Prostate-specific antigen (PSA) is a protein produced by certain cells within the prostate gland. The level of these proteins can be measured through a blood test. An abnormally high level of PSA in the blood is an indication of potential prostate cancer or possibly some benign condition with the prostate.

But with obese patients, the PSA test is harder to perform. At least, according to a recent news story in Reuters. The new findings, published in the journal Urology, suggest that because obese men’s PSA levels tend to be relatively low in general, some cancers may be missed or not detected promptly.

“Obese men have lower PSA values likely due to excess blood volume,” Freedland, the senior investigator on the study, told Reuters Health. He went on to recommend that when performing the PSA test on obese patients, doctors should adjust the value they call “abnormal” downward.

SOURCE: “Obesity may interfere with prostate cancer screen,” Reuters, June 2008.

It is therefore no coincidence that we also more cases of prostate cancer than any other country in the world.

Our love for red meat and animal fat certainly fuels the level of obesity in this country. But there is an ever-growing pool of evidence that also suggests a link between red meat and prostate cancer incidences. More specifically,  it is our high consumption of red meat that is often cited as a risk factor for prostate cancer (and a controllable risk factor at that).

This is the subject of the latest article published in the Articles section of the website:

Prostate Cancer - A Serial Killer in the Red Meat Nation

Discovering I had prostate cancer at the age of 47 was almost an accident and certainly not something that in any way I expected. I had no symptoms - none whatsoever. In layman’s terms, everything seemed to work fine. So the discovery of prostate cancer was quite accidental. It seems I had gone to my doctor simply requesting a pill (propecia - a drug to reduce hair loss). She required I have a blood test, as this drug would have an effect on my PSA. Frankly, all that was greek to me…as I didn’t know what PSA was and had never had it checked. I hated needles - had always said I was allergic to them - hence I avoided being stuck as much as I could. But on this day in November 2004 I decided to take the plunge - have my blood checked - and get the prescription.

Two days later I got a call while out of town saying that all the lab work was fine except that my PSA was a bit elevated - it was 4.58 and for someone my age that was high. My doctor referred me to a Urologist. The appointment was set.

Of course I had some concern, but after all, all the plumbing seem to work fine and I had no symptoms, so surely there was no problem. The Urologist’s exam was routine - in fact he said he thought I had nothing to worry about as he felt nothing abnormal. But, to be on the safe side he schedule a biopsy. Being fearful of needles (and a biopsy is the ultimate needle) I asked if it would hurt. His response, “Most men don’t really feel a thing.” That was a lie! Looking back, I would have asked for good drugs as that was the most painful experience I can recall.

Several days following the biopsy I received the results. Prostate Cancer! I had a Gleason score of 6 and 30% of one side of my prostate was cancerous. My heart sank as I received the news. How could I, a 47 year old healthy male, with no other medical issues have prostate cancer? And, how amazing that it was caught by a simple test that my well versed female doctor required. Looking back, her diligence saved my life.

What next?

My local doctor wanted to schedule surgery immediately. He said I had four options: (1) Radical prostotectemy (traditional surgery); (2) Radiation; (3) Hormone therapy and/or (4) Watch and wait. Again, he recommended surgery. My immediate question was how many of the surgeries that he was suggesting did he do weekly or monthly. The number was low. In the back of my mind I thought, “Hum, maybe I need someone who isn’t so surgery happy and who does this delicate removal frequently.” I was like learning to play golf - I would prefer to learn from someone who plays daily than learn from a weekend hacker. Maybe that analogy seems harsh, but after all the decision made would have lasting and profound effects.

Following the meeting with the Urologist, and after telling my family (who thought I was joking), I spent some time in research. First thing I found - based on my diagnosis - I had time to consider carefully my options. Not that nothing should be done, but I didn’t have to rush into any hasty decisions. Prostate cancer generally is slow in it’s progression. CAUTION - do not use my experience as a crutch to avoid treatment (I witnessed my father-in-law die from complications from prostate cancer), rather, seek competent medical help in making your treatment decisions.

Options Considered:

Watch and wait. Well for several months I did just that. I researched - changed my diet - considered the possibility that I could reverse what existed and even reduce the cancer. I began a regiment of daily intake of cottage cheese and flax seed oil. For a short time I actually saw a decrease in my PSA; however, that was short lived. What I did learn was that diet was important - not only for general well being - but an effective tool in promoting a cancer free body. This was valuable time in that it gave me the opportunity to consider all my options.

Radiation Therapy. Not really an option for me. While I talked with a man in his late 60’s to early 70’s who had outstanding results using focused radiation (proton therapy I think it was called), the reality is - once you opt for radiation and the tissue is destroyed, if prostate cancer returns, it cannot be surgically removed. Hence the best advice I received was, in my case, this would not be a practical option. By the way information on proton treatment can be found at http://www.protons.com/ or at http://www.llu.edu/. The people I talked with who had used this treatment were extremely pleased with the level of care they received and the overall outcome.

High Intensity Focused Ultrasound (HIFU). In my search for the right treatment, I spent much time in considering this alternative. There were three practical objectives I wished to accomplish with whatever treatment I selected: (1) Cancer elimination, (2) Minimal issues with incontinence (preferably none) and (3) minimal issues with erectile function (again, preferably none). Based on my Gleason score and prostate cancer diagnosis, it seemed that this treatment would be viable. For research information visit http://www.ushifu.com/. As part of my consideration I met with Dr. George Suarez, Medical Director for USHifu. He reviewed my medical background and was kind in taking the time to discuss with me my options using this new prostate cancer treatment. Dr. Suarez took the time to explain all my options and how, if I elected, HIFU could be effective while meeting my three objectives. My only resistance was, at the time, it was not an option yet approved by the FDA in the United States, hence I would have to seek the treatment outside the scope of my medical insurance outside of the country. While I gave this serious consideration, I ultimately decided to go another route.

Radical Prostatectomy. All of the possibilities above, brought me back to the original suggestion - SURGERY. The issue I had was what kind and who would perform it. Since I had the time to research I discovered (through the wonder of the Internet) this, then, new procedure called a robotic-assisted radical prostatectomy. Hum…seemed that needed more study. Of course, at the time, Johns Hopkins Brady Urological Institute was recognized as one of the best in the world for prostate cancer research and study. After careful consideration I contacted Johns Hopkins inquiring about this seemingly new procedure - using the daVinci Surgical System. www.urology.jhu.edu/MIS/daVinci/

The folks at Johns Hopkins could not have been more caring and helpful as I sought all my treatment options. Of course, they reviewed my file carefully and spent all the time I wanted and needed to evaluate my options. Dr. Li-Ming Su was my surgeon and my hat is off to him and his skill and patience. In the end, one thing was clear - all other options being equal - surgical removal was still the “gold standard” in the fight against prostate cancer. Likewise, it appeared that this robotic assisted laparoscopic radical prostatectomy would meet my three objectives.

The surgery went fine - of course I don’t remember a thing - so all I can base it on what the Doctor’s report. Initially the report indicated that the cancer was contained in the prostate and the removal should yield me “cancer free.” Of course this was to be confirmed later from lab reports. The first several days following surgery were not pleasant, but tolerable. Within three days, I boarded a plane and flew home to North Carolina - travel was not a big issue. The most discomforting thing following surgery was the catheter - which remained in for three weeks.

Outcome. Within four weeks following surgery I boarded a plane to Dallas, TX to begin a new job. My energy level was back and I had minimal incontinence isses with subsided within another three weeks. Within seven weeks of surgery incontinence was not an issue. Erecticle function returned within three months (with the aid of medication) and returned to full function (without medication) within twelve months.

Now it’s been two years since surgery and all three objective have been achieved. Life is normal. I am cancer free. My sincere thanks to all who were there for me as I sought out the treatment that was right for me. I would not have the opportunity to function as a motivational speaker today if it were not for the skill and help of the fine folks at Johns Hopkins. While printing such personal items for all to read may seem (to some) out there! I feel that, perhaps, others who find themselves diagnosed with prostate cancer may learn from my experience. If you find this helpful, but still need to talk - please visit my web site: http://www.chuckgallagher.com/ and contact me through that portal. I’ll be happy to talk with you via e-mail or phone.

About The Author
Chuck Gallagher is an international speaker and author who shares his life experience in a way that is meaningful for his audiences. For information on Chuck’s presentations or how to subscribe to his free ezine…visit http://www.chuckgallagher.com.

Clinical Trial Aimed to Supplement Current Research Findings on the Treatment of Localized Prostate Cancer

TORONTO, Nov. 14 /PRNewswire/ — A Canadian study on High Intensity
Focused Ultrasound therapy with the Sonablate(R) 500 - a Health Canada
approved treatment for localized prostate cancer - is underway at Can-Am
HIFU. Through funding from AstraZeneca Canada Inc, Can-Am HIFU, a prostate cancer treatment centre, will conduct an REB/Health Canada approved
clinical trial. The objective of the study is to supplement current research findings on safety and efficacy of HIFU therapy in the treatment
of localized prostate cancer. The trial will measure both the biochemical
(PSA) cure rates and the Biopsy-proven cure rates at one year.

“AstraZeneca is committed to promoting excellence in Canadian health
science research and to supporting the growth of Canada’s scientific
community,” says Marc Zarenda, Scientific Director - Oncology at
AstraZeneca Canada Inc. “We are excited to put our support behind this
clinical trial.”

The nation-wide study will involve a select number of men and will be
led by Can-Am HIFU urologists Jack Barkin, MD; Laurence Klotz, MD; Sender
Herschorn, MD; Neil Fleshner, MD; Michael Robinette, MD; Antonio Finelli,
MD; and Sidney Radomski, MD. The study will play an integral role in
building Canadian data on HIFU therapy.

Currently, the data on HIFU are from studies conducted in other
countries,” said Dr. Barkin, Chief of Staff, Humber River Regional Hospital
and Director of Can-Am HIFU. “As more patients are considering HIFU as an
alternative treatment option for prostate cancer, we recognize the need to
build Canadian data on HIFU therapy.”

HIFU has been used in several countries for a number of years to treat
men with localized prostate cancer and benign prostatic hyperplasia. The
therapy uses ultrasound energy to heat and destroy specifically targeted
areas of the prostate. HIFU was approved for use in the treatment of
prostate cancer in Canada in June 2005. Can-Am HIFU urologists have been
treating patients from Canada and abroad on an out-patient basis since
March 2006. Currently the Sonablate(R) 500 is undergoing clinical trials in
the United States and has not been approved for U.S. marketing by the FDA.
For more information on the study please contact Can-Am HIFU at 1 -877-
787-5906. For more information on HIFU with the Sonablate(R) 500, please
visit http://www.internationalhifu.com

About Can-Am HIFU
Can-Am HIFU is a Canadian entity of USHIFU, LLC. The clinic, located in
Toronto, was established in March 2006 and solely treats localized prostate
cancer using HIFU with the Sonablate(R) 500. Can-Am HIFU physicians include Jack Barkin, MD; Laurence Klotz, MD; Sender Herschorn, MD; Neil Fleshner,
MD; Michael Robinette, MD; Antonio Finelli, MD; and Sidney Radomski, MD.

About USHIFU
USHIFU, LLC is a development company headquartered in Charlotte, NC.
USHIFU is the exclusive distributor of the Sonablate(R) 500 in North, South
and Central America, the island nations of the Caribbean and South Africa.
The company holds a minority ownership position in Focus Surgery Inc. of
Indianapolis, the world leader in the development of HIFU products and the
manufacturer of the Sonablate(R) 500 in conjunction with Misonix, Inc
(MSON).

At this point, the patient and all doctors in attendance were
frustrated without a clear path to identify a disease process that was
begging to be discovered. JM came to the Diagnostic Center for Disease in
Sarasota, Florida, as he had heard about an exciting new scan offered that
promised to solve his personal dilemma while erasing his fear of the
unknown.

(Photo: http://www.newscom.com/cgi-bin/prnh/20071105/CLM095 )

Presently, a new case of Prostate cancer is diagnosed every 3 minutes
while 90 men die from prostate cancer every day. Prostate Biopsy, the “gold
standard” for finding cancer of the prostate is associated with trauma,
infection, bleeding and sampling bias. National statistics show that 10 men
must undergo an ultrasound and biopsy to find 2-3 cancers. Translated
another way, 7-8 men must undergo a procedure that is unnecessary as
documented by a negative biopsy. Moreover, it is well known that a biopsy
of the prostate is associated with the possibility that cancer cells, if
encountered, may be carried outside of the prostate capsule through a
phenomenon called, “needle tracking”. Data from Pathologists show that this
phenomenon is real. The problem is compounded when it is realized that
prostate cancer is not just a disease of older men as originally thought
but rather a disease of young men as well. In fact, data from the Detroit
Autopsy Study and Memorial Sloan- Kettering shows 30% of 30 year old men
have prostate cancer.

Given the inability to diagnose prostate cancer using the traditional
system, our attention has turned to imaging to determine the presence or
absence of prostate cancer. Currently data, primarily from Europe, suggests
that prostate cancer detection with MRI-Spectroscopy (MRI-S) has a
sensitivity and specificity in the range of 89-92%. In fact, Peter
Scardino, M.D., Chairman of the Departments of Urology and Surgery at
Memorial Sloan-Kettering has called MRI-S with the 3.0 Tesla magnet, “the
next greatest diagnostic tool for prostate cancer detection”. The
Diagnostic Center for Disease, led by Urologist, Ronald E. Wheeler, M.D.,
is using this new imaging technology to assist in finding prostate cancer
in patients like JM where traditional biopsies continue to miss the lesion.
MRI-S evaluates the integrity of prostate tissue through spatial resolution
as well as the biochemical makeup of cells through a spectral analysis.
Together, this technology establishes a “finger-print” of disease when the
PSA is elevated. Once a lesion is identified, a series of targeted biopsies
can be performed, as we localize the disease in question.

Using a parametric approach, the center is utilizing all sequences of
the 3.0 T MRI-S scan including Dynamic Contrast Enhancement with
traditional prostate cancer diagnostic detection markers such as Color Flow
Doppler Ultrasound, PSA & DRE to establish a clear picture of the disease
process present. Interestingly, this technology often times allows
physicians to alter their treatment course when cancer has escaped the
prostate capsule. Furthermore, preliminary data from the Diagnostic Center
for Disease shows that the use of MRI-S coupled with DRE, PSA and
Ultrasound data provides a 75% yield in diagnosing prostate cancer compared
to the traditional 20-30% yield while using blind or random biopsies. Dr.
Wheeler’s mission is to provide a comprehensive approach to Prostate
Disease detection that while reproducible, is more patient friendly,
allowing Urologists to improve their diagnostic skills, thereby improving
their patient treatment outcomes.

While using the MRI-S scan as a “road map”, JM needed only 5 targeted
biopsies to find the elusive cancer while preventing “needle tracking”.
Subsequent pathology showed a Gleason Score of 7 (3+4). According to Dr.
Wheeler, “while many options of treatment remain for JM, he can at least
sleep better knowing the hidden disease that was chasing him had been
found”.

For more information, please visit http://www.MrisUSA.com or call
1-866-674-7872.

S.T.A.R Program Brings Together Researchers from North America’s
Leading Prostate Cancer Centers

WASHINGTON, Nov. 15 /PRNewswire/ — Safeway Inc. and the Prostate
Cancer Foundation today announced they will collectively donate $6 million
to fund the S.T.A.R. Program (for Special Team Amplification of Research),
an innovative research initiative focused on exploring the role of targeted
heat in cancer therapy to treat prostate cancer, as well as other research
strategies.

The S.T.A.R. Program is being launched for the first phase of research
and development with a $3 million grant from the Safeway Foundation which
raised the funds from its customers with donations made at checkout. The
Prostate Cancer Foundation (PCF) developed the collaborative research
partnership and matched the initial funds dollar-for-dollar, for a total $6
million commitment. PCF is the world’s largest philanthropic source of
support for prostate cancer research and has funded ten of the individual
scientists making up the S.T.A.R. North American team.

The program brings together an interdisciplinary team of investigators
from multiple prominent cancer research centers. The team consists of
investigators from the Johns Hopkins University School of Medicine (program
lead and coordinator), the University of Michigan Cancer Center and the
University of British Columbia.

Additional expertise will be leveraged through the Prostate Cancer
Foundation from the University of Washington, and from M.D. Anderson Cancer
Center and Emory University. This unique program will bring expertise
throughout the cancer research and treatment communities to focus on a new
approach to prostate cancer treatment. “Similar to the program that Robert
Goddard put in place to make space flight a reality, everyone that has
input will be invited to the table to be part of the solution,” noted
Jonathan Simons, M.D., CEO and President of the Prostate Cancer Foundation.

“The S.T.A.R. Program is evidence of what can happen when you link the
fundraising power of a major company like Safeway with the research vision
of the Prostate Cancer Foundation,” emphasized Simons. “This program would
not have happened without Safeway and its long-standing commitment to
helping find a cure for prostate cancer. We are literally turning up the
heat on metastatic prostate cancer research.” Prostate cancer strikes more
than 218,000 men each year making it the most commonly diagnosed cancer in
men. It also is one of the most deadly cancers, with more than 27,000 men
dying each year from the disease, making it second only to lung cancer as a
leading cause of cancer deaths in men.

“Supporting this kind of innovative research has become a trademark of
the Prostate Cancer Foundation, and the principle reason Safeway developed
a relationship with the organization more than seven years ago,” said
Safeway Chairman, President and Chief Executive Officer, Steve Burd. “We
are pleased and honored to be associated with the S.T.A.R. Program
initiative and what promises to be pioneering work by some of the world’s
top cancer researchers,” Mr. Burd said.

In another innovative effort, the S.T.A.R. Program will convene a
“think tank” of some 70 experts in different areas of oncology from across
the nation to explore the question of why current therapies cure some types
of cancer but not others. The learnings from this effort will give
direction to future research on prostate cancer and other types of common
solid tumors that are currently the most difficult to treat.

“We are grateful to the leadership of Safeway and the Prostate Cancer
Foundation for this special effort,” said Robert Getzenberg, Ph.D.,
Director of Research, Brady Urological Institute, Johns Hopkins. “This
unique approach and highly interactive team will develop these new concepts
and extend them from the laboratory through testing in clinical trials to
the patient setting,” Getzenberg said.

The theory that heat can be used to help kill cancer cells comes from
an observation and review of scientific evidence by cancer researchers at
Johns Hopkins that testicular cancer patients, like seven-time Tour de
France winner Lance Armstrong, have much higher rates of survival than
others with different kinds of advanced cancer. Testicular cancer begins in
the testes, which are a few degrees cooler than the rest of the body. The
structural machinery of cancer cells spreading outside the testes may be
altered by the higher body temperatures, making them more susceptible to
standard chemotherapy treatments than other cancer types.

While heat therapy is in limited experimental use, researchers believe
the key to an effective treatment may be selectively heating cancer cells,
which can also prevent damage in adjacent healthy tissues. The goal, note
S.T.A.R. team members, is to find out the best way to deliver heat directly
to cancer cells. To do so, some of the S.T.A.R. Program researchers will
investigate the use of nanoparticles that are attracted to specific
proteins carried by cancer cells. Once the nanoparticle locates this
specific protein, it can enter the cancer cell, heating it from the inside
out after exposure to a magnetic field. The S.T.A.R. Program team will look
at this and other mechanisms for targeted heat delivery systems to cancer
cells.

In addition to Dr. Getzenberg at Johns Hopkins, the research team for
the S.T.A.R. Program includes:

– Theodore L. DeWeese, M.D., Professor and Department Chairman of
Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins
University School of Medicine (Baltimore)
– Donald Coffey, Ph.D., Professor of Urology, Oncology, Pathology,
Pharmacology and Molecular Sciences, Johns Hopkins University School
of Medicine (Baltimore)
– Kenneth Pienta, M.D., Professor of Internal Medicine and Surgery,
and Director of the NCI Research Center in Prostate Cancer at the
University of Michigan (Ann Arbor)
– Martin Gleave, M.D., Professor of Urology, Director of Clinical
and Translational Research, The Prostate Centre, University of
British Columbia (Vancouver)

About Safeway, Inc.
Safeway Inc. is one of the largest food and drug retailers in North
America. The company operates over 1,700 stores in the Western,
Southwestern, Rocky Mountain, and Mid-Atlantic regions of the United States
and in western Canada. The Safeway Foundation has become a major source of
support to cancer research and treatment programs as well as to people with
disabilities and education programs. 2007 marked the seventh consecutive
year that Safeway has been raising awareness and funds for prostate cancer
research in partnership with the Prostate Cancer Foundation; during this
time, Safeway has raised nearly $29 million. http://www.safeway.com.

About the Prostate Cancer Foundation
The Prostate Cancer Foundation (PCF) is the world’s largest
philanthropic source of support for prostate cancer research. Founded in
1993, the PCF has raised more than $300 million and provided funding for
prostate cancer research to more than 1,400 researchers at 100 institutions
worldwide. The PCF has a simple, yet urgent goal: to find better treatments
and a cure for recurrent prostate cancer.
http://www.prostatecancerfoundation.org.

ANN ARBOR, MI – The University of Michigan Center for Translational Pathology and The Prostate Cancer Foundation (PCF) and have joined forces to raise $2 million to accelerate research towards developing targeted therapies for prostate cancer. The Prostate Cancer Foundation, the world’s largest philanthropic source of research funding for prostate cancer, was founded by Mike Milken 14 years ago and has had a profound impact on advancing better treatments and the search for a cure.

Over the past decade, the PCF has awarded the University of Michigan close to $5 million in prostate cancer research funding in recognition of the important research being done here. And now the PCF is stepping up its commitment and has challenged the Michigan Center for Translational Pathology (MCTP) to raise $1 million — which they will match dollar for dollar for a total of $2 million to accelerate the potential of this transformational discovery. This initial $2 million goal is the first phase of a larger $16 million campaign. Proceeds raised will be directed to the U-M Prostate Cancer Targeted Therapy Research Fund.

“U-M has changed the paradigm of how investigators are researching targeted treatments for prostate cancers. This match is to help find a therapy similar to what was accomplished for the gene fusion BCR-ABL that was targeted by the blockbuster drug Gleevec to become an effective treatment for chronic myeloid leukemia,” says Jonathan W. Simons, chief executive officer and president of the Prostate Cancer Foundation.

The monies raised in this campaign will fund work to develop a therapy that can be engineered to seek out cells that harbor the gene fusion discovered by Arul Chinnaiyan, M.D., Ph.D., director of the Michigan Center for Translational Pathology. Chinnaiyan and his team found that two genes unique to prostate cancer fuse together and can be easily detected, resulting in a perfect target for cancer-killing therapies. With a new targeted therapy, physicians will be able to kill prostate cancer cells without damaging healthy cells.

“A therapy of this kind will be able to be extended into other common solid tumors, including cancer of the breast, lung, colon and skin. To accelerate the discovery of a therapy designed against the prostate cancer gene fusion, our research team initially needs $2 million to jump-start the translation of this laboratory discovery to the patients suffering from prostate cancer,” Chinnaiyan says.

Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. More than 218,000 men will be diagnosed with prostate cancer this year, and 27,000 will die from the disease. A little-known fact is that a man is 33 percent more likely to develop prostate cancer than an American woman is to get breast cancer.

“It is an arms race and time is of the essence. We are seeing the largest budget cuts in federal funding ever from the National Institutes of Health and we must rely more and more on philanthropy. A generous commitment to advance this critically important research initiative will be instrumental to ending prostate cancer as a cause of death and suffering,” says Kenneth Pienta, M.D., director of urologic oncology at the University of Michigan Comprehensive Cancer Center.

To join in the $2 million “Wolverines Against Prostate Cancer Challenge”, please contact Steffanie Fineman, director of development for the Michigan Center for Translational Pathology and Department of Urology, 734-615-9843 or ssamuels@umich.edu.

Written by Steffanie Fineman, 734-615-9843

Press release source

STANDARD TREATMENT FOR PROSTATE CANCER MAY ENCOURAGE SPREAD OF DISEASE

A popular prostate cancer treatment called androgen deprivation therapy may encourage prostate cancer cells to produce a protein that makes them more likely to spread throughout the body, a new study by Johns Hopkins researchers suggests.

Although the finding could eventually lead to changes in this standard treatment for a sometimes deadly disease, the Johns Hopkins researchers caution that their discovery is far too preliminary for prostate cancer patients or physicians to stop using it. The therapy is effective at slowing tumor growth, they emphasized.

David Berman, an assistant professor of pathology, urology and oncology at The Johns Hopkins University School of Medicine, and his colleagues identified the unsuspected potential problem with treatments that suppress testosterone after discovering that the gene that codes for the protein, called nestin, was active in lab-grown human prostate cancer cells.

Curious about whether prostate cancer cells in people also produce nestin, the researchers looked for it in cells taken from men who had surgery to remove locally confined cancers of their prostates and found none. But when they looked for nestin in prostate cancer cells isolated from patients who had died of metastatic prostate cancer - in which cancer cells spread out from the prostate tumor - they found substantial evidence that the nestin gene was active.

What was different, Berman speculated, is that androgen deprivation therapy, a treatment that reduces testosterone in the body, is generally given only when prostate cancers become aggressive and likely to metastasize.

Because prostate cancer growth is typically stimulated by testosterone, the treatment is thought to slow tumor growth and weaken the disease. Patients who eventually die because their disease metastasizes are almost certain to have received this type of therapy, he says.

Speculating that depriving cells of androgens might also, however, affect nestin expression, the researchers experimented on a prostate cancer cell line that depends on androgens to grow. When they removed androgens from the chemical mixture that the cells live in, their production of nestin increased.

Aware that the nestin gene has long been suggested to play some role in cell growth and development, Berman and his colleagues used a bit of laboratory sabotage called RNA interference to decrease the genetic expression of nestin and found that these cells weren’t able to move around and through other cells nearly as well as cells with normal nestin levels.

Prostate cancer cells with hampered nestin expression were also less likely than normal prostate cancer cells to migrate to other parts of the body when transplanted into mice. However, while nestin expression seemed pivotal for metastasis in these experiments, it didn’t seem to make a difference in tumor growth.

“What all this suggests is that nestin levels increased when prostate cancer cells are deprived of androgens and may encourage the cells to metastasize,” says Berman.

Besides Berman, other Johns Hopkins researchers involved in this study were Wolfram Kleeberger, M.D., G. Steven Bova, M.D., Matthew E. Nielsen, M.D., Mehsati Herawi, M.D., Ph.D., Ai-Ying Chuang, M.D., and Jonathan I. Epstein, M.D.

The research, published in the Oct. 1 issue of Cancer Research, was funded by grants from the National Institutes of Health, National Cancer Institute, Evensen Family Foundation, and German Cancer Aid Foundation.

Press release source

Bangor, ME 04496 — October 18 2007 — The Prostate Cancer Research Institute (PCRI) was founded in 1996 by internationally recognized prostate-focused oncologists Stephen B. Strum, M.D. and Mark C. Scholz, M.D. with support from the Daniel Freeman Hospital Foundation in Southern California.

The objective of PCRI is to educate patients and their families about prostate cancer, including new advances in diagnosis, staging, treatments and available resources. PCRI believes that a patient who understands his disease and treatment is empowered to communicate more effectively with his physicians and obtain a better outcome.

The PCRI Helpline is a support service available to people dealing with prostate cancer via phone and email. It is staffed by survivors of prostate cancer, some of which are physicians, but the focus is on directing inquirers to information and not practicing medicine.

Bernhoff A. Dahl, M.D. is the former Chief of Pathology at the Eastern Maine Medical Center and co-founder of Dahl-Chase Pathology Associates, which serves twenty hospitals and laboratories in Maine. Although he had no family history of prostate cancer, after years of monitoring his PSA and a negative biopsy, in September 2004 his second biopsy showed aggressive cancer.

Dr. Dahl the set about to gain all the current concepts in prostate cancer diagnosis and treatment and opted for all four major treatment modalities: androgen-depravation therapy (ADT3), radical prostatectomy, chemotherapy, and external beam radiation therapy, all of which he received in one year.

Now three year since the diagnosis was made he has an undetectable PSA, changed his diet drastically, and living every day. During these years of therapy he wrote the book Optimize Your Life!which has become an international best-seller (www.TrionicsUSA.com).

His current work-in-progress is Take Charge of Your Life…or Someone Else Will! which includes material on taking charge of one’s healthcare.

In addition to the Helpline, PCRI works closely with other prostate support groups, planning and presenting eight national and regional conferences. It also maintains a powerful web sites (www.Prostate-Cancer.org) with a full range of literature on prostate cancer, as well as a quarterly newsletter PCRI Insights.

The services of PCRI depend on contributions from the public. Donations can be made via www.PCRI.org.

Bernhoff Dahl, M.D. (DrBDahl@aol.com)
President
Trionics International, Inc.
9 Shore Lane
Winterport, ME
Phone : 207-223-9998
Fax : 207-848-5649

Prostate Cancer Research Institute

Reanalysis of data from the Prostate Cancer Prevention Trial of a chemopreventive agent for prostate cancer shows that the excess prevalence of high-grade prostate cancer in the drug-treated group may be attributable to shrinkage of the prostate at the time of biopsy.

Newswise — Reanalysis of data from the first long-term randomized trial of a chemopreventive agent for prostate cancer shows that the excess prevalence of high-grade prostate cancer in the drug-treated group may be attributable to shrinkage of the prostate at the time of biopsy.

The study of the Prostate Cancer Prevention Trial, led by University of Illinois at Chicago professor of pathology Dr. Peter Gann, is published in the Sept. 12 issue of the Journal of the National Cancer Institute.

The Prostate Cancer Prevention Trial evaluated the drug finasteride, which blocks production of a male hormone within the prostate and is proven effective in treating benign prostatic hyperplasia, or enlargement of the prostate. The trial was stopped in 2003 when finasteride was found to reduce the risk of prostate cancer by nearly 25 percent. However, men assigned to the finasteride group had a greater prevalence of high-grade cancer.

Gann said the results were confusing for clinicians and patients because the drug appeared to retard the development of prostate cancer and decrease its prevalence, but the increased risk of high-grade cancer was unexplained and worrisome.

Researchers reasoned one possible explanation was that because finasteride shrinks the prostate gland, it increases the likelihood that a biopsy will detect high-grade cancer.

“It’s logical that if you shrink the size of the gland and then stick needles in it, you’re more likely to find cancer if it exists,” Gann said.

A second possible source of bias in the trial that may have contributed to overestimation of prostate cancer risk in the finasteride group is that the drug lowers the blood level of prostate-specific antigen by approximately 50 percent. The PSA level is a biological marker doctors use to detect disease, so PSA levels measured in men taking finasteride are routinely adjusted upward. This calculation may have led to overestimation of baseline PSA levels among men in the finasteride group who were already harboring high-grade tumors at the start of the study.

“This is a very unusual situation — though it will become more common in the future — where the drug affects the marker we use to find the cancer,” said Gann.

Using data from the Prostate Cancer Prevention Trial study, Gann and colleagues developed statistical models that took into account the size of the prostate gland and the number of needle cores that were taken during biopsy. In essence, the researchers compared finasteride to placebo among men with an equivalent number of needle samples per unit of gland volume.

The analyses showed that adjusting for changes in gland size due to the drug could account for all of the excess high-grade tumors.

“Once we did this adjustment, all the excess high-grade went away, and the effect of the drug on low-grade cancer was even stronger, as we would expect,” Gann said.

“This drug may have been much better than people thought,” Gann said, “and the fears about its impact on high grade tumors may have been exaggerated based on this bias alone.”

However, he said, the findings must be interpreted cautiously, and the new results alone do not justify definitive changes in clinical practice or widespread use of the drug.

“Our goal is to improve scientific understanding of what happened in this very important and expensive trial.”

Gann’s co-authors include Yael Cohen of Gamida Cell Ltd. in Israel and Kenneth Liu, Norman Heyden, Alexandra Carides, Keaven Anderson, and Anastasia Daifotis of Merck & Co. Inc. Merck markets finasteride as Proscar.

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