As a patient, I feel for anyone who is given a diagnosis of prostate cancer. Hearing the “Big-C” word can be upsetting enough. But the complexity of the disease—diagnosing it, trying to characterize it and selecting the appropriate treatment—can feel like insult upon injury. We need to talk about prostate cancers. With 24 known sub-types of this cancer—from non-life-threatening to very aggressive—it’s no wonder so much time is expended on debating PSA screening and the potential for overtreatment.
While debates continue, more than 32,000 American men die from this disease each year, placing it on par with breast cancer in incidence and mortality.
Oddly, I still contend that when I was diagnosed last year, I was “lucky” enough to have clear diagnostic and prognostic data to inform my decision to have a radical prostatectomy, despite potential side effects . My PSA had nearly doubled in a year’s time. As my urologist reviewed my biopsy results, the extent of the cancer’s involvement in my walnut-sized gland and my Gleason scores, I knew where I was headed. He dutifully began sketching out all treatment options currently available to patients when I told him to stop and move to the top two options. He gave me a dubious look before I shared with him that I had learned much about the disease in two years of working at the Prostate Cancer Foundation.
I was lucky once again when my surgeon’s professional instincts prompted him to remove some of my lower lymph nodes during my robotic procedure, something that’s not always done. The post-surgical pathology report upgraded my diagnosis to Stage 4 metastatic disease with single Gleason 5 cells discovered in the nodes. (Not exactly the kind of upgrades I am accustomed to in my life…) As a result, I headed into seven weeks of radiation therapy and three years of androgen deprivation therapy—a palliative treatment that drastically cuts my production of testosterone, a fuel for prostate cancer growth and proliferation. Today, I have a 60 percent chance that I will have to live with recurrent disease. I look forward without second guessing.
Not all patients have such clarity. Through My New York Minute, I meet many readers who are confused by the complexity of this disease. As a fellow patient who also works for world’s leading private accelerator of prostate cancer research, I remind them:
Science will someday, sooner than later, enable us to identify which prostate cancer a patient has and prescribe highly personalized treatments that will work best for their case. Until then, an in-depth understanding of the disease and the advice of a trusted healthcare professional remain the best tools for making treatment decisions with confidence.
From: http://mynewyorkminute.org/?p=1242&utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+MyNewYorkMinute+%28My+New+York+Minute%29
March is National Nutrition Month®, an annual campaign sponsored by the American Dietetic Association (ADA), focusing attention on healthy eating. This month, ADA is encouraging Americans to “Eat Right with Color.”
What exactly does this mean? The ADA, the world’s largest organization of food and nutrition professionals, is encouraging consumers to “color” their plate with a variety of fruits, vegetables, whole grains, leanproteins and dairy. Fruits and vegtables with vibrant color are generally considered most beneficial. The recently released 2010 Dietary Guidelines for Americans recommend an increased focus on a plant-based diet. This combined with lean meats, fish and poultry, and low-fat dairy products creates a base for a healthful eating plan.
This month would be the perfect time to try something new. There are a multitude of colorful fruits and vegetables, but we often get into the habit of eating the same thing over and over again. Variety is the key. Each fruit and vegetable has its own vitamin/mineral profile – - so the more variety, the more you’ll benefit. Get your whole family involved and challenge them to help create colorful meals using the list provided below. Encourage them to incorporate one new fruit/ vegetable each week. By the end of National Nutrition Month, eating a variety of colors will become a habit and you and your family will be on the road to a lifetime of healthy eating.
Written by Lisa Eisele, RD, CSO, LD (Registered and Licensed Dietitian at RC Cancer Centers)
A moving 10 minute short about a climber’s journey to climb Mount Everest for his sister who died from a rare form of cancer and how he raised breast cancer awareness for a charity – www.climbingforacure.org.
After having to tell one man he has a PSA of 12, I have a heightened admiration for our healthcare professionals.
On Saturday, I had the honor of attending the The African American Men’s Health and Empowerment Summit here in Los Angeles, sponsored each year by the Black Barbershop Health Outreach Program (BBHOP). Black men are 60 percent more likely to be diagnosed with prostate cancer and 2.4 times more likely to die from it. They are also disproportionately affected by diabetes and hypertension. Thus, the summit is an important local event that the BBHOP does extremely well.
As a patient and advocate, I was originally scheduled to participate on an afternoon prostate cancer panel with Dr. Stanley Frencher who heads up the prostate education program for BBHOP. Because Dr. Frencher was called in to perform an emergency surgery Friday evening on the east coast and was delayed in getting to the conference, I was asked to lead the morning workshop on understanding prostate cancer and PSA screening. I am pleased to say that, with the aid of a rather good instructional video, the workshop went well. The group of men engaged with the video and a genuine patient who was able to provide some personal perspectives.
As part of the summit, attendees were able to be screened for diabetes and hypertension, as well as receive a PSA screening. Their PSA results were delivered shortly after the blood draw. I am pleased to say that the vast majority of results that I saw were in the less than 1.0 – 3.0 ng/mL range. It was a good effort. Men were gaining an important understanding of prostate cancer and getting a baseline reading they could share with their physicians.
That was until the early afternoon when I was talking with one gentleman who was awaiting his PSA result. When the volunteer runner approached us and produced this man’s results report, I could hear a hesitation in the volunteer’s voice. Before he could say anything more–there was a deep sigh already forming in the young messenger’s windpipe–I quickly pulled the man’s report and said, in my best calm voice, “let’s take a look at your PSA report…” as I steered the attendee to a quiet corner. I had already seen the number “12? on the page. It seemed to shout out from the report even though it was the same type size as the rest of the printed data.
Without skipping a beat, I reiterated to the gentleman that I was not a healthcare professional, but rather a patient who has gone through the process and went on to tell him that he should schedule an appointment with his primary care physician to discuss the results. I then explained how the PSA is not cancer-specific and how it could be an indication of another prostate condition or even a false positive. I outlined how this is a diagnostic process and impressed upon him the importance of not putting any cart before the horse. He was appreciative. I also reminded him that should he ultimately be told he has cancer, early detection and treatment can result in some very good outcomes. He told me that he had every intention of taking care of his health for the sake of his family–he was going to call his doctor’s office on Monday to schedule an appointment. As we shook hands, I reminded him of the online resources that are available to him and he thanked me.
Since Saturday, this man has lived in my mind. It is difficult to shake him from my waking thoughts. I am left wondering where this information will take him. Will he be joining the ranks of those diagnosed with prostate cancer? Will his world be rocked as a result of his coming to the event? If cancer, what kind of treatment will be appropriate for his case? Or, will it be some other condition that is more readily treatable with less emotional stress? I pray that his reality is the latter.
To say that I was touched by the events of this weekend is an understatement. As it was about a year ago that I was told my PSA had nearly doubled, I could guess what he was feeling all too well. I wish there was some magical way to change his results. But I know I can’t. Information is a valuable ally.
Through all of this, I came away from Saturday with a heightened admiration for medical professionals who have to deliver similar news to perhaps multiple patients each and everyday. All I can ask, is: How do they do it?
Dr. Merlin, of RC Cancer Centers, discusses prostate cancer and answers many common questions relating to the topic.
It’s surprising how landmark deep science can be supported by deeply rooted fun like Movember.
Researchers have sequenced the genomes of prostate tumors from seven men–a landmark event that promises to one day help clinicians learn how to differentiate between those tumors that will be highly aggressive and require immediate treatment and those that are essentially benign and that can be simply observed through proactive surveillance. This project represents a transforming moment in understanding the underlying biology of prostate cancer.
Geneticists have been sequencing a variety of tumors of different types, but the effort on prostate tumors introduces a new level of complexity. If the data for each genome were presented in the form of a printed telephone book, it would form a book 35 feet high.
All of this is deeply complicated science, indeed. And it’s promising news for millions of prostate cancer patients. But it is important to note that is was made possible by an entirely fun–even frivolous–annual campaign known as Movember. Each year, thousands of men around the world grow moustaches to raise funds that support crucial research that can ”change the face of men’s health.” In the case, whole genome sequencing of prostate cancer was made possible by unrestricted funds raised by Movember in the U.S. and donated to PCF.
What really surprised the researchers, said geneticist Levi Garraway from the Dana-Farber Cancer Institute, was the wholesale shuffling of large segments of the genomes, with relatively big chunks of DNA broken out from one site and reinserted elsewhere. The team found more than 100 such rearrangements, far more than had been observed in any other form of cancer studied so far. “Not only were they much more common than one might have imagined, but there were certain patterns,” Garraway said. “It’s important for prostate cancer, but it might be telling us something fundamental about how cancer genomes become messed up in the first place.”
Complete information on this historic sequencing of whole prostate cancer genomes can be found at PCF’s website.
Men of America: Grow on!
Along the way, a patient can have some bizarre thoughts.
Tagore was a Bengali poet. For 12 years I have carried one of his poems in my wallet. Now, more than ever, it seems to apply to my journey: “Thou hast made me known to friends, I knew not. Thou hast given me seats in homes, not my own. Thou has brought the distant near and made a brother of a Stranger.”
Last night I had the privilege of addressing members of the Bellflower/Long Beach Elks Lodge 888. The topic, of course, was prostate cancer. It’s part of my commitment this year to reach out to our Los Angeles-based neighbors and share the facts about this disease and let them know what PCF is doing to improve the lives of patients and families. It’s a matter of think globally, act locally.
I always begin my presentations with the fact that in incidence and mortality, prostate cancer is to men what breast cancer is to women. I then go on to discuss specifics of diagnosing and treating the disease as well as the challenge of supporting research and awareness for a cancer that is often not discussed widely. (Yes, I continue to beat the Make Prostate Cancer Something to Talk About drum.) Thanks to the successes of the breast cancer movement, this opening always provides important context and makes audiences want to hear more. But, it’s when I tell folks that I am a Stage 4 patient that the presentation turns into a dialogue. A little bit of cancer goes along way in terms of making the issue real for others. Hands go up, questions are asked, fellow patients make themselves known publicly and no aspect of the disease is off limits. There is engagement.
With conventional thinking, one could think being so open about one’s cancer might make others uncomfortable. I remember that was true with some relatives, friends and colleagues when I first announced my news. It’s only natural. But, for strangers in a group, they don’t need to produce an immediate response. And, since they’ve just met me, they can can empathize, even relate directly–but, they are not threatened by the prospect of potentially losing a life-long-friend or family member. I can’t fully explain it, but the energy in the room definitely changes.
That’s a positive aspect of being a patient. In the course of last night’s meeting I heard several commitments not to delay an annual physical exam any longer. There was nearly unanimous agreement that the information was going to be shared with brothers, sons or fathers. Some took informational materials for their colleagues at work. There was also open and supportive discussion with prostate cancer survivors and those who are currently in treatment. Without my cancer, last night’s event would have been very different.
As I drove out of the Elks’ parking lot last night and headed home, I was filled with an overwhelming sense of calm knowing that my 20 minte presentation might actually help a few men and their loved ones. I know it helped me. Driving though the streets of Bellflower, I heard myself thinking, Thank God for my cancer…
When I realized what I had just mentally muttered to myself, I shuddered. Did I just think that? Can I actually be grateful for this reality? Sitting at the next stop light I had time to sort through this seemingly bizarre act of thanksgiving. I came to realize that don’t have to be grateful for the cancer. What I am really grateful for is the voice it has given me. With it I can find purpose in this journey.
I intend to use it whenever and wherever I can.
New study underscores the importance of exercise for prostate cancer patients.
In earlier entries, I’ve written of the need to maintain weight loss following a diagnosis of prostate cancer. There is that hockey stick curve that demonstrates the chances of recurrence dramatically increasing with each pound gained. Now, data from a recent study conducted by researchers from Harvard and UCSF, and published online by the Journal of Clinical Oncology, indicates that men who maintain more vigorous levels of physical activity have the lowest risk of dying from this disease. How’s that for motivation?
According to a news release issued from Harvard, “Our results suggest that men can reduce their risk of prostate cancer progression after a diagnosis of prostate cancer by adding physical activity to their daily routine,” said Stacey Kenfield, lead author of the study and a Harvard School of Public Health researcher. “This is good news for men living with prostate cancer who wonder what lifestyle practices to follow to improve cancer survival.”
Researchers who conducted the study reported that the results showed that both non-vigorous and vigorous activity were beneficial for overall survival. Compared with men who walked less than 90 minutes per week at an easy pace, those who walked 90 or more minutes per week at a normal to very brisk pace had a 46% lower risk of dying from any cause. Hopwever, only vigorous activity—defined as more than three hours per week—was associated with reduced prostate cancer mortality. Men who did vigorous activity had a 61% lower risk of prostate cancer-specific death compared with men who did less than one hour per week of vigorous activity.
In addition to having an effect on outcomes, exercise, including light weight lifting, can also help mitigate the fatigue often associated with radiation therapy. Although, anyone who has been through it can appreciate the challenge of trying to exercise “vigorously” while just trying to stay awake and move through your day! While every patient is unique and at vastly different phases of their treatment, the take away is clear: a modest amount of vigorous activity such as biking, tennis, jogging, or even walking at a brisk pace for at least 3 hours a week may substantially improve prostate cancer survival.
This Harvard, UCSF was funded by the National Institutes of Health, Charles A. King Trust and the Prostate Cancer Foundation. PCF is an ardent supporter of research studying the effects of lifestyle factors on prostate cancer. For more information on diet, exercise and prostate cancer, you can download or order a free copy of PCF’s Nutrition and Exercise Guide.
MyNewYorkMinute.org – If you haven’t guessed it already, I love my job. But there are times when I REALLY get excited about where I work… This week’s announcement of a Veridex (a Johnson & Johnson company) five-year, $30 million (that’s a 10x factor) partnership with researchers at Massachusetts General Hospital provides another concrete example of PCF’s ability to lead investment in game-changing research and technology development and parlay its investments into expanded funding for promising new technologies and treatments for patients. When I first joined PCF almost three years ago, the foundation had just made a three year Challenge Award to Dr. Daniel Haber and his research team at Massachusetts General Hospital. It was my first introduction to circulating tumor cells (CTCs). Having just jumped from the nanotech sector, I immediately tracked with the idea and understood its potential. I just had no idea how quickly it would progress.
Circulating tumor cells, found in patients’ bloodstreams, are shed from tumors and may be responsible for metastases. The ability to capture and analyze CTCs from a routine blood draw promises less invasive and better diagnostic tools for prostate and other cancers. CTC “liquid biopsies,” (a term coined in 2007 by PCF for CTC research) can confirm the presence of cancer and provide a tool for researchers to distinguish between the numerous genotypes of prostate cancer, leading to personalized treatments. The ability to actually count cancer cells may also inform physicians if patients are responding to a specific treatment sooner than is currently possible. Studies show that when CTC numbers drop during a course of treatment, it indicates a favorable response to therapy. This ability could alert patients and their physicians when a medicine isn’t working so that new options can be assessed earlier.
As reported this week by ABC, CBS and numerous other leading national media outlets, researchers at Massachusetts General Hospital first published a paper in 2007 in the journal Nature.The paper announced that they had developed new technology—a microfluidic device—to isolate and catch whole CTCs on a microchip covered with 78,000 micro posts. The tiny posts were coated with antibodies that bind to cancer cells. When blood was forced across the chip, the posts combed a few cancer cells out of billions of blood cells and held them for analysis. In the trial, the microchip successfully captured CTCs in nearly all patients with lung, breast, prostate, pancreatic, and colon cancer. Prostate and lung cancer demonstrated the best results. As a result, in 2008, the Prostate Cancer Foundation made a $3 million, multi-year Challenge Award commitment to fast forward research and development of CTC technology specifically for prostate cancer.
Now, less than three years after PCF’s initial investment, the progress made by Dr. Haber’s team in CTC research has resulted in the five-year, $30 million development partnership with Johnson & Johnson’s Veridex. The goal of the partnership is to commercialize a “Version 3.0” of this innovative technology that is capable of rapid and efficient isolation and analysis of CTCs. We anticipate seeing the introduction of this latest version of the technology in clinical trials in approximately 24 months.
As a member of PCF, I am proud and excited. But, as a patient, I am over the moon. Even though it will likely be several years before it can be utilized widely in clinical practice, I am comforted that it may be there for me should I cross the line into that 60 percent chance of recurrence. This device would give me and my doctors a better prognostic tool for my disease and enable them to more rapidly assess my response to new treatments. Further development of this technology may enable the evaluation of even more information such as the genotype of my CTCs, which could help my doctors select the next best treatment for me or, better yet, assure me that I need not worry at all. Wouldn’t that be nice?
As I said, you gotta’ love it.
I will continue to update you on progress in CTC applications for prostate cancer, including updates that come out of PCF’s Annual Scientific Retreat in September.
Related Background
A new study finds finger length may indicate a lower risk of developing prostate cancer. CNN’s Elizabeth Cohen reports.
©2012 Physician Oncology Services. All Rights Reserved.
Also known as RC Cancer Centers.
