Our online forum resources can help current prostate cancer patients research their disease and treatment options. For more information, post a question online today at CancerCompass.com. http://www.cancercompass.com/message-board/cancers/prostate-cancer/1,0,119,2.htm Sun, 08 Nov 2009 00:00:00 GMT Sun, 08 Nov 2009 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ Hi My doctor told me last week that their is a 90% chance that I have lung cancer, I have a large mass at the bottom of my left lung. I am seeing a thoracic doctor today and don't know what i should be asing him, or what he should do for me, where do I start. They have been trying to find out what is wrong with me for 5 years, I am overwhelmed by all the info I found on the internet. Please any info would be greatly appreciated. I  live in a very small city, should I ask him to refer me to a larger city in Canada. Desperate in Canada Regards http://www.cancercompass.com/message-board/message/all,41291,0.htm canadabea Thu, 05 Nov 2009 00:00:00 GMT My father has just been diagnosed with advanced prostate cancer which has unfortunately spread to the bones and lymphs. He is 63 years old, very active and fit. The specialist we saw said there is nothing they can do for him, he is on cyprosterone (unsure of spelling) and gets and injestion once every 3 months, which is the Hormone Therapy. We were told his blood score was over 200, does anyone know what this means as we have not really been given any info as in stages etc. I have contacted a nurse to talk about things, so hopefully we will get a better undersatanding. Is there anyone in a similar position.   http://www.cancercompass.com/message-board/message/all,41071,0.htm Hazellot Tue, 27 Oct 2009 00:00:00 GMT Hi, I am 70 years old and I am having problem prostatitis. I would like to start an anibiotic. But unable to choose the best among the following 3 antibiotics:- 1. Ofloxacin 2. Azythromycin 3. Doxycycline. Please help me. Thanks Shankar K. http://www.cancercompass.com/message-board/message/all,41024,0.htm srkalinge Mon, 26 Oct 2009 00:00:00 GMT I am trying to decide treatment for my cancer psa 4.2 gleason 3-4 pni I am 51 years old http://www.cancercompass.com/message-board/message/all,40946,0.htm WEST22 Fri, 23 Oct 2009 00:00:00 GMT Hi, My father is in Stage IV Prostate cancer. He has developed Bone metastasis ans hence had undergone Radiation around the Spine area for 3 days finishing on 11th Oct 2009. Now since then we are awaiting for chemo but his platelet count has come down from 119 to 89 to 86in the last 11 days. Pls advise as to how can his platelet count be increased Rgds http://www.cancercompass.com/message-board/message/all,40914,0.htm Anant Thu, 22 Oct 2009 00:00:00 GMT Was diagnosed with prostate cancer in 2005,  had hormone treatment andHyperthermia treatment in Germany. In 2007 i was diagnosed with Renal Cell Carcinoma and had a tumor removed from my right kidney. having check ups periodiclyPSA this year has been from 8.5 to now 10.7m and will be checked again in Jan 2010.. Doctors have not recommended anything as of now. what do you think? Skip  http://www.cancercompass.com/message-board/message/all,40868,0.htm Blantyre Tue, 20 Oct 2009 00:00:00 GMT My 81 year old dad was just diagnosed.  The plan is to give him a hormone shot and retest him in three months although they said the cancer was agressive.  We are wanting to get a 2nd opinion but I'm not sure who to go to.  This was all done by the urilogist he had been seeing.  Can anybody direct us where to go and does this treatment sound right? Lynn http://www.cancercompass.com/message-board/message/all,40807,0.htm texasd Sun, 18 Oct 2009 00:00:00 GMT what treatment is available for urinary retention after brachytherapy for prostate?  patient had seeds implanted 9 weeks ago. http://www.cancercompass.com/message-board/message/all,40811,0.htm kayuta Sun, 18 Oct 2009 00:00:00 GMT http://www.msnbc.msn.com/id/33291388/ns/health-cancer/   http://www.cancercompass.com/message-board/message/all,40653,0.htm d2322 Wed, 14 Oct 2009 00:00:00 GMT Hello everyone Has anyone ever heard of or is using the product Zeolite. If so, would any of you let me know if this product is helping you. I,m now taking a product called Cell Food which I think is supposed to do the same thing, increasing oxygen to cancer cells. With so many products out there it gets confusing what to use and spend your money wisely on.Thanks and stay positive. http://www.cancercompass.com/message-board/message/all,40679,0.htm DELTA_1 Wed, 14 Oct 2009 00:00:00 GMT Hello, I want to share my experience with HIFU, I have HIFU in México, Guadalajara, with the only Ablatherm device in México. The doctors are extremely professional and the hospital its great (five stars), right now my psa is 0.3 (Pre HIFU 6.9). I do really recommend HIFU as primary treatment. And the cost is 13,000.00 USDThey have a web sitewww.institutodeprostata.comwww.hifu-planet.com http://www.cancercompass.com/message-board/message/all,40681,0.htm Benny1947 Wed, 14 Oct 2009 00:00:00 GMT I had seed implants almost 4 months age. At first the pain and stream was not too bad but in the last month it has increased to really bad pain and sometimes up to 5 minutes to get my stream started. Has any had this problem? http://www.cancercompass.com/message-board/message/all,40562,0.htm 1benny2 Sat, 10 Oct 2009 00:00:00 GMT Has any one tryed this Dr Red Blueberry Punch from Dr Red Nutraceuticals Pty Ltd), My doctor told me about it. I found some resurch on it, and it look very promising.  (See the reults of the study on this page) this is from just one of the site in Austraila http://www.usyd.edu.au/news/84.html?newsstoryid=2077 Antioxidant cocktail shows good results in fight against prostate cancer7 December 2007Prostate cancer trials undertaken at the University of Sydney have provided exciting results with reductions of up to 25 per cent of tumour growth in mouse models.The trial of the commercially available antioxidant drink, Blueberry Punch, was undertaken by Dr Jas Sing from the University's ANZAC Research Institute and Dr Qihan Dong from the Bosch Institute, and will now to be put forward for human trials.Blueberry Punch is an antioxidant cocktail based on foods which have been recognised as having similar attributes as non-steroidal anti-inflammatory drugs and their ability to inhibit a protein which puts the brakes on rapidly dividing cancer cells.The Sydney University team studied the effect of the beverage on both cancer cell cultures and mouse models that mimic human prostate cancer with results published [online in the current issue of journal of the American Association of Cancer Research.]'After 72 hours exposure to increasing concentrations of Blueberry Punch, prostate cancer cells showed a dose dependent reduction in size and viability when compared with untreated cells,' said Dr Sing. 'After feeding mice a 10 per cent solution of the punch for two weeks, we found the tumours in these mice were 25 per cent small than those found in mice that only drank tap water,' he said.The study was partially funded by the makers of Blueberry Punch, Dr Red Nutraceuticals. The nutrition drink, Blueberry Punch, was developed by Greg Jardine, a biochemist from Dr Red.Notes to Editors:Blueberry Punch consists of a combination of fruit concentrates (blueberry, red grapes, raspberry and elderberry), grape seed and skin extract, citrus skin extracts, green tea extract (EGCG), olive leaf and olive pulp extract, tarragon, turmeric and ginger.Contact: Jake O'ShaughnessyPhone: +61 2 9351 4312 or 0421 617 861Anti-inflammatory Therapy: Poster Presentations - Proffered Abstractshttp://www.aacrmeetingabstracts.org/cgi/content/meeting_abst Suppressive effects of a phytochemical cocktail on prostate cancer growth in vitro and in vivoJas Singh, Mu Yao, Greg Jardine^ and Qihan Dong Dept of Medicine, University of Sydney, Sydney, Australia, University of Sydney, Sydney, Australia, ^Dr Red Nutraceuticals, Mt Nebo, Queensland, Australia Definition of In vitro (Latin: within the glass) refers to the technique of performing a given procedure in a controlled environment outside of a living organism, such as in a "test tube" or Petri dish.[1] Many experiments in cellular biology are conducted outside of organisms or cells; because the test conditions may not correspond to the conditions inside of the organism, this may lead to results that do not correspond to the situation that arises in a living organism. Consequently, such experimental results are often annotated with in vitro, in contradistinction with in vivo.Definition of In vivo : In the living organism, as opposed to in vitro (in the laboratory). Abstract A104 Inflammation is implicated in the etiology of prostate cancer (Etiology meaning in this case what Prostrate cancer could be cause by )[1]. Evidence linking inflammation to prostate cancer includes men with chronic or recurrent inflammation of the prostate having an increased risk of developing prostate cancer Cyokines is meaning in this case the Non-antibody proteins secreted by inflammatory leukocytes and some non-leukocytic cells, that act as intercellular mediators. They differ from classical hormones in that they are produced by a number of tissue or cell types rather than by specialised glands. They generally act locally in a paracrine or autocrine rather than endocrine manner.(12 Dec 1998) http://www.mondofacto.com/facts/dictionary?cytokines [2], over-expression of inflammatory cytokines in serum and prostate tissue of prostate cancer patients and a decreased prostate cancer risk in men on non-steroidal anti-inflammatory drugs. Numerous phytochemicals have been reported to interfere with specific stages of the carcinogenic process [3]. Some of these phytochemicals like curcumin induces apoptosis (Apoptosis in this case meaning cell death) and cell cycle arrest in prostate cancer cells [4] while Green tea has been shown to inhibit prostate cancer development and distant site metastasis in TRAMP mice (Means Prostate pathology genetically engineered mice)[5]. Similarly, resveratrol has also been associated with inhibition of various cancers. Based on the premise that a wide range of phytochemicals in a single formulation are likely to demonstrate greater reduction in cancer cell proliferation than individual molecules administered alone, we investigated the in vitro and in vivo effects of an antioxidant cocktail, Blueberry Punch (BBP*; Dr Red Nutraceuticals Pty Ltd), that incorporates the above mentioned phytoconstituents, in prostate cancer. >Cell viability studies undertaken using the MTS assay on prostate cancer cells (PC3, LNCaP) after 72 hours of exposure to increasing concentrations (0.08% - 5%) of BBP showed a dose-dependent reduction compared with untreated cells. This reduction in cell viability appeared around doses of 0.3%-0.6% BBP. Exposure of non-cancer prostate epithelial cells (PrEC) to similar concentrations demonstrated resistance of cells to BBP. Immunostaining of BBP treated cells indicated reduced COX-2 and phospho- cPLA2 protein levels. For in vivo studies, PC3 xenografts were created in immune-deficient nude Balb/C mice and treatment commenced when the tumors reached between 150-200mm³. Mice (n = 8) were administered BBP (10%) in drinking water for two weeks and tumor size and body weights monitored twice per week. At two weeks of treatment the tumor size decreased by 25% compared with mice (n = 8) that were administered regular tap water as control. Preliminary immunohistochemical analysis revealed decreased levels of Cyclin D1 protein suggesting reduced cell proliferation in BBP administered xenografts compared with vehicle treated mice. Our data provide evidence for in vitro and in vivo suppressive effects of BBP on prostate cancer cell growth. Further studies to determine the mechanistic pathways involved in the inhibition of cancer cell growth are in progress. >1. Nelson et al (2003) NEJM, 349; 366-81 >2. Nelson et al (2004) J Urol, 172; S6-S12 >3. Surh YJ (2003) Nat Rev Cancer, 3; 768-780 >4. Khor et al (2006) Cancer Res, 66; 613-21 >5. Gupta (2001) PNAS, 98; 10350-10355 >* Antioxidant enriched fruit juice concentrate. Ingredients - Fruit juice concentrates (blueberry http://www.cancercompass.com/message-board/message/all,40548,0.htm jcr65566 Fri, 09 Oct 2009 00:00:00 GMT I am now 65 and had an RP in Jan 2007. My surgeon, a leading Canadian specialist, was pleased with the post op bio. Nothing at margins, nothing in the nodes or in the other bits removed. He spared the nerves on the left side because pre op biopsy showed that area clear. However post op bio showed cancer on left side also and peri neural invasion.PSA undetectable for first nine months then slow increase. Now two and a half years later PSA at .2  I have moved to live in the U.K. and saw a specialist at a specialist cancer hospital in London. He reckons it to be impossible to detect any mastises until PSA at least 4.0. He also reckons that with all the negatives in the post op bio that the chances of the cancer being localised is very slim. His answer is to have radiation therapy on the off chance that it might help. He has also started me on androgen deprivation drug Bicalutamide 150mg (Casodex).He is the specialist but his opinion appears to conflict with my specialist in Canada who seemed to think he would do scans and tests at PSA of.3 Is it a good bet to go for six weeks of radiation just on spec?Can scans show anything at this stage?Would it be just as good to stay on the Casodex and do nothing else for now?I am also concerned that with peri neural invasion the cancer might be spreading through the spared nerves. The nerve sparing by the way did nothing to help re erectile dysfunction.. Views based on your experiences and knowledge are sort for.Thanks http://www.cancercompass.com/message-board/message/all,40491,0.htm Viking Thu, 08 Oct 2009 00:00:00 GMT I'm  57 years of age and was dx in April 2009, PSA 3.5, GS 6. Bone scan and CT were neg. Started alternative treatment in May, Vit. A,B, C, D3, E, B-complex, B12, COQ10, manganese, magnesium, zinc & selinium. Also Budwig Diet and Aprocot seeds. Also change my diet to veggies and fruits, no sugar, animal fats or carbhydrates. Had a PSA in July, results were 2.2. Had another PSA in October, results were 1.7. My question is are the lower PSA results being masked by any of these supplements or could this be cancer cells dying. Should I have another biopsy at this time or wait and see if the PSA continues to fall? http://www.cancercompass.com/message-board/message/all,40495,0.htm DELTA_1 Thu, 08 Oct 2009 00:00:00 GMT Historically my PSA count was between 3 and 4. About 3 months ago, during an annual check-up, my PSA was 12.9. About 1 week prior I had a temperature and flu-like symptoms. The doctor felt that this could have been the cause of the high PSA. She put me on an antibiotic after which I had a second PSA test. This time my count was 10.6. I was sent to a Urologist who wanted to test my urine for any residual infections. There was none (just found out yesterday). I am scheduled for a biopsy in two weeks. I am 69 years old and my general health, I believe, is very good. If it is found that I have cancer I am strongly leaning towards Brachytherapy  (with Theraseed) treatments - the insertion of rice-sized, permanent radio-active seeds in the prostrate.Any factual information would be appreciated. I think my PSA count is extremely high - I can't find any information on what the upper limit (if there is one) is for a PSA count. I might add that for two months preceding the first PSA test I was building a block wall, 100+ feet long. Each of the 400+ blocks weighed 60 pounds. I read in another 'message board' that heavy lifting could impact the PSA count. I look forward to and truly appreciate your replies. Thank you! http://www.cancercompass.com/message-board/message/all,40497,0.htm dennisis1 Thu, 08 Oct 2009 00:00:00 GMT At age 64 in 1999, with PSA of 3.5, a nodule was found by DRE on the prostate gland, which was biopsied positive for PC with gleason of 7 (3-4).  Underwent prostatectomy (perineal) in 2001, but post-op pathology showed positive margins and seminal vesticle involvement. Yet PSA remained undetectable for 3-1/2 years but started to rise slowly. Per correlation studies at John Hopkins, (related to age, time since prostatectomy, and doubling rate) PSA was followed for 15 months, but with PSA doubling in approximately 10 months, salvage radiation (EBRT)  for 37 sessions was elected, which completed on 10-20-06. PSA again became undetectable until 02-08 when it rose to 0.3. Casadex 50 MG oral(alone) was prescribed, but by 12-08 PSA had risen to 1.5.  Casadex was discontinued by the Urologist and some alternate form of intermittant harmone therapy was discussed, but unfortunately none was initiated. By 04-09, I became very ill, with much pain. My Internal Medicine doctor ran multiple tests, including PSA, MRI's, CT and bone scan,  and found that the PSA had ran rampant in that uncontrolled period, and was at 167, with major metastasis into the entire spinal area and had caused a spine fracture.. He referred me to a new Urologist, a Medical Oncologist, and a Radiation Oncologist.Aggressive treatment in the last 5.5 months has included: 4-month Lupron shots, combined with 750 MG/day of Flutamide; blood transfusion; Kyphoplasty surgery for spinal fracture repair, Zomato (calcium) infusions each 3 weeks, and Morphine, Hydrocodone, and Radiation to control bone pain. PSA has been sucessively reported at 167, 186, 197, 120, 44. and pain is managed well. Any comments / comparative experience information or recommendations will be greatly appreciated.    .          http://www.cancercompass.com/message-board/message/all,40475,0.htm johnjaniceplano Wed, 07 Oct 2009 00:00:00 GMT Went for my followup PSA test last Friday and the results were 3.46, down from 4.1 (3) months ago and 3.5 (6) months before that. When I think back on it I had my blood test two weeks after I had my DRE exam with my PCP. Read somewhere that disturbing the prostate can also increase the level, so I wonder if that might had spiked the level. Since I am approaching the majic number of 4.0 anyway do you think I should insist on seeing a urologist anyway ? I am relieved that the level is back down. David http://www.cancercompass.com/message-board/message/all,40420,0.htm David1 Mon, 05 Oct 2009 00:00:00 GMT I was treated in Toronto with the Sonsblade 2.5 months ago. It has been pretty much without incident. The greatest discomfort was due to the suprapubic catheter which came out after 12 days. I suffered no pain at any time and had no leakage from the removal (I did lie down on may back for 2 hours post removal.) and no incontinence. I played great tennis 3 weeks after treatment. Urine flow has varied, 70-90% normal, but is on an upward trajectory. Frequency has also varied but keeps getting better. When I have to go it tends to be URGENT. With the help of 5mg of cialis daily and a larger dose for a booster things are shaping up re erections. I will be getting my first post-op blood test in a couple of weeks. This was all in all very smooth & positive. I really sense that life will soon be back to 95% normal soon. I would be happy to answer ANY questions anyone might have. Despite it going well, it IS still a tough thing to go through! http://www.cancercompass.com/message-board/message/all,40358,0.htm Architect Sat, 03 Oct 2009 00:00:00 GMT My Dad was diagnosed with advanced prostate cancer in May.  He started with Lupron and that worked well for the first cycle.  His PSA went from 535 to 49.   Just before his second round of Lupron, his PSA increased to 59.   A week or two after the second round of Lupron, it increased again, this time to 69.   At this point, he was given Casodex.  I don't know for sure, but I believe he had a reaction to the Casodex.  The night of his first dosage, he experienced tremendous pain in his legs and pelvic area.   This continued for several days.  Finally, after consulting with the doctor, they advised him to stop taking the Casodex.   I have two questions for the board.  1.  If this was a reaction to Casodex and not something else, is there an alternative to Casodex/2. If the cancer is no longer responding to hormone treatment, what is the next alternative?   What specific drugs or treatements are appropriate.  ....and to add a third question, what else can we do?  My family and I are out of our wits with fear.   He did so well over the summer and now, I am very afraid that the cancer is becomming more agressive.  any help or comments would be greatly appreciated.   http://www.cancercompass.com/message-board/message/all,40342,0.htm Frydchicken Fri, 02 Oct 2009 00:00:00 GMT Antibiotic Used To Treat Fungal Infections Also Kills Cancer Cells, Research SuggestsScienceDaily (July 9, 2007) — Due to defects in chromosomal distribution, a majority of tumor cells would not be able to survive were it not for a trick that cancer cells have developed to avoid this chaos in the genetic material. Scientists of the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) have discovered that the antibiotic griseofulvin counteracts this tactic of tumors and, thus, forces cancer cells into cell death. The two centrosomes are responsible for proper cell division: It is here that the mitotic spindle made of protein fibers latches onto in order to correctly divide the freshly duplicated set of chromosomes among the two newly forming daughter cells. However, cancer cells often have more than two centrosomes. As a result, their mitotic spindle does not have the normal spindle structure with two poles; dysfunctional multipolar structures are formed instead. These malformed spindles distribute chromosomes completely at random so that daughter cells are usually not viable. In tumors, therefore, those cells have a better chance of survival that manage to divide chromosomes correctly despite too many centrosomes. To this end, some cancer cells have developed a mechanism by which several centrosomes are clustered into aggregates so that eventually a functioning bipolar spindle is formed between two such aggregates. Professor Dr. Alwin Krämer, head of the Clinical Cooperation Unit Molecular Hematology/Oncology of the German Cancer Research Center and the Medical Clinic V of the University of Heidelberg recognized that this trick of tumors is in fact a previously unnoticed Achilles’ heel and may be used to put cancer cells out of action. Collaborating with colleagues in Denmark, Krämer’s team searched for substances that inhibit centrosome clustering. In their search, they focused on biomolecules produced by fungi, which include many substances that are known to interfere with biological reactions.The substance that turned out to be the best inhibitor of centrosome clustering is a long-known antibiotic called griseofulvin which is used primarily to treat fungal infections of the skin. In experiments in the culture dish griseofulvin causes cancer cells to build malformed, multipolar spindles, which eventually leads to cell death by apoptosis. In healthy cells, however, the antibiotic does not cause spindle malformations.“Even though griseofulvin is not yet the ideal molecule for use in cancer treatment,” says Krämer, “we were able to show clearly that this approach may contribute to fighting cancer. Together with our cooperation partners we are producing chemical relatives of griseofulvin, which may have even more advantageous pharmacological properties.” Krämer, a doctor and medical researcher, also sees a chance that the novel working principle may support the effectiveness of other treatment options.Reference: Blanka Rebacz, Thomas O. Larsen, Mads H. Clausen, Mads H. Rønnest, Harald Löffler, Anthony D. Ho and Alwin Krämer: Identification of Griseofulvin as an Inhibitor of Centrosomal Clustering in a Phenotype-Based Screen. Cancer Research, July 1, 2007 http://www.cancercompass.com/message-board/message/all,40284,0.htm jcr65566 Thu, 01 Oct 2009 00:00:00 GMT Had my Hifu done in Munich 2 1/2 years ago by Dr Chaussy and team, my current PSA has remained at .008 or undetectable, without any problems or side effcts http://www.cancercompass.com/message-board/message/all,40289,0.htm Ciscox Thu, 01 Oct 2009 00:00:00 GMT I had a HIFU 15 month ago. My PSA after treatment was 0.05, no side effects and felt great. Last two weeks I have problem with urination. First it was slower flow ending to a total shut down, so I ended in the Emergency room and got catheter installed. They removed catheter after three days, but it did not work and I have catheter reinstalled. Tomorrow I am seeing my urologist, do not know what he will say or do. Has anybody ever had similar problem. They told me that it is common occurrence after HIFU http://www.cancercompass.com/message-board/message/all,40312,0.htm PCSurvivor100 Thu, 01 Oct 2009 00:00:00 GMT My husband is 3 weeks post Internal Beam Radiation Therapy and now having awful nocturnal leg cramps.  Has this happened to any of you? http://www.cancercompass.com/message-board/message/all,40318,0.htm Helper_Wife Thu, 01 Oct 2009 00:00:00 GMT To me the PSA test is nothing but a big con job, and Ill tell you why I have Know I have had prostrate cancer since I was 40 for over fifteen years my cancer did me no harm my psa would rise an fall from a psa of about three and it would some times go up to a psa of four then it would go back down to three again. One day in 2007 my doctor said I should have a biopsy. to make sure so I did as well as a bone scan G/score of Eight no bone mets Six month later trying to get an operation I could aford I found I had pain in my lower back and my ribs I was sent for an other bone scan this time it found I had prostate bone mets in my lower nack and my ribs further Test showed my psa was climbing until in 2008 I was in a lot of pain it hit a psa of thirteen. after seeing a naturopath it now only a PSA of eight since I went on the alliterative treatment she put me on what I mostly do is no sugary foods or drink and high dose of vitamin C and drug called Trinovin at four time the recamended dose. My Psa been droping ever since. Remember the old saying, if it ant broke don't fix it. I should never have gone near the biopsy Ive since lost a lot of my l faith in doctors   I got this off the new york times. it By GINA KOLATA and it was Published: March 18, 2009 about recent studies on the PSA test be well Ray http://www.nytimes.com/2009/03/19/health/19cancer.html The PSA blood test, used to screen for prostate cancer, saves few lives and leads to risky and unnecessary treatments for large numbers of men, two large studies have found. The findings, the first based on rigorous, randomized studies, confirm some longstanding concerns about the wisdom of widespread prostate cancer screening. Although the studies are continuing, results so far are considered significant and the most definitive to date.The PSA test, which measures a protein released by prostate cells, does what it is supposed to do — indicates a cancer might be present, leading to biopsies to determine if there is a tumor. But it has been difficult to know whether finding prostate cancer early saves lives. Most of the cancers tend to grow very slowly and are never a threat and, with the faster-growing ones, even early diagnosis might be too late. The studies — one in Europe and the other in the United States — are “some of the most important studies in the history of men’s health,” said Dr. Otis Brawley, the chief medical officer of the American Cancer Society. In the European study, 48 men were told they had prostate cancer and needlessly treated for it for every man whose death was prevented within a decade after having had a PSA test. Dr. Peter B. Bach, a physician and epidemiologist at Memorial Sloan-Kettering Cancer Center, says one way to think of the data is to suppose he has a PSA test today. It leads to a biopsy that reveals he has prostate cancer, and he is treated for it. There is a one in 50 chance that, in 2019 or later, he will be spared death from a cancer that would otherwise have killed him. And there is a 49 in 50 chance that he will have been treated unnecessarily for a cancer that was never a threat to his life. Prostate cancer treatment can result in impotence and incontinence when surgery is used to destroy the prostate, and, at times, painful defecation or chronic diarrhea when the treatment is radiation. As soon as the PSA test was introduced in 1987, it became a routine part of preventive health care for many men age 40 and older. Experts debated its value, but their views were largely based on less compelling data that often involved statistical modeling and inferences. Now, with the new data, cancer experts said men should carefully consider the possible risks and benefits of treatment before deciding to be screened. Some may decide not to be screened at all. For years, the cancer society has urged men to be informed before deciding to have a PSA test. “Now we actually have something to inform them with,” Dr. Brawley said. “We’ve got numbers.”The publication of data from the two new studies should change the discussion, said Dr. David F. Ransohoff, an internist and cancer epidemiologist at the University of North Carolina. “This is not relying on modeling anymore,” he said. “This is not some abstract, pointy-headed exercise. This is the real world, and this is real data.”Dr. H. Gilbert Welch, a professor of medicine at Dartmouth who studies cancer screening, also welcomed the new data. “We’ve been waiting years for this,” he said. “It’s a shame we didn’t have it 20 years ago.”Both reports were published online Wednesday by The New England Journal of Medicine. One involved 182,000 men in seven European countries; the other, by the National Cancer Institute, involved nearly 77,000 men at 10 medical centers in the United States. In both, participants were randomly assigned to be screened — or not — with the PSA test, whose initials stand for prostate-specific antigen. In each study, the two groups were followed for more than a decade while researchers counted deaths from prostate cancer, asking whether screening made a difference.The European data involved a consortium of studies with different designs. Taken together, the studies found that screening was associated with a 20 percent relative reduction in the prostate cancer death rate. But the number of lives saved was small — seven fewer prostate cancer deaths for every 10,000 men screened and followed for nine years. The American study, led by Dr. Gerald L. Andriole of Washington University, had a single design. It found no reduction in deaths from prostate cancer after most of the men had been followed for 10 years. Every man has been followed for at least seven years, said Dr. Barnett Kramer, a study co-author at the National Institutes of Health. By seven years, the death rate was 13 percent lower for the unscreened group.The European study saw no benefit of screening in the first seven years of follow-up.Screening is not only an issue in prostate cancer. If the European study is correct, mammography has about the same benefit as the PSA test, said Dr. Michael B. Barry, a prostate cancer researcher at Massachusetts General Hospital who wrote an editorial accompanying the papers. But prostate cancers often are less dangerous than breast cancers, so screening and subsequent therapy can result in more harm. With mammography, about 10 women receive a diagnosis and needless treatment for breast cancer to prevent one death. With both cancers, researchers say they badly need a way to distinguish tumors that would be deadly without treatment from those that would not. When the American and European studies began, in the early 1990s, PSA testing was well under way in the United States, and many expected that the screening test would make the prostate cancer death rate plummet by 50 percent or more. Dr. Brawley was at the cancer institute then, though not directly involved with its prostate cancer screening study. But he saw the reactions.Some urologists said the study was unethical, because some people would not be screened, and demanded it be shut down, he said. One group of black urologists encouraged black men not to participate because blacks have a greater risk of prostate cancer and it seemed obvious they should be screened.Some thought that they would see fewer cancer deaths among screened men as quickly as five years. But it became clear that screening would not have a large, immediate effect — if it did, the stud http://www.cancercompass.com/message-board/message/all,40279,0.htm jcr65566 Wed, 30 Sep 2009 00:00:00 GMT