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A new treatment for advanced prostate cancer improves survival in phase 3 clinical trial

Radiation therapy is getting more precise, making it easier to kill tumors while sparing their surrounding tissues. Some newer therapies deliver radiation particles directly to the cancer cell itself. One of these new therapies is now generating promising data for men with the most aggressive prostate cancer.

Steps to treating an enlarged prostate

As men age, they often experience a new kind of growth spurt, known as benign prostatic hyperplasia, or an enlarged prostate gland. The first line of treatment is lifestyle changes to help manage symptoms. These include maintaining a healthy weight, avoiding medications like antihistamines and decongestants, adopting a healthy diet, and limiting caffeine. If these are not helpful, then medication is prescribed. However, men who don’t respond to medication or have trouble taking it, can benefit from several types of minimally invasive surgeries.

Large review study finds low risk of erectile dysfunction after prostate biopsy

Prostate cancer biopsies have a low risk of side effects, but some men do experience sexual dysfunction after the procedure. But a large review of sdudies has found that these issues usually resolve within one to three months.

MRI looking better for detecting prostate cancer

Using magnetic resonance imaging (MRI) to screen for prostate cancer can identify higher-grade cancers just as well as a standard biopsy, and may help some men with high prostate-specific antigen (PSA) numbers avoid biopsies.

American Heart Association issues statement on cardiovascular side effects from hormonal therapy for prostate cancer

The American Heart Association issued a statement addressing cardiovascular risks from hormonal therapy for prostate cancer, emphasizing the need to identify men with pre-existing cardiac risk factors or a family history of cardiovascular diseases who should be monitored closely during treatment.

New ways to test for prostate cancer

Recent advances can help men with a worrisome PSA result avoid immediate biopsy.

Prostate-specific antigen (PSA) blood testing receives high marks as an effective way to monitor disease activity in men diagnosed with prostate cancer. Yet, as a screening tool for prostate cancer, PSA testing is problematic.

PSA naturally tends to increase as men get older, but levels that get too high may suggest prostate cancer. A PSA level of less than 4 nanograms per milliliter (ng/mL) is often reassuring, unless there has been a sudden jump from a much lower number. Many doctors consider a total PSA level higher than 10 ng/mL as the threshold for getting a biopsy to check for cancer.

Predicting low-risk prostate cancer

New calculators can estimate the chance your cancer might — or might not — become more aggressive.

Active surveillance is a popular option for men with low-risk prostate cancer, defined as a tumor that is confined to the prostate gland and unlikely to grow or spread. It involves monitoring prostate-specific antigen (PSA) levels in the blood for changes and having regular digital rectal exams to look for abnormal areas on your prostate.

During active surveillance, you have a PSA test and a digital rectal exam every six months and prostate biopsies approximately every other year. If your PSA level rises, your doctor will likely recommend a prostate MRI or an immediate prostate biopsy to see if the cancer has become more aggressive. If so, you and your doctor can decide whether to continue with active surveillance and have another biopsy six months or a year later, or move ahead to treatment, such as radiation, hormonal therapy, or surgery.

Radiation after prostate cancer surgery may not be necessary

In the journals

Many men with prostate cancer who have a radical prostatectomy (prostate removal) receive radiation therapy afterward to wipe out any residual cancer cells. Alternatively, men can choose to delay radiotherapy and be monitored for evidence of prostate cancer activity, such as a rising blood level of prostate-specific antigen (PSA). If PSA testing or an imaging test like an MRI shows cancer, these men can then consider radiation therapy.

According to the findings of an analysis published online Sept. 28, 2020, by The Lancet, there is no clear benefit of immediate radiation over monitoring with later radiation therapy as necessary. Since some men will never need radiotherapy, this means that by forgoing immediate treatment, they can avoid potential side effects like incontinence and bowel problems.

Hormone therapy and radiation may help with certain prostate cancer

In the journals

Men with intermediate-risk prostate cancer may benefit from undergoing androgen-deprivation therapy (ADT) depending on how far the cancer has progressed, says a study published online Sept. 9, 2020, by JAMA Network Open. The results could help men better weigh risk versus reward when choosing their prostate cancer treatment options.

The study looked at men with intermediate-risk prostate cancer. This is the mid-range of prostate cancer in terms of aggressiveness between low-risk (which often doesn't need treatment) and high-risk cancer. There are two categories of intermediate-risk cancer: favorable intermediate-risk (FIR) and the more advanced unfavorable intermediate-risk (UIR).

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