Enlarged Prostate Raises Chronic Kidney Disease Risk In Men
Written byMohan GarikiparithiPublished onNovember 27, 2015
Benign prostatic hyperplasia enlarged prostate can raise the risk of chronic kidney disease . BPH is an enlarged prostate that is not cancerous. In males, the prostate goes through two growth periods, once during early puberty and again around the age of 25. As the prostate enlarges the gland can press and pinch the urethra and the bladder walls become thicker. Over time the bladder can become weaker and lose its ability to fully empty. If the urethra continues to narrow and the bladder maintains the inability to fully empty, it can lead to complications associated with benign prostatic hyperplasia.
Prostate Cancer Kidney Disease Detected In Urine Samples On The Spot
When you flush the toilet, you may be discarding microscopic warning signs about your health.
But a cunningly simple new device can stop that vital information from “going to waste.”
Brigham Young University chemist Adam Woolley and his students made a device that can detect markers of kidney disease and prostate cancer in a few minutes. All you have to do is drop a sample into a tiny tube and see how far it goes.
That’s because the tube is lined with DNA sequences that will latch onto disease markers and nothing else. Urine from someone with a clean bill of health would flow freely through the tube . But even at ultra-low concentrations, the DNA grabs enough markers to slow the flow and signal the presence of disease.
“In a disease state, this particular marker is equal to about one billionth of a percent of the content of urine.” Woolley said. “We can detect close to those levels. If we can get below that, it would give us better sensitivity for somebody at an early stage of the disease.”
Grad students Debolina Chatterjee and Danielle Mansfield co-authored the study for the journal Analytical Methods using synthetic urine samples. The next step is to do human trials with this “lab on a chip.”
The method holds several advantages over current tests for prostate cancer: No blood draws, instant results and potentially higher accuracy.
“The flow distance is about 20 to 40 millimeters longer if just one of those 22 letters is wrong,” Woolley said.
Metastatic Spinal Cord Compression
Metastatic spinal cord compression happens when cancer cells grow in or near to the spine and press on the spinal cord. MSCC isnt common, but you need to be aware of the risk if your prostate cancer has spread to your bones or has a high risk of spreading to your bones. The risk of MSCC is highest if the cancer has already spread to the spine. Speak to your doctor or nurse for more information about your risk.
MSCC can cause any of the following symptoms.
- Pain or soreness in your lower, middle or upper back or neck. The pain may be severe or get worse over time. It might get worse when you cough, sneeze, lift or strain, or go to the toilet. It might get worse when you are lying down. It may wake you at night or stop you from sleeping.
- A narrow band of pain around your abdomen or chest that can move towards your lower back, buttocks or legs.
- Pain that moves down your arms or legs.
- Weakness in your arms or legs, or difficulty standing or walking. You might feel unsteady on your feet or feel as if your legs are giving way. Some people say they feel clumsy.
- Numbness or tingling in your legs, arms, fingers, toes, buttocks, stomach area or chest, that doesnt go away.
- Problems controlling your bladder or bowel. You might not be able to empty your bladder or bowel, or you might have no control over emptying them.
It is very important to seek medical advice immediately if you think you might have MSCC.
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Rct Evidence That Earlier Intervention Is Effective
The benefits attained in screening trials are mediated by shift to a less advanced stage and more effective treatment for earlier diseases. There are two types of screening trial designs. Participants could be randomly assigned to screening and no screening groups. Alternatively, all participants are screened but only those with positive results will be randomly assigned to earlier or standard intervention. In RCT, benefits are defined as significant reduction in cancer-specific mortality and morbidity. Survival benefits, measured from the time of diagnosis, are misleading as a result of length-time and lead-time bias. Individuals only seem to be living longer because indolent diseases, with minimal propensity to progress, are detected earlier, allowing people to live with the disease diagnosed for a longer period of time.
Review Looked At Side Effect From Androgen Deprivation Therapy
TUESDAY, July 16, 2013 — Hormone therapy for prostate cancer may dramatically increase a man’s risk of kidney failure, according to a new study.
Use of androgen deprivation therapy was tied to a 250 percent increase in a man’s chances of suffering acute kidney injury, Canadian researchers found in a review of more than 10,000 men receiving treatment for early stage prostate cancer.
The study appears in the July 17 issue of the Journal of the American Medical Association.
Androgen deprivation therapy uses medication or surgery to reduce the amount of male hormones in a man’s body, which can then cause prostate cancer cells to shrink or grow more slowly.
It is a therapy usually reserved for advanced cases of prostate cancer, said study co-author Laurent Azoulay, a pharmacoepidemiologist at Jewish General Hospital’s Lady Davis Institute, in Montreal. Previous research already has linked androgen deprivation therapy to a possible increased risk of heart attack.
These new findings tying hormone therapy to acute kidney injury — a rapid loss of kidney function with a 50 percent mortality rate — should prompt doctors to think twice before using androgen deprivation therapy to treat prostate cancer patients at little risk of dying from the disease, said Azoulay, also an assistant professor in McGill University’s department of oncology.
The American Cancer Society has more about prostate cancer treatment.
Journal of the American Medical Association
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Recommendation For Skin Cancer Screening
The American and European transplantation organizations recommend skin cancer screening in renal transplant individuals using monthly self-skin examination and 6- to 12-monthly total body skin examination by expert physicians and dermatologists. The US Preventive Services Task Force concluded that there is insufficient evidence to recommend for or against population skin cancer screening using total skin examination . The American College of Preventive Medicine recommended that high-risk individuals be screened regularly, but no recommendation was made for individuals with low risk for skin cancers .
Are the Recommendations Valid?
There is no evidence from RCT to verify that total body skin cancer examination reduces skin cancer mortality and no data to suggest that early treatment for either melanoma and nonmelanocytic skin cancers found by screening reduces the overall skin cancerrelated mortality and morbidity in the general and renal transplant populations. An RCT that involves > 600,000 participants is now being conducted in Queensland, Australia, to evaluate the mortality and morbidity benefits of skin cancer screening using self-skin and total body skin examination by physician . The results of this landmark trial will be available in the next decade.
Harms from Skin Cancer Screening.
Cost-Effectiveness of Skin Cancer Screening.
Acute Kidney Injury In Patients With Cancer
AKI, as defined by the Kidney Disease Improving Global Outcomes or other older AKI grading systems , is a common occurrence in patients with cancer.-, – For instance, in a study from Denmark of 1.2 million people, there were 37,267 patients with incident cancer between 1999 and 2006. Over a 5-year period, 27% of patients developed AKI , and 7.6% of patients developed severe AKI and AKI requiring dialysis support. In that study, the highest risk of AKI was among patients with kidney and liver cancer and MM. In a more recent study of 163,071 patients undergoing therapy for cancer between 2007 and 2014, AKI that required dialysis occurred in nearly 10% of all patients . Advanced cancer stage, CKD, and diabetes were associated with an increased risk of AKI. The annual incidence of AKI increased from 18 to 52 cases per 1000 person-years over the duration of the study period. This rise in AKI was likely explained in part by an increase in drug-related kidney toxicities.
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Enlarged Prostate Treatment And Prevention
Depending on the size of the prostate and the symptoms associated with it, there are many different treatment options available, for example:
- Transurethral resection of the prostate a scope removes the center of the prostate only leaving the outside
- Transurethral incision of the prostate cuts are made in the prostate gland to allow easier urination
- Transurethral microwave thermotherapy electrodes destroy the inner part of the prostate, shrinking it and improving urination
- Transurethral needle ablation radio waves destroy excess prostate tissue that block urine flow
- Laser therapy
- Prostate lift
Although you may not be able to prevent your prostate from becoming enlarged, sticking with these habits can help ease symptoms and improve prostate health.
- Reduce beverage consumption in the evening to minimize urge to urinate at night
- Limit caffeine and alcohol
New technology could help your bladderWe all love movies it seems like the next big blockbuster is being released every weekend and there are endless lineups just to catch the first glimpse. Although movies can be a great form of entertainment, or a fun date-night idea, they can wreak havoc on your bladder. Continue reading
Adt And Risk Of Pneumonia
A recent publication by Chung et al reported that among over 2,000 Taiwanese patients with prostate cancer, those who received a luteinizing hormonereleasing hormone agonist were almost twice as likely to be hospitalized with pneumonia during a 1-year follow-up period than those who did not receive an LHRH agonist. The authors propose four mechanisms which may increase the risk of lung infections: morphologic and biochemical changes in the lungs, alterations in antibiotic susceptibility and microbial growth, changes in the composition of gastrointestinal microflora to allow the outgrowth of pathogenic flora, and decreased neutrophil production. To date this is the only report of an increased risk of pneumonia with ADT and thus will require confirmation in other populations, ideally as part of a prospective study. Moreover, there are no data comparing LHRH agonists vs gonadotropin-releasing hormone antagonists in terms of this potential new complication of treatment.
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Prostate Bladder And Kidney Cancer Treatment
Our urologic cancer surgery team is board-certified and fellowship-trained, bringing national experience from the top cancer centers in the county. Our cancer specialists are part of a multidisciplinary team approach to treating prostate and urological cancers. Experts from several specialties will work together to design a personalized treatment plan specifically for your individual case, which may include one or more of the following:
- Active surveillance, or watchful waiting
- Cancer surgery – uses minimally invasive techniques such as robotic-assisted surgery
- Chemotherapy – drugs that work to remove, kill or damage cancer cells
- Hormone therapy – for prostate cancer that has spread
- Immunotherapy – activates the bodys own immune system to fight the cancer
- Radiation therapy – uses ionizing radiation to kill cancer cells and shrink tumors and includes stereotactic body radiation therapy
- Targeted therapies – uses antibodies that target specific molecules within cancer cells
Ask your provider about clinical trials.
Management Of Prostate Cancer
Treatment for prostate cancer may involve active surveillance, surgery, radiation therapy including brachytherapy and external-beam radiation therapy, proton therapy, high-intensity focused ultrasound , cryosurgery, hormonal therapy, chemotherapy, or some combination. Treatments also extend to survivorship based interventions. These interventions are focused on five domains including: physical symptoms, psychological symptoms, surveillance, health promotion and care coordination. However, a published review has found only high levels of evidence for interventions that target physical and psychological symptom management and health promotion, with no reviews of interventions for either care coordination or surveillance. The favored treatment option depends on the stage of the disease, the Gleason score, and the PSA level. Other important factors include the man’s age, his general health, and his feelings about potential treatments and their possible side-effects. Because all treatments can have significant side-effects, such as erectile dysfunction and urinary incontinence, treatment discussions often focus on balancing the goals of therapy with the risks of lifestyle alterations.
Prostate Cancer Hormonal Therapy Tied To Kidney Risks
By Genevra Pittman, Reuters Health
4 Min Read
NEW YORK – Men who are treated for prostate cancer with hormone-targeted therapy have a higher risk of developing kidney problems, a new study suggests.
The treatment, known as androgen deprivation therapy, lowers the risk of death among men with advanced, aggressive prostate cancer.
However, researchers said its increasingly being used to treat possible recurrences among men with less advanced disease – for whom the benefits are less clear, and the risks more worrisome.
Our study does raise the concern that perhaps we should be more careful in prescribing androgen deprivation therapy in patients who do not have the clear indication for it, said Laurent Azoulay, who worked on the research at McGill University in Montreal.
Its all about the balance, finding the right population for which the benefits clearly outweigh the risks, he told Reuters Health.
Hormone-targeted treatment has been linked to a higher risk of diabetes and heart disease.
For their study, Azoulay and his colleagues used UK data on 10,250 men who were diagnosed with prostate cancer between 1997 and 2008. The men were followed for an average of just over four years after their diagnosis.
During that time, 232 of them developed an acute kidney injury – a rapid drop in kidney function. The researchers compared those men to 2,721others from the study who were the same age and were not diagnosed with kidney problems.
Are The Recommendations Valid
None of the six RCT in the general population using chest x-rays alone or combined with sputum cytology demonstrated mortality benefits in the screened populations . In fact, two of the trials showed that lung cancer mortality was significantly greater in the group with more frequent chest x-ray screenings than less intense screening after a longer follow-up period . There is now emerging evidence from observational studies to suggest that low-dosage spiral CT increases the detection rate of stage I lung cancer and 5-yr survival in high-risk individuals . This finding, however, may represent overdetection and lead-time bias with no real benefit in overall cancer-specific mortality. One large RCT is in progress, with the aim to provide an unbiased assessment of lung cancer screening with this potential screening tool .
Harms from Lung Cancer Screening.
Cost-Effectiveness of Lung Cancer Screening.
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High Intensity Focused Ultrasound
High intensity focused ultrasound was first used in the 1940s and 1950s in efforts to destroy tumors in the central nervous system. Since then, HIFU has been shown to be effective at destroying malignant tissue in the brain, prostate, spleen, liver, kidney, breast, and bone.
HIFU for prostate cancer utilizes ultrasound to ablate/destroy the tissue of the prostate. During the HIFU procedure, sound waves are used to heat the prostate tissue, thus destroying the cancerous cells. In essence, ultrasonic waves are focused on specific areas of the prostate to eliminate the prostate cancer, with minimal risks of affecting other tissue or organs. Temperatures at the focal point of the sound waves can exceed 100 °C . However, many studies of HIFU were performed by manufacturers of HIFU devices, or members of manufacturers’ advisory panels.
Contraindications to HIFU for prostate cancer include a prostate volume larger than 40 grams, which can prevent targeted HIFU waves from reaching the anterior and anterobasal regions of the prostate, anatomic or pathologic conditions that may interfere with the introduction or displacement of the HIFU probe into the rectum, and high-volume calcification within the prostate, which can lead to HIFU scattering and transmission impairment.
Does Surgery On The Prostate Gland Interfere With Sexual Function
Surgery for an enlarged prostate does not usually interfere with a man’s sexual functioning. However, about 10 to 15 percent of men may have trouble getting erections after surgery. Men may have a problem called retrograde ejaculation, which causes semen to go backward into the bladder instead of through the urethra to the outside. This means no longer being able to father children but causes no other harm.
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Cv And Kidney Safety Considerations In Current Guidelines
Based on the available evidence, the US Food and Drug Administration issued a drug safety communication requiring new safety information about the risk of diabetes and certain CV diseases with ADT, and a consensus paper was published by the American Heart Association, the American Cancer Society, and the American Urological Association. Current National Comprehensive Cancer Network guidelines recommend screening for CV disorders and intervening to prevent or treat CVD, considering that CVD is relatively common in the general population and increases with age, as does the incidence of prostate cancer. However, the guidelines also note that it is unclear whether screening, prevention, and treatment strategies for CVD should differ between men receiving ADT and those in the general population.
In Europe, the latest European Association of Urology guidelines judge the available data on CV mortality to be inconsistent and make no specific recommendations in relation to ADT but note that general improvements in health can be gained by adoption of nonspecific measures, including weight loss, increased exercise, improved nutrition, and smoking cessation. As of late 2014, the authors are uncertain whether existing guidelines should be updated. However, expert panels must keep a close eye on this area. Currently, footnotes should be considered in the guidelines to apprise the practicing clinician of these emerging concepts of toxicity and risk.