Researchers identify indicators predicting lethal outcomes in high grade prostate cancer

Prostate cancer is one of the most common cancers among men in the United States; one in nine men will be diagnosed during his lifetime. When they are diagnosed, a patient’s disease is graded from 1 to 5 based on how aggressive it is, with 5 being the most aggressive.

Patients with grades 4/5 disease are at the highest risk of poor outcomes or death from the disease; however, there are no immunologic or genomic indicators that can help physicians determine the best course of treatment for this group of patients.

Moffitt Cancer Center researchers are hoping to change that. The team conducted studies to determine if genomic heterogeneity in tumors from grade 4/5 prostate cancer patients can be exploited to identify patient subsets that are at higher risk for lethal outcomes and therefore may benefit from targeted treatment strategies.

The studies from these researchers focused on transcriptomic interactions between the tumor immune content score and the Decipher score, a 22-gene classifier that provides a score predicting the probability that cancer will spread. They analyzed data from 8,071 prostate cancer patient samples of any disease grade (6,071 prostatectomy and 2,000 treatment naïve) in the Decipher Genomics Resource Information Database (GRID) registry. Each of the patient sample swas also given an immune content score (ICS) that was derived using the mean expression of 264 immune cell-specific genes.

All T=the samples were separated into four distinct immunogenomic subsets based on their results: ICS high/Decipher high, ICS low/Decipher high, ICS high/Decipher low and ICS low/Decipher low. These researchers discovered that approximately 25% of all grade 4/5 patient samples were in the ICS high/Decipher high subset.

The ICS high/Decipher high patient samples were further evaluated for the association between immunogenomic subtypes and radiation response signatures and they found that the ICS high/Decipher high subset were genomically more radiosensitive, meaning these tumors would respond well to radiation therapy. They determined that this subset also had a higher abundance of T cells and monocyte/macrophages. However, the research team says further research is needed to unravel the biologic mechanisms of this association.

These results will aid in the subtyping of aggressive prostate cancer patients who may benefit from combined immune-radiotherapy modalities.

The search for the prostate cancer treatment right for you

A prostate cancer diagnosis always brings with it great emotional stress for patients and their families. Choosing a treatment plan can be daunting. Questions arise like what treatment options exist, and what options are right for each patient and their specific diagnosis.

No matter what the cancer status, it is important to remember that no matter whether your cancer was caught early, or if found in Stage IV; patients do not need to feel alone.

Organizations such as ZERO – The End of Prostate Cancer (the nation’s leading nonprofit in the fight against this awful disease) have resources, support, and education materials to help all men determine the best treatment path.

In order to make a good decision about treatment options, patients should feel free talk with their urologist, oncologist, and other members of their medical team.

Different stages mean different treatment options

If a patient in the early stage he may be directed to active surveillance instead of pharmaceutical or surgical treatments. In cases like these a doctor simply monitors the cancer through regular tests to watch for signs that the cancer may be spreading or becoming more aggressive.

If a man has a cancer that is at risk of spreading, surgery, cryotherapy, radiation, or other treatments may be recommended to prevent the cancer from growing. Some patients may also have the option of hormonal therapies, which work in different ways to stop or inhibit the actions of the male hormones (androgens), such as testosterone, which fuel prostate cancer growth.

If a patient has advanced cancer he may be facing metastatic castration-resistant prostate cancer (mCRPC). They also may be eligible for immunotherapy, which uses immune cells (white blood cells) to attack advanced prostate cancer.

As of 2020, advanced prostate cancer patients now have the option of PARP inhibitors, thanks to the recent FDA approvals of Rubraca and Lynparza. PARP inhibitors are designed to disable DNA repair pathways in cancer cells, which make it difficult for cancerous cells to survive or populate.

NBA legend who is prostate cancer survivor talks about inequities in healthcare

Basketball legend Kareem Abdul-Jabbar recently opened up about his private battle with prostate cancer since being diagnosed 11 years ago.

The NBA’s all-time leading scorer revealed how he’s had prostate cancer, leukemia and heart bypass surgery. He is sharing his story in order to shed light on the health challenges facing black people.

While he’s received some of the best medical attention over the years as an NBA star, he’s aware of how others in the Black community do not.

In an essay, Abdul-Jabbar pointed out that some of the health issues black people are prone to as a group include diabetes, heart problems, obesity and cancer.

According to the U.S. Department of Health and Human Services Office of Minority Health African Americans have the highest mortality rate of any racial group for all cancers combined, and have higher rates of diabetes, hypertension and heart disease than other groups. This trend is continuing with COVID-19, which Abdul-Jabbar highlighted in his essay.

Abdul-Jabbar pointed out how more black people are dying from COVID-19 at higher rates because they are essential workers.

Based on data from several states, the coronavirus pandemic has hit Black and Latino communities across the U.S. hard, killing people of color at a disproportionate rate compared to white Americans.

The fact that people of color have more face-to-face jobs with people, they are more likely to be involved in healthcare, and they have to use public transportation. Those factors in and of themselves will make the people of color more susceptible, more vulnerable to a pandemic.

New drug research for prostate cancer may also aid in fighting COVID-19

Two women from the QUT Faculty of Health’s School of Biomedical Science, are developing drugs to fight advanced prostate cancer that could also prevent and or treat acute respiratory distress syndrome (ARDS).

Dr. Lisa Philp and Professor Colleen Nelson and their research team, based at the Translational Research Institute, realized their research on two hormones secreted by body fat, that modulate prostate cancer tumor growth could also have roles in driving the rapid-onset, severe lung inflammation that kills patients with serious COVID-19 disease.

The research team had been investigating two novel drugs that target fat hormones, one hormone which is pro-inflammatory, and another hormone that has an anti-inflammatory effect; each of which is involved in the progression of prostate cancer.

Using their data and knowledge of COVID-19 research the team came to the hypothesis that these drugs could be effective treatments for ARDS.

The team had been collaborating with two US-based biotech companies to advance their research on the drugs to a phase 1 clinical trial in prostate cancer patients. They have very strong data that both these drugs suppress tumor progression in advanced treatment-resistant prostate cancer and, importantly, inflammation.

The good news is the San Francisco company working on this drug has already used it in patients with inflammatory eye conditions, so we know it is safe for human use. In fact, the company is developing it for other illnesses such as liver disease.

The team had been working with this company in the prostate cancer context but when COVID hit we said to them that it could be a great treatment for ARDS. The company is supporting us financially to be able to get through these proof of principle pre-clinical studies.

Today Show host talks about his prostate cancer

In November 2020, 66 year old Al Roaker one of the hosts of the Today revealed on the NBC News show that he had been diagnosed with prostate cancer. Weeks later the famous weatherman underwent prostate cancer surgery.

During his recovery he has been inundated with supportive messages from fans. He has been very open about how he has been taking care of himself following his surgery.

The popular weatherman posted on social media photos of himself going for a walk, with comments about how much he truly needs to exercise and how it helps him feel like he is doing things to truly take care of himself. He encourages his fans to take care of themselves.

Many people commented back thanking Al for his daily inspirational thoughts. They encouraged him to stay strong and safe and thanked him for his positivity. Fans also commented on how his upbeat spirit was perceived as very healing. People appreciate the fact that Al brings a smile to their faces even in these difficult times.

Before physically returning to the studio Al made a virtual appearance from his home saying that the pathology report had showed there was no evidence of cancer beyond his prostate.

Al recently returned to the Today Show studios after his recovery post-surgery. Fortunately, he was able to announce to viewers the positive news that doctors were certain that they had managed to remove the cancer. He credited his triumphant return to the studio to great medical care and the love of friends and family.

When back at work, the star told co-workers that he was feeling good.

Cal Ripken Jr. Talks About His Recovery From Prostate Cancer Surgery

“It stops you in your tracks, for sure. I mean, as a kid, when you go back to the days when I was a kid and you heard cancer, it was a death sentence. It was the worst possible news you could hear,” said Mr. Ripken.

Ripken, who recently turned 60, was diagnosed with prostate cancer just as the coronavirus pandemic was starting to set in.

Fortunately, the prostate cancer was caught early and Mr. Ripken was able to undergo surgery at Johns Hopkins, but was able to avoid both radiation and chemotherapy.

Because it was very early in the process, Mr. Ripken felt that surgery was the right answer. “It was a great ending, it was all contained in the prostate, it’s all gone. I’m cancer-free and basically resumed normal activities as I always did,” says Ripken.

At first, Mr. Ripken chose to remain very private about his diagnosis and he didn’t tell anyone. But then as time went on, he changed his mind because he wanted to encourage men to get their physicals.

It is very important for men to get regular checkups because catching prostate cancer early is key. If it is caught early prostate cancer is very treatable. And checking for prostate cancer is easy.

Website Provides Good Education About Chemotherapy to the Prostate Cancer Community

Three non-profit organizations have joined together to help prostate cancer patients better understand chemotherapy and when its right for them

Prostate cancer advocacy organizations ZERO, Us TOO International and Prostate Conditions Education Council announce the launch of an educational website specific to chemotherapy for treating prostate cancer.

It is estimated that more than 191,000 men in the U.S. will be diagnosed with prostate cancer in 2020. While most prostate cancer is diagnosed at an early stage, prostate cancer can recur or advance after an initial treatment; and some men have an initial diagnosis of advanced prostate cancer. Once prostate cancer is advanced, it can be managed but not cured. Chemotherapy is a common treatment for managing advanced prostate cancer but not routinely considered as a treatment option at other stages of the disease.

The prostate cancer chemotherapy website provides objective, balanced information about how chemotherapy works and when it should be considered as a treatment option. It addresses using chemotherapy in combination with other treatments and the potential for sequencing it in a treatment regimen. Along with the benefits of chemotherapy, probable treatment side effects are outlined as well as information for managing side effects.

“The purpose of the website is to provide an enduring educational platform on prostate cancer chemotherapy with current, accurate, and unbiased information,” noted Wendy Poage, President of the Prostate Conditions Education Council. “Content will help to educate patients and caregivers about how chemotherapy fits into the evolving prostate cancer disease journey. It features questions to ask your doctor and debunks some common myths about chemotherapy.”

The idea for the website was the result of a brainstorming session at an industry meeting attended by all of the participants. A discussion about current challenges for finding comprehensive information about chemotherapy for prostate cancer led to the idea of developing the website.

“Patients are finding it increasingly difficult to understand various prostate cancer treatment options throughout the disease journey,” stated Jamie Bearse, CEO of ZERO. “This website will serve as an important online destination for the prostate cancer community to find reliable facts about chemotherapy.”

A common deliverable of the three prostate cancer nonprofit organizations collaborating on this project is educational content to help men living with prostate cancer make informed treatment decisions at all phases of the disease. In addition to comprehensive educational written content and videos, the website will feature links to other resources including support groups.

“Beyond the facts and stats, it’s important to provide opportunities for men with prostate cancer to learn from each other and share their personal experiences with treatment decisions and side effect management,” said Us TOO International CEO Chuck Strand. “This website includes connections to support groups for men to exchange peer to peer information in person, online, or on a conference call.”

Collaboration on the chemotherapy prostate cancer website will extend beyond the launch to include future content updates.

The chemotherapy website can be found at any of the web addresses below:

Ideas for Healthy Living Post Prostate Cancer Treatment

Seeking emotional support and adopting a healthy diet are important.

The end of treatments for prostate cancer can be both a relief and anxiety-provoking time in a man’s life, as well as the lives of his caregivers and loved ones. While there is usually great relief that the treatments are complete, many men may be worried about whether the cancer is really gone. Which is why this a great time for men to focus on some well-deserved self-care. Regular check-ups with your doctor will be ongoing, but there are some things you can and should do for yourself.

They include:
-Seeking emotional support
-Adopting a healthy diet and exercise routine
-Restoring sexual health
-Embracing a new normal

Emotional Support

The cycle of prostate cancer treatments and the instructions and restrictions that can come with them is stressful for many men. While your friends and family will have your best interests at heart, it may be difficult for them to understand what you’re going through. Finding support is important. If you’re unable to openly talk with those who are close to you, you may want to seek out some like-minded people who understand firsthand what you have experienced.

There are in-person and online support groups that can help. If you find the idea of talking to a group of strangers a bit daunting, perhaps seek out some of your fellow treatment “buddies.” If there are men you bonded with during your treatment journey, consider reaching out and keeping in touch with them. Indeed, support may prove to be more important than just surviving prostate cancer treatment.

Diet and Exercise

Considering a celebratory feast with food and drink post-treatment? While these types of indulgences are OK in moderation, you want to land on a healthy routine with exercise and a balanced diet that you won’t hate as critical features.

Load up on fresh fruits and vegetables, whole grains and fewer refined foods. Adding in some regular exercise can make a big difference in your recovery timeline, as well as your mood. Some studies show a healthful diet and regular exercise after treatment can help prevent prostate cancer recurrence. Yes, even a walk around the block counts. Take the dog or your grandkids and enjoy the view. The small effort can have a majorly positive effect on your overall outlook on life.

Sexual Health

There may be a change in your sex life after prostate cancer treatment. Anything from being unable to achieve an erection to loss of desire entirely is common, and it’s also often temporary. Try to be patient and in not too great a hurry to get back to whatever “normal” was for you before treatment. The body needs time to recover and heal. If you reach a point where you’re concerned, talk to your doctor. There are plenty of treatments available.

Creams, pills, injections and, in severe cases, surgical implants are all options you can discuss with your doctor or health care provider. You should also talk openly with your partner. Couples therapy, individual therapy and group therapy are all options to consider. No man should be ashamed to make restoring his sexual health an essential part of his overall wellness focus after prostate cancer treatment.

A Different You

Your life will be undoubtedly different after a prostate cancer journey. From the symptoms and diagnosis to the treatments and life afterward, the “new normal” can be uncomfortable at first. But that doesn’t mean it’s all bad. While there’s no surefire way to prepare for life after prostate cancer, have confidence that you will find your way. You have gained wisdom and a perspective on life that may very well help another man who finds himself at the beginning of a prostate cancer journey.
Remember that emotional support is just as important as the medical treatments, and a healthy lifestyle afterward will help with physical and emotional recovery. Don’t be afraid to ask for help or guidance from your doctor, health care team and trusted loved ones and friends.

Immune Discovery Show Possibilities of ‘Treating all Cancers’

A newly-discovered part of our immune system could be harnessed to treat all cancers, say scientists.

The Cardiff University team discovered a method of killing prostate, breast, lung and other cancers in lab tests.

The findings, published in Nature Immunology have not been tested in patients, but the researchers say they have “enormous potential”.

Experts said that although the work was still at an early stage, it was very exciting.

What have they found?

Our immune system is our body’s natural defense against infection, but it also attacks cancerous cells.

The scientists were looking for “unconventional” and previously undiscovered ways the immune system naturally attacks tumors.

What they found was a T-cell inside people’s blood. This is an immune cell that can scan the body to assess whether there is a threat that needs to be eliminated.

The difference is this one could attack a wide range of cancers.

This raises the prospect of a ‘one-size-fits-all’ cancer treatment, a single type of T-cell that could be capable of destroying many different types of cancers across the population.

How does it work?

T-cells have “receptors” on their surface that allow them to “see” at a chemical level.

The Cardiff team discovered a T-cell and its receptor that could find and kill a wide range of cancerous cells in the lab including lung, skin, blood, colon, breast, bone, prostate, ovarian, kidney and cervical cancer cells.
Crucially, it left normal tissues untouched.

Exactly how it does this is still being explored.

This particular T-cell receptor interacts with a molecule called MR1, which is on the surface of every cell in the human body.

It is thought MR1 is flagging the distorted metabolism going on inside a cancerous cell to the immune system.

The researchers are the first to describe a T-cell that finds MR1 in cancer cells.

This finding is significant

T-cell cancer therapies already exist and the development of cancer immunotherapy has been one of the most exciting advances in the field.

The most famous example is CAR-T – a living drug made by genetically engineering a patient’s T-cells to seek out and destroy cancer.

CAR-T can have dramatic results that transform some patients from being terminally ill to being in complete remission.

However, the approach is highly specific and works in only a limited number of cancers where there is a clear target to train the T-cells to spot.

And it has struggled to have any success in “solid cancers” – those that form tumors rather than blood cancers such as leukemia.

The researchers say their T-cell receptor could lead to a “universal” cancer treatment.

With Equal Care, African American and White Men Have Same Prostate Cancer Survival

A new study suggests that when it comes to prostate cancer, African American men have similar survival rates to white counterparts if they have equal access to healthcare.

Research conducted in the past has found African Americans are twice as likely to die from prostate cancer as whites, and the reasons may include diagnosis when the disease is more advanced as well as differences in medical care.

However, this new study, which followed more than 60,000 men with prostate cancer getting care from the U.S. Veterans Administration Health System, found African American men did not have more advanced disease at diagnosis and did not die earlier than white men, researchers reported in Cancer.

“Throughout the U.S. population, African Americans usually have worse outcomes with prostate cancer,” said the study’s senior author Dr. Brent Rose of the University of California, San Diego. “The hypothesis has been that the disease is just biologically more aggressive in African American men.”

“Our study suggests that is not a foregone conclusion,” Rose said. “There’s something about the way the VA medical system reduces disparities seen in normal healthcare that suggests that equal outcomes could be created with smart policy decisions.”

These findings doesn’t mean there are no biological differences between blacks and whites when it comes to prostate cancer. African Americans are more likely to get prostate cancer than whites: one in eight versus one in twelve. And they tend to get it three to four years younger for reasons that are unknown.

The findings suggest that when African Americans get good access to care and prompt treatment, disparities in survival disappear.

To determine whether access to healthcare might play a role in the disparity in survival between blacks and whites, the researchers analyzed information on more than 20 million veterans who receive care through the San Diego VA’s healthcare system.

These researchers focused on 60,035 men diagnosed with prostate cancer between 2000 and 2015, 30.3% of whom were African American and 69.7% were non-Hispanic white. Fifty percent of the men were followed for nearly six years, and some were followed for as long as 10 years.

The overall results showed that there were 3,067 deaths from prostate cancer in the group, 848 among African American men and 2,219 in non-Hispanic white men.

The rate of prostate cancer death over a 10-year span among black men was slightly lower than the rate among whites: 4.4% versus 5.1%.

The new results are very good news, because when you find the cancer at the same stage you can have the same survival outcome. However many more African Americans still die from prostate cancer.

Researchers determined that they still need need to find a way to diagnose prostate cancer earlier in African American men in the general population.