The diagnosis of prostate cancer could be significantly improved with a new blood test that looks for circulating tumor cells. Unnecessary biopsies and treatments could also be avoided.

According to a recent study, combining the new test with prostate specific antigen (PSA) results can yield a diagnosis of aggressive prostate cancer that is more than 90% accurate.

This level of accuracy is higher than that of any other biomarker for prostate cancer, according to the study author, who says it could lead to a paradigm shift in the way prostate cancer is diagnosed.

PSA test not enough to diagnose cancer

The prostate produces a protein called PSA. When there is cancer in the prostate, the gland releases more PSA into the blood, and therefore, raised levels of PSA in the blood can be a sign of prostate cancer.

Unfortunately, other prostate conditions, such as inflammation or noncancerous enlargement of the gland, can also raise PSA levels.

In order to confirm the presence of cancer, the patient undergoes a biopsy, which is an uncomfortable procedure where the surgeon removes pieces of the prostate and sends them for tissue analysis.

A biopsy of the prostate is not only invasive but can also have risks such as infection and a high chance of bleeding. And the biopsy results of most men with raised PSA levels come back saying that they do not have cancer.

And when prostate biopsies do reveal the presence of cancer, in most cases, the tumor is not aggressive and will not be fatal if doctors leave it untreated.

Experts say that the first genetically targeted drug for fighting prostate cancer could become a become a revolutionary treatment.

Olaparib is a precision medicine already used by the NHS for ovarian cancer and has been called a game-changer by cancer doctors.

In trials the drug has slowed tumor growth in men with advanced prostate cancer. Researchers hope that this could improve survival for some men. Experts say the drug could be made available to patients in the next couple of years.

Precision medicine

Olaparib, also called Lynparza, works by targeting and killing cancer cells with faulty genetic code, while at the same time sparing normal cells with healthy DNA.

Researchers say that the drug won’t work for everyone with prostate cancer, but it is effective for some men with the disease.

Patients can be tested to see if they have the genetic errors that the drug can attack – faulty DNA repair genes including BRCA1 and BRCA2. This precision approach means that the patients most likely to benefit will be treated, avoiding potential side-effects from other drugs that may not work as well for them.

During the trial, doctors compared Olaparib with two other commonly prescribed prostate drugs (hormone treatments called Abiraterone and Enzalutamide).

It appeared that Olaparib delayed cancer growth by months, which researchers say hopefully means men can survive for longer even when their disease is advanced. The researchers will be monitoring patients to confirm this.

About prostate cancer

One in eight men will be diagnosed with prostate cancer in their lifetime. It mainly affects men over the age of 50 and the risk increases with age.

Not all of these tumors need immediate treatment. If the cancer is at an early stage and not causing symptoms, doctors may instead suggest careful monitoring.

Some cases are more aggressive and need treatment but can be cured if caught early enough.

Other cases may only be diagnosed at a late stage when the cancer has spread and cannot be cured.

All treatments, including Olaparib, can have side-effects. Doctors can talk advise patients about what might be the best treatment for them.

A team of medical researchers led by University of Michigan doctors wanted to answer the question of whether black race associated with worse prostate cancer outcomes after controlling for variables such as access to care.

This question of racial disparity in regard to prostate cancer is important because African American men in the United States are more than twice as likely to die from prostate cancer as Caucasian men. The reason for the disparity, in black and white men with similar stages of prostate cancer disease, is still unclear, especially in regard to the contribution of biological versus non-biological differences.

The University of Michigan conducted an extensive study which concluded that the reason for the prostate cancer outcome disparity isn’t that black men intrinsically and biologically harbor more aggressive disease. The study stated that when provided the same access to treatment and care, black and white men have very similar cure rates.

However, black men get fewer prostate cancer screenings, and are more likely to be diagnosed with later-stage cancer. They are also less likely to have health insurance.

The study from the University of Michigan also suggests that when it comes to African American prostate cancer, health care, and socioeconomic factors play a larger role than genetics.

This study is very important to African American men and also for the physicians who treat them. The key takeaway is that now, more than ever, it is important for African American men to be proactive about their prostate health, and that a good first step in that direction is to initiate a discussion with a primary care physician or a urologist about the benefit of prostate cancer screening.

The University of Michigan study reviewed data on 306,100 men — 54,840 black men — ages 59 to 71 from the Veterans Affairs system and four other clinical trials.

Thanks to this study from the University of Michigan, urologists and other physicians now have evidence that prostate cancer outcomes in African Americans are substantially linked to access to care rather than genetic factors.

According to the results of a recent study, there was no difference in disease recurrence among men with prostate cancer when they were given radiation after surgery or not.

The results from the study could mean that men with prostate cancer could be spared having to undergo radiation after surgery. The study found no difference in disease recurrence at five years between those who did and did not utilize the adjuvant therapy.

As an added benefit for patients, these findings could lead to patients experiencing far fewer side effects. The good news could be that in future, many men will avoid the side-effects of radiotherapy. These side effects can include urinary leakage and narrowing of the urethra, which can make urination difficult. Both are still potential complications after surgery alone, but the risk is increased if radiotherapy is used as well.

In the trial, researchers enrolled 1,396 patients after surgery for prostate cancer, and randomized them to receive either postoperative radiotherapy or the standard approach of observation only (in this particular group radiotherapy was only kept as an option if the disease recurred).

After five years at a median follow-up, progression free survival (the time from treatment to disease progression or worsening) was 85% in the radiotherapy group, compared with 88% in the standard care group.

After one year post-surgery, self-reported urinary incontinence was worse in the radiotherapy group (5.3%), compared with those who underwent observation (2.7%).

There is a strong case to be made that observation could be the standard approach after surgery and radiotherapy should only be used if the cancer comes back.

These same findings were also confirmed in a collaborative meta-analysis that included three randomized trials comparing adjuvant radiotherapy with early salvage radiotherapy following prostatectomy for men with localized prostate cancer.

The analysis was comprised of 2,151 men, including 1,074 who were randomized to adjuvant radiotherapy and 1,077 men were randomized to early salvage radiotherapy. Of those randomized to early salvage radiotherapy, only 37% started salvage treatment to date.

Similarly, the analysis did not find a significant difference supporting the use of adjuvant therapy to improve prostaAfter Surgery May Not Be Necessary Among Men With Prostate Cancer
According to the results of a recent study, there was no difference in disease recurrence among men with prostate cancer when they were given radiation after surgery or not.

The results from the study could mean that men with prostate cancer could be spared having to undergo radiation after surgery. The study found no difference in disease recurrence at five years between those who did and did not utilize the adjuvant therapy.

As an added benefit for patients, these findings could lead to patients experiencing far fewer side effects. The good news could be that in future, many men will avoid the side-effects of radiotherapy. These side effects can include urinary leakage and narrowing of the urethra, which can make urination difficult. Both are still potential complications after surgery alone, but the risk is increased if radiotherapy is used as well.

In the trial, researchers enrolled 1,396 patients after surgery for prostate cancer, and randomized them to receive either postoperative radiotherapy or the standard approach of observation only (in this particular group radiotherapy was only kept as an option if the disease recurred).

After five years at a median follow-up, progression free survival (the time from treatment to disease progression or worsening) was 85% in the radiotherapy group, compared with 88% in the standard care group.

After one year post-surgery, self-reported urinary incontinence was worse in the radiotherapy group (5.3%), compared with those who underwent observation (2.7%).

There is a strong case to be made that observation could be the standard approach after surgery and radiotherapy should only be used if the cancer comes back.

These same findings were also confirmed in a collaborative meta-analysis that included three randomized trials comparing adjuvant radiotherapy with early salvage radiotherapy following prostatectomy for men with localized prostate cancer.

The analysis was comprised of 2,151 men, including 1,074 who were randomized to adjuvant radiotherapy and 1,077 men were randomized to early salvage radiotherapy. Of those randomized to early salvage radiotherapy, only 37% started salvage treatment to date.

Similarly, the analysis did not find a significant difference supporting the use of adjuvant therapy to improve prostate cancer from recurring, compared to early salvage radiotherapy. Based on these results, the difference in five-year event free survival is likely only to be around 1%, according to the release.

te cancer from recurring, compared to early salvage radiotherapy. Based on these results, the difference in five-year event free survival is likely only to be around 1%, according to the release.

A retrospective cohort study showed that men who used statin drugs had a lower risk of prostate cancer but only with prolonged use or higher doses.

Men who had a history of treatment with statins was associated with a 15% reduction in the relative risk of low-grade prostate cancer and a 46% lower risk of developing high-grade disease. The association, however, was limited to men who took statins for at least 11 months or who had a specific defined daily dose of ≥121. This number is based on a reference dose of 20-mg simvastatin.

According to a report, lipophilic statins appeared to be more protective against prostate cancer than did hydrophilic drugs.

Researchers believe that mechanistically, statins have been found to reduce intracellular and serum cholesterol, and therefore may affect cell membrane organogenesis, steroidogenesis, and proliferation. Growth inhibition in prostate-derived cells lines was observed at clinically relevant statin concentrations.

This study adds to numerous others that preceded it, which collectively showed that statin use is associated with a lower risk of prostate cancer. The cumulative data does suggest only a modest effect on prostate cancer diagnosis.

Statins and Prostate Cancer

Over the past 15 years, statin use has increased dramatically, and as a class, the drugs are among the most widely prescribed medications in the world. It is thought that lowering serum and tissue levels of cholesterol may disrupt cellular lipid rafts, leading to reduced raft-dependent signaling and cell proliferation. And by extension, statins may have chemopreventive effects that reduce carcinogenesis, including prostate cancer carcinogenesis.

A recent study has found that eating dairy products has been linked to a higher chance of developing prostate cancer, and a plant-based diet appears to cut the risk.

In the past, some studies have found a link between consuming dairy products; such as milk and cheese; and prostate cancer. The disease is more prevalent in Western countries with the biggest consumption of calcium. The researchers in the study cited that prostate cancer is less common in Asian countries where such foods are consumed much less.

The team of Mayo Clinic researchers examined more than 47 existing scientific journal articles published between 2006 and February 2017, and involved more than 1 million participants in total.

The study results linked plant-based diets, such as vegetarian and vegan diets with a lower or unchanged risk of developing prostate cancer from the baseline.

Eating animal products, and dairy in particular, was associated with an increased or unchanged risk of being diagnosed with the disease.

Each year, approximately 175,000 new cases of prostate cancer are diagnosed, making it the most prevalent form of the disease among men other than skin cancer.

The disease is the second leading cause of cancer death in the U.S. after lung cancer, and kills around 31,620 people annually.

The study highlighted a cause for concern with high consumption of dairy products and the findings also support a growing body of evidence on the potential benefits of plant-based diets.

However, the study was limited because it included a range of different papers with varying methods. The researchers said that future research could test the validity of the findings by carrying out randomized control trials. Researchers would also like to look at the effects of other lifestyle factors like smoking and exercise.

A research team has been investigating the mechanisms driving prostate cancer progression and have been developing novel treatments and models to combat metastasis for the past 15 years. The team has mechanistically examined how cancer cells have been able to bypass immune cells and survive. The work initially started with the discovery that in advanced stages of prostate cancer, the cancer cells could not only escape immune system surveillance, but could also disable the immune system response.

The research found that the underlying mechanisms for these events came from the oncogenic stress-induced molecule called “MIC.” When found in healthy cells, MIC is not expressed on cell surfaces. However, the researchers discovered that during cancer development, and even at very early stages, prostate cells start to express MIC. MIC’s primary function is to “flag down” the immune cells, particularly the natural killer and cytotoxic T cells, to initiate their response in fighting cancer cells. However, it was found that in stages of advanced prostate cancer, the cancer cells have “chopped off” or eliminated the ability of MIC to “flag down” the immune cells.

Therefore, the cancer cells are able to bypass immune surveillance and roam free. Then, detrimentally, cancer cells release a soluble form of MIC, called sMIC, which shuts down the immune system and this allows for the cancer cells to “dodge” immune cells. When considered together, the research team reasoned that these mechanisms may explain the non-responsiveness to immunotherapy in patients with advanced prostate cancer.

The team developed a first-in-class monoclonal antibody to target sMIC. In preclinical models, the antibody has been found to “revive” immune system function and eliminate prostate cancer metastasis to solve this problem. The antibody has already shown promise in controlling metastasis of cancer cells when administered solo, and even in non-responders to immunotherapy. When it has been administered in combination with an immune checkpoint blockade, a synergistic anti-tumor effect occurred where both agents work to restore immune function.

The team is also working toward bringing this anti-sMIC antibody from preclinical to clinical use in humans. Plans are to conduct a preclinical safety assessment for clinical trials, examine how the antibody would work with current standards of care for prostate cancer, and investigate how to use the antibody to tackle neuroendocrine prostate cancer, the most lethal type prostate cancer.

After presenting the results of a new study, researchers have called for immediate action to recommend screening for prostate cancer for men with BRCA2 mutations over the age of 40.

It is widely known that BRCA mutations greatly increase the risk of breast and ovarian cancer in women with the disease. However they also increase the risk of several types of cancer in men, including prostate and breast.

Scientists have also determined that BRCA2 mutations are likely to increase the chance of a type of childhood cancer called non-Hodgkin lymphoma.

The sturdy research looked at almost 3,000 men aged 40-69, with just over half carrying inherited mutations in either BRCA1 or BRCA2, while the others were healthy controls. These men were screened with a common test for prostate cancer called the PSA (prostate-specific antigen) test.

The researchers found that the incidence of prostate cancer in men with BRCA2 mutations was significantly higher than in men with no BRCA mutations. They also determined that BRCA2 carriers were typically diagnosed when younger and had more substantial disease. However, there were no differences observed in men who carried BRCA1 mutations, compared to healthy controls.
The researchers feel that the study shows very clearly that men with the BRCA2 gene fault are at increased risk of aggressive prostate cancer and that regular PSA testing could go some way to improving early diagnosis and treatment.

The research indicates that men over the age of 40 who carry a mutation in the BRCA2 gene should undergo an annual PSA test as a way of identifying prostate cancer which in their case may be more aggressive.

1. If you are a man who has an inherited BRCA gene there is a possibility that if you develop prostate cancer, it will be at a younger age, and have a higher mortality rate.

2. Men who have been found to have a BRCA mutation have an increased risk for developing prostate cancer (3 – 8 times) compared to men without the BRCA mutation. Those men who have a family history of prostate cancer should talk with their doctor about whether genetic tests should be considered.

3. If you are a man who has been diagnosed with prostate cancer and also have a BRCA mutation, you are more likely to have an aggressive form of cancer. Knowing your BRCA status may be a key tool in helping your doctor anticipate the aggressiveness of your disease and evaluate treatment and management options.

4. In some cases a BRCA gene mutation may not be present when a man’s prostate cancer is first diagnosed, however it can occur over time. This is a reason why many doctors may discuss genetic testing at different times throughout the course of the disease.

5. Many experts suggest that men get tested to learn more about their genetic composition and BRCA status. Men who know their status can prevent misleading management options if diagnosed with prostate cancer and it can be determined whether they are at a higher risk of an aggressive form of cancer if diagnosed.

There are lots of spouses who will say that cancer didn’t just hit the husband, it hits the spouse/partner as well.

Like all cancer diagnoses, telling a man he has prostate cancer can force him — and his loved ones — to confront his mortality for the first time. But unlike many other cancers, prostate cancer often has a direct effect on the significant other, particularly in the form of erectile dysfunction, a common side effect of treatment, according to the Prostate Cancer Foundation.

The diagnosis can influence a man’s mental health and, in turn, his relationship. A 2014 review of 27 studies published in the journal BMJ Open concluded that the prevalence of depression and anxiety in men with prostate cancer, across the treatment spectrum, is relatively high. The diagnosis of cancer has a psychological impact on the body and mind.

Some side effects of treatment like incontinence can also influence a man’s behavior. Men may not feel comfortable socializing, and so spouses will believe he must be depressed but he may actually just anxious and doesn’t know how to deal with it.

On the upside, it’s possible for the mental health and relationships of survivors to actually improve after prostate cancer. Most men that go through treatment end up on the other side with a great quality of life, and their relationship is the same — sometimes even better because they have a new perspective on the important things in life.