Already available, designed to reduce unneeded biopsies
May 18, 2015 ANN ARBOR, Mich. — A new urine-based test improves prostate cancer detection – including detecting more aggressive forms of prostate cancer – compared to traditional models based on prostate serum antigen, or PSA, levels, a new study finds.

The test, developed at the University of Michigan Comprehensive Cancer Center, is called Mi-Prostate Score, or MiPS. It combines PSA with two markers for prostate cancer, T2:ERG and PCA3, both of which can be detected through a urine sample. The test has been available clinically since September 2013. ...continue reading "Urine-Based Test Improves on PSA for Detecting Prostate Cancer"

(TORONTO, Canada – Jan. 24, 2012) – For men diagnosed with low-risk, localized prostate cancer, treatment with dutasteride (brand name “Avodart”) delays disease progression, a 3-year study has found. The drug is classed as a 5a-reductase inhibitor. In men opting at this stage for "Active Surveillance," Avodart delayed the start of more active treatment while reducing anxiety.

...continue reading "Avodart Delays Low-Risk Prostate Cancer Progression, Study Finds"

Active surveillance may be a viable option for some men with prostate cancer. Regular tests and careful tracking of any changes in the patient's disease risk over time are imperative to ensure good outcomes, according to researchers in Toronto presenting at the annual meeting of the American Urological Association (AUA).

Active surveillance is typically offered to men with prostate cancer if biopsy results, staging and PSA doubling time all indicate that the tumor is so small and slow-growing that it is unlikely to develop into fatal illness within the man's lifetime.

...continue reading "For Low Risk Prostate Cancer, Personalized Monitoring An Option"

Clinical data links oral bisphosphonates to increased jaw necrosis, according to research at the University Of Southern California School Of Dentistry. A study published today in January 1 Journal of the American Dental Association (JADA) is among the first to acknowledge that even short-term use of common oral osteoporosis drugs such as Fosamax may leave the jaw vulnerable to devastating necrosis.

Osteoporosis, or loss of bone density, currently affects 10 million Americans. And TV commercials like the one for Boniva featuring Sally Field ("I've got this one body") tend to popularize and even glamorize anti-osteoporosis drugs.

Fosomax is the most widely prescribed oral bisphosphonate, ranking as the 21st most prescribed drug on the market since 2006, according to a 2007 report released by IMS Health.

...continue reading "Dentist Links Fosamax-type Drugs to Jaw Necrosis"

For men diagnosed with low-risk prostate cancer, active surveillance can be a sensible first step in managing the disease.

Mark Solloway and a team of urologists at University of Miami Miller School of Medicine have reported on outcomes for a group of their patients.

In all, 157 men with localized prostate cancer were followed on AS.

...continue reading "Most Low-Risk Prostate Cancer Patients Stay Treatment-Free for Five Years"

For patients with small, low-grade prostate cancer, delaying surgery -- even for years -- does not appear to increase the risk of the disease progressing to an incurable form.So finds a 10-year Johns Hopkins Medicine study. This discovery could prevent over-treatment, the authors say.

...continue reading "For Slow Growing Prostate Cancer Delay May be Reasonable, Hopkins Study Finds"

January 7, 2006. A new radiation therapy for prostate cancer -- Cesium-131 brachytherapy -- has fewer side effects than other treatments. NewYork-Presbyterian Hospital/Weill Cornell Medical Center is the only hospital in the Northeast to offer the new therapy.

...continue reading "Cesium-131 Brachytherapy for Prostate Cancer Has Fewer Side Effects"

PSA Rising, December 13, 2004. Men who are in treatment for prostate cancer using hormone therapy are not receiving the protection they need to prevent crippling osteoporosis.

Currently, a study has found, just 1 out of 7 prostate cancer patients who need protection against osteoporosis to prevent serious fractures actually gets it. Primary care physicians were the most aggressive at managing osteoporosis while cancer specialists were the least.

Researchers writing in the January 15, 2005 issue of CANCER, a peer-reviewed journal of the American Cancer Society, say few prostate cancer patients are ever  tested for osteoporosis during hormonal therapy treatment. This widely used type of treatment deprives the man's body of the male hormone testosterone. One effect of this is to cause osteoporosis, which in some men happens within the first six months of therapy.

Even men with other known risk factors for osteoporosis, such as smoking or receiving the hormone treatment for a long time, are unlikely to receive prevention or treatment.

Osteoporosis is a disease characterized by brittle, easily fractured bones. It is associated with major ill-effects including hip fracture, which can cause lasting disability or death. Private health insurers and Medicare have an interest in preventing osteoporosis because it adds significantly to healthcare costs.

Osteoporosis occurs when disregulation of the hormone-regulated bone remodeling system leads to a loss of bone mineral density. Risk factors for male osteoporosis include age-associated hormone changes, alcoholism, smoking, and.or some medications, including those used in the treatment of prostate cancer.

Screening tests such as  Dual-energy X-ray absorptiometry (DXA) scan are available. But so far there is no established national consensus guiding doctors on when and what to prescribe.

Osteoporosis can be prevented and even treated using a wide range of therapies. Common prevention measures include calcium and vitamin D supplements and regular exercise.

Treatment strategies include bisphosphonates, which have been shown to prevent further bone loss.

[Update: bisphosphonatres have since been shown to carry risks of avascular necrosis including to the jaw after tooth extraction].

The extent of the problem

To find out how clinicians were managing osteoporosis risk in the U.S. in year 2003 and identify factors that might predict who gets treated, Tawee Tanvetyanon, M.D. from Loyola University Chicago Stritch School of Medicine reviewed the sampled records of 184 prostate cancer patients who received androgen deprivation therapy (ADT), which is known to raise the risk of osteoporosis.

Dr. Tanvetyanon found that "the majority of patients undergoing ADT did not receive osteoporosis prevention or treatment," even when they reported other risk factors, as well.

Only about one in seven (14.7 percent) eligible patients received any sort of osteoporosis management.

Only one in ten (8.7 percent) received at least one DXA scan within three years.

Only one in twenty (4.9 percent) was prescribed a bisphosphonate.

The one factor that predicted clinical management of osteoporosis risk and disease was the presence of bony metastases (prostate cancers that had spread to the bones). Analysis also showed that primary care physicians were the most aggressive at managing osteoporosis while cancer specialists were the least.

Article: "Physician Practices of Bone Density Testing and Drug Prescribing to Prevent or Treat Osteoporosis during Androgen Deprivation Therapy," Tawee Tanvetyanon, CANCER; Published Online: December 13, 2004 Print Issue Date: January 15, 2005.

This article edited by J. Strax, updated December 13, 2004 and May 2015.