Wednesday, March 22, 2006

ANDY DWORKIN

Across the country, urologists increasingly give men with localized prostate cancers hormone-blocking treatments normally used on late-stage cancers.

Doctors hope that early use of the testosterone-fighting weapon might keep the cancer from spreading in the body.

But that is probably a pipe dream, Oregon Health & Science University researchers say.

In a group of 276 men who had this treatment at OHSU, almost one in 10 died from prostate cancer within five years.

“Ten percent dying at five years from any localized prostate cancer is not good,” said Dr. Tomasz Beer, director of OHSU’s Prostate Cancer Research Program. “What this suggests to me is that this treatment is not very effective.”

When Houston restaurateur Tony Masraff was diagnosed with early-stage prostate cancer, his life was packed with dancing, running marathons, playing tennis, gardening, leading a successful business and spending time with his family.

But it wasn’t until his doctor at The University of Texas M. D. Anderson Cancer Center advised “watchful waiting” as an option to invasive surgery and radiation that he realized he could continue his active life – free of treatment side effects, but with the cancer.

Masraff is one of about 200 men diagnosed with low-risk prostate cancer at M. D. Anderson on active surveillance for their disease, having changes monitored through regular Prostate Specific Antigen (PSA) tests, biopsies and check-ups.
Full story

A New View on Prostate Cancer
Treating elderly men right after diagnosis is better than the current ‘watchful waiting’ approach, a study indicates.
By Thomas H. Maugh II, Times Staff Writer
Los Angeles Times
February 26 2006

It is better to treat prostate cancer in the elderly early on rather than to wait and watch for signs of progression, as is now commonly done, according to a new study that may change the care for many patients with the deadly disorder.

Surgery or radiation therapy in elderly men increases survival by at least 30%, raising median survival times from 10 years to more than 13 years, researchers reported Saturday at a prostate symposium in San Francisco.

The finding in a study of about 49,000 men “challenges long-held beliefs about prostate cancer treatment” by suggesting that treatment is better than so-called watchful waiting, said Dr. Paul Lange of the University of Washington, who did not participate in the study.

“It’s a wonderful paper that validates what many of us have believed for a long time,” said Dr. Mark Kawachi, director of the prostate cancer center at City of Hope National Medical Center in Duarte.

“Age, in and of itself, is not a definitive determinant of whether you should be excluded from treatment” for prostate cancer, he said.

New research at Wake Forest University Baptist Medical Center shows that Positron Emission Tomography (PET) is more accurate than conventional imaging in identifying patients who have good responses to chemotherapy and radiation treatment, a finding that could one day help some patients avoid surgery.

The results, from a study of 64 patients with esophageal cancer, are published in the April issue of Annals of Surgery. PET, a technology that produces images of the metabolic function of tissue, was used to test patients for cancer after treatment with a combination of chemotherapy and radiation (chemoradiation).

“While additional multi-center studies are needed, the research clearly shows that PET is a useful tool for identifying patients who respond well to chemoradiation,” said Edward A. Levine, M.D., lead investigator. “Being able to identify these responders may alter the need to take some patients to surgery.”

Lung cancer patients should not be denied surgery based on their age, concluded UAB researchers Robert J. Cerfolio, M.D., and Ayesha S. Bryant, M.D., in a study of 726 patients with non-small cell lung cancer.

Researchers compared morbidity, mortality and long-term survival rates among different age groups, including patients younger than age 70, those between 70 and 74, 75 and 79, and 80 and older.

They found no significant difference in hospital length of stay, major morbidity or death rates during surgery between the elderly groups and the younger control groups. “Short-term risks and long-term survival are similar to younger patients,” Bryant said. The award winning study was presented at the 2006 Society of Thoracic Surgeons‘ meeting in Chicago.

FIGHTER: David Wright is making the most of the precious time he has left.

Within a month after David Wright, now 62, was diagnosed with prostate cancer he had been told by his doctor at the Western General Hospital in Scotland that the disease had spread so far into his bones that it was “incurable”.

Prostate cancer is now the cause of more cancer deaths in men in Scotland than any other form of the disease, claiming hundreds of lives each year.

Yet new figures released last week revealed that less than half – 48 per cent – of all men diagnosed with prostate cancer in Scotland began treatment within the two month standard set by the Scottish Executive last year.

While the message from David, 62, and prostate cancer groups is that more men should get checked, and therefore diagnosed, more quickly, the statistics raise fears that not enough is being done to treat them swiftly once the disease is spotted.

Sitting in his home in East Comiston, David says: “Prostate cancer is often described as a curable disease made incurable by late diagnosis.

“The most important message for men is not to ignore the signs – like problems with urination – and to get checked out.

“Not many men know this, but all men over 50 in Britain have the right to a simple blood test for prostate cancer called a PSA (prostate specific antigen).

“It is not 100 per cent reliable, and GPs don’t always want to do the test, but it picks up most cases which need further investigation.

“I certainly would not be in the position I’m in now if there had been routine testing.”

“Prostate cancer is a slow-growing cancer, so in a sense waiting times being missed is not as serious as it is for other cancers. Six months might go past from diagnosis and there could be little change in the cancer.

“But that is not to excuse hospitals. They must improve and I think they will.

“I think it’s the silence in the waiting which is more of a problem than the waiting itself. Men don’t know whether to ask their GP or the hospital for test results.”

Full story: Scotsman.com Living – Health – The looming shadow of prostate cancer

David Wright is chair of Edinburgh & Lothian Prostate Cancer Support Group.

Useful contacts: Edinburgh & Lothian Support Group, 0131 445 1960 or 01506 845981 or 0131 5528360 Garner; Prostate Cancer Charity Helpline, 0845 300 8383; Maggie’s Centre (Western General Hospital), 0131 537 3131. or email cgarner@ecosse.net or obtain details of support groups from the Scottish Association’s website, www.prostatescot.co.uk, or email, supportprostate@tiscali.co.uk, or phone 01738 450415.

Speed of rise of prostate specific antigen that is measured in PSA blood test screening for prostate cancer may be affected by lifestyle and demographic factors, according to a study published in the January 15, 2006 issue of CANCER, a peer-reviewed journal of the American Cancer Society.

The study reveals that the rate of change in concentration of prostate specific antigen (PSA) over time – a calculation called PSA velocity – can be significantly affected by age, race, and diet, leading to falsely lower or elevated values and possible misinterpretation by doctors. Single determinations of PSA concentration, the most common use of the PSA screening test, were minimally but significantly affected by age and body mass index (BMI).

Animal tests on the kind of drug given to the six men ill in a London hospital may not be the best way of evaluating the effects in people, an expert warns.

The drug they took stimulates a protein only found in humans.

Dr David Glover, an expert in drug testing, said this meant animal tests of medicines of this sort might give falsely reassuring results.

He said it might be better to look at innovative ways of testing small amounts of such drugs on people.
Full story from BBC: BBC Animal tests ‘false reassurance’

An urgent message from the National Prostate Cancer Coalition:

HELP STOP CUTS TO PROSTATE CANCER RESEARCH IN THE FY2007 BUDGET!

The President has proposed serious cuts to funding for cancer research
at the National Institute of Health and the Center for Disease Control
and Prevention. In order to stop these cuts from taking effect,
Senators Feinstein and Mikulski have offered an amendment to the FY07
Budget Resolution which would increase money to these federal programs
by offsetting corporate tax loopholes. Senators will be voting on this
amendment today or tomorrow.

How you can help:

Call your Senator today and ask them to vote for the
Feinstein-Mikulski Amendment to the FY07 Budget Resolution. Call the
Senate Switchboard at (202) 224-3121 and aske to be connected to your
Senator. If you don’t know who your Senators are, name the state
in which you live and you will be connected!

* Once connected to the office, ask to be connected to the
legislative assistant that handles health care.
* Share with them your personal story with cancer and share why
these programs are important to you, their constituent or simply
say:

- I am asking you to support the Feinstein-Mikulski and Specter-Harkin
Senate budget amendments for increased funding for health programs and
any other amendments that will give more money to Cancer research and
programs.

- Now is not the time to turn our back on Cancer research and
programs, when we’ve made so much progress in fighting this disease in
recent years.

Thank you very much for helping us in the fight against cancer.

National Prostate Cancer Coalition
1154 Fifteenth Street, NW
Washington, DC 20005

Tel: 202-463-9455
Fax: 202-463-9456

By ROBERT BARR Associated Press Writer
© 2006 The Associated Press

LONDON — Two men were hospitalized in critical condition Wednesday and four others were in serious condition after suffering adverse reactions in trials of a new drug, and British regulators ordered the tests suspended.

Parexel International, which supervised the trial, identified the drug as TGN1412, a monoclonal antibody developed by TeGenero AG of Wuerzburg, Germany, for treatment of autoimmune and inflammatory diseases and leukemia.

Ganesh Suntharalingam, clinical director of intensive care at Northwick Park Hospital, said two of the men were in critical condition and four were in serious condition but showing signs of improvement.

“The drug, which is untested and therefore unused by doctors, has caused an inflammatory response which affects some organs of the body,” Suntharalingam said.