Surgery Seen as Superior to Radiation Therapy in Younger Men with High-risk Prostate Cancer, Study Finds

A recent study concluded that men under age 60 with high-risk prostate cancer who underwent radical prostatectomy; or surgery to remove all or part of the prostate; as an initial treatment, showed significantly improved overall survival at four years than those given radiation therapy.

Researchers used the National Cancer Database to analyze 16,944 high-risk prostate cancer patients, age 59 or younger, who had Gleason scores of 8 to 10 with no metastasis or nodal involvement. The study included data collected between 2004 and 2013.

Of the study population, 12,155 men had radical prostatectomy, and 4,789 had external beam radiation therapy (EBRT) — alone or in combination with brachytherapy — as a first therapy. In 82.5 percent of radiation-treated patients, hormone therapy was also used. Post-operative radiation therapy was given 17.2% of those who had a radical prostatectomy.

After a median 50-month follow-up, statistical modeling was used to determine differences in overall survival between the two groups, and found a significant 48 percent improvement in those who underwent surgery. The estimated survival rate at eight years was also higher in this group, 85.1 percent versus 74.9 percent, respectively.

“When a younger man has high-risk prostate cancer, it generally makes sense to choose surgery over radiation,” a prostate cancer surgeon and urologic oncologist said in a recent press release. “Radical prostatectomy has many advantages over radiation which include shorter recovery times, less pain, and from what this study is showing, the prostate cancer is removed with a higher cancer control and survival rate.”

The findings were presented at the 2017 American Society of Clinical Oncology Annual Meeting, which took place in Chicago in early June. The study was published in the Journal of Clinical Oncology, under the title “Survival impact of initial local therapy selection for men under 60 with high risk prostate cancer.”

It concluded: “Compared to RT [radiation therapy], initial treatment of men under 60 with high risk PCa [high-risk prostate cancer] with RP [radical prostatectomy] results in a large, statistically significant improvement in overall survival that remains consistent over time and remains significant in a multivariable model adjusting for known prognostic variables.”

Shortcomings noted by the study’s researchers included its retrospective nature as a database analysis, and a lack of cancer-specific survival information.

Social Media Is Helping To Support People Diagnosed With Cancer

The digital age has changed the way we live, the way we work and now it has also changed the way we view cancer. In addition to offering a world of information, the internet can offer hope, solace and support to cancer patients.

On Twitter, clicking a hashtag like #prostatecancer can instantly return thousands of people who are going through prostate cancer. It can also lead patients to helpful information about the latest treatments or clinical trials.

There are also Facebook groups that offer a safe haven for patients to share some of the thoughts and fears that they might not feel comfortable sharing with their family, friends, or even doctors.

Support groups whether in-person or online can also serve as passive places to read and digest other people’s experiences with cancer. Many patients benefit in the feeling that they are “not alone”.

A columnist for the Lymphoma News Today shared a story online about how the fellow lymphoma sufferers she met online have become her closest friends; so much so that they served as bridesmaids in her wedding. She told about how the strength she drew from online support helped her through the darkest times. She said that in her experience, social media became her safe haven.

In addition, blogs, YouTube channels, and Instagram accounts allow users to reach out to others with cancer in faraway places. Many patients report that they have made lasting friendships that endure way beyond their final rounds of chemotherapy or final cancer treatments. Social media has made a huge impact; becoming the 24-hour support group patients need. Patients are comforted when they can reach out and touch and be touched by people who truly understand what life with cancer is like.

Social media also empowers cancer sufferers to share their knowledge and empower themselves and others. Sharing knowledge through online outlets helps patients make informed decisions and be more proactive about their treatments. Today’s patients often bring up new treatment ideas with their doctor; vs. the not so distant past where they were more likely to wait for their doctor’s suggestions.

Your Job; How it Can Be Affected by Prostate Cancer

Many patients are very concerned about keeping their job after receiving a prostate cancer diagnosis.

It can require quite a bit of time away from work once a patient is undergoing prostate cancer treatment. Money and health insurance are two pressing concerns for any patient during prostate cancer treatment, so how it will affect your job is an important consideration.

Prostate Cancer Diagnosis; What About Missing Work?

Whether you have surgery, hormone therapy or radiation treatment to treat prostate cancer, there will be side effects of each that may require you to miss work. Most patients need time off to have surgery and recover (anywhere from a week to more than a month), and radiation treatment appointments for prostate cancer may cause you to miss work regularly for a long period.

It is important to consider the options your employer offers to allow time off to take care of your health.

• FMLA. The Family and Medical Leave Act is a federal law that allows you up to 12 weeks off work, unpaid, to take care of a health condition. There are conditions to such leave: Your employer must have 50 or more employees, and you must be a full-time employee. You are also required to have been employed by the company for at least one year before you can take FMLA. Ask your employer if you qualify.
• Disability pay. Your employer may offer short-term or long-term disability, or your state government may provide it. These programs allow you to receive a certain percentage of your pay if you are unable to work because of a health condition. Ask your employer if any disability pay is offered through your benefits. Disability insurance policies can be bought independently; ask an insurance agent or a financial planner.
There will also need to be time devoted to managing health care bills and the paperwork relating to your prostate cancer treatment for insurance purposes. You will want track doctor’s visits, hospital visits, treatment dates, and medications that you’ve taken and received. Develop a good filing system so you can. Develop a good system to file all paperwork from your health care providers and your insurer.

Co-Workers May Be Glad To Lend Their Support

You may find that co-workers are a great source of support during and after prostate cancer, and you should tell them as much or as little about your situation and prognosis as you are comfortable with.

Keeping Up With Your Work During Prostate Cancer Treatment

It is a good idea to try to keep up with your work as much as you are able to while you’re out, or during your intermittent time out of the office. Try to talk to colleagues about handling some of your work, and make sure that meetings and deadlines aren’t missed while you’re gone; if possible, see if someone else can cover for you. Many patients also try making a to-do list of everything that you’re working on, so that your manager and co-workers are kept up to date.

If you can investigate the work-related benefits available to you early after your diagnosis can provide peace of mind. If you can keep the communication lines open at work you’ll feel more comfortable knowing that people are there for you.

Caring for a Partner With Prostate Cancer

How to Care for a Partner With Prostate Cancer

The whole world can seem to change in an instant when a you find out that your partner has been diagnosed with prostate cancer. Both of you will probably feel overwhelmed, and afraid. It will most likely be a confusing time for both of you.

The Best Thing to do is to Learn What to Expect

You both should take steps to educate yourself about the disease. In this case knowledge can certainly be power. There are many possible side effects of both the cancer and the types of treatments that you should be prepared for. These can include:

A man can be rendered infertile due to prostate cancer treatment, whether it be surgery or radiation therapy. For partners that want to have children after treatment, if is recommended to investigate options such as sperm banking pre-treatment.

Sex life changes.
It is common for men to experience erectile dysfunction (impotence) after treatment for prostate cancer. It may be temporary or permanent depending on the treatment.

Changes in urination/bowel issues.
Lack of control/urinary incontinence can be a common after prostate cancer treatment. Bowel issues such as diarrhea can be long-term effects of some kinds of radiation therapy.

Hormonal changes.
Numerous side effects can occur from the hormone therapy used to treat prostate cancer. These side effects can include weight gain, and muscle loss, fatigue, low sex drive, hot flashes, and brittle bones.

Subtle hormonal changes could be evident as well including memory and multi-tasking difficulties. For example, hormone deprivation therapy can potentially have some subtle, cognitive (thought process) effects in the men prescribed this treatment. The knowledge you can gain about the types of side effects that can occur, and what you can do about them, can empower you and help you and your partner know when/how to take action.

Prostate Cancer Caregiving: More Tips
Your partner will need you to be there to listen. Make sure to encourage him in his treatments by going to doctor’s appointments, treatment sessions, and tests. Make sure that he knows that you want to be a part of this process with him. You are the best person to encourage him to look forward to the life he can enjoy once his treatments are completed and successful.

You Are Important Too
Some find it helpful to join a group for caregivers of prostate cancer patients. It can be a good place to share your experiences with others.

When You Have Prostate Cancer Make Physical Activity a Priority

From improving your mood to helping you fight fatigue; physical activity can have lots of benefits when you have prostate cancer, from improving your mood to fighting fatigue. Physical activity doesn’t have to mean something of the level of running a marathon or climbing a mounting. There are many small ways to encourage yourself to get more active; move more. Talk to your doctor and ask for a good exercise plan that meets your personal needs.

Activity Can Help Ease Treatment Side Effects

For patients that are getting hormone therapy for their prostate cancer, exercise can help with some of the side effects, some of which can be similar to those that women get during menopause. Some of the potential problems with hormone therapy can be osteoporosis, hot flashes, issues with sexual libido and weight gain. Staying physically active can help minimize these side effects.

Physical Activity Can Improve Your Treatment Options

There are a wide variety of reasons to keep up your fitness level throughout your life, however for prostate cancer patients research suggests that physical activity activates certain genetic pathways in your body, which can help improve how well medicines work.

Try to Keep Your Weight To a Normal Level.

Researchers at Fred Hutchinson Cancer Research Center conducted a study that suggests the risk of dying from prostate cancer is more than double in obese men diagnosed with the disease, compared with men of normal weight. Men that are obese and have cancer that is limited to a specific area, have nearly four times the risk of their cancer spreading.

Activity Can Help You Beat Fatigue

Cancer treatments can often make patients feel tired. This is due to many factors including anemia, chemotherapy and radiation side effects, depression, and the cancer itself.

People often think that exercising when you are fatigued sounds counterproductive, but it is indeed a good way to combat fatigue. Researchers have proved that people with cancer who exercise regularly have 40%-50% less fatigue than those who don’t.

Activity Can Be a Mood Booster

Keeping your spirits up is easier when you are physically active. It’s a way to have control over your body in a good way. Exercise for prostate cancer patients can really help make them feel more positive.

What Activity Is Best For You?

Experts say that the ideal exercise/activity plan includes three parts: an activity like a brisk walk to get your heart pumping, strength training such as lifting weights to build muscle, and stretching to keep your muscles and joints limber.

For patients that weren’t physically active before their diagnosis, the advice is to start slowly. Each day just do a little more and a little more. Don’t strain yourself at the start of your new regime or you will just get discouraged. It’s fine to being with a simply 10-minute walk and work your way up slowly to a level such as 30 minutes, 5 days a week.

Your Relationship And The Effects Of Advanced Prostate Cancer

When a patient gets a diagnosis of advanced prostate cancer many things can change. One of those can be their relationship with their partner. There are ways to respond to this situation that can be helpful to the relationship.

What Can You Expect?

The statement “Knowledge is power” can be very apropos in this kind of circumstance. Understanding the physical and sexual side effects that could occur during or after prostate cancer treatment, will help couples be better prepared to handle them.

Your doctor can help you understand the symptoms a patient might experience and how to best manage them. It’s important that both partners understand this information.

It is very common for men who go through prostate cancer treatment have trouble getting or maintaining an erection in the first few months after treatment. On occasion these problems can be long-lasting.

Strong medicine is used in advanced prostate cancer including radiation, chemotherapy, surgery, and medications (including hormone therapy). Their side effects can include weight gain, lower libidos, fatigue and urinary incontinence. The side effects can be very upsetting to patients but there are many ways to help manage them.

Some men for example who experience erectile problems after treatments may be able to get erections with the help of medications, injections, or surgeries (such as penile implants).

Extra Affection Can Help

At a stressful time like this it’s important to focus on your relationship as a couple. Kisses and hugs and physical touch are good ways to keep the feeling of being connected. Even extra eye contact can help couples feel more in touch with each other.

Intimacy Can Come in Many Forms

During and after treatments sex may have to take a backseat and that’s to be expected. There are many ways to be sexual and couples just have to be open to new ways of looking at this issue.

There Are Pros Who Can Help

A couple’s therapist can help you and your partner if you are having trouble with sexual or emotional closeness when you’re dealing with cancer. Many men are reluctant to see a therapist, but it can be an important part of the whole treatment process/plan.

Keep The Faith It Will Get Better

Even you and your partner struggle with your relationship at times, patients need to realize that in the majority of cases it does get better and their relationship with their spouse does not have to deteriorate. In fact, when asked after treatment is finished, many couples say that dealing with prostate cancer has made their relationship stronger than ever.

Making the Choice: Advanced Prostate Cancer Treatments

Today patients have many choices on how to treat their advanced prostate cancer. There are many new therapies that have been approved by the FDA in the last few years and more are in development for the future. It can be challenging to decide which treatment to choose.

When patients are deciding on their course of action there a many important things to consider.

What are the Possible Side Effects?

As patients weight their options they need to consider their quality of life. It’s important to discuss the risks and benefits of each possible treatment with your doctor. Ask them to tell you about any side effects that medications may have both long term and short term.

Some drugs have risks such as muscle weakness or nausea. It is important to weigh those side effects against the benefits of that particular drug.

Take a Good Look at the Costs

Don’t hesitate to ask your doctor about the cost of certain treatments. Doctors understand that patients are very worried about the cost of care. Your doctor might not initially bring up the subject, but you can initiate the conversation by saying something like “Is there any way I can get an estimate on the costs of my cancer treatment before we start it?” Your doctor should be glad to help address these valid concerns.

Consider Your Family History

Doctors always ask whether prostate cancer runs in the family. And for good reason. The family history can influence the treatment plan that they suggest for you. For instance, a study published in The New England Journal of Medicine determined that more than 10% of men with advanced prostate cancer have a genetic mutation that raises the chance of having cancer.

Schedule of Treatment

You need to carefully consider how the treatment you choose affects might your daily routine. Questions like these are very relevant:
• Will I need to leave work/take vacation time early to get treatment?
• What will the arrangements be for transportation to get to and from the treatment center?
• If you have a caregiver, determine whether the treatment works with their job and schedule.

There is no treatment available, no matter how advanced it is, that will work if you don’t stick to it/remain compliant to the schedule. Some treatments have schedules that are more flexible than others so discuss that with your doctor.

Carefully Factor in Any Additional Health Problems You May Have

Many times your overall health will determine how well you handle a particular treatment. 66 is the average age of prostate cancer diagnosis in the U.S. Men with advanced prostate cancer are on average, about 10 years older when they get diagnosed. During your mid 70’s and later, patients are more likely to have long-term health conditions like diabetes and heart disease. These conditions can complicate cancer treatment.

Determine the Level of Your Personal Support Network

When you need treatment for prostate cancer, ask for help and support. Tell your family and friends and let them give you some assistance. That kind of help can be invaluable. You can also hire reliable staff that can be of aid. Your doctor or a staff member at the clinic may know about local organizations that offer discounted home care services.

Eating Right is Especially Important When You Have Prostate Cancer

Cancer treatments can cause side effects. These side effects are often more pronounced when patients are not eating enough and/or are not eating the right foods. Prostate cancer patients need to maintain good nutrition to feel their best and have the most energy possible. Here are some strategies to improve your diet:

Set a goal to meet your basic calorie needs.

For a cancer patient, the estimated calorie needs can be determined by multiplying their weight x 15 calories a pound (if their weight has been stable). If the patient has lost weight another 500 calories per day can be added. Example: A person who weighs 150 lbs. needs about 2,250 calories per day to maintain his or her weight.

Plenty of protein is recommended.

To rebuild and repair damaged and normally aging body tissue, protein can be an important factor. The estimated protein needs are 0.5 to 0.6 grams of protein per pound of body weight. Example: A 150-pound person needs 75 to 90 grams of protein per day.

The best sources of protein include foods from the dairy group (8 oz. milk = 8 grams protein) and meats (meat, fish, or poultry = 7 grams of protein per ounce), as well as eggs and legumes (beans).

Make sure to stay hydrated.

In general, people should take in between 30 and 50 ounces of fluid daily to prevent dehydration. (That’s 1 to 1.5 liters). Fluids can come in many types including water, juice, milk, broth, and milkshakes, as well as gelatin, fruits, and salads. The need to stay hydrated becomes very important if you have treatment side effects such as vomiting or diarrhea.

Keep in mind that beverages containing caffeine do not count as much, because they may make you urinate out as much or more than you take in.

Get your vitamins.

If you are not sure you are getting enough nutrients it’s a good idea to take a vitamin supplement. A multivitamin that provides at least 100% of the recommended dietary allowances (RDA) for most nutrients is a good option.

Make an appointment with a dietitian.

You can get a great deal of help from a registered dietitian who can provide suggestions to work around any eating problems that may be interfering with proper nutrition (such as early feeling of fullness, swallowing difficulty, or taste changes).

A dietitian can also help you maximize calories and show you how to include proteins in smaller amounts of food (such as powdered milk, instant breakfast drinks, and other commercial supplements or food additives).

Users of smokeless tobacco product were found to have higher risk of death from prostate cancer

According to a new study, snus, a smokeless tobacco product, may increase a prostate cancer patient’s risk of death.

Some have suggested that because it lacks the combustive effects of smoking, that snus is a less a harmful alternative to smoking.

However, researchers found the men who used snus and had prostate cancer were at increased risk of premature death.

Pronounced as though it rhymes with “goose”, snus is used mainly in Sweden but is also available in the United States. Sold most often in a bag resembling a tea bag, users place the powdered tobacco product under the upper lip for extended periods.

The researchers investigating snus users, found that, compared with men who never used tobacco, those non-smokers who used snus had a 24 percent higher risk of death from prostate cancer during the study period. They also had a 19 percent higher risk of death from any cause.

The study found that for those non-smokers who used snus whose cancer had not spread; these patients were three times more likely to die from prostate cancer than those who never used tobacco.

The study co-author concluded that there is some evidence from animal studies that nicotine can promote cancer progression, and snus users have high blood levels of nicotine. Although snus is a smokeless product, users are still exposed to other carcinogens in tobacco.

The results of the study suggest that the health effects of smokeless tobacco products can be detrimental to men diagnosed with prostate cancer.