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It’s Men’s Health Month – Is prostate cancer prevention possible?

Urologist and prostate cancer specialist Dr. Michael Lazar talks about prevention and options for maintaining health after a cancer diagnosis.

Do these things: • Maintain a healthy weight • Get some exercise • Choose a healthy low-fat diet • Eat more fruits and veggies • Take Omega 3 supplements • Add selenium rich foods to the dietJune is Men’s Health Month and the focus is on prostate cancer. Second only to skin cancer, prostate cancer is the most common cancer among men in the U.S. and the third most common cause of cancer related death today; lung cancer remains in the number one spot. Currently it is estimated that one man in seven will be diagnosed with prostate cancer during his lifetime. Those at highest risk are men who have a family history of prostate cancer and black men, who are more than twice as likely to die from the disease as any other group.

Although experts will say that there’s no sure way to prevent prostate cancer, there are measures a man can take to increase the odds of staying healthy. “While there are no guarantees, when you follow the research it’s easy to conclude that there appear to be simple measures we can take to stack the odds in our favor,” explains Dr. Lazar. “As with most any health condition, prostate cancer may have less of a chance of occurring in men who proactively pursue an healthy lifestyle.”

Preventing Prostate Cancer

Literally dozens of studies are conducted every year on various cancer groups and increasingly those focusing on prostate cancer point to the same results. Men who want to stay healthy and avoid prostate cancer (as well as most other types of cancer) are more likely to achieve their goal if they:

Do these things:

  • Maintain a healthy weight
  • Get some exercise
  • Choose a healthy low-fat diet
  • Eat more fruits and veggies
  • Take Omega 3 supplements
  • Add selenium rich foods to the diet

Avoid these things:

  • Smoking
  • Animal fat
  • Dairy
  • Red and processed meats
  • Sugar

When Your Luck Runs Out

Even when a person adheres to a healthy lifestyle, things can still go wrong. But the good news with a prostate cancer diagnosis is that the vast majority of cancers tend to grow slowly, and therefore don’t cause obvious health problems. It all depends on the type of cancer that is found in the prostate; while many grow slower, some are more aggressive.

Seeking treatment at the right time is imperative for the best the outcome in some scenarios. Annual screenings for men (particularly those over 50) is one of the ways to have control over potential treatment options – as newer treatments need to be pursued at the earliest stages.

Prostate Cancer Therapy Options

There are a number of treatment options that can be effective under the right circumstances, and many of them have side effects that most men would prefer to avoid, whenever possible.

The last option on this list; HIFU – is perhaps one of the most exciting non-invasive prostate cancer treatment options available today – with few to zero side effects in most cases. The key to success is early detection, and swift treatment.

“HIFU may not be appropriate in every situation, but it is most effective for men who have early stage, localized prostate cancer that has not spread or metastasized outside the prostate,” says Dr. Lazar.  About Dr. Lazar and California HIFU

Dr. Michael Lazar is the only Northern California physician recognized as a leader in the use of high-intensity focused ultrasound (HIFU) for prostate cancer. He has been successfully treating patients with HIFU since 2007. For more information about HIFU treatment, which is now available in the San Francisco area, or to make an appointment call: (707) 546-5553. Visit us online to learn more.

 

 

 

By | June 26th, 2017|Uncategorized|0 Comments

Key ingredients to thwart the growth of prostate cancer found in certain foods

When you dine on curry and baked apples, enjoy the fact that you are eating something that could play a role starving — or even preventing — cancer.

New research from The University of Texas at Austin identifies several natural compounds found in food, including turmeric, apple peels and red grapes, as key ingredients that could thwart the growth of prostate cancer, the most common cancer afflicting U.S. men.

Published online this week in Precision Oncology, the new paper uses a novel analytical approach to screen numerous plant-based chemicals instead of testing a single agent as many studies do, discovering specific combinations that shrink prostate cancer tumors.

“After screening a natural compound library, we developed an unbiased look at combinations of nutrients that have a better effect on prostate cancer than existing drugs,” says corresponding author Stefano Tiziani, assistant professor in the Department of Nutritional Sciences and Dell Pediatric Research Institute at UT Austin. “The beauty of this study is that we were able to inhibit tumor growth in mice without toxicity.”

During the past decade, some cancer research has highlighted the potential therapies found in plants, including chemicals found in foods such as turmeric, apple peels and green tea. These compounds minimize one of the risk factors for cancer, inflammation within the body. People who have chronic inflammation because of chronic infection, autoimmune disease or conditions such as obesity have a higher cancer risk because of damage to normal cells.

The researchers first tested 142 natural compounds on mouse and human cell lines to see which inhibited prostate cancer cell growth when administered alone or in combination with another nutrient. The most promising active ingredients were then tested on model animals: ursolic acid, a waxy natural chemical found in apple peels and rosemary; curcumin, the bright yellow plant compound in turmeric; and resveratrol, a natural compound common to red grapes or berries.

“These nutrients have potential anti-cancer properties and are readily available,” says Tiziani. “We only need to increase concentration beyond levels found in a healthy diet for an effect on prostate cancer cells.”

The new research paper also demonstrates how the plant-based chemicals work together. Combining ursolic acid with either curcumin or resveratrol prevents cancer cells from gobbling something that they need to grow, glutamine. This is a neat solution: blocking the uptake of a nutrient needed by prostate cancer cells with nutrients that are commonly in the human diet.


Story Source:

Materials provided by University of Texas at Austin. Note: Content may be edited for style and length.


Journal Reference:

  1. Alessia Lodi, Achinto Saha, Xiyuan Lu, Bo Wang, Enrique Sentandreu, Meghan Collins, Mikhail G. Kolonin, John DiGiovanni, Stefano Tiziani. Combinatorial treatment with natural compounds in prostate cancer inhibits prostate tumor growth and leads to key modulations of cancer cell metabolism. npj Precision Oncology, 2017; 1 (1) DOI: 10.1038/s41698-017-0024-z

Read this article on Science Daily: University of Texas at Austin. “Starving prostate cancer with what you eat: Apple peels, red grapes, turmeric.” ScienceDaily. ScienceDaily, 6 June 2017. www.sciencedaily.com/releases/2017/06/170606112750.htm.

New blood test better at predicting prostate cancer risk than PSA

A new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease. By identifying molecular changes in the PSA protein, the findings of this study suggest that once validated, use of IsoPSA may reduce the need for biopsy, and may lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.

A team of researchers from Cleveland Clinic, Louis Stokes Cleveland VA Medical Center, Kaiser Permanente Northwest, and other clinical sites have demonstrated that a new blood test known as IsoPSA detects prostate cancer more precisely than current tests in two crucial measures — distinguishing cancer from benign conditions, and identifying patients with high-risk disease.

By identifying molecular changes in the prostate specific antigen (PSA) protein, the findings, published online last month by European Urology, suggest that once validated, use of IsoPSA may substantially reduce the need for biopsy, and may thus lower the likelihood of overdetection and overtreatment of nonlethal prostate cancer.

The research team, led by Cleveland Clinic’s Eric Klein, M.D., conducted a multi center prospective study of 261 men scheduled for prostate biopsy at five academic and community centers in the U.S. enrolled between August 2015 and December 2016.

“Despite criticism, PSA has transformed the landscape of early detection, screening, and management of prostate cancer in the last few decades,” said Dr. Klein, chair of Cleveland Clinic’s Glickman Urological & Kidney Institute. “Unfortunately, PSA is tissue-specific but not cancer-specific, leading to overdiagnosis and overtreatment of biologically insignificant cancers, which is widely recognized as a key limitation in its clinical utility.”

The study directly compared the clinical performance of a new test based on PSA, called IsoPSA, to PSA itself with patients already scheduled for prostate biopsy. IsoPSA proved significantly superior to PSA in two key indications: discriminating between prostate cancer and benign conditions; and identifying patients with high-grade disease. The former indication is potentially useful for using IsoPSA for screening by primary care physicians, while the second is helpful for urologists in identifying patients who would benefit from curative intent therapy and other applications.

The results show that if validated and adopted clinically, IsoPSA could significantly reduce the rate of unnecessary biopsies by almost 50 percent. “The methodology used in the IsoPSA assay represents a significant departure from conventional ways to define biomarkers in blood, and may be applicable to improving other cancer biomarkers,” said Dr. Klein.

“Due to its inherent simplicity, requiring only a blood draw and presenting information to the physician in familiar context using a single number — just like PSA itself — we are quite hopeful in IsoPSA’s future utility after further validation studies,” said Mark Stovsky, M.D., co-author and staff member, Cleveland Clinic Glickman Urological & Kidney Institute.


Story Source: Materials provided by Cleveland Clinic.

Journal Reference: Eric A. Klein, Arnon Chait, Jason M. Hafron, Kenneth M. Kernen, Kannan Manickam, Andrew J. Stephenson, Mathew Wagner, Hui Zhu, Aimee Kestranek, Boris Zaslavsky, Mark Stovsky. The Single-parameter, Structure-based IsoPSA Assay Demonstrates Improved Diagnostic Accuracy for Detection of Any Prostate Cancer and High-grade Prostate Cancer Compared to a Concentration-based Assay of Total Prostate-specific Antigen: A Preliminary Repo. European Urology, 2017; DOI: 10.1016/j.eururo.2017.03.025

Read this article on Science Daily. “New blood test is more accurate in predicting prostate cancer risk than PSA: IsoPSA assay can help in determining the need for prostate biopsy for patients.” ScienceDaily. ScienceDaily, 15 May 2017. www.sciencedaily.com/releases/2017/05/170515122149.htm.

By | May 16th, 2017|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments

Doctors believe it’s important to discuss pros and cons of prostate cancer screening with patients

A new study finds that while a blood test that helps to screen for prostate cancer remains common, only 30 percent of men in a large national survey reported having a balanced discussion of the advantages and disadvantages of the screening with their doctor. Moreover, having such a discussion of both pros and cons has become less likely since the U.S. Preventive Services Task Force issued a recommendation against performing prostate-specific antigen (PSA) testing in 2012.

“That only about a third of patients reported having a discussion of advantages and disadvantages is an alarming statistic,” said study lead author Dr. George Turini III, clinical instructor in medical science at the Warren Alpert Medical School of Brown University and a urologist with the Southcoast Physician Group.

Co-author Dr. Joseph Renzulli, associate professor of surgery and a urologist at the Minimally Invasive Urology Institute at Miriam Hospital, added, “The concept of ‘shared decision making’ for prostate cancer screening is not occurring in the community.”

For example, in 2014 out of a sample of 111,241 men who responded to the national Behavioral Risk Factor Surveillance System survey, 29.5 percent reported discussing both advantages and disadvantages, 33.9 percent discussed neither, 35.7 percent reported discussing only advantages of PSA, and 0.8 percent reported discussing only disadvantages. In data from 2012, before the task force made its recommendation against the test, out of 105,812 men who responded to the survey, 30.1 percent discussed both, 30.5 percent discussed neither, 38.5 percent discussed only advantages, and 0.8 percent discussed only disadvantages.

Meanwhile, 63.0 percent of the men in 2012 had PSA tests, as did 62.4 percent of the men in 2014, according to the study published online in the journal Urology. In each year thousands of men had the test without having a discussion of how it could either benefit them, for instance via early detection of cancer, or lead to unnecessary adversity, such as a side effects from biopsy or unneeded treatment. They either got no information or only one side of the story.

In addition, the researchers found, men who have low incomes, did not finish high school, lack insurance, or are Hispanic were significantly less likely than men overall to report hearing about the pros and cons of screening via the PSA test, the study found.

“The most vulnerable men are getting less counseling,” said co-author Annie Gjelsvik, assistant professor of epidemiology in the Brown University School of Public Health.

A controversial topic

The PSA test reveals blood levels of a protein naturally secreted by the prostate. Levels could become elevated for a number of reasons including the normal enlargement of the prostate as men age, Turini said. But cancer could also elevate them.

When the task force in 2012 discouraged PSA testing, Turini said, it was because there are risks to what follows from screening. If cancer is suspected, it can only be confirmed with a biopsy and that could cause problems such as infection, bleeding or discomfort.

Beyond those concerns, if prostate cancer is confirmed, the risks inherent in treatment options such as surgery, radiation or hormonal alteration, can be “truly life altering,” he said.

“In some cases, a low volume of less aggressive prostate cancer may not necessitate treatment, but even in those cases where a ‘treatment’ is not performed in favor of active surveillance, the emotional distress of a cancer diagnosis shouldn’t be underestimated,” Turini said.

But whenever a cancer does present a threat to health, there are also clear advantages to catching it early. Therefore many urologists still believe that doctors and their patients should weigh these pros and cons of screening. For that reason, the authors wrote, the American Urologic Association and the American Cancer Society advocate thorough discussion and decision-making between doctors and patients.

The study authors sought to understand the state of those discussions and how the task force recommendation may have changed them. Gjelsvik noted that it’s important to measure and track the full spectrum of effects of public health actions, such as the new national recommendations.

The findings could be explained by factors independent of the U.S. Preventive Services Task Force recommendation, the authors acknowledged, but they concluded the paper with this concern: “We believe our findings may be indicative of a shift in practice patterns away from detailed pre-screening discussions among health care providers who have implemented the [USPSTF] recommendation into their care giving. Long-term evaluation of this trend is necessary, particularly to ensure that men who are given an order for a PSA test receive the absolutely necessary counseling required to allow them to appreciate the important consequences associated with the decision to pursue screening.”

Amid all the findings of concern, including the overall trend and disparities of income, education, insurance and ethnicity, the researchers did find one bright spot: Black men, who are known to be at higher risk for prostate cancer incidence and death, were more likely to report having discussed advantages and disadvantages than men on average.

Turini said the study suggests that urologists may be able to do more to help their primary care physician colleagues have balanced and informative conversations with their patients. Primary care physicians are increasingly pressed for time with each patient and it can seem easy to order an additional test if blood is going to be drawn for other purposes anyway, Turini said. But the moment when a PSA test comes back with an elevated reading is not the ideal moment to only begin the conversation of what that could mean.

“It’s our job in the urology community to make it as easy as possible for the primary care physicians and other general practitioners to comfortably disseminate as complete and balanced information as possible,” he said.


Story Source:

Materials provided by Brown University. Note: Content may be edited for style and length.


Journal Reference:

  1. George A Turini, Annie Gjelsvik, Joseph F Renzulli. The State of Pre-Screening Discussions About PSA Testing Following Implementation of the 2012 USPSTF Task Force Statement. Urology, 2017; DOI: 10.1016/j.urology.2016.12.069

Read this article on science daily: www.sciencedaily.com/releases/2017/03/170328132148.htm.

By | April 24th, 2017|Uncategorized|0 Comments

Study reveals genetic connection to aggressive prostate cancer

An international study published in the Journal of the National Cancer Institute has identified a genetic connection to the aggressive form of prostate cancer. The study showed a threefold increase in the risk of aggressive prostate cancer for men with the genetic mutation. The frequency of the gene variants varied from 6 to 14% of the population of men with prostate cancer.

Much like the association between BRCA gene mutation and the risk for breast cancer in women changed the approach to treatment/ prevention, the identification of the Kallikrein 6 gene region may change the course of prostate cancer care through a blood test developed by the Lunenfeld-Tanenbaum Research Institute.

The study was led by Dr. Alexandre Zlotta, Director of Uro-Oncology at Mount Sinai Hospital, and researcher with the Lunenfeld-Tanenbaum Research Institute, part of Sinai Health System in Toronto, Canada, and Dr. Paul Boutros, Principal Investigator, Informatics and Bio-computing, Ontario Institute for Cancer Research (OICR). The first author of the paper was Dr. Laurent Briollais, Senior Investigator, Lunenfeld-Tanenbaum Research Institute.

These findings are important because it is well established that most men will die with prostate cancer, and not from the disease. Dr. Zlotta was the lead author of a study in 2013 which revealed the unexpected high prevalence of indolent prostate cancer in men. Diagnosing the aggressive form of the disease is an important unmet need.

“As an oncologist I know firsthand how valuable it would be to have a genetic tool that could help choose the best course of action with my patients,” explains Zlotta. “It would help spare patients with indolent disease from unnecessary treatments and their side effects and aid in the diagnosis and directing patients with aggressive disease to the appropriate treatment.” Up until now, no single test could predict the severity of the cancer type- the current PSA test (Kallikrein 3), which is located near Kallikrein 6, only identifies the risk of prostate cancer, not the severity.

To identify the relevant mutations the scientists analyzed the blood samples of 1,858 men from three independent cohorts in Europe and North America: the Swiss arm of the European Randomized Study for Prostate Cancer Screening, the large American Screening trial, Prostate, Lung, Colorectal, and Ovarian (PLCO), Princess Margaret Cancer Centre (University Health Network) and Mount Sinai Hospital (Sinai Health System) in Toronto. The KLK6 variants also independently predicted treatment failure after surgery or radiation for prostate cancer in an independent cohort of 130 men from the International Cancer Genome Consortium (ICGC).


Story Source:

Materials provided by Lunenfeld-Tanenbaum Research Institute. Note: Content may be edited for style and length.


Journal Reference:

  1. Laurent Briollais, Hilmi Ozcelik, Jingxiong Xu, Maciej Kwiatkowski, Emilie Lalonde, Dorota H. Sendorek, Neil E. Fleshner, Franz Recker, Cynthia Kuk, Ekaterina Olkhov-Mitsel, Tristan Juvet, Ioannis Prassas, John Trachtenberg, Ants Toi, Michael Fraser, Theodorus van der Kwast, Robert G. Bristow, Bharati Bapat, Eleftherios P. Diamandis, Paul C. Boutros, Alexandre R. Zlotta. Germline Mutations in the Kallikrein 6 Region and Predisposition for Aggressive Prostate Cancer. JNCI: Journal of the National Cancer Institute, 2017; 109 (4) DOI: 10.1093/jnci/djw258

Read this article on ScienceDaily:

“Genetic association with aggressive prostate cancer discovered: Study showed a threefold increase in the risk of aggressive prostate cancer for men with the genetic mutation..” 16 March 2017. www.sciencedaily.com/releases/2017/03/170316141120.htm.

By | March 21st, 2017|Dr. Michael Lazar, HIFU, News, Prostate Cancer|0 Comments

New discovery may lead to blood test predicting and preventing prostate cancer spread

University of Adelaide researchers have uncovered a new pathway which regulates the spread of prostate cancer around the body.

Published in the journal Cancer Research, the discovery has potential to lead to the development of a blood test that could predict whether cancer will spread from the prostate tumour to other parts of the body. The research also reveals potential new targets for drugs that may inhibit the spread of cancer.

“Prostate cancers only kill men after they have spread or ‘metastasised’ from the prostate,” says project leader Dr Luke Selth, Senior Research Fellow at the University of Adelaide’s Dame Roma Mitchell Cancer Research Laboratories and a member of the Freemasons Foundation Centre for Men’s Health.

“The identification of markers that accurately predict, at an early stage, prostate tumours that are likely to metastasise could guide the urgency and aggressiveness of treatment — and this could save lives.”

The international research team — led by the University of Adelaide and including members from the University of Michigan, Vancouver Prostate Centre, the Mayo Clinic and Johns Hopkins University — showed that a specific microRNA (a type of molecule involved in regulating the level and activity of genes) called miR-194 promotes cancer metastasis by inhibiting a key protein called SOCS2. SOCS2 can suppress the spread of cancer cells.

“In previous work, we had found that a high level of miR-194 in a patient’s blood was associated with rapid relapse of prostate cancer following surgical removal of the tumour,” says Dr Selth. “This new work explains why miR-194 is associated with a poor outcome, and in the process reveals a completely novel pathway regulating prostate cancer metastasis.

“Importantly, measuring miR-194 in a patient’s blood at the time of diagnosis could become a test for the likelihood of metastasis. Patients with high levels of miR-194 in their blood could receive more aggressive treatment to reduce the chance of the cancer spreading to other parts of the body.” Dr Selth’s team is currently testing this idea using larger patient groups to validate their findings.

Dr Selth says miR-194 also represents a potential therapeutic target. “There are currently no drugs that effectively inhibit the spread of prostate cancer,” he says. “We propose that inhibiting miR-194 could reduce rates of metastasis in patients with aggressive disease, but the development of a drug to achieve this goal is still a long way off.”

Story Source:

Materials provided by University of Adelaide. Note: Content may be edited for style and length.

Journal Reference:

  1. Rajdeep Das, Phillip A Gregory, Rayzel C Fernandes, Iza Denis, Qingqing Wang, Scott L Townley, Shuang G. Zhao, Adrienne Hanson, Marie A Pickering, Heather K Armstrong, Noor A Lokman, Esmaeil Ebrahimie, Elai Davicioni, Robert B. Jenkins, R. Jeffrey Karnes, Ashley E. Ross, Robert B Den, Eric A. Klein, Kim N. Chi, Hayley S Ramshaw, Elizabeth D Williams, Amina Zoubedi, Gregory J Goodall, Felix Y. Feng, Lisa M. Butler, Wayne D Tilley, Luke A Selth. MicroRNA-194 promotes prostate cancer metastasis by inhibiting SOCS2. Cancer Research, 2016; canres.2529.2016 DOI: 10.1158/0008-5472.CAN-16-2529

Read this article on ScienceDaily:

University of Adelaide. “Predicting and preventing prostate cancer spread.” ScienceDaily. ScienceDaily, 25 January 2017. www.sciencedaily.com/releases/2017/01/170125091702.htm.
By | February 21st, 2017|HIFU, News, Prostate Cancer|0 Comments