and other hereditary cancer mutations."

Adds Silver, "This is not only a women's issue. Family history is so important. When a man shares his family history with his doctor, he may not realize that he should mention that his mother had breast cancer or his sister had ovarian cancer, as these are not general 'men's diseases.' They are not aware that these cancers could mean that they themselves are at increased risk for cancer and that they can pass on these mutations to the next generation."

Sidlow notes that "most men are pretty happy to enroll income kind of surveillance program once they get over the initial shock" of being a mutation carrier.

Luxner's story indicates that there are various precautions they can take for themselves and their children where the BRCA gene is concerned — as well as such mutations as ATM, TP53, CHEK2, and PALB2. They can "monitor their own health more closely, they can encourage their children to test to see if they are carriers and, for any future children, to take steps to prevent the mutated genes from being passed down. For example, couples can conceive via in vitro fertilization, or IVF, and then test the embryo before implantation to ensure that only those unaffected by the genetic mutation are implanted."

Much more information on BRCA1 an BRCA2 can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, its author, aimed at male caregivers.

Small study finds some patients can de-escalate, skip cancer surgery, do only chemo and radiation

Not doing surgery and relying only on chemo is possible for some women, a new study says.

Dr. Henry Kuerer

According to a story by Roni Caryn Rabin in The New York Times some time ago, the research, an early-stage clinical trial, found that "a carefully selected group of patients who responded remarkably well to chemotherapy could skip surgery altogether."

About 60% of the test patients fit that category and went on to receive radiation treatment. They were still in remission, the article says, "after a median follow-up period of two years and two months," quoting Dr. Henry Kuerer, principal investigator of the study, which was published in Lancet Oncology.

"The elimination of surgery for invasive breast cancer is 'the ultimate form of breast-conserving therapy,'" the Times quotes him as saying.

Why skip an operation? It can lead to complications such as infections or lasting nerve pain.

Under any conditions, "there are always going to be people who would rather not have surgery," Rabin quotes Kuerer, professor of breast surgical oncology at the University of Texas Anderson Cancer Center in Houston.

The work, the story continues, "is part of an approach to cancer treatment called de-escalation — an effort to individualize treatment to a specific subtype of the disease, achieving the same results with less treatment and fewer interventions."

According to Karen Knudsen, chief executive officer of the American Cancer Society, "asking whether we can scale back surgery is a reasonable next consideration for the future of cancer care."

In a separate clinical trial, Kuerer is testing whether radiation is always necessary.

More information about choices when facing a life-threatening disease can be found in Rollercoaster: How a man can survive his partners breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

'New frontier' blood tests to find cancer may create risks for patients, N.Y. Times story says

Blood tests that detect cancer can create risks for those who use them, according to a story by Gina Kolata a while back in The New York Times.

The article indicates that "the tests screen for cancers that often go undetected, but they are expensive and some experts worry they could lead to unnecessary treatments without saving patients' lives."

Some companies, Kolata's piece says, aren't waiting for Food and Drug Administration approval before they sell the tests. One of the companies, Grail, is selling an annual version, and a second company, Exact Sciences, plans to do the same, using a loophole provision "known as laboratory developed tests."

The tests, the story contends, "are a new frontier in screening. Companies developing them say they can find dozens of cancers."

Supporters of the tests insist they can "slash cancer death rates by finding tumors when they are still small and curable. But a definitive study to determine whether the tests prevent cancer deaths would have to involve more than a million healthy adults randomly assigned to have an annual blood test for cancer or not. Results would take a decade or longer."

While standard screening tests "are commonly used to detect cancer of the breast, colon, cervix and prostate," Kolata's article notes, "73 percent of people who die of cancer had cancers that are not detected by standard test."

The story quotes Dr. Tomasz Beer a cancer researcher at Oregon Health & Science University who is directing a Grail-sponsored study of the test. "We're at a point now where the blood tests are in their early days," he says, but "I think there's promise for a real impact."

Dr. H. Gilbert Welch

Dr. H. Gilbert Welch, a senior investigator in the Center for Surgery and Public Health at Brigham and Women's Hospital, raises a red flag: "Grail proposes to test every Medicare beneficiary every year, making it the screening test that could bankrupt Medicare."

Among other risks the story attributes to some doctors are that "some will have a positive test, but doctors will be unable to locate the cancer. Others will be treated aggressively with surgery or chemotherapy for cancers that, if left alone, would not have grown and spread and may even have gone away."  

Dr. Barnett Kramer, former director of the Division of Cancer Prevention at the National Cancer Institute and a member of the Lisa Schwartz Foundation for Truth in Medicine, according to Kolata's story, "fears that the tests will come into widespread use without ever showing they are beneficial" and hopes that "we are not halfway through a nightmare." 

Once the tests are being used broadly, he adds, "it is difficult to unring the bell."

More information about clinical trials can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at caregivers.

Crucial climate push by Biden in Louisiana's 'cancer alley' is under fire from environmentalists

Activists are afraid Environmental Protection Agency (EPA) regulations regarding carbon storage in Louisiana's "cancer alley" could perpetuate fossil fuel industry.

That's one of the main thrusts of a story by Timothy Puko in recent editions of The Washington Post.

Carbon capture, according to the Post, is a process that has experts fighting one another. The U.N. Intergovernmental Panel on Climate Change has said "developing new technology to capture or remove carbon is essential for limiting rising world temperatures in line with the 2015 Paris climate accord."

Many environmental-justice advocates, the article also notes, "object to carbon capture projects, especially in a region where petrochemical plants often sit next to black churches and schools, and high cancer rates have led to the nickname 'Cancer Alley.'"

The Biden administration sees carbon capture "as a key tool to reduce emissions from businesses that have few other options," the Post piece reports.

Beverly Wright, PhD

Puno's story quotes Beverly Wright, PhD, a member of the White House Environmental Justice Advisory Council and executive director of the Deep South Center for Environmental Justice in east New Orleans, as saying, "What they're trying to do to Louisiana now is I think the worst of anything we've been exposed to because of all the uncertainly. In the real world, this is an experiment, and this experiment is going to be conducted on the same communities that have suffered from the oil and gas industry."

On the other hand, just last month a different U.S. climate supervisory panel postulated that some of "these technologies are unproven and 'pose unknown environmental and social risks.'"

Additional information on EPA regs can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

 

New study shows cancer among younger women in U.S. is on the rise, Washington Post reports

Some of the biggest increases in disease among younger Americans, a new study shows, is in those diagnosed with gastrointestinal and breast cancers. 

According to a story by Lindsey Beyer in today's editions of The Washington Post, endocrine cancers are also on the rise in that grouping — especially, like the other cancers, among women.

The study, published today in JAMA Network Open, showed that cancers "among people younger than 50 have increased slightly overall, with the largest increases [19 percent] among those age 30 to 39." 

Dr. Paul Oberstein

"It's important to do more research to understand why this is happening," Beyer's story quotes Dr. Paul Oberstein, director of the Gastrointestinal Medical Oncology Program at NYU Langone's Perlmutter Cancer Center who was not involved in the study, as saying. "If we don't understand what's causing this [increased] risk and we can't do something to change it, we're afraid that as time goes on, it's going to become a bigger and bigger challenge."

Experts, the article indicates, say possible reasons behind the trend include "rising obesity rates and lifestyle factors such as drinking alcohol, smoking, sleeping poorly and being sedentary." 

Environmental factors, "including exposure to pollutants and carcinogenic chemicals, also probably play a role," the story continues.

The study, for which researchers analyzed data from more than 560,000 patients in the United States with early-onset cancer, also showed that cancers among older adults have declined.

Dr. Daniel Huang

According to Dr. Daniel Huang, assistant professor at the National University of Singapore and a transplant hepatologist at the National University Hospital, who is the senior author of the study, breast cancer accounted for the highest number of cancers cases in younger people — an increase of about 8 percent in the 10-year period examined (between 2010 and 2019).

More information about disease research can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Artificial intelligence improves breast cancer detection rate by 20 percent, Politico reports

The detection rate of breast cancer can go up 20 percent when AI is used, according to a story this week on the Politico website.

Ashleigh Furlong's article says the results from a study in Sweden "show the potential of using artificial intelligence in mammography."

The study, the first "randomized controlled trial" to look at using AI in breast cancer screening, showed that interim results have indicated "that using AI-supported analysis of mammograms alongside either of two radiologists was as good as using two radiologists without AI and led to 20 percent more cancers being detected," the story contends.

A significant reduction in workload for radiologists reportedly occurred, Furlong's piece continues, "with the doctors having to spend 44 percent less time reading mammograms."

The still-ongoing trial looked at more than 80,000 women.

Kristina Lang

Despite the positive findings, the story says, lead author Kristina Lang maintains that the results "are not enough on their own to confirm that AI is ready

to be implemented in mammography screening" outside clinical trials yet because additional screenings are necessary. 

The story also quotes Stephen Duffy, professor of cancer screening at Queen Mary University of London, as saying that there could be concern that using AI might over-detect harmless lesions.

More information about global research is available in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at caregivers.

New study finds skin cancer is more deadly in black men, Washington Post story declares

Melanoma is more deadly in black men, who may get skin cancer in unexpected places such as nails and feet, a new study says.

According to a story today by Andrea Atkins in The Washington Post, the study of 105,000 cases show black men are "26 percent more likely to die of the disease" — despite the fact that melanoma is "far more common in white men."

It has long been known, not incidentally, that men have a higher risk of being diagnosed and succumbing to the disease than women do.

Dr. Ali Hendi

The Post story quotes Dr. Ali Hendi, a specialist in skin cancer surgery in Chevy Chase, Md., who didn't participate in the study, as saying, "I think [the findings are] significant. This study doesn't give us the answer as to why, but it sheds light on the numbers." 

Atkins' article notes that the study, published in the Journal of the American Academy of Dermatology, found that:

• "Among black men with melanoma, 48.6 percent at diagnosed at late stages of the disease, when it is harder to treat, compared with 21.1 percent among white men."

• "The data showed that 50.7 of black men with melanoma have it on their lower extremities. Fewer than 10 percent of white men with the disease have it on their lower extremities."

• "Melanoma in black men is often found in areas not typically exposed to the sun, such as the soles of the feet, toes, toenails, fingers, fingernail beds, and palms."

The Post piece also quotes Dr. Jeremy Brauer, clinical associate professor of dermatology at NYU Langone Health, who was not connected with the study, as saying that physicians are often trained to identify cancers on white skin and may not know how the disease shows up differently in different races. "This disproportionate and unfortunate rate of death means we have to try to be much more preventative," he said. 

More information about studies of diseases can be found in Rollercoaster: How a man can survive his partner's breast cancer, a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.