Prostate cancer patients can benefit greatly from exercise post-treatment

The therapies and procedures that prostate cancer patients go through can have a negative effect on their physical capabilities to complete normal activities of daily living. Side effects of treatments can include: fatigue, loss of muscle mass, increased body fat percentage and perceived decline of function of daily activities. A great way fight against these unwanted side effects is by exercising.

In one recent study 155 men were randomly assigned to either a control group (no exercise intervention) or a 12-week exercise program including resistance training three days per week. The men in the group who participated in exercise reported less frequency and less severity of fatigue from normal activities of daily living. These same men also demonstrated increases in upper body and lower body muscular strength and endurance.

Resistance exercise has been widely reported as having beneficial effects on increasing muscle mass, muscle strength and muscle endurance in prostate cancer patients. It is also known to have positive effects on maintaining bone and connective tissue health which may help men reduce their risk of injuries while exercising and in everyday life.

It is highly recommended that men talk with their doctor or other health care provider before starting an exercise routine. The guidance of a fitness professional with certifications and experience working with the sub-specialty of cancer survivorship is also very helpful.

Vanished or hidden prostate cancer and the outcomes

An important question in prostate cancer is “Can early-stage prostate cancer “vanish” during follow-up?”

It seems more likely that the cancer is just “hidden”–either way, negative biopsies during active surveillance for prostate cancer are associated with excellent long-term outcomes, reports a study in The Journal of Urology®

For men undergoing active surveillance, negative biopsies indicate low-volume disease and lower rates of disease progression. These ‘hidden’ cancers can have excellent long-term outcomes and remain ideal for continued active surveillance.

Excellent long-term outcomes with negative biopsies on active surveillance have been noted

During active surveillance, prostate cancer is carefully monitored for signs of progression through regular prostate-specific antigen (PSA) screening, prostate exams, imaging, and repeat biopsies. The goal is for men to be able avoid or delay treatment-related side effects without compromising such long-term outcomes as cancer progression or survival.

In some cases, men undergoing active surveillance have negative biopsies showing no evidence of prostate cancer. And while these patients may believe their cancer has “vanished,” they most likely have low-volume or limited areas of prostate cancer that were not detected in the biopsy sample.

To evaluate the long-term significance of negative biopsies, researchers recently analyzed 514 men undergoing active surveillance for early-stage prostate cancer at UCSF between 2000 and 2019. All these patients had at least three surveillance biopsies after their initial prostate cancer diagnosis (total four biopsies). The median follow-up time was nearly ten years.

Thirty-seven percent of these patients had at least one negative biopsy during active surveillance, including 15 percent with consecutive negative biopsies. The men with negative surveillance biopsies had more favorable clinical characteristics, including low PSA density and fewer samples showing cancer at the initial prostate biopsy.
The negative biopsies were also associated with good long-term outcomes. At 10 years, the rates of survival with no need for prostate cancer treatment (such as surgery or radiation) were 84 percent for men with consecutive negative biopsies, 74 percent for those with one negative biopsy, and 66 percent for those with no negative biopsies. After adjusting for other factors, men with one or more negative biopsies were much less likely to have cancer detected on a later biopsy.

However, having negative biopsies didn’t mean that the cancer had “vanished” – even some men with consecutive negative biopsies later had positive biopsies or were diagnosed with a higher stage of cancer. Therefore, surveillance, although less intense, is still recommended rather than “watchful waiting” for men in good health. Higher PSA density and suspicious findings on prostate magnetic resonance imaging (MRI) scans were associated with a higher risk of cancer detected on later biopsies.

Negative surveillance biopsies in men on active surveillance indicate low-volume prostate cancer with very favorable outcomes. A less-intensive surveillance regimen should be supported in these patients after discussion of risks and benefits, particularly in those with low PSA density and adequate MRI-targeted sampling.

Researchers identify indicators predicting lethal outcomes in high grade prostate cancer

Prostate cancer is one of the most common cancers among men in the United States; one in nine men will be diagnosed during his lifetime. When they are diagnosed, a patient’s disease is graded from 1 to 5 based on how aggressive it is, with 5 being the most aggressive.

Patients with grades 4/5 disease are at the highest risk of poor outcomes or death from the disease; however, there are no immunologic or genomic indicators that can help physicians determine the best course of treatment for this group of patients.

Moffitt Cancer Center researchers are hoping to change that. The team conducted studies to determine if genomic heterogeneity in tumors from grade 4/5 prostate cancer patients can be exploited to identify patient subsets that are at higher risk for lethal outcomes and therefore may benefit from targeted treatment strategies.

The studies from these researchers focused on transcriptomic interactions between the tumor immune content score and the Decipher score, a 22-gene classifier that provides a score predicting the probability that cancer will spread. They analyzed data from 8,071 prostate cancer patient samples of any disease grade (6,071 prostatectomy and 2,000 treatment naïve) in the Decipher Genomics Resource Information Database (GRID) registry. Each of the patient sample swas also given an immune content score (ICS) that was derived using the mean expression of 264 immune cell-specific genes.

All T=the samples were separated into four distinct immunogenomic subsets based on their results: ICS high/Decipher high, ICS low/Decipher high, ICS high/Decipher low and ICS low/Decipher low. These researchers discovered that approximately 25% of all grade 4/5 patient samples were in the ICS high/Decipher high subset.

The ICS high/Decipher high patient samples were further evaluated for the association between immunogenomic subtypes and radiation response signatures and they found that the ICS high/Decipher high subset were genomically more radiosensitive, meaning these tumors would respond well to radiation therapy. They determined that this subset also had a higher abundance of T cells and monocyte/macrophages. However, the research team says further research is needed to unravel the biologic mechanisms of this association.

These results will aid in the subtyping of aggressive prostate cancer patients who may benefit from combined immune-radiotherapy modalities.

The search for the prostate cancer treatment right for you

A prostate cancer diagnosis always brings with it great emotional stress for patients and their families. Choosing a treatment plan can be daunting. Questions arise like what treatment options exist, and what options are right for each patient and their specific diagnosis.

No matter what the cancer status, it is important to remember that no matter whether your cancer was caught early, or if found in Stage IV; patients do not need to feel alone.

Organizations such as ZERO – The End of Prostate Cancer (the nation’s leading nonprofit in the fight against this awful disease) have resources, support, and education materials to help all men determine the best treatment path.

In order to make a good decision about treatment options, patients should feel free talk with their urologist, oncologist, and other members of their medical team.

Different stages mean different treatment options

If a patient in the early stage he may be directed to active surveillance instead of pharmaceutical or surgical treatments. In cases like these a doctor simply monitors the cancer through regular tests to watch for signs that the cancer may be spreading or becoming more aggressive.

If a man has a cancer that is at risk of spreading, surgery, cryotherapy, radiation, or other treatments may be recommended to prevent the cancer from growing. Some patients may also have the option of hormonal therapies, which work in different ways to stop or inhibit the actions of the male hormones (androgens), such as testosterone, which fuel prostate cancer growth.

If a patient has advanced cancer he may be facing metastatic castration-resistant prostate cancer (mCRPC). They also may be eligible for immunotherapy, which uses immune cells (white blood cells) to attack advanced prostate cancer.

As of 2020, advanced prostate cancer patients now have the option of PARP inhibitors, thanks to the recent FDA approvals of Rubraca and Lynparza. PARP inhibitors are designed to disable DNA repair pathways in cancer cells, which make it difficult for cancerous cells to survive or populate.

NBA legend who is prostate cancer survivor talks about inequities in healthcare

Basketball legend Kareem Abdul-Jabbar recently opened up about his private battle with prostate cancer since being diagnosed 11 years ago.

The NBA’s all-time leading scorer revealed how he’s had prostate cancer, leukemia and heart bypass surgery. He is sharing his story in order to shed light on the health challenges facing black people.

While he’s received some of the best medical attention over the years as an NBA star, he’s aware of how others in the Black community do not.

In an essay, Abdul-Jabbar pointed out that some of the health issues black people are prone to as a group include diabetes, heart problems, obesity and cancer.

According to the U.S. Department of Health and Human Services Office of Minority Health African Americans have the highest mortality rate of any racial group for all cancers combined, and have higher rates of diabetes, hypertension and heart disease than other groups. This trend is continuing with COVID-19, which Abdul-Jabbar highlighted in his essay.

Abdul-Jabbar pointed out how more black people are dying from COVID-19 at higher rates because they are essential workers.

Based on data from several states, the coronavirus pandemic has hit Black and Latino communities across the U.S. hard, killing people of color at a disproportionate rate compared to white Americans.

The fact that people of color have more face-to-face jobs with people, they are more likely to be involved in healthcare, and they have to use public transportation. Those factors in and of themselves will make the people of color more susceptible, more vulnerable to a pandemic.

Today Show host talks about his prostate cancer

In November 2020, 66 year old Al Roaker one of the hosts of the Today revealed on the NBC News show that he had been diagnosed with prostate cancer. Weeks later the famous weatherman underwent prostate cancer surgery.

During his recovery he has been inundated with supportive messages from fans. He has been very open about how he has been taking care of himself following his surgery.

The popular weatherman posted on social media photos of himself going for a walk, with comments about how much he truly needs to exercise and how it helps him feel like he is doing things to truly take care of himself. He encourages his fans to take care of themselves.

Many people commented back thanking Al for his daily inspirational thoughts. They encouraged him to stay strong and safe and thanked him for his positivity. Fans also commented on how his upbeat spirit was perceived as very healing. People appreciate the fact that Al brings a smile to their faces even in these difficult times.

Before physically returning to the studio Al made a virtual appearance from his home saying that the pathology report had showed there was no evidence of cancer beyond his prostate.

Al recently returned to the Today Show studios after his recovery post-surgery. Fortunately, he was able to announce to viewers the positive news that doctors were certain that they had managed to remove the cancer. He credited his triumphant return to the studio to great medical care and the love of friends and family.

When back at work, the star told co-workers that he was feeling good.

Cal Ripken Jr. Talks About His Recovery From Prostate Cancer Surgery

“It stops you in your tracks, for sure. I mean, as a kid, when you go back to the days when I was a kid and you heard cancer, it was a death sentence. It was the worst possible news you could hear,” said Mr. Ripken.

Ripken, who recently turned 60, was diagnosed with prostate cancer just as the coronavirus pandemic was starting to set in.

Fortunately, the prostate cancer was caught early and Mr. Ripken was able to undergo surgery at Johns Hopkins, but was able to avoid both radiation and chemotherapy.

Because it was very early in the process, Mr. Ripken felt that surgery was the right answer. “It was a great ending, it was all contained in the prostate, it’s all gone. I’m cancer-free and basically resumed normal activities as I always did,” says Ripken.

At first, Mr. Ripken chose to remain very private about his diagnosis and he didn’t tell anyone. But then as time went on, he changed his mind because he wanted to encourage men to get their physicals.

It is very important for men to get regular checkups because catching prostate cancer early is key. If it is caught early prostate cancer is very treatable. And checking for prostate cancer is easy.

African-American Men; Prostate Cancer Risk

Men of all ages should be concerned about and aware of the signs of prostate cancer. It’s recommended that men talk to their doctors about when they should be screened based on their family history and other risk factors. Early screening is especially important if a man has one or more risk factors and is at an increased risk of developing prostate cancer.

Statistically it is a fact that men of African-American descent are at a higher risk of developing prostate cancer than white men. 19 percent of black men, almost one in five — will be diagnosed with prostate cancer. Five percent of that group will eventually die from the disease. Prostate cancer is the fourth most common reason for death in African-American men.

The risk for prostate cancer in African-American Men is greater, but how much greater?

No one is certain of the reasons why black men are at an increased risk of developing and dying from prostate cancer. In part this group is more likely to die from prostate cancer in part because of delayed diagnosis and also because of limits in access to treatment. One recent study suggests that there may be a genetic link.

If there is a family history of prostate cancer for an African-American man, their risk increases dramatically. Those with an immediate family member who had prostate cancer have a one in three chance of developing the disease. This risk rate increases to 83 percent if two immediate family members have had the disease.

It’s so important to have early prostate cancer screening, and here is why:

By the time noticeable symptoms of prostate cancer appear, the cancer is likely in an advanced state so early prostate cancer screening is of utmost importance. The changes of recover increase the earlier the prostate cancer is caught.

When caught early, prostate cancer is highly treatable. Nearly 100 percent of men who are diagnosed with prostate cancer in its earliest stage will be alive five years later.

African American men should have prostate cancer screening at young age.

For African American men, routine prostate cancer screening should start at a young age; the American Cancer Society recommends that these men discuss testing with their doctor at age 45, or at age 40 if they have several close relatives who have had prostate cancer before age 65.

There are some different types of screening tests and those can include a prostate-specific antigen (PSA) blood test and/or a digital rectal exam (DRE). A family doctor can usually perform both tests.

The signs and symptoms of prostate cancer are important for all men to know. These symptoms can include urinating in the middle of the night, urinating more frequently than normal, and feeling like the bladder doesn’t completely empty. Also blood in the urine may be a sign of prostate cancer.

If men experience these symptoms it is important for them to talk to their doctor about diagnostic testing for prostate cancer.

Hounds Astound: Prostate Cancer Found 100% (Around)

ORLANDO, Florida — With an accuracy rate of nearly 100%, 2 specially trained dogs were able to detect prostate cancer with their olfactory system — by sniffing urine samples, according to a new study that is the largest of its kind.
Italian researchers tested each dog’s ability to sniff out prostate cancer in urine samples from 362 men with prostate cancer and 540 men with either non-neoplastic prostate disease or nonprostatic tumors.
The dogs, German Shepherds named Liu and Zoey, had their day, time and again.
Liu had an accuracy rate of 99.0%, with a sensitivity of 100.0% and specificity of 97.8%. Zoey had an accuracy rate of 97.0%, with a sensitivity of 98.6% and specificity of 95.9%.
“This is a real clinical opportunity,” said lead researcher Gianluigi Taverna, MD, chief of the prostatic disease unit at Humanitas Research Hospital in Milan, about the results. The opportunity includes the possibility that specially trained dogs could provide a noninvasive method of cancer detection.
He spoke during a press conference here at the American Urological Association (AUA) 2014 Annual Scientific Meeting.
The dogs were equally capable of detecting low-risk and more advanced prostate cancers. “The dog has a quality, not quantity, response,” said Dr. Taverna.
When evaluating the rare wrongly detected cases, the researchers found no differences between epidemiologic, clinical, or histopathologic characteristics.
The frozen urine samples used in the study were obtained from local Milan hospitals and then thawed for the testing.
The smell tests occurred in a small room with a video recorder mounted on one wall. A dog handler walked a single dog in a circle around a series of mesh covered bowls. The dog went around the full circle once, and then on the second go-round, stopped at specific bowls if they contained urine with prostate cancer odors.
The dogs are not any old mutts, said Dr. Taverna. They are very well-trained dogs who are also experts at detecting explosives. “They are Ferraris,” he explained, referring to the Italian high-performance cars.

They are Ferraris.

Two important questions remain.
First, what do the dogs actually smell? The answer to this is not known, Dr. Taverna said.
Second, how can a dog be used in daily clinical practice? He explained that an international center could be developed to train dogs, and then send them to other countries and medical centers.
An American urologist has a different vision. “Someone discovers what these organic compounds are and uses gas chromatography or the “electric nose” as a sensor to pick them up,” said press conference moderator Brian Stork, MD, from West Shore Urology in Muskegon, Wisconsin, who is a member of the AUA social media committee.
Electronic nose technology, first developed for the military to detect chemical warfare, analyzes odors.
In a recent proof-of-concept pilot study, one such device — the ChemPro 100 eNose (Environics) — detected prostate cancer from a urine sample with nearly 80% accuracy.
Electronic noses have also been shown to identify lung cancer with a high degree of accuracy, as reported by Medscape Medical News.
However, in commenting on the Italian study, Dr. Stork, who is a self-proclaimed dog lover, said that it would be “more beautiful” if dogs were used to detect prostate cancer.
Indeed, there is a growing body of literature on the ability of dogs to sniff out cancer. Previous studies have reported on dogs that can smell and detect lung and breast cancer from breath samples and colon cancer from stools, and there has been anecdotal evidence suggesting that dogs can detect melanoma and bladder and ovarian cancer.
There has been one other study of dogs sniffing out prostate cancer in 33 patients, according to AUA press materials.
The Italian researchers are studying the volatile organic compounds that are behind the odorous signature of prostate cancer.
Dr. Taverna and Dr. Stork have disclosed no relevant financial relationships.
American Urological Association (AUA) 2014 Annual Scientific Meeting: Abstract PD19-01. Presented May 19, 2014.

Prostate Cancer Facts

September is Prostate Cancer Awareness month. It’s important to be aware of the symptoms and treatment options for prostate cancer so you can detect and treat it as early as possible.

What is Prostate Cancer?

Prostate cancer starts in the prostate gland, which is a small, walnut-sized structure that is part of the man’s reproductive system. Though there are some cases of prostate cancer that are more aggressive, prostate cancer usually grows slowly and remains confined to the prostate gland.

Symptoms of Prostate Cancer

Prostate cancer in its early stages might not cause noticeable symptoms. As it becomes more advanced, it may cause symptoms including:

Discomfort in the pelvic area
Blood in both semen and urine
Difficulty urinating
Pain in lower back
Pain in hips or thighs
Light stream of urine

Treating Prostate Cancer

Treatment options for prostate cancer depend greatly on the stage the cancer is at. The stages of prostate cancer include:

Stage I – During this stage, the cancer isn’t considered aggressive. During this stage, your physician may decide that treatment isn’t necessary and may choose to simply monitor the cancer.
Stage II – Cancer at this stage may still be considered aggressive. It may be larger and may involve both sides of the prostate gland.
Stage III – The cancer has spread from the prostate gland to other nearby tissues.
Stage IV – During stage IV, the cancer has spread to nearby organs, such as the bladder or lymph nodes.

Depending on the stage of the prostate cancer, your physician may choose radiation therapy, hormone therapy, surgery to remove the prostate, chemotherapy or immunotherapy.