Biden and his allies are 'very optimistic' about his ability to beat metastasized prostate cancer

Former President Joe Biden

Former President Joe Biden and those around him appear to be sanguine about his being able to whip his metastasized prostate cancer — even though there is no cure.

Looking forward to his recovery, he specifically told reporters last week that "we're going to be able to beat this."

According to an online story by Sebastian Murdock in the HuffPost, he also said, "The prognosis is good. We're working on everything. It's moving along, and I feel good. All the folks are very optimistic."

Earlier last month the 82-year-old was diagnosed with the Stage 4 cancer that had metastasized to the bone. Biden's office admitted it was "a more aggressive form of the disease."

In a chat with reporters at his home, Biden said, "The expectation is we're going to be able to beat this...It's not in any organ, my bones are strong."

The New York Times earlier had quoted Dr. Judd Moul, a prostate cancer expect at Duke University, as saying that men whose prostate cancer had metastasized "can live five, seven, 10 more years." 

He noted that "survival rates have almost tripled in the last decade."

More information on metastasis 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. My other books are MysteryDates — How to keep the sizzle in your relationship; The Roving I, a compilation of 70 of my newspaper columns; and Grampy and His Fairyzona Playmates, a whimsical fantasy intended for 6- to 10-year-olds that I co-authored with my then 8-year-old granddaughter. Check out my website, https://woodyweingarten.com/.

Study at UC San Francisco finds 'alarming' hike in advanced prostate cancer across California

An "alarming" surge in advanced prostate cancer across California in the past decade may be linked to changes in guidelines that have reduced routine screenings for the disease.

At least  that's the conjecture in a story by Aidin Vaziri in recent e-editions of the San Francisco Chronicle about a new study at UCSF published in JAMA Network Open.

The study, which according to Vaziri analyzed nearly 388,000 prostate cancer cases between 2004 and 2021, "found that the number of advanced prostate cancer diagnoses statewide increased by 6.7% annually from 2011 to 2021."

Erin Van Blarigan

The Chronicle piece quotes Erin Van Blarigan, ScD, the study's led author and an associate professor professor at  the University of California, San Francisco, as believing "this overall rising trend is alarming and has occurred across age groups, regions of California, races, and ethnicities."

Prostate cancer is the most common cancer among men in the United States.

Although the U.S. Preventive Services Task Force in 2012 stopped recommending routine PSA testing for all men, citing concerns over  unnecessary treatments, "UCSF researchers suggest that the shift may have missed opportunities to catch aggressive cancers early, when treatments are more effective," the story indicates. 

California does not stand alone. Nationally, advanced cases of the disease have also risen since the screening guidelines changed. But the Golden State's annual climb is 6.7% as opposed to the countrywide percentage of 4.5. 

More information about screening guidelines 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.

Washington Post writer explains why our general fear of cancer is outdated — and is harmful

Has cancer-phobia become an outdated — and harmful — concept?

In an opinion piece by David Ropeik in editions of The Washington Post earlier this week, the writer maintains that "our cancer phobia [is] a fear that in some ways no longer matches the facts."

David Ropeik

His column explains that we now know "that tens of thousands of common breast, prostate, and thyroid cancers that are detected early never go on to do any harm." 

Still, he writes, people "'over-diagnosed' with these types of cancer are understandably frightened and usually choose more aggressive treatment than their clinical conditions require. Some 'fear-ectomies' cause great harm, leading to side effects that range from moderate to severe and include death itself."

The columnist goes on to say that "we spend an estimate $5.2 billion a year on…clinically unnecessary treatment, 3 percent of the total spent on all cancer care annually."

Ropeik, author of Curing Cancer-phobia: How Risk, Fear, and Worry Mislead Us, maintains that "a diagnosis of cancer is still thought to be a death sentence [despite the fact that] mortality in the United States is down 33 percent in the past three decades [and as] many as two-thirds of all cancers can now be treated as chronic conditions or cured outright."

There apparently are more than 200 types of cancer, which all told kill roughly 600,000 people each year.

Ropeik, a former environmental journalist and retired instructor in the environmental management program at Harvard University's School of Continuing Education, writes that we collectively "have feared cancer more than any other disease since it became the No. 2 cause of death in the United States in the 1920s (after heart disease)."

The writer's opinion piece asserts that although "a majority of people believe that most cancer is caused by environmental carcinogens…we now know that cancer is principally a natural disease of aging, which allows DNA mutations that cause uncontrolled cell growth to accumulate." 

Despite that information, he says, "governments spend hundreds of billions of dollars each year to reduce the risk from environmental carcinogens [and] we spend billions on organic foods, vitamins, and supplements, as well as many other products that promise to reduce our risk of cancer but don't." 

Ropeik concludes that even though "we cannot absolutely cure cancer, nor will we ever entirely erase our cancer-phobia…we need to understand and battle both the disease and our fear, because both are doing terrible harm."

More information about fear 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.

University of California San Francisco study examines trans prostate cancer risk for first time

A first-of-its-kind study by UCSF researchers finds that transgender women face an increased risk of prostate cancer.

According to a story by Erin Allday in the San Francisco Chronicle a while back, the peril is "small but meaningful."

The article also cautions that "traditional screening tools may not work well for them, especially if they're taking estrogen for gender-affirming care."

The study, published in the journal JAMA last Saturday, is the first in the United States to look at prostate cancer in transgender women., who were born with male sex organs. The Chronicle story indicates that transgender people are "underrepresented in medical research and…experience worse outcomes than cisgender parents for all kinds of health issues."

Stephen Freedland

Allday's piece quotes Dr. Stephen Freedland, an author of the paper and a urologist at Cedars-Sinai Medical Center in Los Angeles, to the effect that "there's a misperception, both by patients and clinicians, the because these are women — they identify as women, they look like women — you don't necessarily think you should check for prostate cancer."

The story also quotes Dr. Farnoosh Nik-Ahd, a University of California San Francisco urologist and the lead author of the paper, as saying, "We're still very much at the beginning of how best to care for this population — and it's a population nation that will probably increase, in terms of the number of people owning identifying as transgender."

Allday's article notes that transgenders "remain a highly vulnerable population, a situation potentially made worse with anti-trans legislation being pushed across the United States that could further limit health care access."

Transgender people, who "are thought to make up less than 1% of the [general] population," the story continues, "have been mostly left out of large studies of all kinds of health issues."

More information about prostate 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.

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.

'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.

Pennsylvania senator Bob Casey expects to make full recovery from surgery and prostate cancer

Sen. Bob Casey, a Pennsylvania Democrat, needs to undergo surgery for prostate cancer but expects to make a full recovery.

Sen. Bob Casey

According to a story by Neil Vigdor in a recent edition of The New York Times, the 62-year-old wrote on Twitter that he is "confident that my recommended course of treatment will allow me to continue my service in the 118thNN Congress with minimal disruption, and I look forward to the work ahead."

Casey's seat is up for election in 2024. A potential challenger, Vigdor's article contends, is "David McCormick, a former hedge fund executive who lost last year's Republican primary against the celebrity physician Mehmet Oz for Pennsylvania's other Senate seat."

Pennsylvania is a swing state that's played a big role in the last two presidential elections.

Casey, who currently is in his third term, didn't mention any other treatments for the prostate cancer.

Health has played a major role in Pennsylvania politics recently. John Futterman, the state's lieutenant governor who beat out Oz, is recovering from a stroke that he had last May.

More information on surgeries and other disease treatments 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. 

Depression and suicide rates jump for patients diagnosed with cancer, two new studies indicate

Two new studies have found cancer patients are at a higher risk for depression and suicide.

According to a story this week by Jessica Wapner in The New York Times, the "findings make a compelling case for oncologists to have more discussions with  their patients about mental health struggles."

A caption with the story notes that one of the studies found "suicide rates among people with cancer were notably higher in the United States than in Europe, Asia or Australia." 

Dr. Corinna Seliger-Behme

The article quotes Dr. Corinnas Seliger-Behme, a neurologist at Heidelberg University in Germany, as saying, "Probably, we can prevent suicide if we talk about it, and if we really start that early."

Seliger-Behme and a colleague reviewed in their report "28 studies that included more than 22 million cancer patients across the world. Their analysis showed that the suicide rate as 85 percent higher for people than the general population."

Cancers with the worst prognoses, like stomach and pancreatic cancers, had the highest rates while the diseases with the best prognoses, including prostate, non-metastatic melanoma and testicular cancers, had the lowest.

The study's authors, according to the story, speculated that "the high cost of health care" in the U.S. might had led some patients "to forgo treatment to avoid bankrupting their families." The authors also wondered if easy access to firearms may have contributed to the higher suicide rates.

In the other new study, Alvina Lai, PhD, an associate professor at University College London, and a colleague examined health records of about 460,000 people in Britain with 26 different cancers. Five percent were diagnosed with depression, with the same number diagnosed with anxiety, after their diagnoses.

Alvina Lai, PhD

"Patients with brain tumors, prostate cancer, Hodgkin's lymphoma, testicular cancer and melanoma were most likely to hurt themselves," Wapner's piece reports.

Moreover, about 25% of the patients suffered from substance abuse — and psychiatric issues "tended to increase over time, even years after a diagnosis."

The biggest risk factor for developing a mental health condition, according to the story, was to those undergoing the triple-threat approach of surgery, radiation and chemotherapy. "The length, intensity and cumulative side effects… could explain why it triggers depression, anxiety and even personality disorders in many people," the article contends.

Chemotherapy on its own, it continues, is "also tied to high rates of psychiatric disorders, whereas 'kinase inhibitors' — targeted drugs that often have fewer side effects — had the lowest rates."

Dr. Lai wonders "whether patients are given enough opportunities to weigh the psychological risks of potential treatments," the story states. She's quoted as maintaining that "it would be useful for cancer patients who are newly diagnosed to see what the data tell us and make an informed decision."

Testicular cancer "carried a higher risk of depression than any other cancer type, affecting 98 of every 100 patients," according to her study, an unexpected result.  

Dr. Nathalie Moise, professor of medicine at Columbia University's Vegelos College of Physicians and Surgeons, suggests that while "current treatment guidelines suggest screening for depression as part of routine cancer care," these findings "may support the need to also screen for suicide and other risk factors."

More on the mental state of patients 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.

Survival rates jump 80% with new treatment

Clinical trial finds drug combination that might stop metastasized prostate cancer from worsening

A new study shows that an experimental drug combo that controls hormones may halt the progression of prostate cancer.

Dr. Chris Sweeney

A clinical trial led by Dr. Christopher Sweeney at Dana-Farber Cancer Institute in Boston, according to a story in the October-November issue of AARP Magazine, determined that survival rates could jump as much as 80 percent when the combination is used.

Sweeney's study, the AARP article notes, focused on what can happen when enzalutamide, an oral drug that blocks hormone reception, is combined with testosterone-suppressing medication. 

That study, like other research, was based on the notion that "testosterone and other male hormones can fuel the growth of cancer cells." 

What was being sought were ways "to either suppress the production of hormones or stop cells from receiving them."

Sweeney's study, the story asserts, did both.

The AARP article centered on one particular participant in the study, Dr. John Hammel, a psychiatrist who was diagnosed in 2016 with late-stage prostate cancer that had already begun to metastasize.

Hammel's quoted as saying "I was despondent — I didn't think I'd live a year."

That attitude made him, after initial skepticism, jump at the chance when his oncologist told him about the "real treatment" that was available, "not just palliative care." 

During the study, Hammel reportedly saw his PSA test numbers "drop from 2,000 to 450 to four and then to undetectable for six months" — and then stay there.

The trial, the story says, helped him start living again, "instead of focusing on his prognosis." 

For more information about clinical trials and their results, check out "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten, aimed at male caregivers.

Help possible for some breast, prostate diseases

Common dietary supplement might be the remedy for a rare genetic mutation that can lead to cancer

Although a rare genetic mutation leads to cancer, a fix may already be available.

According to a recent story by Gina Kolata in The New York Times, "a common dietary supplement may help overcome mutations in the Pten gene."

The real question, the Times asks, is, "Should patients take it?"

And the paper's answer, based on medical personnel that were interviewed, is a qualified yes.

Kolata's article says that the mutation "markedly raises the risk for several cancers, including prostate and breast cancer…as well as autism and schizophrenia in some individuals."

The lifetime risk in carriers, it indicates, is an astoundingly high 85 percent.

In theory, those at risk could help themselves by eating brussels sprouts, broccoli or other cruciferous veggies. The problem is, Kolata reports, to get enough to be of real use, "they'd have to eat a lot: six pounds of brussels sprouts a day — raw."

Instead, a healing compound "is widely available as a dietary supplement" found in local drugstores.

Experts, Kolata adds, "are debating whether to embark on a clinical trial with it."

The Times specifically cites a study published in the journal Science in which "researchers found evidence that a compound called indole-3-cabinol (i3c) blocks an enzyme that inhibits the activity of Pten. With the gene more active, patients with the mutation may be better protected against cancer."

The study, Kolata notes, "was done only in mice and in human cancer cells grown  in petrie dishes."

She explains, further, that although the findings do apply to Pten gene activity, "there is little evidence for most of the other wild claims made for i3c by supplement makers."

Although inherited Pten mutations are rare, striking one in 200,000, the gene also spontaneously mutates in many tumors. "When that happens," the Times piece maintains, "the patient's prognosis is poor."

Dr. Mustafa Sahin

The article quotes Dr. Mustafa Sahin, an expert on the gene at Boston Children's Hospital (who wasn't involved in the work at Beth Israel Deaconess Medical Center in Boston that was the basis for the Journal report), called the research a "tour de force study" whose result was "a paradigm shift in the field [that is] very exciting in terms of its therapeutic implications."

The Times also quotes Dr. Pier Paolo Pandolfi, director of the center who's been trying to find a way to restore Pten activity for years and is the senior author of the paper, as saying about the findings: "We got lucky — or smart."

More information about mutations, especially the BRCA1 and BRCA2 gene, 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.

Once you hit 80, odds say you'll live past 90

Risk factors for another cancer jump up if you've already had one kind — or if one of your kin has

Is it possible to live cancer-free?

The answer is a resounding yes, at least according to a recent non-bylined article in the AARP Magazine, whose subhead reads in part, "Age is a risk factor for cancer, but the chances of developing a fatal cancer may actually begin to decline at age 70."

It also contends that "once you hit 80, our chance of living to 90 and beyond goes way up."

The article isn't totally positive, however.

It says, for instance, that "women who have had breast cancer are more at risk for another type of breast cancer, and other cancers."

And it notes that "a Stanford University study showed that people diagnosed with six or more basal cell carcinomas have more than three times the odds for developing future cancers, such as breast, colon and prostate cancer as well as leukemia and lymphoma — likely due to an underlying  problem in genes that repair DNA."

In short, having one kind of cancer makes a woman or man prone to other kinds. 

And if you smoked, it says, "you're at increased risk for not only lung cancer but also a dozen other cancers, including oral, cervical, bladder and pancreatic."

Your family medical history can also increase your risk.

Heather Hampel

The AARP piece quotes Heather Hampel, associate director of the Ohio State University Comprehensive Cancer Center, as saying that if you have a family history of cancer you should coordinate with a genetic counselor who can put your results in perspective and recommend an action plan.

"Women who carry the BRCA1 or BRCA2 gene, for example, have up to a 72% chance of developing breast cancer and 44% chance of ovarian cancer by age 80," the article states.

But, even though in the general population women have only about a 12% lifetime risk of breast cancer, and "though those statistics sound scary, genetic testing can help doctors guide you on the best ways to prevent cancers, or diagnose this earlier, when they are treatable," the AARP mag further   quotes Hampel.

More information about risks 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.

New insights, treatments, tests in disease 'war'

Medical community is starting to believe less is more when it comes to cancer treatments 

More and more doctors and patients apparently are using less aggressive weapons to fight cancer these days.

Dr. Justin Bekelman

A story by Laurie McKinley in yesterday's Washington Post quotes Dr. Justin Bekelman, a radiation oncologist at the University of Pennsylvania, about the medical community's focus on the "war on cancer."

Historically, he says, that phrase "implied that more is better and decimation is desired."

McKinley's story contends, however, that the idea is "falling out of favor," not only because it "subtly blames patients" who die "but also because it doesn't capture a world of new biological insights, improved treatments and molecular tests that are transforming how cancer is treated."

According to Bekelman, "Knowing when not to treat" can be "great medicine" — because, the story charges, oncologists equipped with new tools and evidence can cut back on toxic and costly approaches likely do more harm than good.

Cancer, nevertheless, is not monolithic, the story indicates.

Rather, some cancers "need to be bludgeoned, but others can be treated with more tailored therapies or simply watched."

Although the latest mindset of "doing less in the face of danger" can be "emotionally difficult" for both patients and physicians, the article notes, proof that less is more has been frequently popping up lately, including a landmark clinical trial published in June that found more than "two-thirds of women with early-stage breast cancer can safely avoid chemotherapy." 

Not to mention the fact, according to the piece, that "men with early-stage, low-risk prostate cancer are rapidly embracing 'active surveillance' over surgery — and avoiding possible complications such as incontinence and sexual dysfunction," and that throat cancer caused by human papilloma virus, because it varies from other types of the disease, allows a cutback "in a brutal treatment regimen and [reduces] the risk of potentially devastating disfigurement."

The Post story also mentions the emergence of immunotherapy, usually less toxic than chemo, "as a first-line treatment for many patients," and cites a recent study showing that "people with advanced kidney cancer can skip surgery to have their kidneys removed and instead go right to drug treatment."

De-escalation isn't happening universally, however. 

McKinley contends that the "most common form of thyroid cancer, which poses little risk, is often still treated with unnecessary surgery, experts say. And some malignancies, such as pancreatic cancer, are so lethal that doctors are racing to find ways to ramp up treatment."

Details on trends and clinical trials in treatment 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.

Deaths from lung, breast, prostate cancer dip

United States cancer mortality rates have dropped 26% since 1991, new report indicates

The good news: U.S. cancer death rates have continued to fall.

The bad news: While the incidence has dropped for some cancers, it has risen for others.

Those conclusions, according to a story by Judy George on the MedPage Today website yesterday, are based on a statistical report from the American Cancer Society.

Cancer mortality in the U.S. fell 1.7% from 2015 to 2015 — a decline that "continued a long-running trend, with a 26% drop since 1991," George's piece indicates. 

Rebecca Siegel

Her story notes that "the reduction was fueled largely by fewer deaths from lung, breast, prostate and colorectal cancer," and cites information from Rebecca Siegel of the ACS and colleagues in CA: A Cancer Journal for Clinicians. 

"Steady reductions in smoking, plus better detection and treatment, accounted for a significant part of the decline," the MedPage Today article adds.

Dr. Otis W. Brawley

The article also quotes Dr. Otis W. Brawley, chief medical officer of the ACS, from a statement: "A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates."

Over the past decade of available data, the story continues, "the overall cancer incidence in men fell by about 2% per year, with the pace accelerating in recent years."

But in women, "declines in lung and colorectal cancers were offset by increasing or stable rates for breast, uterine corpus and thyroid cancers and for melanoma."

Liver cancer incidence has also continued to rise in women.

Siegel's piece also says that researchers have predicted "1,735,350 new cancer cases and 609,640 cancer deaths in the United States in 2018."

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

How high-risk men's lives may be extended 37%

UK clinical trial shows that two prostate cancer therapies can be much better than one

Can combining two existing therapies extend the life of men with advanced, high-risk prostate cancer by 37%?

A new study seems to answer that question with a "yes."

Nicholas James

"These are the most powerful results I've seen from a prostate cancer trial," reported Nicholas James, professor of clinical oncology at Queen Elizabeth Hospital in Birmingham, United Kingdom, lead author of an abstract presented to the American Society of Clinical Oncology, in a recent story by Jessica Glenza in The Guardian. 

It's a "once in a career feeling," he noted. "This is one of the biggest reductions in death I've seen in any clinical trial for adult cancers."

Researchers, the Glenza story indicated, "combined standard hormone therapy with a drug called abiraterone, which is typically used only for cancer patients whose disease has stopped responding to standard hormone therapy."

Patients who received both medications did have "slightly stronger side effects," however — "especially cardiovascular and liver problems."

The study, which looked at a group of 2,000 men, was done as part of an ongoing randomized trial conducted in the United Kingdom and Switzerland.

James also was quoted as saying that "abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%."

More than 27,000 men in the United States, and 11,000 men in the UK, die of prostate cancer each year.

Details about many clinical studies on cancer can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Mistaken diagnoses plague patients, doctors

DNA 'fingerprinting method' might lower risk of lab errors on thousands, N.Y. Times says

Lab mixups and mistaken diagnoses (both positive and negative) may be happening to thousands of patients each year.

That's what Gina Kolata indicated recently in The New York Times.

Her article focuses on how to avoid those errors — a "high-tech solution: a way to fingerprint and track each sample with the donor's own DNA." 

But it's costly: About $300 per sample. So labs are reluctant to employ them.

Dr. John Pfeifer

Kolata, however, quotes Dr. John Pfeifer, vice chair of clinical affairs in the pathology and immunology department at Washington University School of Medicine in St. Louis as saying, "All the process improvement in the world does not get rid of human errors…Millions get biopsies every year. Is society going to say, 'Yeah, mistakes happen but we're not going to look for them?"

When the fingerprinting method is used, the lab tries to match the DNA from a swab taken from a patient's mouth. If it doesn't match, that signals a lab mix-up.

Errors, according to Kolata, "may lead a patient down a life-altering path, to a grueling treatment that was unnecessary, or to the neglect of a cancer that may or may not prove deadly."

Pfeifer actually reviewed more than 13,000 biopsy results from men evaluated for prostate cancer at a number of labs. The results were supplied by the chief exec at Strand Diagnostics, the company that's marketing the fingerprinting method.

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

'Transformative" treatments deemed possible

Race underway to create gene therapies for breast, prostate, ovary, lung, pancreas cancers

Pharmaceutical companies and universities are in a race to develop "utterly transformative" gene therapies, according to a recent article by Denise Grady in The New York Times.

The story says "one of the big goals now is to get them to work for many [cancers other than leukemia, for which approval is expected soon], including those of the breast, prostate, ovary, lung and pancreas."

The radically new class of treatments, it also says, may "re-engineer and turbocharge millions of patient's own immune cells, turning them into cancer killers that researchers call a 'living drug.'"

Dr. Stephan Grupp

The Times piece contends that the new leukemia drug, called CAR-T therapy, "has been utterly transformative in blood cancers," according to Dr. Stephan Grupp, director of the cancer immunotherapy program at the Children's Hospital of Philadelphia, a professor of pediatrics at the University of Pennsylvania, "and a leader of major studies."

Although Grupp cautions that it will take at least five years to make an accurate determination, he maintains that if the treatment "can start to work in solid tumors, it will be utterly transformative for the whole field."

The treatment apparently is also being studied in conjunction with "glioblastoma, the aggressive brain tumor that Sen. John McCain was found to have."

Grupp says one particularly encouraging potential avenue of research with children involves earlier stages of disease "instead of very late, as rules now require," the Times story indicates. 

Earlier treatment, it reports him as believing, "might help some patients avoid bone-marrow transplant, a grueling, last-ditch treatment. Children with less advanced disease also tend to have milder side effects."

Other studies are underway to combine the new therapy "with immunotherapy drugs called checkpoint inhibitors, which help unleash the cancer killing power of T-cells" — which the story describes as the white blood cells "often referred to as the soldiers of the immune system."

One of the big problems with the new treatment — which "involves removing millions of…T cells…from the patient's bloodstream, genetically engineering them to recognize and kill cancer, multiplying them and then infusing them back into the patient" — is its cost factor.

The process, the story explains, is very expensive (at least $300,000 per treatment, other articles have said)  "because each treatment has to be made separately for each person."

The treatment was developed at the University of Pennsylvania and licensed to Novartis.

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

Fed task force changes its mind — for a change

Whether to get PSA prostate cancer screenings can still be guesswork, N.Y. Times warns

Should men between the ages of 55 and 70 get prostate cancer screening?

Depends on whom you're listening to, and when, I guess — especially if it's the federal government making the suggestions.

Aaron E. Carroll

According to a story by Aaron E. Carroll  in The New York Times today, the U.S. Preventive Services Task Force "changed its recommendation…from a D (that is, don't do it) to a C (discuss it with your doctor)."

Five years ago, the piece indicated, "the task force gave prostate cancer screening a D recommendation because there are real harms from over-diagnosis of the disease."

The story went on to say that "over-diagnosis leads to unnecessary treatments, and a newly discovered cancer could lead to no symptoms or harm over the patient's lifetime."

It also said that — while "there appeared to be little evidence that screening with with prostrate-specific antigen blood test (PSA) reduced prostate cancer mortality" — "about 75 percent of all the men treated will have impotence, incontinence or both."

A 2014 study that was the largest randomized controlled trial to that date showed, however, "that offering men screening reduced their relative risk of dying of prostate cancer over 13 years by 21 percent."

Those figures are applicable for men between the ages of 55 and 70; after that age, the harms seem to definitely outweigh the benefits.

Carroll is a professor at Indiana University School of Medicine who blogs on health research and policy.

To learn more about research regarding prostate cancer and other diseases, check out "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Risks determined after 200 studies are reviewed

Is fat the worst cancer-causing agent of all? British journal review leads writer to say 'yes'

Being overweight, according to a story in the Marin Independent Journal recently, can be the worst carcinogen.

The condition, proclaims the article by Dr. Salvatore Iaquinta, surgeon at Kaiser Permanente San Rafael, "greatly increases a person's chance of getting cancer."

Dr. Salvatore Iaquinta

A woman "50 pounds overweight," he continues, "has a greater risk of developing breast cancer than a soldier who was exposed to Agent Orange during the Vietnam War devoting prostate cancer."

Iaquinta, who writes a regular column under the rubric "Highway to Health" and who is the author of the book, "The Year They Tried to Kill Me," cites as the source for his belief a recent review in the "British Medical Journal." He notes that the authors had checked out more than 200 studies before determining their findings.

"Some of the associations between weight and cancer were gender specific," Iaquinta reports — such as breast cancer in postmenopausal women as well as cancer of the uterus lining.

Or colon and gallbladder cancers in men.

Other cancers "with increased risk related to body mass index," he indicates, include cancers of the kidney, stomach and pancreas as well as esophageal adenocarcinoma and multiple myeloma.

One of the doctor's main conclusions is that "rather than spending so much time and money to circumvent potential chemical exposures, we should be focusing our energy into staying in shape."

Details of other tests on the risks of contracting cancer can be found in "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book I, Woody Weingarten, aimed at male caregivers.

Radiation time down from 2 months to 2 weeks

Newest prostate cancer therapy cuts length of treatments but adds intensity, NY Times says

A comparatively new — and popular — prostate cancer therapy can be shorter (and more intense) than standard treatments.

But it's efficacy is unproven.

And there's insufficient data so far to compare side effects.

According to an article by Gina Kolata in The New York Times today, the new treatment — called SBRT, or stereotactic body radiation therapy — usually involves five sessions within two weeks instead of 40 seasons spread over two months or 28 sessions over five or six weeks.

The National Cancer Institute (NCI) has just agreed to fund a clinic trial that will compare the SBRT and 28-session treatments, although it may be eight years before the results are finalized.

"Ideally," the Times quotes Dr. Rodney J. Ellis, a radiation oncologist at Case Comprehensive Cancer Center in Cleveland and the principal investigator for the trial, as saying, "we want to show five treatments is better."

The Times pieces says the number of men getting SBRT more than doubled between 2007 and 2013, according to the most recent Medicare data.

Prostate cancer strikes about 180,000 men annually, second only to lung cancer.

Some clinical trials, Kolata's story indicates, have provided "important information. For example, a recent one shows that hormone-blocking drugs can prolong life for men whose prostate cancer recurs after surgery to remove the prostate."

The article also indicates that a change in attitude seems to be occurring.

In favor of the shorter, more intense treatments.

Dr. Michael J. Zelefsky

Kolata's article quotes Dr. Michael J. Zelefsky, a Memorial Sloan Kettering Cancer Center radiation oncologist, to the effect that "several years ago, 90 percent of his patients had the standard course of treatment. Now 90 percent choose the shorter course."

The newer treatment, he added, "is emerging as a very exciting form of therapy."

Why? Probably because more patients are considering "quality of life" issues and the shorter length of therapy may add to that.

Want an additional look at clinical trials and new treatments? "Rollercoaster: How a man can survive his partner's breast cancer," a VitalityPress book that I, Woody Weingarten (a guy who's undergone regular radiation, brachytherapy and hormonal therapy for prostate cancer), aimed at male caregivers, provides it.

Gene mutation may portend four times the risk

Men worry about defective breast cancer genes as possible clue to deadly prostate cancer

Holy cow, it wasn't enough that I worried about women I know having BRCA1 and 2 mutant genes that portend breast and ovarian cancers.

Now I'm worrying about the guys, too.

Seems that, according to a recent article in The Washington Post by Laurie McGinley, men (like me) are becoming more aware that the defective genes — "the kind that prompted actress Angelina Jolie to have her breasts and ovaries removed preemptively," the story notes — have also been linked to aggressive, potentially deadly prostate cancer.

McKinley writes that "men with these mutations are more likely than non-carriers to contract aggressive, lethal prostate cancer, to be diagnosed at a more advanced stage and to ultimately die of the disease, researchers say."

A study recently presented to a meeting of  the American Urological Association found 17 percent of patients with BRCA2 "already had advanced [prostate] disease, four times the rate of patients without the mutation," the article states. 

Dr. Bruce Montgomery

McKinley's story quotes Dr. Bruce Montgomery, an oncologist at the Seattle Cancer Care Alliance-University of Washington Medical Center as saying, "The problem is, everyone associates this with women and their cancers. In men's minds, BRCA is about breast cancer, so they don't see it as relevant."

The implication, of course, is that they're wrong. It is not only relevant, knowledge about the mutation is a crucial part of a health-education learning curve.

Although "an estimated 12 percent of women will develop breast cancer during their lifetimes, according to the National Cancer Institute," McKinley's story says, "that proportion rises to as high as 65 percent of women who inherit a BRCA1 mutation and about 45 percent for those with a BRCA2 defect."

Men with the BRCA mutation also are at a higher risk of getting breast cancer. Currently, more than 2,000 American males contract that disease each year.

To learn even more about the BRCA defects, check out "Rollercoaster: How a man can survive his partner's breast cancer," the VitalityPress book I, Woody Weingarten, aimed at male caregivers.