Monday, 14 August 2017

Discovery of new prostate cancer biomarkers could improve precision therapy

Mayo Clinic researchers have identified a new cause of treatment resistance in prostate cancer. Their discovery also suggests ways to improve prostate cancer therapy. The findings appear in Nature Medicine.
In the publication, the authors explain the role of mutations in the SPOP gene on the development of resistance to one class of drugs. SPOP mutations are the most frequent genetic changes seen in primary prostate cancer. These mutations play a central role in the development of resistance to drugs called BET-inhibitors.
BET, bromodomain and extra-terminal domain, inhibitors are drugs that prevent the action of BET proteins. These proteins help guide the abnormal growth of cancer cells.
As a therapy, BET-inhibitors are promising, but drug resistance often develops, says Haojie Huang, Ph.D., senior author and a molecular biologist within Mayo Clinic's Center for Biomedical Discovery. Prostate cancer is among the most diagnosed malignancies in the United States. It is also the third leading cause of cancer death in American men, according to the American Cancer Society. Because of this, says Dr. Huang, improving treatments for prostate cancer is an important public health goal.
In the publication, the authors report SPOP mutations stabilize BET proteins against the action of BET-inhibitors. By this action, the mutations also promote cancer cell proliferation, invasion, and survival.
"These findings have important implications for prostate cancer treatment because SPOP mutation or elevated BET protein expression can now be used as biomarkers to improve the outcome of BET inhibitor-oriented therapy of prostate cancer with SPOP mutation or BET protein overexpression," says Dr. Huang. Mutations in the SPOP gene can then be used to guide administration of anticancer drugs in patients with prostate cancer: The Nature Medicine publication presents four major discoveries:
  • BET proteins (BRD2, BRD3, and BRD4) are true degradation substrates of SPOP.
  • SPOP mutations cause elevation of BET proteins in prostate cancer patient specimens.
  • Expression of SPOP mutants leads to BET-inhibitor resistance and activation the AKT-mTORC1 pathway that promotes cancer cell growth and survival.
  • Co-administration of AKT inhibitors overcomes BET inhibitor resistance in SPOP-mutated prostate cancer. Mayo Clinic Ventures, the technology commercialization arm of Mayo Clinic, has a patent application in place for this promising prostate cancer biomarker and therapeutic technology.

Story Source:
Materials provided by Mayo Clinic August 2017

Sunday, 6 August 2017

The robot that could cure your prostate cancer

A guide to the other advances helping win the war against this disease feared by men

     Thirty men a day in the UK die of prostate cancer. It is a gloomy statistic – yet talk to experts in the field and the mood is anything but pessimistic. In fact, there is a sense that science is on the verge of turning the disease from one to be feared to little more than a chronic illness controlled with drugs, like asthma or diabetes.

Survival rates are better than ever: the number of deaths keeps falling and ten years after diagnosis, 84 per cent of men are still alive.
From more accurate screening and less invasive diagnostic techniques to robotic surgery and targeted drugs, huge advances in treatments also mean men are more likely to be cured, and less likely to be left impotent or incontinent – the big worries for most.
Surgeon Christopher Ogden with the da Vinci Xi surgical robot that he uses to perform robotic prostatectomy at the Royal Marsden Hospital, London
Surgeon Christopher Ogden with the da Vinci Xi surgical robot that he uses to perform robotic prostatectomy at the Royal Marsden Hospital, London

‘Soon this could be a disease that men routinely survive, and has little impact on their daily life,’ says Dr Iain Frame, research director at the charity Prostate Cancer UK.
But with advances in therapies comes new information for every man with prostate cancer and his loved ones to absorb – much of it complex. We spoke to Britain’s foremost experts, who between them have treated tens of thousands of men, about the new developments every patient should be aware of and the treatments that really do make a difference…
Christopher Ogden is a surgeon at the Royal Marsden Hospital in London
Christopher Ogden is a surgeon at the Royal Marsden Hospital in London
Christopher Ogden, a surgeon at the Royal Marsden Hospital in London, pioneered the use of robotic surgery for prostate cancer – treating more than 2,500 men with a technique that revolutionised the treatment of the disease. 
He says: ‘Although surgery might not be the first thing we offer men with prostate cancer, many will at some point need to have the gland removed. The operation is called a radical prostatectomy and it offers a cure in 95 per cent of cases.
‘Decades ago, the only option was open surgery – with the prostate removed through a long incision below the navel. Then came keyhole surgery, where instruments and a camera were inserted though several tiny cuts in the abdomen.
‘About 13 years ago, I was the first British surgeon to use the Da Vinci robot, which is a high-tech version of keyhole surgery, where instruments are held by a machine with robotic arms.
‘Back then it was seen as a bit outlandish. Now it’s the gold standard in surgery, with nearly 100 robots in the country, and hundreds more surgeons trained to use them.
‘The arms are controlled by the surgeon from a console next to the operating table. The procedure eliminates the risk of surgical error through hand tremors or shakes. And the video display in the console is highly magnified, which means we are better at avoiding damage to nearby nerves.
‘This means the risk of the complication feared most by men, erectile dysfunction, may be reduced.
‘The robot performs at least twice as well as the best surgeon in getting all cancer out in one go – reducing the need for repeat surgery, and greater risk of erectile dysfunction and incontinence.’
Professor Roger Kirby is a consultant urologist and director of The Prostate Centre in London
Professor Roger Kirby is a consultant urologist and director of The Prostate Centre in London
Professor Roger Kirby, consultant urologist and director of The Prostate Centre in London, is a leading light in the field, having published more than 300 scientific papers on prostate tumours. He says:
‘Today, two-thirds of men with prostate cancer will never need to have surgery, and can instead undergo active surveillance – where regular checks are carried out to see if the tumour is progressing. If the cancer remains small and slow-growing, then there is no reason to operate.
‘Last year a study that tracked 1,600 men with prostate cancer for ten years found no difference in survival rates between men who had active surveillance, surgery or radiotherapy.
‘If they do need treatment, there are several options before surgery. Prostate tumours are very sensitive to testosterone, so we give men powerful hormone-blocking drugs which slow down cancer growth.
‘High-Intensity Focused Ultrasound [HIFU] – where a targeted blast of ultrasound is fired at the cancerous part of the prostate – destroys the tumour by heating it but leaves the rest of the prostate intact. But it's only offered on the NHS in clinical trials, and more research is needed before it can be more widely used.
‘Radiotherapy and chemotherapy also remain important treatment options – but robotic surgery may mean less so in the future.’
Nicholas James is Professor of Clinical Oncology at the Institute of Cancer and Genomic Sciences at the University of Birmingham
Nicholas James is Professor of Clinical Oncology at the Institute of Cancer and Genomic Sciences at the University of Birmingham
Nicholas James is Professor of Clinical Oncology at the Institute of Cancer and Genomic Sciences at the University of Birmingham, and chief investigator of the huge Cancer Research UK-funded STAMPEDE trial into treating aggressive prostate cancer. He says:
‘Prostate cancer is often in the news with stories of new drug developments, treatments, and tests. However, until a therapy is approved for use in the NHS, often the only way to access it is via a clinical trial.
‘I recommend men get themselves on to one if they can, and there are many being run by the NHS right now.
‘In a trial, all treatment must be done to impeccable standards to ensure the quality of the data.
‘This means that even patients who aren’t receiving the “new” drug or whatever is on trial still get a gold-standard level of quality when it comes to treatment.
‘If you are told there is a trial that isn’t suitable for you at the moment, then fine, but if your hospital simply doesn’t run trials, then I would try to look elsewhere for treatment. It is a badge of quality if a hospital is actively engaged in clinical trials.
‘One of the biggest recent treatment breakthroughs was discovered in the Cancer Research UK-funded STAMPEDE trial that I led.
‘There is also growing evidence from another British trial that doing an MRI of the prostate might spare some men the ordeal of a biopsy.
‘The scans also enable us to keep monitoring the patient more safely without them having to have a needle inserted into the prostate.
‘This means surveillance becomes safer, and more men will be able to avoid radiotherapy and surgery – in some cases totally, others for as long as possible.’
Dr Iain Frame is research director for the charity Prostate Cancer UK
Dr Iain Frame is research director for the charity Prostate Cancer UK
Dr Iain Frame, research director for the charity Prostate Cancer UK, describes it's ambitious’ ten-year plan to halve mortality and bolster survival through better diagnosis and new treatments. He says:
‘Our main goal is to improve diagnoses, which will cut death rates by picking up cancers at an earlier stage. At the moment we are not very good at differentiating very aggressive tumours from the slow-growing ones that may never cause a problem.
‘So we are funding research looking at ways to tell them apart – in cancer blood tests that have been dubbed liquid biopsies.
‘Most middle-aged men will be familiar with prostate specific antigen or PSA testing. The newer tests being researched look for genetic material and other compounds in the blood that are produced by tumours, and can tell us about the cancer without us actually having to take solid samples.
‘Last year, we drew up a ten-year plan which has a key objective of halving halve the number of deaths to about 7,000 a year by 2026, and better diagnosis will help make this a reality. We think it is ambitious but achievable.’
Rock drummer Kenney Jones has played in The Faces and The Who 
Rock drummer Kenney Jones has played in The Faces and The Who 
Rock drummer Kenney Jones, 68, of iconic bands The Faces and The Who, was diagnosed in 2013. The father- of six, who lives in Surrey with wife Jayne, 59, is now cancer-free. He says:
‘I am passionate about talking about prostate cancer because I want men to catch it early, giving them a better chance of survival.
‘I was incredibly lucky to have been caught at the “late” end of early. The disease was still contained inside the prostate.
‘But looking back, I’d had symptoms for years. I blamed getting up two or three times a night on having a few glasses of wine in the evening. I also ignored the fact that my urine flow had slowed down.
‘I was offered a PSA test, a blood test that can detect problems with the prostate, while at my GP surgery for something else. I’d never heard of this test, but it saved my life. Just over a week later I was diagnosed with prostate cancer and discussing treatment options.
‘My biggest worry was whether the cancer had spread. Thankfully, it hadn’t – and I was offered brachytherapy, a type of radiotherapy.
‘This involved having 80 tiny titanium pellets inserted into my prostate to kill the tumour. They blast away at it for a few months and once they’ve done their job, they become inert and remain inside.
‘There were side effects – the radioactivity causes the prostate, bladder and the whole area to become inflamed. I couldn’t pee. It all calmed down after a few months and it worked. I am cancer-free and everything down there works fine.
‘All men need to talk about prostate cancer. It’s a killer – I lost my friend Alvin Stardust to it because he was diagnosed so late.
‘I have also warned my four sons to be vigilant – there were many men younger than me in hospital when I was there. This disease doesn’t discriminate.’

Don't fear THAT won't hurt! 

By Dr Ellie Cannon  
Q) Does a test still involve THAT rather intimate examination?
A) A digital rectal examination is the normal way for a GP or specialist to examine a prostate. The gland is located in the pelvis, below the bladder, and can be examined by placing a finger into the rectum. It’s really not painful, and we do it all the time so you shouldn’t be embarrassed. The doctor can feel whether the prostate feels hard and irregular, which may be a sign of cancer. Urinary tract symptoms can also signal many far more common benign conditions, so an examination is an important way to distinguish between these.
Q) Is there anything I can do to reduce my risk?
A) Unlike other cancers, there are no ‘modifiable’ risk factors for prostate cancer – ones that you can improve yourself through lifestyle changes such as diet. It’s why screening tests and awareness is so important.
Q) If it’s not prostate cancer, what’s causing my symptoms?
A) You are far more likely to have a benign prostate condition than prostate cancer. Lower urinary tract symptoms such as waking at night to pass water, difficulties with flow and the increased need to go are common in men. These can be the signs of cancer but are also symptoms of benign prostate enlargement – a noncancerous condition treated with medication.
Q) Who needs to worry about prostate cancer?
A) A quarter of all new cancers in men are prostate, making it the most common male cancer – so really all men need to know about it. The average age of diagnosis is 72 and it is considered uncommon under the age of 50. Men from black Caribbean or African ancestry are at highest risk – and they are also more likely to have a more aggressive cancer. Your risk is increased by 2.5 times if your father had it.

Daily Mail publication August 2017

Monday, 3 July 2017

Treament with modified citrus pectin

Treament with modified citrus pectin (MCP), a nutritional supplement, led to promising results in men with recurrent prostate cancer, according to preliminary results from a Phase 2b trial.
The protein PSA (prostate specific antigen) is made only by the prostate gland. Although the increase in PSA production is not exclusive to prostate cancer, its measurement is a valuable tool in cancer screening. Therefore, assessing the PSA doubling time (PSADT) is a viable measure of tumor growth in patients whose prostate has been targeted with surgery and/or radiation. The PSADT reflects the time taken by the number of tumor cells to duplicate.
Current treatment options for patients with biochemically relapsed prostate cancer (BRPC; rising PSA levels), such as androgen deprivation therapy, have significant toxicity concerns. That’s why new non-toxic therapies are being investigated.
Pectin is extracted from the pith of citrus fruit peels and is subjected to a modification process to ease its entrance in the bloodstream. PectaSol-C MCP (or P-MCP) inhibits galectin-3, a carbohydrate-binding protein, which is involved in cancer development and inflammation.
Preliminary data indicates that P-MCP is active in prostate cancer. But its safety and effect on PSA dynamics in patients with BRPC had not been tested.
The clinical trial performed at Meir Medical Center in Kfar-Saba, Israel, included 35 patients from multiple cancer centers with non-metastatic biochemical relapse. Patients had a median age of 74 years. P-MCP was given orally three times per day. Patients who did not show disease worsening either clinically, biochemically (PSA), or radiologically at six months were treated for another 12 months.
Results at six months of treatment showed that P-MCP slowed PSA doubling time in 79 percent of non-metastatic patients and halted growth or induced a decrease in size in 62 percent of patients. Final results of the clinical trial are expected at 18 months of treatment.
“This study confirmed the results seen in two previous smaller studies,” Moshe Frenkel, MD, co-investigator of the trial and clinical associate professor at the University of Texas Medical Branch, said in a press release.
“We are constantly looking for natural options that affect cancer progression with minimal side effects. Based on the intermediary findings of the study, MCP has the potential to fall into this category with patients affected by prostate cancer,” added Frenkel, who is also the director of the Complementary and Integrative Medicine Unit in the Institute of Oncology at Meir Medical Center.

Thursday, 29 June 2017

Advance in Prostate Cancer Surgery from New Zealand

New Zealand’s Kathleen Kilgour Centre (KKC) has treated the country’s first patient with Augmenix‘s SpaceOAR system, a medical device that protects men from rectal complications after prostate cancer radiation therapy.
Because the prostate and the rectum are anatomically adjacent, radiation therapy targeting the prostate can injure the rectum and cause pain, discomfort or diarrhea.
The SpaceOAR system works by injecting an hydrogel into the space between the prostate and the rectum, generating a pressure force that pushes the organs further away from each other. As a result, during prostate radiation therapy, the rectum is out of the region affected by radiation and suffers less damage.
“KKC is dedicated to providing the best care for our patients and the introduction of SpaceOAR hydrogel for men with prostate cancer is yet another step in achieving this,” Dr. Leanne Tyrie, the KKC’s clinical director, said in a press release. “The significant decrease in bowel, urinary and sexual side effects following radiotherapy when SpaceOAR hydrogel is utilized made our decision to incorporate it as part of the standard of care for prostate cancer patients very easy.”
Besides increasing protection to the rectum, the hydrogel can also decrease radiation’s harmful side effects to urinary and sexual organs.
The hydrogel maintains spacing for three months and then gradually becomes a liquid which is cleared in urine through renal filtration about six months after injection.
“Recent clinical data show that SpaceOAR hydrogel helps to significantly reduce the risk of rectal and urinary side effects and loss of sexual function associated with radiation therapy in the treatment of prostate cancer,” said Augmenix CEO John Pedersen. “We are pleased that the first patient to be treated with SpaceOAR hydrogel in New Zealand took place at the Kathleen Kilgour Centre, which prides itself on offering high quality, multi-modality radiation therapy treatment options for men with a diagnosis of prostate cancer.”
Augmenix, based in Bedford, Massachusetts, sponsored a Phase 3 clinical trial in the United States (NCT01538628) to evaluate the system’s safety in men undergoing Image-guided intensity-modulated radiotherapy (IG-IMRT) and to assess whether using SpaceOAR hydrogel reduced radiation exposure to the rectum.
Results showed that the hydrogel spacer was safe and well tolerated. It significantly reduced rectum radiation injury with decreased reports of pain during treatment. One year after radiation, treatment decreased rectum complications by 71 percent and who had not been injected with the hydrogel were 3.5 times more likely to have rectal complications than those who received SpaceOAR.
Three years after treatment, patients treated with SpaceOAR had 73.5 percent less radiation in their rectum, as well as better urinary and sexual functions.
Men who received SpaceOAR were eight times less likely to experience significant declines in their quality of life and 78 percent of the men who were sexually active before receiving SpaceOAR treatment were more likely to retain sexual function three years later.

Monday, 19 June 2017

Surgery or Radiotherapy?

I chose surgery over radiotherapy for a far more basic reason. I preferred to think of the cancerous tissue, as it was thrown into the hospital incinerator, destroying what would have destroyed me. I didn't like the idea of having a radiated piece of gunk, sitting in my groin area, not knowing if it really was completely dead.

But you might see things differently?

Surgery Seen as Superior to Radiation Therapy in Younger Men with High-risk Prostate Cancer, Study Finds

Jun 16, 2017 06:23 am | Carolina Henriques


prostate cancer risk

Men under 60 with high-risk prostate cancer who underwent radical prostatectomy — or surgery to remove all or part of the prostate — as an initial treatment, showed significantly improved overall survival at four years than those given radiation therapy, a study found. Researchers used the National Cancer Database to analyze 16,944 high-risk prostate cancer patients, age 59 or younger.

Saturday, 10 June 2017

Do not trust your doctor...

A very useful article written by Dr Samadi, a renowned Urologic Oncologist from the USA. 

If you've just been diagnosed, he makes one statement here that should be flashing in lights at you....

"Every man needs to become his own health advocate by becoming familiar with the risk factors and possible signs and symptoms of prostate cancer." 

Before you read this article, know that I strongly disagree with one thing that Dr Samadi suggests, maybe he has more faith in the medical profession than I do.

I say DO NOT trust your doctor, it could cost you your life. Be your own case manager and research the hell out of everything   ( you would if you were buying a new laptop ),  including the abilities of those treating you. Don't think because they wear a white coat and Ralph Lauren glasses that they know everything about your condition, YOU need to help them.

Read on........

A diagnosis of prostate cancer is certainly up setting for any man. But if his knowledge of this type of cancer is limited, it can possibly set him on the wrong track of knowing how best to fight it.
Figuring out what needs to be known about prostate cancer can be overwhelming, with decisions to be made, treatment options to condider and not knowing what the future holds.
To beat back the second leading cause of cancer in American males behind only skin cancer, men need to arm themselves with adequate knowledge of what exactly prostate cancer is.
The more a man knows and understands what prostate cancer is and knows what he is dealing with, the more he can take charge of his condition and vastly improve his chances of defeating it in the end.
Prostate gland and prostate cancer statistics
The prostate is a gland of the male reproductive system which sits below the bladder and in front of the rectum. Its function is to produce a fluid that contributes to the formation of semen. Normally the size of a walnut in younger men, the prostate can grow much larger as a man ages.
Prostate cancer is when cells in the prostate gland grow uncontrollably. According to the National Cancer Institute (NCI) approximately 14% of men will be diagnosed with prostate cancer at some point during their lifetime, based on 2010-2012 data.
This cancer is considered a fairly common one for men, with estimates in 2017 of 161,360 new cases being diagnosed. An estimated 26,730 men will die from the disease.
However, if prostate cancer is discovered in its early stages, it has a 98.9% survival rate as reported from the NCI.
Treatment options
Each individual patient's prostate cancer treatment depends on many factors — the man's age, overall health, staging of the cancer and its location.
Tailoring a treatment plan best suited for each patient's unique needs is necessary to have the best outcome. When the options available are thoroughly explained, a man and his physician will be better prepared to choose the one right for him
The best defense is to have a game plan of good offense when it comes to prostate cancer.
Men need to have yearly exams to assess what is going on with their prostate. A simple rectal exam which takes less than a minute and a yearly PSA blood test starting at age 40 are good screening tools urologists use to detect any changes in the prostate gland.
Not getting screened is unwise, as a man will be missing his opportunity to catch any changes before it's too late
The outcome of the rectal exam and PSA blood test, will determine what the next steps are. While the PSA test and rectal exam are not perfect, when performed regularly they still remain the best way to detect prostate cancer.
If abnormalities are found with either the rectal exam or the PSA test, from there the doctor may decide to do a prostate biopsy in which a urologist obtains tissue samples from the prostate gland.
Those samples of tissue are sent to a pathologist to screen the size, shape, and pattern of growth of possible cancer cells, and he or she will assign what is called a Gleason score.
The Gleason score is used to describe the aggressiveness of the cancer cells and to predict prognosis and to determine what therapy is best for the patient.
Once the initial diagnostic findings (PSA, Gleason score, rectal exam) are sorted out, from there it will be determined if further imaging tests are required. The imaging tests could be the use of a computed tomography (CT) scan used to determine if cancer has spread outside of the prostate, particularly to the lymph nodes.
Magnetic Resonance Imaging (MRI) is another imaging test using strong magnets to look for cancer that has spread through the edge of the prostate.
After any imaging testing is completed, treatment options will be decided depending on what stage the cancer is in. One option a man and his doctor may decide to pursue is called active surveillance. This is the decision not to treat prostate cancer at the time of diagnosis based on the man's age, health condition and the rate of growth of the cancer.
If the cancer needs to be treated more aggressively, there are several methods of therapy to consider, all depending again on each individual man's prostate cancer, the expected rate of growth, staging and other factors.
The doctor may decide to choose one type of therapy or a combination to beat back the cancer. His choices range from the da Vinci prostatectomy, radiation therapy, Cyberknife SBRT procedure, IMRT procedure, seed implant procedure, or hormone therapy.
Every man needs to become his own health advocate by becoming familiar with the risk factors and possible signs and symptoms of prostate cancer. If something doesn't seem right, men should seek out advice and help from their doctor.
The best way to fight off this potential killer is to get regular checkups, understand the prostate and prostate cancer, and to find a urologist who will guide you through the battle every step of the way.
Dr. Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery and is an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital. He is a medical correspondent for the Fox News Channel's Medical A-Team. Follow Dr. Samadi on Twitter, Instagram, Pintrest, and Facebook

Monday, 5 June 2017

Promising Results from Prostate Cancer Trial

Extending the life of many men who have advanced prostate cancer...
Combining two existing prostate cancer therapies could extend the life of men with advanced, high-risk prostate cancer by 37%, according to a study presented at the world’s largest cancer conference. The new findings could change how doctors first approach treatment of prostate cancer.
“These are the most powerful results I’ve seen from a prostate cancer trial,” said Nicholas James, the lead author of the abstract presented as the American Society of Clinical Oncology. “It’s a once in a career feeling. This is one of the biggest reductions in death I’ve seen in any clinical trial for adult cancers.”
Researchers 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. The research was conducted as part of the Stampede trial, an ongoing randomized trial conducted in the UK and Switzerland. 
“Abiraterone not only prolonged life, but also lowered the chance of relapse by 70% and reduced the chance of serious bone complications by 50%,” James said. “Based on the magnitude of clinical benefit, we believe the upfront care for patients newly diagnosed with advanced prostate cancer should change.”
The study looked at a group of 2,000 men. Patients who received both abiraterone and normal hormone therapy were significantly less likely to die, compared to patients who received only hormone therapy. 
Comparatively, 83% of men assigned abiraterone therapy survived versus 76% of men on standard hormone therapy. Researchers also found that patients who received both medications had slightly stronger side effects, especially cardiovascular and liver problems. 
One patient who participated in the trial, Alfred Samuels, 59, was diagnosed with advanced prostate cancer in January 2012. “It felt like my world fell apart overnight,” Samuels said. “The doctors explained that surgery wasn’t an option for me because the cancer had spread beyond my prostate.”
“As part of the trial, I started taking abiraterone four times a day and had a hormone injection every eight weeks,” he said. “During the first six months, tests showed that the treatment was working. I’m still on the trial, which I find reassuring and, fortunately, my cancer is being managed well.”
More than 27,000 men in the US and 11,000 men in the UK die of prostate cancer each year, according to the US Centers for Disease Control and Prostate Cancer UK. In the US, aside from skin cancer, it is the most common cancer in men. 
“The potential benefits of giving some men abiraterone alongside hormone therapy are clearly impressive and we will be working with all relevant bodies to make sure this treatment becomes an option available for these men via the NHS,” said Dr Iain Frame, director of research at Prostate Cancer UK.

Sunday, 28 May 2017

New e-book

My new e-book will be published later this year. First, I would like to put it out to my wider family (only) for comment, recommendation etc.  
If you would like access please let me know....

Hereditary Prostate Cancer

Kyle, this one's for you...

If your father or/and brother/s have had prostate cancer, and you're wondering what your risks are, and what you should do now to help yourself, then read on from this recent study in the USA...

Hereditary Prostate Cancer 

In 1992, William Isaacs and other researchers at the Brady Urological Institute were the first to establish an undeniable link between a family history of prostate cancer and a man's risk of developing the disease, and to characterize the distinct phenomenon of Hereditary Prostate Cancer (HPC). We proved that prostate cancer, like other cancers, can be inherited - a fact once widely doubted. 

Since that time we have assembled one of the largest collections of families with hereditary prostate cancer and have characterized a number of chromosomal sites where the genes responsible may be located.  In 2012, in collaboration with investigators from the University of Michigan, we identified the first mutation responsible for hereditary prostate cancer in families – HOXB13.  We are continuing to pursue other genes that may turn out to be informative and are anxious to enroll families with multiple affected members.  

An estimated 250,000 American men may carry one of these defective genes; in these men, the odds of developing prostate cancer are extremely high. Having identified this mutation we have have a powerful tool to spot cancer early in men who have inherited this potentially lethal mutation. Also, discovering how this mutated gene triggers the cascade of prostate cancer may help us find new ways of preventing or treating the disease in all men. Although only about 10 percent of all cases of prostate cancer are thought to be purely hereditary, we believe that the defective gene or mechanisms involved in HPC are the same ones that somehow go askew in "sporadic" cancer (disease that just develops over the course of a lifetime - the kind most men get.) Here, as well, we have a one-of-a-kind resource - our pool of 2,500 families with HPC whose DNA may help us crack the genetic code of prostate cancer. 

Hereditary Prostate Cancer Study
The Johns Hopkins Department of Urology is actively recruiting families with familial prostate cancer and benign prostate enlargement in an effort to identify genetic determinants of these diseases. Clinical information of interest to physicians and patients is also included below. 
The importance of asking about a family history of prostate cancer 
The Department of Urology strongly encourages clinicians to take a family history of prostate cancer from each adult patient, as a positive family history markedly increases the risk of prostate cancer in first degree male relatives. For example, a patient with a father or brother with prostate cancer has two times the usual risk of developing prostate cancer. A man with both his father and brother affected with prostate cancer has almost a 50% chance of developing the disease. In addition, in such families prostate cancer occurs at an earlier age. At this time, our recommendation is that men with more than one first degree relative affected (father or brother) should be encouraged to undergo yearly digital rectal exam and yearly serum prostate specific antigen (PSA) beginning at age 40.

Planned NHS Tory cuts threaten future treatments

drugs under plans to cap spending by NHS England, prompting
 "serious concern" and an online petition from leading health 
and care charities.
Prostate Cancer UK has joined 10 other health and care charities* in calling for NHS England to urgently rethink plans for a new spending cap on treatments, which could see the next generation of life-saving prostate cancer drugs delayed indefinitely from reaching the men who need them.
We're urging everyone to ask NHS England and the National Institute for Health and Care Excellence (NICE) to reconsider their proposed 'budget impact threshold', which gives the option to postpone any new treatments that would cost more than £20 million in any of the first three years.

Proposals could devastate men with advanced prostate cancer

The restrictions would have meant the breakthrough drugs for advanced prostate cancer, enzalutamide and abriaterone, would have been delayed by negotiations with the manufacturers over costs for many years, arriving in NHS hospitals too late for the thousands of men whose lives they have extended.
Alan Oliver with his wife and grandchild
"Abiraterone has without question given me several extra years," says Alan Oliver (pictured above with his wife and grandchild), who started taking the hormone therapy drug in 2014.
"It has allowed me to enjoy my four grandchildren, three of whom are now in school, and I just couldn't put a price on this.
"It scares me that if this so-called cost cap comes in then in the future drugs, like abiraterone, would not get through the threshold, and people like me could potentially have the chance of precious time with loved ones held just out of reach."

1-in-5 new treatments could be delayed by cap

These vital 'end-of-life' drugs used by men like Alan already face a stringent and lengthy licensing and approval process, which the government is currently looking to expedite through its Accelerated Access Review and reforms to the Cancer Drugs Fund.
The proposed spending cap would add yet another layer of unnecessary bureaucracy and could stall up to 1-in-5 new treatments currently under review.
"Although we recognise the significant financial challenges facing the NHS, this arbitrary limit is not the solution and we're seriously concerned for the treatments of the future," says Angela Culhane, CEO of Prostate Cancer UK.
"NHS England and NICE need to hear this is unacceptable for patients and come up with a proposal that makes sure patients get the drugs and treatments they need, when they need them."