Men’s Health

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.

What men can gain from therapy

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

Men are often reluctant to seek therapy. After all, it involves asking for help and talking candidly about one’s emotions, two things that many men are eager to avoid. But men should know that there’s no need to “tough out” whatever they’re going through. There are plenty of professionals out there who are ready and willing to lend an ear.

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.

Why men often die earlier than women

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Although it may sound alarming, the statistics don’t lie: on average, men are likely to die at earlier ages than women. There are a number of factors that might explain this; some of them can’t be changed, but others can. Regardless of the reasons, the best thing men can do to enjoy a long life is to proactively protect their health, with their doctor’s help.

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.

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.

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.

Following low-risk prostate cancers before starting treatment becoming more common

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

Treatment decisions are complicated for men with low-risk prostate cancer that grows slowly. These cancers may never become deadly during a man’s expected lifespan. And there is no conclusive evidence showing that treatment in these cases extends survival. So cancer specialists have been leaning toward monitoring low-risk prostate cancer carefully and starting treatment only when it begins to spread. This approach was once used only in academic cancer centers, but new research suggests that this strategy is becoming more common in urology practices throughout the United States and other countries as well.

Is treating “low T” really safe and effective?

Daniel Pendick
Daniel Pendick, Former Executive Editor, Harvard Men's Health Watch

If you’re a man, you’ve undoubtedly heard that lack of energy or sex drive, trouble concentrating, or feeling down or not quite yourself could be related to low testosterone, or “low T” — and that a little testosterone replacement could have you back on your game. But testosterone replacement is tricky business, and its safety and effectiveness remain controversial. Further, there can be many other causes for the symptoms of “low T.” A thorough evaluation to determine whether low testosterone is really the problem, along with a careful weighing of the potential risks and benefits of testosterone replacement, are essential before considering this drug.

Editorial calls for more research on link between football and brain damage

Patrick J. Skerrett, Former Executive Editor, Harvard Health

Is brain damage an inevitable consequence of American football, an avoidable risk of it, or neither? An editorial published yesterday in the medical journal BMJ poses those provocative questions. Chad Asplund, director of sports medicine at Georgia Regents University, and Thomas Best, professor and chair of sports medicine at Ohio State University, offer an overview of the unresolved connection between playing football and chronic traumatic encephalopathy, a type of gradually worsening brain damage caused by repeated mild brain injuries or concussions. The big question is whether playing football causes chronic traumatic encephalopathy or whether some people who play football already at higher risk for developing it. The Football Players Health Study at Harvard University hopes to provide a solid answer to that and other health issues that affect professional football players.