Posts tagged ‘prostate cancer’
Today is National Doctors Day, the official day to recognize, thank and celebrate the tremendous work physicians do each and every day.
Launched in 1991 via a presidential proclamation from then-President George Bush, the observance offers a chance to reflect on the qualities that define truly great medical care. Compassion and expertise are vital, of course, as is the intuitive understanding that each patient must be treated as a person, not his or her disease. But research is vital as well.
As the proclamation states: “The day-to-day work of healing conducted by physicians throughout the United States has been shaped, in large part, by great pioneers in medical research.”
Here, we acknowledge a few of the City of Hope physicians working to improve care and treatment of patients everywhere by maximizing the most leading-edge research from around the world – and by conducting it themselves at City of Hope.
Karen S. Aboody, M.D.: Pushing the frontiers of brain cancer therapy
Although the mass of a glioblastoma, the most aggressive and common type of primary brain tumor in adults, can be removed surgically, removal of all the tumor cells is virtually impossible – meaning recurrence is common. Karen S. Aboody, M.D., professor in the Department of Neurosciences and Division of Neurosurgery at City of Hope, believes the answer could lie in special cells called neural stem cells. Neural stem cells are known for their ability to become any type of cell in the nervous system. These cells not only are attracted to cancer cells, they have the ability to deliver drugs directly to the tumor sites, sparing healthy tissues and minimizing side effects. City of Hope is currently conducting a phase I clinical trial of neural stem cells to treat glioblastoma. » Continue Reading
When considering cancer risk, categories like “women’s cancers” and “men’s cancers” may not matter. A complete medical history, especially of first-degree relatives, must be considered when evaluating risk.
A new study drives home that fact. Published in the journal Cancer, the study found a link between a family history of prostate cancer and an increased risk of breast cancer in women. The study, one of the largest efforts to examine the link between these cancers, found that women with a father, brother or son with prostate cancer may have a 14 percent higher risk of breast cancer than women without that family history. Women with a family history of both prostate and breast cancer appear to have a 78 percent greater risk of developing breast cancer, according to the study.
The researchers, from the Barbara Ann Karmanos Cancer Institute at Wayne State University in Detroit, cautioned that their study found a connection, not a cause-and-effect relationship. Nonetheless, it gives food for thought to how women should think comprehensively when assessing individual cancer risk.
My colleagues in the clinic know I’ve got a soft spot. Last week, a patient of mine offered me a fantastic compliment. “You’re looking younger these days, Dr. Pal!” she said, offering me a big hug as she proceeded out of the clinic room.
Lovely, I thought. The early morning workouts are paying off.
She continued: “Now if you’d just consider using some Rogaine, I think you’d set the dial back about 10 years!”
Ouch. My nurse gave me a somber look, understanding the pain these words had inflicted. I wouldn’t consider myself to be vain by any means, but my hair loss has created increasing conflict between me and my bathroom mirror. With every passing morning, I notice a little less hair up front, and a bit less up top. This pattern, termed frontal and vertex balding respectively, plagues nearly half of American males, albeit to different degrees. Until recently, the major toll of this hair loss for me has been cosmetic, chipping away at my self-image as a youthful oncologist.
A recent study published in the Journal of Clinical Oncology, however, suggests a more significant price. The study authors, based at several U.S. institutions, utilized a database of over 39,000 male patients who were involved in a trial to assess cancer screening. These men were asked to recall their pattern of hair loss at the age of 45, characterizing the degree of frontal and vertex balding. » Continue Reading
Pick up any biotech industry report and you’re guaranteed to come across one term repeatedly – CAR-T therapy. A fierce competition is now underway to bring CAR-T treatments to market – several companies (Juno, Novartis, Kite and Cellectis, to name a few) have major stakes in the race. I’ve found the CAR-T buzz has also penetrated the clinic — not a day goes by that I don’t have a conversation with a patient regarding this emerging technology.
So what is CAR-T? Essentially, it’s an engineered immune cell (called a T cell) that has on its surface a highly specific protein called a chimeric antigen receptor (CAR). These “souped up” immune cells can mount a potent and highly specific attack against tumors.
Last year, a group of researchers from the University of Pennsylvania published results in the New England Journal of Medicine pertaining to 30 patients who had received CAR-T therapies. These patients were suffering from a relapse of acute lymphoblastic leukemia (ALL) and had failed standard treatments. The results were nothing short of remarkable – at six months following treatment, roughly two-thirds of patients remained free of disease.
These findings were a phenomenal leap forward for patients with this relatively rare disorder. A couple of roadblocks stand in the way of further development of CAR-T cells, however. » Continue Reading
The prostate cancer screening debate, at least as it relates to regular assessment of prostate specific antigen levels, is far from over.
The U.S. Preventive Services Task Force recommended against routine PSA screening for prostate cancer in 2012, maintaining that the routine use of the PSA blood test does more harm than good, threatening men’s quality of life. Many doctors and other medical professionals, however, never accepted this recommendation as prudent. They’ve continued to debate, or argue, the benefits and risks of regular prostate cancer screening.
A new study, led by Timothy E. Schultheiss, Ph.D, professor and chief of radiation physics at City of Hope, will add data fuel to the debate fire. In findings presented this week at the 2015 Genitourinary Cancers Symposium in Orlando, Florida, Schultheiss reports that the recommendations against PSA screening for prostate cancer may have led to an increase in higher-risk prostate cancer.
Schultheiss and his colleagues analyzed data on nearly 87,500 men treated for prostate cancer since 2005 and found a 6 percent increase in intermediate and higher-risk cases of the disease between 2011 and 2013. They estimated that the suggested trend could produce an additional 1,400 prostate cancer deaths annually.
For men walking out of the doctor’s office after a diagnosis of cancer, the reality can hit like a ton of bricks. The words echo: “Prostate cancer” … “Aggressive prostate cancer.” The initial feelings of grief, denial and anger are mixed with many thoughts: How much time do I have left? What else do I want to accomplish? What about my family, job and retirement plans?
Prostate cancer is the most common cancer in men – and the second-leading cause of cancer death – and a diagnosis of aggressive disease is often life-changing. As a urological oncology expert, I see men face the ups and downs of their diagnosis.
Although slow-growing cancers take decades to cause serious problems, fast-growing, or high-risk, cancer has the potential to quickly spread to other parts of the body. These tumors occur in up to 25 percent of men with prostate cancer, encompassing cancers of high Gleason grade, high levels of prostate specific antigen (PSA) or extremely abnormal prostates on physical exam.
Even if tests indicate that the cancer is only in the prostate, the prospect of cancer spreading or leading to death is anxiety-provoking and intimidating. Once men are able to reach the acceptance phase, the primary question becomes: What are my treatment options?
At City of Hope, our multidisciplinary team manages aggressive prostate cancer and the circumstances in which men need multiple forms of treatment. We not only have a proven track record in surgery for high-risk cancer, we also provide extended lymph node dissection, which offers extremely accurate assessment of the cancer’s spread. » Continue Reading
With this week’s World Cancer Day challenging us to think about cancer on a global scale, we should also keep in mind that daily choices affect cancer risk on an individual scale. Simply put, lifestyle changes and everyday actions can reduce your cancer risk and perhaps prevent some cancers.
According to the World Cancer Research Fund, about a third of the most common cancers could be prevented through reduced alcohol consumption, healthier diets and improved physical activity levels. If smoking were also eliminated, that number could jump to as many as half of all common cancers.
Here are a few suggestions. Truly, they’re not that difficult. Give them a try this week to mark World Cancer Day, Feb. 4, Try them the next week too. And the week after that …
In a word, exercise. Simple exercise benefits everyone, and even a little helps. Leslie Bernstein, Ph.D., professor and director of the Division of Cancer Etiology at City of Hope, recommends a 45-minute walk five days a week. While that is ideal, her research has found that, for some people, even 30 minutes per week can make a difference. The benefit of exercise applies for people of all weights and fitness levels.
The American Cancer Society recommends 150 minutes of moderate intensity or 75 minutes of high intensity exercise each week, preferably spread throughout the week. Don’t deny yourself the benefits just because you don’t have a large block of time or can’t get into the gym for a more formal workout. » Continue Reading
Explaining a prostate cancer diagnosis to a young child can be difficult — especially when the cancer is incurable. But conveying the need for prostate cancer research, as it turns out, is easily done. And that leads to action.
Earlier this year, Gerald Rustad, 71, who is living with a very aggressive form of metastatic prostate cancer, found himself trying to explain his heath condition to 10-year-old granddaughter Aurora.
He told her that his cancer couldn’t be cured, but that scientists at City of Hope were busily conducting research so they could help patients like himself. His doctor, for example, Sumanta Pal, M.D., co-director of City of Hope’s Kidney Cancer Program, was working with other City of Hope researchers to develop a drug that could treat metastatic prostate cancer without targeting testosterone.
The targeting of testosterone is too arcane for most 10-year-olds, but the need for scientific answers isn’t. Aurora asked if there were any way she could help. » Continue Reading
The American Cancer Society’s annual statistics show the death rate from cancer in the U.S. is down significantly from its peak more than a decade ago – certainly a reason to celebrate. But before the kudos give way to complacency, be forewarned: A number of increasingly serious public health issues could send cancer deaths and cancer incidence climbing again.
That’s the sobering perspective provided by City of Hope’s provost and chief scientific officer, Steven T. Rosen, M.D.
He added some context to the annual statistical analysis from the American Cancer Society. That analysis found that the death rate from cancer has dropped 22 percent from its peak in 1991; amounting to about 1.5 million deaths from cancer avoided. Between 2007 and 2011 – the most recent five years with data available – new cancer cases dropped by 1.8 percent per year in men and stayed the same in women. Cancer deaths decreased 1.8 percent per year in men and 1.4 percent in women for that same period of time.
Rosen attributed the overall decline in deaths to a number of factors, namely prevention, early detection and better therapies. » Continue Reading
Jonathan Yamzon, M.D., assistant clinical professor of surgery in the Division of Urology and Urologic Oncology, explains his approach to what’s known as “active surveillance” of men with prostate cancer. Patients need to be educated about their treatment options, he writes.
Active surveillance is an option offered to patients with “low-risk” prostate cancer. It entails forgoing any immediate treatment, and instead monitoring a patient’s cancer to ensure it shows no signs of worsening. If there are any signs of disease progression, the option for curative treatment can still be offered. Active surveillance attempts to avoid unnecessary treatments for patients with prostate cancers that may not become clinically significant or impactful to a man’s life.
Such treatments have potential risks for side effects. Those considered low-risk have a prostate specific antigen (PSA) value of less than 10, a biopsy Gleason of six or less, and a rectal exam that reveals nothing beyond a small nodule confined to one side of the prostate. When one of my patients embarks on active surveillance, I repeat the PSA, rectal exam and biopsy to ensure that their tumor is in fact truly low-risk. The success of this strategy is predicated on recurring follow-ups and reassessment to detect worsening changes of the tumor grade, volume or stage. It is important to understand that if there are signs of cancer progression, we can still offer treatment with curative intent.
Currently, our ability to stratify who is low-risk is based on clinical parameters of the PSA, Gleason score and clinical stage, which is detected by a rectal exam. Newer biomarkers are being studied to improve risk stratification, including the use of novel markers in serum, urine, biopsy tissue and radiographic test like magnetic resonance imaging (MRI).