Cancer

The risks of active surveillance for men with intermediate-risk prostate cancers

Charlie Schmidt
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Disease

Many men with prostate cancer benefit from active surveillance, in which treatment doesn’t begin unless the cancer spreads. There has been some debate about whether this strategy is safe for men with intermediate-risk prostate cancer. A new study suggests that this type of cancer is more likely to spread than previously thought — but active surveillance can still be a good option for many intermediate-risk men.

Can aspirin protect against cancer?

Lori Wiviott Tishler, MD, MPH
Lori Wiviott Tishler, MD, MPH, Assistant Professor of Medicine, Harvard Medical School

You may have heard somewhere that an aspirin a day can prevent cancer. It almost sounds too good to be true. For many people, it is, but for a select few, it might not be. We’ve taken a look at the (often confusing) evidence that gave rise to this statement.

Long-term hormonal therapy benefits men with locally advanced prostate cancer

Charlie Schmidt
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Disease

Long-term hormonal therapy, which blocks the effect of testosterone on prostate tumors, was once reserved for prostate cancer that has spread. But recent research has found that it had enormous benefits for men with earlier stages of prostate cancer, slashing their risks of metastasis and death from prostate cancer. However, some questions remain — for example, exactly how long to use “long-term hormonal therapy” is still up for debate.

Promising results for a targeted drug in advanced prostate cancer

Charlie Schmidt
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Disease

The same BRCA mutations that increase a woman’s risk of breast and ovarian cancers can also increase a man’s risk of dying from prostate cancer. Recently, an ovarian cancer drug intended for BRCA-positive women has shown impressive results in BRCA-positive men with metastatic prostate cancer. This drug, and others like it, could provide another, much-needed treatment option for men with advanced prostate cancer.

The empowering potential of end-of-life care

Beverly Merz
Beverly Merz, Executive Editor, Harvard Women's Health Watch

There’s almost always something we can do to improve our health and well-being — even at the end of our lives. Palliative care is designed to improve the quality of life for people with life-threatening illnesses and their families by keeping a person comfortable and making sure his or her values and preferences guide the medical team’s actions. For this reason, good communication with your care team — and your loved ones — is essential, even before you or a loved one has developed a serious illness.

Taking new aim at cancer

Matthew Solan
Matthew Solan, Executive Editor, Harvard Men's Health Watch

Last year, only months after announcing that he had an aggressive form of melanoma, former President Carter declared that he was cancer free — thanks at least in part to a recently approved immunotherapy drug. Immunotherapy is a type of targeted therapy that helps boost the body’s own immune response to cancer. It does so while sparing healthy cells, thus minimizing side effects.

Does fewer PSA tests mean less prostate cancer?

Charlie Schmidt
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Disease

Fewer men are being given PSA tests to screen for prostate cancer. As screening rates have fallen, so have the number of prostate cancer diagnoses. This probably also means that fewer men are receiving potentially unnecessary treatment, with its attendant negative side effects. At the same time, it isn’t yet clear whether that comes at the cost of more aggressive cancers being caught at an incurable stage. Better screening tests may make the difference in helping strike the right balance between limiting harm and preventing prostate cancer deaths.

The “right” goal when managing pain

Robert R. Edwards, Ph.D.
Robert R. Edwards, Ph.D., Contributing Editor

When it comes to pain management, focusing only on reducing the intensity of pain may lead to treatments that do as much harm as good. Ideally, pain-management plans should be tailored to each patient and include a range of therapies that not only reduce pain but also help improve pain-related quality-of-life problems.

Active surveillance is safe for low-risk prostate cancers

Charlie Schmidt
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Disease

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

Hidden cancer rarely causes out-of-the-blue clots in the bloodstream

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

Blood clots can be lifesavers when they form outside the bloodstream to stop bleeding from an injury. But they can wreak havoc when they form inside the bloodstream. A blood clot in a coronary artery can cause a heart attack. One in the brain can cause a stroke. Blood clots that form in a leg vein cause a problem known as venous thromboembolism, or VTE. If the clot stays in the leg, it can cause swelling or pain. If it breaks away and travels to the lungs, it can cause a potentially deadly pulmonary embolism. In about half of people who develop a VTE, doctors can identify what caused it. In the other half, VTE is something of a mystery. These are called “unprovoked” VTEs. Such unprovoked VTEs often spark a search for hidden cancer. But a study published in The New England Journal of Medicine suggests that these searches are usually fruitless — and costly.