Gláucio Ary Dillon Soares's Public Library

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Prostate Cancer Death











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Prostate Cancer Clinical Study Resumes At Virginia Urology Center



EDAP, Duke Restart Ablatherm-HIFU Localized Prostate Cancer Clinical Study



New Prostate Cancer Treatment Wins Operations Research Award



Better Blood Test for Prostate Cancer



Quality Of Life After Common Treatments For Prostate Cancer





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Prostate Cancer

Clinical factors including the time to biochemical recurrence following surgery can help predict the risk of prostate cancer death for patients following a radical prostatectomy, according to a study in the July 27 issue of JAMA.

Radical prostatectomy (removal of the prostate) is one of the most common treatments for prostate cancer and generally provides excellent cancer control, according to background information in the article. However, approximately 35 percent of patients will develop a prostate-specific antigen (PSA) recurrence ("biochemical recurrence") within 10 years after surgery. Due to the sensitivity of PSA to detect disease recurrence early, many patients have a long interval between biochemical recurrence and the development of local recurrence or distant metastasis.

Given the protracted natural history, the researchers had previously identified clinical variables to help stratify patients for risk of metastasis: time from surgery to biochemical recurrence, pathological Gleason score (a grading system for prostate tumors), and PSA doubling time (PSADT; the time it takes for the PSA value to double). Previous research has confirmed that a short PDADT is a risk factor for clinical progression and prostate cancer-specific death.

Stephen J. Freedland, M.D., of The Brady Urological Institute, Johns Hopkins Medicine, Baltimore, and colleagues conducted a study to 1) identify clinical factors that are associated with increased risk for prostate cancer-specific death following radical prostatectomy, and 2) to identify men who are at high risk and may benefit from aggressive treatment and as well as to identify those men who are at low risk and can be safely observed. The study included 379 men who had undergone radical prostatectomy between 1982 and 2000 and who had a biochemical recurrence. The average follow-up after surgery was 10.3 years.

The researchers found that PSA doubling time (less than 3.0 vs. 3.0-8.9 vs. 9.0-14.9 vs. 15.0 or more months), pathological Gleason score (7 or less vs. 8-10), and time from surgery to biochemical recurrence (3 or less vs. greater than 3 years) were all significant risk factors for time to prostate-specific death. Using these 3 variables, tables were constructed to estimate the risk of prostate cancer-specific survival at year 15 after biochemical recurrence.

Patients with a PSADT less than 3 months had a median survival of 6 years. Patients with a PSADT less than 3 months, biochemical recurrence 3 years or less after surgery, and a pathological Gleason score of 8-10 had a median survival of 3 years. Patients with a PSADT of 15 or more months and a biochemical recurrence more than 3 years after surgery had a 100 percent prostate cancer-specific survival.

"Using the current data, patients at high risk of death due to prostate cancer can be identified. These patients should be offered aggressive combined multimodality treatment using hormonal and cytotoxic chemotherapy, particularly in light of recent data suggesting that chemotherapy can modestly, but significantly, prolong survival in patients with hormone refractory disease," the authors write.

(JAMA. 2005;294:433-439) - Chicago


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Researchers at the University of California measured how long it took for PSA levels to double - an indicator that cancer is returning; the average time for prostate cancer patients is about 15 months. But in the study, published in the journal Clinical Cancer Research, those drinking a 225ml daily dose of pomegranate juice had a doubling time of 54 months - almost four times as long.

Dr Allan Pantuck, the lead researcher, said: "I was surprised when I saw such an improvement in PSA numbers. In older men who have been treated for prostate cancer, we can give them pomegranate juice and it may be possible for them to outlive their risk of dying from cancer."

Pomegranate juice 'helps to beat prostate cancer'

DRINKING pomegranate juice every day helps to combat prostate cancer and may even prevent deaths, researchers say.

A study of 50 men treated for prostate cancer found that a medium-sized glass of the juice drunk daily stabilised blood levels of prostate-specific antigen (PSA) - a biomarker showing the presence of cancer.

Experts said it was also possible that pomegranate juice could help to prevent cancer in a wider male population.

Researchers at the University of California measured how long it took for PSA levels to double - an indicator that cancer is returning; the average time for prostate cancer patients is about 15 months. But in the study, published in the journal Clinical Cancer Research, those drinking a 225ml daily dose of pomegranate juice had a doubling time of 54 months - almost four times as long.
>

Dr Allan Pantuck, the lead researcher, said: "I was surprised when I saw such an improvement in PSA numbers. In older men who have been treated for prostate cancer, we can give them pomegranate juice and it may be possible for them to outlive their risk of dying from cancer."
>

He said using pomegranate juice may prevent or delay the need for other therapies, such as hormone treatment, which have harmful side-effects. "This is not a cure, but we may be able to change the way prostate cancer grows," he said.

"We don't know yet the specific factors behind this response - that's the next step in this research."

The study showed that the speed at which PSA levels rose in the men fell by an average of 35 per cent after they started drinking pomegranate juice. There was evidence also that cancer cells were being killed in those who drank the juice.

The number of cells grown from blood samples decreased by almost 30 per cent, and cell proliferation - the rate at which cells divided - by 12 per cent.

Pomegranate juice is known to have anti-inflammatory effects and high levels of antioxidants, which are believed to protect the body from free-radical damage in the cells.

Prostate cancer is the most common cancer affecting men in the UK. More than 30,000 men in Britain are diagnosed each year and about 10,000 die from the disease.

The Prostate Cancer Charity said it may be that pomegranate juice has a wider use in men with raised PSA levels but not to the extent where they require active treatment. Chris Hiley, the charity's head of policy and research, said: "This is certainly interesting and attractively simple.

"Time and some more research will show us exactly how important pomegranate juice will turn out to be.

"This, we hope, will confirm the benefit and provide more detail on what men could reasonably expect from drinking pomegranate juice."

Dr Hiley added: "It may well turn out that pomegranate juice has a wider application than just delaying disease progression in men with prostate cancer who have already been treated.

"It might also help as a reassuring low-key intervention for men whose cancer is being monitored rather than treated."

And she said that further work might also uncover whether pomegranate juice has a preventative role as well.

The face of fear

James A Levine MD^a, Ioannis Pavlidis MD^b and Murray Cooper MD^b