Prostate Health

Movember: Stashing prostate and testicular cancer awareness into the limelight

Paul G. Mathew, MD, FAAN, FAHS

The Movember movement began in 2003 to help raise awareness of prostate and testicular cancers as well as other health concerns including mental health issues. One of the primary goals of this initiative is to encourage men to take the time to pay attention to their health. This includes doing self-exams and getting the necessary screenings so that cancers can be detected and treated earlier.

Treatment versus monitoring of prostate cancer: Survival rates the same after 10 years

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

Two new studies add to the evidence that for many men with prostate cancer, if it is detected early and has not metastasized beyond the prostate gland, monitoring the cancer will lead to the same chance of survival after 10 as choosing surgery or radiation. Men treated with surgery or radiation often experience significant side effects. The rates of depression and anxiety were the same in men who opted for monitoring and those who opted for treatment.

Treating the primary tumor can improve survival in men whose prostate cancer has spread

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

For men with prostate cancer that has metastasized, treatment usually focuses on the tumors that develop elsewhere in the body. But treating the primary tumor in the prostate with radiation or surgery could result in longer overall survival.

New urine test predicts high-grade prostate cancer

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

Researchers believe that a non-invasive screening test that can identify genetic markers for high-grade prostate cancer in urine may eventually reduce the number of prostate biopsies needed. However, experts also caution that while the number of non-invasive tests for prostate cancer diagnosis is growing, these are still early days in their development.

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.

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.

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.