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Early Disease Detection

Marine General Shares Prostate Cancer Story

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Lt. Gen. Robert Milstead, deputy commandant of manpower and reserve affairs, began 2012 with news that no one would want to learn. The three-star manpower chief of the Marine Corps had been diagnosed with an aggressive form of prostate cancer.

His diagnosis was the result of a battery of tests that began in November last year, as part of his annual physical. The sign that something was wrong came from the score on his prostate-specific antigen (PSA) test, which had increased when compared against the previous year.

Lt. Gen. Milstead shared: “Once they told me, ‘You’ve got cancer,’ I said, ‘Whoa’… The C-word can be intimidating. The range of options goes from denial to acceptance, and I think I was able to jump pretty quickly up to, ‘OK, I’ve got cancer. How am I going to deal with this?’”

Last February 28, the general underwent surgery to remove his prostate. He is sharing his story, he said, in order to help raise awareness regarding the importance of annual physical exams and regular screenings. He shared further that he sought to undergo screening as his father and paternal grandfather were both treated for prostate cancer.

“This is a huge fraternity,” Milstead shared. “You’ve got a better chance as a man of getting prostate cancer than you do as a female of getting breast cancer. It’s not a club I ever wanted to join, but I’m a card-carrying member now.”

Early Disease Detection

Mixed Results on Significance of Prostate Cancer Screening

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A study led by Dr. Fritz Schroder of Erasmus University Medical Center in the Netherlands, and published on the New England Journal of Medicine arrived at mixed results in as far as the value of prostate cancer screening is concerned.

The study was able to determine that conducting prostate-specific antigen (PSA) tests every four years can reduce the risk of death from prostate cancer.  However, it also found that these tests do not necessarily favorably affect overall mortality rates, as most men may die of other causes outside of their prostate tumors.

The effort is a large European study involving 162,000 men ages 55 to 69. It was able to determine that there was a need for 1,055 men to be offered cancer screening, and 37 cancers to be detected, before one death due to prostate cancer could be prevented.

The results of the study lend further credence to an exasperating reality about prostate cancer: most of them progress too slowly to ever become threatening to a man’s life, and there is no good way to date to identify which ones will eventually become fatal. The detection of prostate cancer may lead to treatments that may cause impotence, incontinence, or other problems.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, who is not involved in the study, shared: “A man needs to make a choice for himself, realizing the benefits exist in theory, but the harms have been shown in every study that we’ve ever done in prostate cancer… If there is an overall mortality benefit from prostate screening it is very, very small.”

Early Disease Detection

Is There Really No Need for PSA Screening?

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It may take a whole lot of convincing before some prostate cancer patients will concede to anyone that will recommend that men forego PSA screenings altogether, but in the interest of keeping readers informed about the latest developments in prostate cancer research, we share this piece of information.

The U.S. Preventive Services Task Force may soon recommend that men forego undergoing screening for prostate cancer, in very much the same way they previously recommended that women in their 40s do not need to undergo mammograms.

The reason behind this possible recommendation, according to an unnamed source who has inside info regarding task force deliberations, is that the group is expected to recommend a rating of “D” for the protein specific antigen (PSA) test, which screens for prostate cancer. What this rating means is that “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”

On Friday, a draft copy of the report that was released indicated that a review of studies related to the screening showed that screening with PSA blood test only leads to “small or no reduction” in prostate cancer deaths. In addition, the report indicated that the screening is “associated with harms related to subsequent evaluation and treatments.”

The decision of the task force did not sit well with some prostate cancer patients, and shared further that the decision has been called “a tremendous mistake” by a spokesman for the Prostate Cancer Foundation.

Early Disease Detection

Scientists to Develop Blood Test for Lung Cancer Detection

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Scientists are working on a simple blood test that could detect lung cancer, considered as the most common cause of cancer-related death worldwide.

Lead scientist Dr. Samir Hanash of the Hutchinson Center in Seattle is positive that they are close to developing a blood test that can spot lung cancer before the onset of symptoms. The test, which will look into blood samples for certain proteins, aims to find tumors at their earliest, most treatable stage.

According to Dr. Hanash, “There is a substantial need for simple, noninvasive means to detect lung cancer. While imaging-based screening to detect lung cancer has shown promise, blood-based diagnostics provide a complementary means for detection, disease classification, and monitoring for cancer progression and regression.”

While CT scans are able to detect tiny tumors in patients at risk of lung cancer, a high percentage of images obtained through this screening reveal nodules that appear as potentially malignant tumors. “That necessitate surgery, that turns out to be benign and a lot of other potential complications. So there’s a need for a blood test so that we can make CT scans more reliable,” explained Dr. Hanash.

The blood test for lung cancer will look for protein signatures of the disease in the same way that other cancer blood tests — such as the CA 125 test for ovarian cancer and the prostate specific antigen (PSA) test for prostate cancer — work.

The team’s research findings are published in the medical journal Cancer Cell.

Seattle Health Screening

Early Disease Detection

Prostate Cancer Screening Decision Should Come from Patient

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The American Cancer Society released new guidelines for prostate cancer screening on Wednesday, according to various news reports. Although a report on CNN described the new guidelines as “pretty much like the old guidelines issued in 1997 and 2001,” there is one area that is being emphasized this time around: the importance of laying all the advantages and disadvantages of undergoing a screening in the open before making the decision to undergo the procedure.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, made the following statement: “What we are trying to say to men is the harms (of prostate screening) are better proven than the benefits.”

prostate cancerProstate cancer detection consists of prostate specific antigen (PSA) screening, a procedure that can detect cancer but can also generate false alarms. These false positives can “lead to unnecessary and uncomfortable biopsies and treatments that carry undesirable side effects such as impotence and urinary incontinence.” At the same time, there are instances when tests that come out as normal do not detect existing cancers.

Hence, the Society suggests that men aged 50 and older who have “no special risk of prostate cancer” work closely with their respective doctors regarding the “pros and cons” of undergoing screening. Patients and doctors should discuss what risks exist and then make an informed decision together on whether undergoing a screening is worth it; the focus, therefore, is on individual counseling, as opposed to a general practice applicable to everyone.

American Society of Clinical Oncology president Dr. Douglas Blaney gave the following statement: “All men considering testing for prostate cancer should be fully informed by their clinicians about their risk factors and other uncertainties before being screened.”

Early Disease Detection

How Accurate Are At Home Cancer Testing Kits?

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cancerYou probably have heard that there are at home testing kits that can test for cancer. These kits test for prostate cancer, a common cancer in older men.  At home testing kits can signal that there is something wrong with the PSA levels in the urine which can be a precursor to prostate cancer. The at home test kits do not diagnose cancer nor do elevated levels of PSA mean that you have cancer.

Many men who are concerned with their prostate health prefer to test their PSA levels at home, especially if they are on medication for prostate health. Because elevated PSA levels are common in older men and are often controlled with medication, many men seek to see if the medication is working to control the levels by using at home prostate cancer testing kits.

At home prostate cancer tests are made to help those who are concerned with prostate health and only measure PSA levels. They are not meant as a way to diagnose cancer. As prostate cancer is very treatable when caught early, testing PSA levels at home can help some men catch a problem before it becomes a life threatening disease.

Early Disease Detection

More Health Tests for Men

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We conclude our feature on health tests for men by sharing with you more details on the last set of tests that we mentioned on our list on the first post. One of our readers, who signed his comment as “Natural Prostate Health”, shared his experience with initially fighting off the need to undergo a health test – in his case, the screening for prostate cancer – and ending up being relieved that he decided to take the test, sharing that these tests, indeed are important, and we thank him for supporting our goal to be of help to our readers.

prostateWe start off with the test our reader decided to undergo – the prostate cancer screening. This is a rather controversial test, though, as there are ongoing debates regarding the benefits of having prostate specific antigen (PSA) tests as a routine test for men, with arguments indicating that for some people, the risks may far outweigh the benefits. That being said, however, it is still undeniable that the PSA can lead to the early detection of prostate cancer, increasing the probability of beating the disease. Hence, it will be very important for men to discuss risk factors such as family history with their respective doctors so that he and his doctor can make an informed decision regarding the need to undergo the test and when it should be done. The PSA test is more likely beneficial to men between 50 and 70; younger men aged 45 and over may also find the test beneficial if they have risk factors for the disease.

Another form of cancer that men can develop is testicular cancer. As opposed to prostate cancer, which is normally developed by older men, testicular cancer usually affects men in their 20s and 30s. It is a rather rare form of cancer, and is highly curable if detected early. According to the American Cancer Society, men may undergo a testicular exam as part of a routine cancer-detection check up; unlike breast cancer in women, there is no need to regularly perform self-exams.

The last two health tests involve diseases that men and women also have in common: diabetes and skin cancer. Monitoring blood sugar levels, especially for men who are at high risk for developing diabetes is important to ensure that diabetes is detected in a timely manner and treated accordingly. People who should think about this are those with high blood pressure and cholesterol levels, and those who are overweight.

Lastly, despite the fact that men are least likely to visit a dermatologist than women, they should try to at least undergo a skin exam annually, as a precautionary measure against skin cancer.

Early Disease Detection

Prominent Leaders with Prostate Cancer

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Cancer does not recognize famous men or world leaders. It strikes as it wishes, and here are a few prominent leaders who had to face the battle against the most common cancer in men — prostate cancer.

Nelson MandelaNelson Mandela. Former President of South Africa Nelson Mandela was diagnosed and treated for prostate cancer in 2001. A few years after, he announced his retirement as a public figure to allow more time with his family. He still appears in a few public events, although not as frequent as before. He remains to be a respected leader, having received more than 100 awards including the Nobel Peace Prize in 1993.

John Kerry. We, of course, all know US Senator John Kerry of Massachusetts. He ran for President during the 2004 elections against former President George W. Bush. He was diagnosed with and successfully treated for prostate cancer in 2003.

Jesse Alexander Helms, Jr.† It has been reported that five-term US Senator Jesse Helms from North Carolina decided not to run for a sixth term due to health problems. Aside from prostate cancer, he had heart disease and bone disorders. He died of multi-infarct dementia almost a year ago.

Louis Farrakhan. Supreme Minister and National Representative of the Nation of Islam and Elijah Muhammad Louis Farrakhan underwent a major abdominal surgery in 2007 to correct the side effects of a procedure for prostate cancer he had years earlier.

Rudolph William Louis Giuliani. Rudy Giuliani was Mayor of New York City from 1994 to 2001. He was named ‘Person of the Year’ for 2001 by Time Magazine; this is the same year when the World Trade Center was attacked. He ran for Senator in 2000, but withdrew his candidacy due to being diagnosed with prostate cancer.

New York Health Screening

Early Disease Detection

Common Cancers Affecting Men: Prostate Cancer

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In observance of the National Men’s Health Week, we shared several points about men’s health, including breast cancer in men and testicular cancer. For today, let us talk about the most common cancer affecting men – prostate cancer.

Although this is rather rare in men under 50 years old, prostate cancer remains to be the leading cancer affecting men in the Western world. Unlike most other cancers, prostate cancer develops slowly and does not exhibit any symptom until it has reached a certain stage. It is thus important that men undergo early detection tests to determine the disease before it progresses.

prostateDiagnostic tests for prostate cancer includes rectal examination, PSA blood test, biopsy and bone scan. Your doctor will most probably use a combination of these tests to get a more conclusive result.

Aside from age, men should also watch for other known risk factors, like family history, race and environment. Men with a father or a brother who has been diagnosed with prostate cancer are more likely to suffer from the disease as well. African-American men display the highest tendency to develop prostate cancer while Asian men exhibit lower rates. Obesity, high fat diet and exposure to radioactivity are believed to also have effects on the development of prostate cancer.

As previously mentioned, prostate cancer symptoms do not reveal themselves until the cancer has already progressed. In some cases, patients do not feel any symptom at all. However, it is still important to know these symptoms and to watch out for them. Symptoms may include frequent urination, difficulty in urination (whether starting or stopping it), painful urination, painful ejaculation, blood in urine or semen, and stiffness in the lower back, hips or pelvis.

Early Disease Detection

Gene Fusion Related to Prostate Cancer Discovered

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Researchers at the Weill Cornell Medical College have discovered a gene fusion that may lead to more accurate tests for prostate cancer. The gene fusion, SLC45A3–ELK4, can be detected at high levels in the urine of men at risk. If proven and validated, the level of gene fusion may be used as a more accurate indicator for prostate cancer.

Doctors have long dealt with the limitation of Prostate-Specific Antigen (PSA) testing as it detects both benign prostate conditions such as inflammation of the prostate and enlargement of the prostate, in addition to prostate cancer. There is a clamor among oncologists for a screening procedure that can detect clinically significant prostate cancer so that cancer patients can be treated using individualized therapies.

prostateThe senior author for the research, Dr. Mark A. Rubin, is the Homer T. Hirst Professor of Oncology in Pathology, professor of pathology and laboratory medicine, and vice-chair for experimental pathology at Weill Cornell Medical College. The team worked previously with members of the research group of Dr. Arul Chinnaiyan at the University of Michigan, credited with the discovery of the gene fusion TMPRSS2-ERG.

In February last year, a study that uses the concept of gene fusion and how these are common in prostate cancer for possible prostate cancer testing, from the University of Michigan team, was published in Cancer Research. The study further indicated that the gene fusion TMPRSS2-ERG can be used to screen for prostate cancer through a urine test, as opposed to the PSA blood test that is in use today.

Currently, Dr. Rubin’s team is working with a company in the development of a urine test for prostate cancer utilizing TMPRSS2–ERG. After discovering the SLC45A3–ELK4 gene fusion, the team forecasts its addition to the urine test in the future in order to increase its accuracy. It may also be used to assist in determining the level of response to certain non-surgical systemic treatments. Early clinical trials are currently being conducted in the United States and Europe to evaluate the urine test that uses the TMPRSS2–ERG gene fusion.

Michigan Health Screening