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What Makes Prostate Cancer Aggressive

Vitamin D Deficiency And Sun Exposure

How Does Prostate Cancer Kill Us?

Vitamin D behaves like a hormone in the body and is produced in the skin upon exposure to ultraviolet light from the sun. It’s been known for some time that people assigned male at birth who live in northern regions are more likely to develop the disease than those in southern latitudes, and this increased risk is thought by some to be related to vitamin D deficiency.

Other research has suggested that high serum vitamin D levels may reduce the risk of aggressive prostate cancer. Fortunately, vitamin D levels can be tested a via a simple blood test, and people assigned male at birth can talk to healthcare providers about supplementation if needed.

Clues In Diet And Lifestyle

To clarify the prognosis for a tumor, HSPH researchers are homing in on other factors that might affect susceptibility to prostate cancer, especially the aggressive form of the disease. Edward Giovannucci, professor of nutrition and epidemiology, recently looked at nine diet and lifestyle factors. He found that smoking, obesity, and lack of physical activity raise the risk of developing a more virulent cancer. According to Giovannucci, The question is whether there are two types of prostate canceran aggressive and nonaggressive formor whether certain factors cause a nonaggressive form to become more aggressive. Evidence provided by HSPH researchers suggests that an increase in insulin in the bloodstream, caused by obesity and physical inactivity, may encourage tumor growth.

Other investigations have linked dietary factors to the disease. A 2011 study by HSPH research associate Kathryn Wilson, together with Mucci and Giovannucci, professor of nutrition and epidemiology Meir Stampfer, and other colleagues, found that men who drank coffee had a notably lower risk of aggressive prostate cancer. Those who consumed six cups or more a day were 20 percent less likely to develop any form of the disease, and 60 percent less likely to develop a lethal disease those who consumed one to three cups a day showed no difference in developing any form of the disease, but had a 30 percent lower risk of developing a lethal form.

When Does Prostate Cancer Become Life Threatening

May 18, 2014

Prostate cancer becomes life threatening when it has metastasized or spread into the body, such as the bones, brain, liver, or lungs. Prostate cancer is generally a slow growing disease however once it has spread to other areas of the body it is considered aggressive and difficult to treat. Usually when any type of cancer spreads throughout the body, it is life-threatening.

When it comes to prostate cancer, the treatment recommendations are based on your PSA score, the grade of cancer, the amount of cancer present, and your medical state/history. If the cancer is present in a very small portion of the biopsy tissue, it is low grade, and poses a low risk of spreading you may be put on active surveillance. With active surveillance your PSA is checked more frequently with the possibility of repeat prostate biopsies if PSA rises. If it is suspected that the cancer is growing, more aggressive management should be implemented. Treatment recommendations will be at the discretion of your doctor, and you should always make sure you follow up regularly for surveillance even if a small amount of cancer is present.

Georgetown, Round Rock, and Austin-area residents seeking prostate cancer treatment should contact Dr. Koushik Shaw and his staff at the Austin Urology Institute.

Learn more about when to get a prostate exam to see if you are at risk.

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Talk To Your Cancer Care Team

Your team is an important source of advice. Some men may benefit from having a low-risk tumor treated right away, even if they might have side effects. Discuss your treatment options and quality-of-life issues with your team.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.


Prostate Cancer Survival Rates

Tumor cell type identified that makes prostate cancer more aggressive

Answering the question of how curable is prostate cancer? first requires understanding what doctors mean when they refer to curability. Regardless of the type of cancer, doctors consider cancer cured when a patient remains cancer-free for a specified period after treatment. The higher the number of patients who stay cancer-free for five years or longer, the higher the curability of that particular disease.

Prostate cancer, therefore, has one of the highest curability rates of all types of cancer, thanks in large part to early detection standards and advances in treatment, such as the stereotactic body radiation therapy offered by Pasadena CyberKnife. When the cancer is detected in the early local or regional stages that is, before the cancer has spread or when it has only spread to limited areas in the pelvic regions the five-year survival rate is nearly 100 percent.

Survival rates decline significantly when cancer is detected at later stages however, the good news is that only about five percent of men are diagnosed after the cancer has become widespread throughout the body. In short, more than 90 percent of men who are diagnosed with prostate cancer live for five years or longer after treatment, making it one of the most curable forms of cancer.

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Reduced Psa Prostate Cancer Screening: Life

In 2012, the United States Preventive Services Task Force issued a grade D recommendation against PSA-based prostate cancer screening. This is because early diagnosis of low-grade cancers can lead to unnecessary overtreatment and patient suffering. However, many epidemiologists are concerned that this could lead to severe unintended consequences. Dr Thomas E. Ahlering, from the University of California, has further explored these concerns and has shown in a ground-breaking study that reduced PSA-screening can lead to increased incidence of high-risk disease and increased mortality rate.

Prostate cancer is the second most common cancer worldwide and the sixth leading cause of cancer-associated death among men. In 2012, there were approximately 1.1 million cases and 307,000 deaths. Generally, prostate cancer affects men over the age of 50 years old and the majority of patients are over 60 years of age. The prostate is a small gland in the pelvis that is only found in men. The main function of the prostate is to produce seminal fluid that is then mixed with sperm made by the testicles. Often patients suffering from prostate cancer are asymptomatic until the prostate is large enough to affect the urethra and urination.

Limitations of the PSA blood test led to the United States Preventive Services Task Force issuing a grade D recommendation.

The one-year biochemical recurrence post-radical prostatectomy increased from 6.3% to 17.5%.

To Treat Or Not To Treat

Up until now, with a few notable exceptions, doctors have myopically focused on treating prostate cancer, says Adami. They are willing to spend tens of thousands of dollars on chemotherapy that has minimal effects on cancer mortality, often with substantial side effects. But we ignore entirely the fact that large groups of prostate cancer patients die from other causes that actually are preventable.

Among older patients especially, that activity can take the form of vigorous walking. Recently, Mucci has spearheaded an intervention with Adami and other colleagues in Sweden, Iceland, and Ireland in which men walk in groups with a nurse three times a week. In a pilot study, researchers found improvements in just 12 weeks in body weight, blood pressure, sleep, urinary function, and mental health.

Scientists at HSPH are also searching for genetic and lifestyle markers that help predict how aggressive a patients prostate cancer will be. For example, an ongoing project led by Mucci and Adami draws on detailed cancer registries in Nordic countries, including an analysis of 300,000 twins, to tease out the relative contribution of different genes to prostate cancer incidence and survival.

is a Boston-based journalist and author of The Coke Machine: The Dirty Truth Behind the Worlds Favorite Soft Drink.

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What Is Prostate Cancer

Prostate cancer only affects men. Cancer begins to develop in the prostate a gland in a mans reproductive system. The word prostate comes from Medieval Latin prostate and Medieval French prostate. The ancient Greek word prostates means one standing in front, from proistanai meaning set before. The prostate is so called because of where it is at the base of the bladder.

The prostate is an exocrine gland of the male reproductive system, and exists directly under the bladder, in front of the rectum. An exocrine gland is one whose secretions end up outside the body e.g. prostate gland and sweat glands. It is approximately the size of a walnut.

The urethra a tube that goes from the bladder to the end of the penis and carries urine and semen out of the body goes through the prostate.

It is a myth to think that a high blood-PSA level is harmful to you it is not. High blood PSA levels are however an indication that something may be wrong in the prostate.

Prognostic Factors That Determine The Need For Further Investigation Following A Negative Biopsy

Gleason 4 4=8 Prostate Cancer Treatments | Ask a Prostate Expert, Mark Scholz, MD

In developing a recent UK National Institute for Health and Care Excellence clinical guideline for the diagnosis of treatment of prostate cancer, the UK National Collaborating Centre for Cancer undertook a systematic review to identify the prognostic factors that determine the need for further investigation following a prior negative biopsy in men who have been referred with suspected prostate cancer. The review included retrospective and prospective cohort studies that reported on the following potential prognostic factors: age, ethnicity, family history of prostate cancer, DRE, total PSA, free-to-total PSA%, PSA density, PSA velocityii and PCA3 score at the time of initial biopsy, and histopathological features reported on initial biopsy .

The NICE systematic review classified the results of relevant predictive studies into two broad groups: results of univariate analyses and results of multivariate analyses . The multivariate analyses are likely to provide more reliable evidence, because they reduce the risk of bias due to confounding variables. The most frequently addressed potentially confounding variables were age, DRE, PSA, free-to-total PSA%, PSA density, PSA velocity, high-grade PIN, ASAP and prostate volume.


Family history

Digital rectal examination

The updated NICE systematic review found one additional study, which reported an OR of 1.36 for abnormal DRE relative to normal DRE in a multivariate model.

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Can Prostate Cancer Treatment Affect Your Quality Of Life

Your age and overall health will make a difference in how treatment may affect your quality of life. Any health problems you have before youre treated, especially urinary, bowel or sexual function problems, will affect how you recover. Both surgery and radiation can cause urinary incontinence or impotence .

How Active Surveillance Works

The Gleason score is just one way that doctors monitor prostate cancer during active surveillance. They also do periodic follow-up biopsies and measure PSA levels, which may rise if cancer starts to spread in the prostate. Doctors may recommend treatment sooner if PSA begins to rise quickly or if a follow up biopsy reveals a higher Gleason score or more widespread cancer within the prostate. Its an inexact science that depends on a doctors skill and experience and a mans willingness to wait for signs that a cancer poses a clear threat before opting for treatment and its potential for side effects.

Penney says she and her Harvard colleagues are among the many scientists now searching for better ways to predict which prostate cancers are likely to be lethal and which can be monitored and not treated. The answer may be found in genetic changes in prostate cancer cells that signal a higher threat. But finding a better way to predict which prostate cancers are likely to turn lethal is far from guaranteed.

Some believe its not possible, Penney says. After the cancer is diagnosed, so many things can change in unknown ways. Diet, exercise, and other lifestyle factors, for example, could affect whether low-risk prostate cancers become more aggressive or threatening over time.

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Watchful Waiting And Active Surveillance

Watchful waiting is an adequate approach in patients who are at low risk of death from prostate cancer because of their limited life expectancy due to severe comorbidities., Watchful waiting resulted in similar overall survival when compared with radical prostatectomy, but disease-specific survival was better in patients who had undergone surgery. For some patients it turns out to be hard to persist on a watchful waiting policy, and many men drop out and seek active treatment within several years, mostly when PSA elevation is noted.

Active surveillance is a novel and fascinating approach to distinguish between patients who are at higher risk and need active therapy and patients who are at low risk for disease progression., This approach avoids the risks of therapy while allowing early detection of those patients who are prone to progress. In these high-risk individuals, delayed active treatment is offered. Periodic monitoring of the PSA serum level, digital rectal exam, and repeated prostate biopsies are performed in patients who are on active surveillance, and active therapy is started when predefined threshold values are reached. This concept makes it possible to offer curative treatment to individuals who are at high risk for disease progression as indicated by active surveillance parameters.

Who Is At Risk For Prostate Cancer

Aggressive prostate cancer

All men are at risk for prostate cancer, but African-American men are more likely to get prostate cancer than other men.

All men are at risk for prostate cancer. Out of every 100 American men, about 13 will get prostate cancer during their lifetime, and about 2 to 3 men will die from prostate cancer.

The most common risk factor is age. The older a man is, the greater the chance of getting prostate cancer.

Some men are at increased risk for prostate cancer. You are at increased risk for getting or dying from prostate cancer if you are African-American or have a family history of prostate cancer.

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Myth: Prostate Cancer Isnt Deadly

Fact: While the five-year survival rate with prostate cancer is very high 90 percent, according to the ACS its still the second leading cause of cancer death in men. The only cancer that kills more men is lung cancer.

Most prostate cancers are what doctors call indolent, which means that they grow slowly and can often be actively monitored over the course of many years without other treatment. But sometimes prostate cancer is aggressive, and grows quickly.

While most men dont have a prostate cancer thats fast and deadly, acknowledges Sartor, it does exist. And you wont know which type you have until its thoroughly checked out.

In other words, assuming prostate cancer isnt serious and not having further testing because of this misconception could be a downright deadly way of approaching the illness.

The dangers and risks of prostate cancer arent distributed evenly among American men, either. The U.S. Department of Health and Human Services Office of Minority Health reports that African-American men are 2.3 times as likely to die from prostate cancer as compared to non-Hispanic white men.

Emerging Therapies For Prostate Cancer

Researchers are pursuing several new ways to treat advanced prostate cancer. Vaccines that alter the bodys immune system and use genetically modified viruses show the most promise. One vaccine technique works by manipulating blood cells from the patients immune system and causing them to attack the prostate cancer.

Blood is drawn from the patient. From the blood sample, cells that are part of the immune system are exposed to cells that make up prostate cancer. Then the blood cells are placed back in the body, with the hope that they will cause other immune system cells to attack the prostate cancer. In a more traditional type of vaccine, the patient is injected with a virus that contains PSA. When the body is exposed to the virus, it becomes sensitized to cells in the body that contain PSA and their immune system attacks them.

Immune or genetic therapy have the potential to deliver more targeted, less invasive treatments for advanced prostate cancer. This would result in fewer side effects and better control of the prostate cancer.

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Types Of Prostate Cancer Cell

Prostate tumors contain a variety of cell types, each posing a different level of risk.

The UEA scientists set out to develop a classification system for the most common cell types based on patterns of gene activity, known as gene expression pattern.

Their previous research used some complex math called Latent Process Decomposition to identify the unique molecular signature of an aggressive expression pattern they call DESNT.

In their new work, they analyzed patterns of gene expression in 1,785 tumor samples. They then correlated the amount of DESNT in each tumor sample with the outcome of the disease for that individual.

The researchers found that the more DESNT cells a sample contained, the more likely it was that the cancer would metastasize.

At the same time, the researchers identified three other prostate cancer molecular subtypes, making it a total of four categories of gene expression patterns in prostate cancer.

In the future, they hope to develop a classification system based on the four cell types that will not only help identify people whose cancers will metastasize but also predict their response to different drug treatments.

They note that a similar classification system for breast cancer has been developed using the same mathematical technique and is already being used to guide treatment.

Adenocarcinoma Of The Prostate

10 Warning Signs of Prostate Cancer

Adenocarcinomas may occur almost anywhere in the body. They form in the glandular epithelial cells that line the insides of the organs and secrete mucus, digestive juices or other fluids. In the prostate, adenocarcinoma is also called glandular prostate cancer.

Symptoms of adenocarcinoma of the prostate may include a frequent urge to urinate, painful urination and ejaculation, and blood in the semen. Treatment options may start with active surveillance of the cancer, which generally grows very slowly. Treatments may include surgery, chemotherapy, radiation therapy, immunotherapy or hormone therapy. A radical prostatectomy, which is a surgical procedure to remove the prostate, may be an option when the cancer is limited to the prostate.

Some side effects of treatment may include urinary problems or erectile dysfunction.

Main subtypes of adenocarcinoma of the prostate

Acinar adenocarcinoma : This cancer accounts for virtually all prostatic adenocarcinomas. Acini cells line the prostates fluid-secreting glands. The cancer starts growing in the back of the prostate near the rectum and may be felt during a doctors digital rectal exam. The disease increases PSA levels.

Prostate cancer treatment: The care you need is one call away

Your multidisciplinary team will work with you to develop a personalized plan to treat your prostate cancer in a way that fits your individual needs and goals.

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