Common Treatment For Prostate Cancer Appears To Double Alzheimers Risk
Short-circuiting the need for expensive clinical trials, researchers uncovered an association between androgen blockers and cognitive decline by examining patient medical records.
A review of the electronic medical records of thousands of prostate cancer patients at two major medical institutions revealed a nearly two-fold increase in the rate of Alzheimers disease diagnosis among those treated with androgen deprivation therapy.
The study, by researchers at the Stanford University School of Medicine and the University of Pennsylvania Perelman School of Medicine, demonstrates emerging techniques for extracting biomedical data from ordinary patient medical records.
The paper was published online Dec. 7 in the Journal of Clinical Oncology.Nigam Shah, MBBS, PhD, associate professor of biomedical informatics research at Stanford, is the senior author. The lead author, Kevin Nead, MD, is a resident at the University of Pennsylvania who got his medical degree at Stanford.
Because testosterone can promote the growth of prostate tumors, clinicians have used androgen deprivation therapy to lower testosterone and other androgens in prostate cancer patients since the 1940s. In the United States, about a half-million men currently receive ADT as a treatment for prostate cancer.
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Current Research And Scholarly Interests
The Genito-Urinary Multidisciplinary tumor board at Stanford specalizes in taking care of patients with prostate cancer, renal cancer, testicular and bladder cancer. Patients are seen at different stages of their tumor. A multisdiscplinary approach is used. A variety of clinical trials are available to patients. Phase II trials using unique combination of chemotherapy agents, antiangiogenic drugs, novel agents are being explored.Co-operative group particpation through ECOG is also available
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While cycling through Oklahoma, he crashed, landing on his head. He spent nine days in a coma. When he was stable enough to be moved, his family chose Stanford. There, a team of traumatic brain injury specialists stabilized his inter-cranial pressure, rebuilt his skull and supported him through his neurologic therapy. Facing multiple years to fully recover, Brett pushed himself physically and mentally. Six years later, Brett walks 40 to 70 miles a week and has completed 600 rides on a stationary bicycle. I really feel like Ive pulled through it the best I possibly could, he said. At Stanford, the whole team was great at making sure the right things happened for me to have the amazingly good recovery Ive had so far.
Types Of Prostate Cancer Treatment
Every cancer is different, even in the early stages. The best treatment for one person might not be the best treatment for another. Your doctor will help you make an informed decision about which options may be right for you. Your treatment plan may consist of one or any combination of the following:
- Participation in research that can save lives in the future
Possible risks of a clinical trial:
- Treatment that may not work for you
- Side effects that may be unexpected or worse than current standard-of-care treatments
- Additional doctor visits, meaning more time and travel
- Additional tests, which may be uncomfortable or time consuming
- Extra expenses if your health insurance does not cover all patient costs for a trial
Simon Conti Named Program Director For Urology Residency Program
Simon Conti, MD has moved into the position of Program Director of the Urology residency program as of May 2021. He brings with him 6 years of experience as Assistant Program Director as well as a Masters in Education. As a graduate of the program along with his additional training in education he hopes to continue innovating and providing a learning environment that has a strong tradition of graduating leaders in the field of urology in a broad range of post-graduate practice settings. Dr. Conti most recently spearheaded the transition to a night float system at Stanford Hospital due to the surge in volume and expanded emergency room services. The pandemic has presented many educational challenges over the past 18 months. We hope to emerge from this trying period with a new set of educational tools developed out of necessity.
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Using Existing Clinical Data
Shah said the idea for the study started with Nead, who noticed some references in the medical literature to men who had ADT treatment for prostate cancer subsequently experiencing cognitive declines. There was some chatter in the literature, said Shah. But no one had formally tried to find out if ADT therapy leads to cognitive defects.
This is the kind of question that typically you would need a large clinical trial to answer, said Shah. But a formal clinical trial would be enormously expensive. So instead, were making secondary use of existing clinical data collected as part of routine medical care clinical data thats practically free.
The association found in this study should be evaluated in the context of the overall treatment choices available to any specific patient.
Although ADT may increase the risk of defects in cognition and hand-eye coordination for reasons other than Alzheimers disease, the team decided to focus specifically on Alzheimers because the condition is easier to identify in medical records, said Shah. Broader dementias and vascular dementia are kind of hard to quantify and define, so we had to narrow the scope of the analysis to make it feasible with the methods that we have available, he said.
They also looked for associations likely to be positive, such as age and cardiovascular disease both conditions known to be associated with a risk of Alzheimers disease. Those positive associations were confirmed in the data.
Years After A Rocky Start A Pioneering Immunotherapy Drug Gets A Fresh Analysis
When Richard Cardoni was diagnosed with prostate cancer 20 years ago, his doctors chose a conventional treatment route: hormone therapy, followed by radiation. That worked beautifully for nearly 10 years, Cardoni said, until tests showed his tumor had rebounded.
This time, his Stanford oncologist, Sandy Srinivas, MD, decided to try an experimental drug that used a radically new approach to attack the disease. Cardonis cancer had spread beyond the prostate to nearby lymph nodes, so he qualified for the treatment, which at the time was available only to men with metastatic disease.
I had this cancer that was coming back. I wanted to try anything that would stop it, said Cardoni, a retired San Jose surgeon who asked that his real name not be used in this article.
The new treatment, known as Provenge, capitalizes on the bodys own powers to combat cancer. It helped set the stage for a revolution in cancer treatment when in 2010 it became the first immunotherapy drug the federal Food and Drug Administration approved for use in patients in this case, for those with advanced disease.
In 2010, people thought this would just open the floodgates, said Srinivas, professor of urologic oncology at Stanford. Every patient would get Provenge, and this would be the wonder drug.
Provenge, the first immunotherapy drug to receive FDA approval for use in patients, had its origins decades ago in the lab of Edgar Engleman. Timothy Archibald image
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Research At The Stanford Cancer Institute
Investigators at Stanford are leading a revolution in cancer biology and transforming how we treat cancer patients. The SCI has over 250 available clinical trials across all types of cancer and all phases of trials, including a rapidly growing phase 1 clinical trials portfolio. Stanford is committed to diversity and inclusion in its research and is very interested in partnering with communities to remove barriers to participation.
The SCI has scientific strengths in cancer cell and stem cell biology, radiation biology, genetics and genomics, immunology and immunotherapy, and molecular imaging. Dating from the first use of the linear accelerator in 1955 and the pioneering work in the combined modality treatment of Hodgkin disease, Stanford has provided innovative ideas that have greatly advanced the diagnosis and treatment of a wide variety of cancers. Stanford faculty members have pioneered the development of genomic technologies, detection of circulating tumor DNA, and the application of monoclonal antibodies to cancer treatment, among many other major advances.
What We Offer You For Urology Care
- Specialized expertise in treating issues affecting the urinary tract, including prostate disease, erectile dysfunction, stones, and urinary incontinence. Go to Conditions Treated
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- In-depth education by your provider to make sure you understand all the important factors related to prostate cancer screening. Go to About Prostate Cancer Screening
- Evidence-based screening for prostate cancer based on recommendations from the American Cancer Society. Go to Techniques
- Patient-centered care that considers your needs and preferences when making important health care decisions. Go to Benefits and Risks
- Convenient access to care at primary care and urology clinics located throughout the Bay area. Go to Our Clinics
Stanford Researcher Declares ‘psa Era Is Over’ In Predicting Prostate Cancer Risk
- Stanford University School Of Medicine
- The PSA test, commonly used as a screening tool for detecting prostate cancer, is now all but useless for predicting prostate cancer risk, according to Stanford University School of Medicine researchers.
STANFORD, Calif. – The PSA test, commonly used as a screening tool for detecting prostate cancer, is now all but useless for predicting prostate cancer risk, according to Stanford University School of Medicine researchers. A study of prostate tissues collected over 20 years – from the time it first became standard to remove prostates in response to high PSA levels to the present – reveals that as a screen, the test now indicates nothing more than the size of the prostate gland.
“The PSA era is over in the United States,” said Thomas Stamey, MD, professor of urology and lead author of the study published in the October issue of the Journal of Urology. “Our study raises a very serious question of whether a man should even use the PSA test for prostate cancer screening any more.”
Stamey explained the change in correlation over the years by noting that the tumors encountered 20 years ago were generally so large they generated PSA levels high enough to provide a reasonably good measure of cancer severity. Now that screening is more commonplace in this country, many cancers are being caught earlier and are usually smaller – not generating enough PSA to be a good indicator of severity.
Stanford University Medical Center To Acquire Second Accuray Cyberknife M6 System
New system will be used to treat diseases in the brain and base of the skull
December 11, 2019 Accuray Incorporated announced today Stanford University Medical Center has selected a second CyberKnife M6 System to expand access to precise radiosurgery treatments to more of their patients. With its installation, the hospital’s clinicians will have a CyberKnife System dedicated to the treatment of diseases in the brain and base of the skull, making it possible for the existing system to be used to treat more patients with tumors elsewhere in the body. The new CyberKnife System will be installed at the Stanford Neuroscience Health Center, a comprehensive facility offering integrated outpatient services in one location designed to provide more accurate diagnoses, organized care, better quality of life and improved outcomes for the patient.
The CyberKnife System is routinely used to treat conditions in the brain including, but not limited to, benign and malignant primary tumors, brain metastases, trigeminal neuralgia, acoustic neuromas and arteriovenous malformations . CyberKnife radiosurgery is even used to treat complicated neurosurgical cases, while maximally sparing brain tissues involved in important functions such as hearing and vision.
For more information: www.accuray.com
Advancing The Standard Of Care For Prostate Cancer
What you should know about Prostate Cancer
The doctors of the Stanford Urologic Cancer Program are dedicated to preserving quality of life and providing exceptional care directed by customized treatment plans for each patient.
Advanced treatments and technologies available at Stanford include:
- State-of-the-art surgical techniques, including minimally invasive and robot-assisted surgery
- Immunotherapies to leverage the body’s immune system to eliminate cancer
- Image-guided 3D Conformal Radiation Therapy to reduce damage to important structures surrounding the prostate
- Clinical trials of the latest prostate cancer treatments
Stanford specialist Geoffrey Sonn, MD has conducted 300 targeted prostate biopsies, a procedure he learned from the doctor who developed the technique.
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What Is Prostate Cancer Screening
About Prostate Cancer Screening
The prostate is part of the male reproductive system and helps produce some of the fluid found in semen. It surrounds the urethra and is located just in front of the rectum.
Prostate cancer is a type of cancer that occurs in the prostate. You may be at higher risk if you are Black or have a family history of prostate cancer.
Prostate cancer screening includes a blood test and a physical examination of the prostate, which can detect prostate cancer in its early stages, before you experience symptoms. With early detection, doctors may be able to treat prostate cancer before it spreads.
You should consider prostate cancer screening if you are:
- Age 55 or up, at average risk of developing prostate cancer, and expect to live at least 10 more years. Because much prostate cancer develops slowly, older men may not need to worry about screening any longer.
- Age 50 and at high risk of developing prostate cancer.This high-risk group includes Black men and men with a first-degree relative who received a prostate cancer diagnosis before age 65.
Common Prostate Cancer Treatment Linked To Later Dementia Researcher Says
A new retrospective study of the health records of prostate cancer patients supports an association between androgen deprivation therapy and future risk of dementia.
Men being treated with prostate cancer therapies that reduce their testosterone levels are at greater risk of developing dementia within five years, a new study shows.Alexander Raths/Shutterstock
A new retrospective study of patient medical records suggests that men with prostate cancer who are treated with testosterone-lowering drugs are twice as likely to develop dementia within five years as prostate cancer patients whose testosterone levels are not tampered with.
The study, by researchers at the Stanford University School of Medicine and the University of Pennsylvania Perelman School of Medicine, also demonstrates emerging techniques for extracting biomedical data from ordinary patient medical records.
The paper describing the research was published online Oct. 13 in JAMA Oncology. Kevin Nead, MD, DPhil, a resident at the University of Pennsylvania who got his medical degree at Stanford, is the lead author. Nigam Shah, MBBS, PhD, associate professor of biomedical informatics research at Stanford, is the senior author.
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