The Cancer Rise Among Hispanic Americans Varies Widely

A recent report highlights the wide variation in cancer risk within the US Hispanic/Latino population. The report was published by the American Cancer Society and illustrates some of the wide differences in Hispanic Americans when it comes to cancer risk by comparing newly available data from Puerto Rico that has a 99% Hispanic population, with cancer statistics for other US Hispanics. Even though Hispanics have lower rates of cancer as an aggregated group, some Hispanic subgroups have cancer rates that approach or surpass those in non-Hispanic whites. There is a huge diversity rate in cancer occurrence in Hispanics.

This report concludes that men in Puerto Rico have higher prostate and colorectal cancer incidence and death rates than non-Hispanic whites in the continental US, in contrast to US Hispanics as a whole, who have lower rates for these cancers. However, the lung cancer incidence rate in Puerto Rico is one-third that of non-Hispanic whites and two-thirds that of other US Hispanics.

Among the men in Puerto Rico, prostate cancer accounts for the largest proportion of cancer deaths, at approximately1 in 6 cancer deaths. This makes it the only state or territory included in the report in which lung cancer is not the leading cause of cancer death among men of all races combined.

This report also reviews cancer statistics for Hispanics residing within the continental US and Hawaii. The leading cause of death among Hispanics overall is cancer, followed by heart disease. 42,700 cancer deaths were expected in 2018 among Hispanics in the continental US and Hawaii, with lung (16%), liver (12%), and colorectal (11%) cancers expected to cause the most cancer deaths among men and breast (16%), lung (13%), and colorectal (9%) cancers expected to cause the most among women. Among continental Hispanics, lung cancer accounts for 14% of cancer deaths compared to 25% in the overall population, mainly because of lower smoking rates among Hispanics.

The rates of new cancer cases and cancer deaths among Hispanics overall in the continental US are 25% to 30% lower than in non-Hispanic whites. However, rates among some US-born Hispanics have shown to approach those in non-Hispanic whites. The overall Hispanic population in the US is growing rapidly, mainly due to an increase in births, rather than immigration. This fact has led the study authors to predict that the cancer burden among Hispanics will grow too.

One-third of continental Hispanics are foreign-born and they have a cancer risk that largely reflects their country of origin. Hispanics as a group are less likely than non-Hispanic whites to be diagnosed with the four most common cancers (prostate, breast, lung, and colorectal) but have a higher risk of certain infection-related cancers (stomach, liver, and cervix), which are more frequent in Latin American countries.

Shortened Radiation Time Part of New Prostate Cancer Guideline

A panel of experts from the American Society for Radiation Oncology, American Society of Clinical Oncology and the American Urological Association has concluded that men being treated for early-stage prostate cancer with external beam radiation therapy (EBRT) can safely choose an option that reduces the number of treatment sessions. This new guideline developed for doctors who treat men with prostate cancer was published October 11, 2018 in Practical Radiation Oncology, Journal of Clinical Oncology, and The Journal of Urology.

For those men that have been diagnosed with prostate cancer while it’s still at an early stage, they often have several treatment options, including active surveillance (also called watchful waiting), surgery, or radiation. All these options have about the same cure rates for the earliest stage prostate cancers. Each type of treatment has pros and cons.

(ERBT) or external beam radiation therapy, is a type of radiation therapy used to treat prostate cancer. This involves using a machine that focuses beams of radiation on the prostate gland to kill the cancer cells. Most patients typically receive treatments 5 days a week for several weeks. This new guideline uses hypofractionated radiation, where external beam radiation is given in larger doses and fewer treatments. When men are treated with this shortened approach, they can typically expect to complete treatment in 4 to 5 weeks, compared with 8 to 9 weeks for conventional EBRT. There is another option called ultrahypofractionated therapy which increases the radiation dose even further and this can be completed in as few as 5 treatments.

To develop this new guideline, the panel reviewed more than 60 journal articles published between December 2001 and March 2017. They ultimately concluded that hypofractionated radiation therapy is a safe option. They found that the cure rates and side effects are very similar to a conventional ERBT treatment schedule. There is, however, a slightly greater risk of severe gastrointestinal complications with hypofractionated radiation therapy.

According to the panel, the benefits of a shorter radiation schedule include more convenience for patients and reduced use of medical resources.

It’s time to quit smoking

The single largest preventable cause of disease and premature death in the United States is smoking. From way back when the Surgeon General’s Report on Smoking and Health was first released in 1964, there have been more than 21 million deaths due to tobacco.

Cigarette smoking creates so many health issues. It increases the risk of cancers of the mouth and throat, lung, esophagus, pancreas, cervix, kidney, bladder, stomach, colon, rectum, and liver, as well as acute myeloid leukemia. There are studies that also link smoking to breast cancer and advanced-stage prostate cancer.

Over and above cancers, smoking also greatly increases the risk of debilitating, long-term lung diseases like emphysema and chronic bronchitis. Smoking raises the risk for heart attack, stroke, blood vessel diseases, and eye diseases. Fifty percent of all smokers who refuse to quit will eventually die from a smoking-related illness.

The good news is that no matter how old you are or how long you’ve smoked, quitting can help you live longer and be healthier. Yes, quitting is hard, mostly because nicotine, a drug found naturally in tobacco, is so addictive. However, millions of Americans have quit smoking after taking advantage of some type of help.

There are many different methods available to help people quit smoking:

There is a great deal of research that shows using a medication to help you quit smoking can increase your chances of being successful.

The FDA has approved a variety of medications to safely and effectively help people quit smoking. Choosing which one to use is a matter of personal choice and should be discussed with your pharmacist or health care provider.

These three types of medications are available over-the-counter at most pharmacies and can be helpful in easing the symptoms of nicotine withdrawal when used as directed:
• Nicotine gum
• Nicotine patches
• Nicotine lozenges

There are other medications that are only available by prescription:
• Nicotine inhalers
• Nicotine nasal sprays
• Zyban (bupropion) – an antidepressant
• Chantix (varenicline) – a drug that blocks the effects of nicotine in the brain

When counseling is combined with medication it can increase the chances that you can quit smoking and stay away from tobacco for good.

Help to quit smoking can be as close as an app on your smartphone. However, it’s important to choose a program that’s based on quit-smoking recommendations proven through research to be effective.

The National Cancer Institute has a quit-smoking app that allows users to set quit dates, track financial goals, schedule reminders, and more. It also offers a text messaging service that provides round-the-clock encouragement and advice to people trying to quit. You can sign up by texting “QUIT” to iQUIT (47848) and entering the date of your Quit Day – the day you will stop smoking.

Cold Turkey
When someone goes “cold turkey” it means that they stop smoking all at once. People have a better chance of success if they make a plan and prepare for nicotine withdrawal. A gradual plan of smoking fewer cigarettes each day can help reduce nicotine withdrawal symptoms and make it easier for some people to quit “cold turkey”.

Bottom Line

Smokers need to know that one of the most important things researchers have learned about quitting smoking is that the persons needs to persevere and keep on trying. It may take several serious attempts before a smoker can quit forever. Rather than looking at a slip back to smoking as a failure, it should be considered an opportunity to learn from experience and be better prepared to quit the next time.

Coffee and How it Affects Cancer Risks; No Clear Cut Answers

Americans love their coffee and most drink at least 1 cup of coffee a day; many feel like they can’t possibly face a morning without it. The findings that this coveted beverage may protect from cancer would be spectacular. In fact, there is indeed some reason to believe it could.

Because it is brewed from beans that contain antioxidants which are thought to have a protective effect against cancer, coffee could prove to be beneficial.

After conducting more than 1,000 studies, researches have looked at this question, with mixed results. The original results did not look promising because some early studies seemed to show that coffee might increase risk of some cancer types. However, since those early studies, others that were larger and better designed weakened those early conclusions. In fact, many of the newer studies link coffee drinking to a lowered risk of some types of cancer. These include liver cancer, endometrial cancer, prostate cancer and some types of cancers of the mouth and throat.

Some of these studies found benefits only in a group of people who drank 4 to 6 cups of coffee a day. This amount is more than the average coffee drinker. When people ingest too much caffeine it can interfere with their sleep, cause digestive issues and trigger migraines. For people that take their coffee with cream and sugar, the added fat and calories can contribute to weight gain. This can increase the risk for many types of cancers.

An alternative way for people to consume more antioxidants is by adding more vegetables and fruits to their diets. These are rich sources of antioxidants. Many studies show that people who eat more fruits and vegetables may be helping to lower their cancer risk.

Acrylamide: a chemical found in coffee

A California court ruling related to acrylamide which is a chemical formed during the coffee roasting process, was made in March of 2018. This ruling raised some concerns and questions with consumers. Originally a judge in California ruled in favor of a consumer group that argued coffee companies in California must post cancer warnings to customers. However, since then, the state’s environmental health arm argued that based on the latest research, acrylamide in coffee poses no significant cancer risk. This group found that it may even have health benefits.

Here Are Some Ways That Family History Affects Prostate Cancer Risk

It has been well known for years that men with a family history of prostate cancer are at higher risk of getting it themselves. Researchers from Sweden have recentlo calculated just how much having a brother or father with prostate cancer, or both, affects and raises the risk. They also determined out how likely it is that a man with a family history will get a mild or aggressive (fast-growing) type of the disease. The authors of this study believe that their findings could possibly be useful in counseling men who have prostate cancer in the family.

It is believed that having more information about the risks of getting an aggressive type of prostate cancer can be of help when men are asked to make their own personal decision about testing and treatment.

Even though it may seem like it would make sense for everyone to get checked to find out if they have cancer. But cancer screening is not a perfect science. Some screenings can miss cancers, and in many cases screenings find something that seems suspicious but turns out to be harmless. Also, right now there still aren’t reliable tests that are able to determine the difference between prostate cancer that’s going to grow so slowly it will never cause a man any problems, and dangerous cancer that will grow quickly. Treatments for prostate cancer can have urinary, bowel, and sexual side effects that may seriously affect a man’s quality of life.

The American Cancer Society recommends that men with a family history of prostate cancer should talk to their doctor at age 40 or 45 about the pros and cons of prostate cancer testing. Because African American men are at higher risk for the disease, they should also have this talk; whether they have a family history or not. Everyone else should begin talking to their doctor about testing at age 50.

Brothers and fathers

The researchers looked at medical records of 52,000 men in Sweden with brothers and fathers who had prostate cancer. They found:

-Men with a brother who had prostate cancer had twice as high a risk of being diagnosed as the general population. They had about a 30% risk of being diagnosed before age 75, compared with about 13% among men with no family history.

-Men with a brother who had prostate cancer had about a 9% risk of getting an aggressive type of prostate cancer by age 75, compared with about 5% among other men.

-Men with both a brother and father with prostate cancer had about 3 times the risk of being diagnosed as the general population. They had about a 48% chance of getting any type of prostate cancer, compared with about 13% among other men.

-Men with both a brother and father with prostate cancer had about a 14% chance of getting an aggressive type of prostate cancer by age 75, compared with about 5% among other men.

The researchers found that while the number of close relatives with prostate cancer affected the risk, the type of prostate cancer in the family did not have a strong effect on risk. For example, the risk of an aggressive prostate cancer was just as high in men whose brothers had the mildest form of prostate cancer as those whose brothers had an aggressive type.

While the results of study might provide men with better estimates of their risk when deciding whether to be tested, one note of caution is that the study looked only at men in Sweden. While the results might be similar in other parts of the world where prostate cancer screening rates are fairly high and where people come from similar genetic backgrounds, such as in other parts of northern Europe and North America, it is not clear how well these results would apply among people with different genetic makeups, such as African Americans.

Prostate Cancer Screening FAQs

Along with other leading medical organizations, The American Cancer Society recommends informed decision-making when it comes to screening for prostate cancer. What this means is that every man should make his own decision, along with his medical care providers, about whether to be screened.

Screening or testing to find a disease in people without symptoms can help find some types of cancer early, when it’s more easily treated. But for some men, the risks of prostate cancer screening may outweigh the benefits. Asking questions is an important step in deciding whether to be screened.

Q: What are the screening tests for prostate cancer?

A: There are 2 main screening tests for prostate cancer

The PSA test is a blood test to check the level of prostate-specific antigen in your blood. Most healthy men have levels under 4 nanograms per milliliter of blood. But everybody is different, and a lower PSA level doesn’t guarantee a man is free of cancer, just like a higher level doesn’t mean he has cancer.

For the digital rectal exam (DRE), a doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that may need to be tested for cancer. This test may be done with the PSA or the PSA may be done alone.

Q: What if the results are not normal?

A: If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will do a prostate biopsy to find out. A sample of prostate tissue is removed using a needle and sent to a lab, where a specialist will look at it to see if it contains cancer cells.

Q: At what age should I have my first screening test?

A: The American Cancer Society recommends men learn as much as they can about prostate cancer screening risks and benefits and discuss the information with their doctor before deciding whether to be tested at all. Men at average risk of prostate cancer should have this discussion starting at age 50. Men at higher than average risk should have the discussion starting at age 40 or 45.

Q: Who is at higher than average risk for prostate cancer?

A: African American men and men who have a father, brother, or son who were diagnosed with prostate cancer when they were younger than 65 are at high risk. Men with more than one of these close relatives diagnosed before age 65 are at even higher risk.

Q: Why shouldn’t all men be screened for prostate cancer?

A: It seems like it makes sense to check everyone to find out if they have cancer. But screening isn’t perfect. Sometimes screening misses cancer, and sometimes it finds something suspicious that turns out to be harmless. Also, there aren’t reliable tests yet to tell the difference between prostate cancer that’s going to grow so slowly it will never cause a man any problems, and dangerous cancer that will grow quickly. In addition, studies have not been able to show that annual PSA screening helps men live longer. However, most men who find out they have cancer want to treat it. Treatments for prostate cancer can have urinary, bowel, and sexual side effects that may seriously affect a man’s quality of life. So, testing really is a decision that men should make after they have all the information.

Observation as Good as Surgery in Early-stage Prostate Cancer Says 20-Year Study

The Minneapolis Veterans Affairs Health Care System led a 20-year study and found more evidence that surgery for early-stage prostate cancer does not help men live longer than observation. Sometimes observation, which is also called “watchful waiting”, is where doctors monitor a man’s prostate cancer over time to make sure it’s not getting worse. Only then do the doctors consider surgery or other active treatment. Because most prostate cancers grow very slowly and may never cause health problems, this can be a good option for many men. .

The study, which also included research teams from across the US, used data from the Prostate Cancer Intervention Versus Observation Trial (PIVOT). The study compared treatment with surgery to treatment with observation in 731 men with prostate cancer that had not spread beyond the prostate. Approximately half the men (364) were assigned to surgery to remove the prostate. The other half (367) were assigned to observation. The men in the observation group received surgery or other active treatment only if tests or symptoms indicated their prostate cancer might be growing.

When it first bean in 1994, the average age of the men in the PIVOT study was 67. After a follow-up of 20 years, 61% of men in the surgery group had died; 7% of them died from prostate cancer. In the observation group, 67% of them died; 11% from prostate cancer. The differences between the two groups was found to be non-significant.

The men in the surgery group, however, were more likely to have side effects that needed treatment. In the surgery group, 17% reported urinary incontinence compared with 4% of the observation group, and 15% reported erectile dysfunction compared with 5% of the observation group. The study was published July 13, 2017 in the New England Journal of Medicine.

Key takeaways

Some previous studies have also found no difference in survival between men who have surgery and men who use observation. However, others have found that those who have surgery might live longer. According to the study’s authors, the combined results from the studies show:

Long-term, death from prostate cancer is low among men with early-stage prostate cancer who are treated with observation.

Men with intermediate-risk prostate cancer who have long life expectancies are more likely to see a survival benefit from surgery.

Even though men with high-risk disease may have a poor prognosis, surgery may not help them live any longer.

Surgery seems to help keep the cancer from coming back, but most cancer recurrences don’t cause problems. Therefore, the benefits of slowing cancer growth through surgery are unclear.

Long-term side effects from surgery can include incontinence, erection problems, and other complications, some requiring treatment.

Facts and Figures from 2018: Rate of Deaths From Cancer Continues Decline

Cancer mortality drops another 1.7%

The US death rate from cancer has declined steadily over the past 2 decades, according to annual statistics reporting from the American Cancer Society. According to the ACS, as of 2015, the cancer death rate for men and women combined had fallen 26% from its peak in 1991. This decline in deaths translates to nearly 2.4 million averted during this time period.

The rate of new cancer diagnoses decreased by about 2% per year during the most recent decade of available data, in men and stayed about the same in women.

Cancer Statistics, 2018 published in the American Cancer Society’s journal CA: A Cancer Journal for Clinicians, estimates the numbers of new cancer cases and deaths expected in the US this year. The estimates are some of the most widely quoted cancer statistics in the world. The information is also released in a companion report, Cancer Facts and Figures 2018, available on the interactive website, the Cancer Statistics Center. A total of 1,735,350 new cancer cases and 609,640 deaths from cancer are projected to occur in the US in 2018.

The drop in cancer mortality is thought to be mostly due to two major factors; steady reductions in smoking and advances in early detection and treatment. A decline in consumption of cigarettes is credited with being the most important factor in the drop in cancer death rates. However, tobacco remains by far the leading cause of cancer deaths, responsible for nearly 3 in 10 cancer deaths.

Major cancer types: Lung, breast, prostate, and colorectal cancer

The overall drop in cancer death rates is largely due to decreasing death rates for lung, breast, prostate, and colorectal cancers.

Prostate cancer death rates declined 52% from 1993 to 2015 among men. Routine screening with the PSA blood test is no longer recommended because of concerns about high rates of over-diagnosis (finding cancers that would never need to be treated). Therefore, fewer cases of prostate cancer are now being detected.

Lung cancer death rates declined 45% from 1990 to 2015 among men and 19% from 2002 to 2015 among women. From 2005 to 2014, the rates of new lung cancer cases dropped by 2.5% per year in men and 1.2% per year in women. The differences reflect historical patterns in tobacco use, where women began smoking in large numbers many years later than men, and were slower to quit.

Breast cancer death rates declined 39% from 1989 to 2015 among women. The progress is attributed to improvements in early detection.

Colorectal cancer death rates declined 52% from 1970 to 2015 among men and women because of increased screening and improvements in treatment. However, between 2006 and 2015, the death rate among adults younger than 55 increased by 1% per year.

Erleada is approved by FDA for some prostate cancers

The FDA (US Food and Drug Administration) has recently approved the drug Erleada to treat men with prostate cancer that has not yet spread, but has a quickly rising PSA level while on treatment with hormone therapy, causing a big concern for cancer growth and spread. Erleada is the first FDA-approved treatment for this high-risk type of prostate cancer which is called non-metastatic castration-resistant prostate cancer.

The way Erleada works is that it blocks the effect of androgens, a type of hormone, on the tumor. Research has shown that androgens such as testosterone can help tumors grow.

The FDA based its decision to approve Erleada on a randomized clinical trial of 1,207 men with high-risk non-metastatic, castration-resistant prostate cancer. The trial measured the amount of time that the patients’ tumors did not spread (metastasize). While all of the men in the trial received hormone therapy, only some also received Erleada. The group of men who received Erleada had no metastasis for an average 40.5 months compared to metastasis in 16.2 months for the group of men who did not.

Erleada was approved under the FDA’s new priority review program. This new program is designed to speed up approval of drugs that would significantly improve the safety or effectiveness of treating, diagnosing, or preventing a serious condition.

Common side effects of Erleada include high blood pressure, fatigue, diarrhea, rash, nausea, joint pain, weight loss, falls, hot flashes, decreased appetite, fractures and swelling in the limbs. Additional possible side effects could include falls, fractures, and seizures.

Men who have had prostate cancer have an increased risk of certain cancers

A major concern of many cancer survivors is whether they will have to face cancer again. When a cancer comes back after treatment it is technically a “recurrence”. However some survivors may develop a new and unrelated cancer which is termed a “second cancer”.

Men who are being treated for prostate cancer can indeed get another cancer, and in fact they might be at higher risk for certain types including cancers of:

• The small intestine
• Soft tissue
• Bladder
• Thyroid
• Thymus
• Melanoma of the skin

In addition, men who are treated with radiation therapy also have a higher risk of:

• Rectal cancer
• Acute myeloid leukemia (AML)

It is believed that the higher risk could be related to the dose of radiation.

There are ways to lower the risk of getting a second cancer

Prostate cancer patients can take steps to lower their risk of second cancers. One example is that prostate cancer survivors should do their best to stay away from all tobacco products and tobacco smoke. Smoking has been shown to increase the risk of bladder cancer after prostate radiation, as well as increase the risk of many other cancers.

There are other steps to take to help maintain overall good health:

• Get to and stay at a healthy weight
• Stay physically active
• Eat a healthy diet focusing on fresh foods
• Limit alcohol to no more than two drinks per day

As an added bonus, taking steps may also lower the risk of other types of health issues.