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Men’s Health News
A simple blood test screening for a panel of biomarkers can accurately predict whether a patient who has had prostate cancer surgery will have a recurrence or spread of the disease.
Generique cialis soft pilules bon marche Calling their findings a major step forward in prostate cancer care, Texas researchers report in the June 15 issue of Clinical Cancer Research, a journal of the American Association for Cancer Research, that the presence of seven of these biomarkers can predict prostate cancer risk with 86.6 percent reliability. This is at least 15 percentage points higher than standard clinical measures currently in use, the researchers say.
"We have been looking at these biomarkers for the past 10 to 15 years in the laboratory, but now we can translate these findings into progress for the individual patient," said Shahrokh F. Shariat, M.D., chief resident in urology at the University of Texas Southwestern Medical Center.
Clinicians need this information to decide whether to take a "watchful waiting" approach with their prostate cancer patients or to move to more aggressive additional therapy such as hormone therapy, chemotherapy or radiation, Shariat says. Urologists currently use a risk predictor that includes variables like stage, Gleason score and serum levels of prostate-specific antigen. "However, this method is only accurate about 70 percent of the time, which is not optimal," Shariat said.
Shariat and colleagues enrolled 423 patients who were surgically treated for prostate cancer with either radical prostatectomy or bilateral lymphadenectomy.
Using commonly available blood tests, they measured levels of the following seven biomarkers: transforming growth factor-â1, interleukin-6, interleukin-6 soluble receptor, vascular endothelial growth factor, vascular cell adhesion molecule-1, endoglin, urokinase plasminogen activator.
"We reviewed background literature over 60 separate biomarkers and determined that these were the optimal seven that would have predictive value," Shariat said.
Patients were followed for approximately four years, and researchers noted cancer recurrence in 17.7 percent of patients. Elevated levels of the seven biomarkers were associated with increased risk of relapse. For example, the presence of urokinase plasminogen inhibitor-1 increased risk by 37 percent, while the presence of vascular endothelial growth factor increased risk by 47 percent.
The combination of all seven biomarker variables accurately predicted risk 86.6 percent of the time in this study.
"This is a large and unique improvement for patient care. Neither preoperative MRI nor any of the clinical features we have used before even comes close to this level of accuracy," Shariat said.

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Men’s Health News
Men with prostate cancer caused by a faulty BRCA2 gene are more than twice as likely to die from the disease than those carrying the faulty BRCA1 gene - reveals a study published in the British Journal of Cancer today (Tuesday).
These findings could help tailor treatment and target chemotherapy more effectively to men with prostate cancer that is caused by a BRCA gene fault.
Carriers of the BRCA2 gene were found to live for an average of four years following a diagnosis of the disease, compared to an average of eight years in men carrying the BRCA1 gene.
Lead researcher, Dr Steven Narod, based at the University of Toronto in Canada, said: "We know that carrying a faulty BRCA2 gene increases a man’s risk of getting prostate cancer, and our study shows that it also affects how long he will survive a diagnosis of the disease.
"This information is important because it shows that men with BRCA2 are not responding as well to current therapies, so we hope these findings could help doctors more effectively tailor treatment to this group."
Prostate cancer is the most common cancer in men in the UK. Around 35,000 new cases of the disease are diagnosed in the UK and around 10,000 men die from the disease each year. Around one in every 500 men carry the BRCA2 gene.
The lifetime risk for developing prostate cancer is one in 14 for men in the UK. Previous studies have shown that men with a faulty BRCA2 gene can be up to five times more likely to develop prostate cancer than the general population.
Dr Narod continued: "The results of our study are very exciting - if this link is confirmed in further clinical trials, it could help doctors develop new treatment methods for prostate cancer patients with a faulty BRCA2 gene."
generishe viagra pillen Ohne Rezept A greater understanding of who is most at risk and most likely to die from prostate cancer could also lead to targeted screening for men with a family history.
Dr Lesley Walker, director of cancer information at Cancer Research UK, said: "Although only a very small percentage of men with prostate cancer will carry a faulty BRCA2 gene, they’re much more likely to die from the disease. It’s important that more research is done in this area to ensure that this group is targeted effectively so cancer is picked up at an early stage and, more importantly, that they are given the most appropriate treatment.
"Men with a strong family history of prostate or breast cancer can visit their GP for advice."

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Men’s Health News
Men whose tumors recur after prostate cancer surgery are three times more likely to survive their disease long term if they undergo radiotherapy within two years of the recurrence. Surprisingly, survival benefits were best in men whose new tumors were growing fastest, according to results of a ‘look-back’ study of 635 men by Johns Hopkins Medical Institutions researchers reported June 18 in the Journal of the American Medical Association.
Previous studies of radiation therapy for recurrent prostate cancer found that it reduced disease progression, but this study demonstrates that it significantly prolongs survival, as well, according to Bruce J. Trock, Ph.D., associate professor of urology, epidemiology, oncology, and environmental health studies, and director of the Division of Epidemiology in the Brady Urological Institute at Johns Hopkins.
"What this new study tells us is that even men with aggressive disease that has recurred after surgery appear to benefit from radiation therapy. It also means that we may be able to give radiation selectively to those who are really likely to benefit from it," advises Trock.
"I found the results of this study remarkable," says Patrick C. Walsh, M.D., University Distinguished Service Professor of Urology at the Brady Urological Institute. "Previously, we believed that these men -who have aggressive disease defined by a rapid doubling of PSA in six months or less — had distant metastases and would not benefit from any form of local salvage therapy."
PSA, or prostate specific antigen, is the blood-based protein shed by the organ that signals the likely presence of cancer. Rapid rises in PSA levels after surgical removal of the prostate signal the recurrence of cancer and often convey a poor prognosis.
Approximately 30 to 40 percent of men with high-risk tumors experience no recurrence of their cancers after surgery and can be spared the side-effects, that is, urinary and bowel problems, that may come with radiation. So, the Johns Hopkins researchers were looking to determine whether radiation could improve survival in men with recurrent prostate cancer and the optimal timing for the therapy.
In the new study, the researchers reviewed records of 635 men who developed recurrent cancer following radical prostatectomy at Johns Hopkins Medical Institutions between June 1982 and August 2004. Of these, 397 received no salvage radiation therapy, 160 received only salvage radiation, and 78 received both salvage radiation and hormonal therapy. acheter viagra soft bon marche Median follow-up was six years after recurrence.
Among men who had received radiotherapy for prostate cancer recurrence, the probability of surviving 10 years was 86 percent, compared to 62 percent among those who did not have radiation. For patients with rapidly growing tumors, defined by a PSA doubling time of less than six months, the benefits of salvage radiation therapy existed regardless of Gleason score, a numerical value that measures prostate cancer aggressiveness.
"This review suggests that even patients with aggressive cancer at the time of surgery not only benefit from salvage radiation therapy, but also actually live longer without a second prostate cancer recurrence," says Theodore L. DeWeese, M.D., professor and chairman of the Department of Radiation Oncology and Molecular Radiation Sciences. "This is the most important news for this group of patients in a long time."
DeWeese suggests that radiation oncologists and urologists now consider salvage radiation therapy for a broader group of patients with recurrent prostate cancer following surgery.
In addition to Trock, Walsh and DeWeese, the research team included Misop Han, M.D., of the Brady Urological Institute at Johns Hopkins; Stephen J. Freedland, M.D., of the Surgery Section, Durham Veterans Affairs Medical Center and Duke Prostate Center, Departments of Surgery and Pathology, Duke University School of Medicine; Elizabeth B. Humphreys, M.S. of the Brady Urological Institute at Johns Hopkins; and Alan W. Partin, M.D., Ph.D., of the Brady Urological Institute at Johns Hopkins.
Funding for this study was supported in part by the National Cancer Institute, gifts by Dr. and Mrs. Peter S. Bing, the Department of Defense Prostate Cancer Research Program, and the American Urological Association Foundation’s Astellas Rising Star in Urology.

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Men’s Health News
A simple blood test may help doctors better predict whether prostate cancer will recur or spread in patients who have undergone surgery for the disease, researchers at UT Southwestern Medical Center have found.
In a study published in the June 15 issue of Clinical Cancer Research, UT Southwestern scientists identified a panel of seven biomarkers that can predict with 86 percent accuracy which prostate cancer patients will experience a recurrence and progression of the disease. Biomarkers are proteins circulating in a patient’s blood that are specific to a disease.
Current risk assessment methods, which include stage and grade of cancer and the level of prostate-specific antigen, can predict prostate cancer recurrence with about 70 percent accuracy.
"There are several unresolved issues in the clinical and surgical management of prostate cancer, one of them being the identification of men who have insignificant cancers and can be followed, and another being the identification of men most likely to have spread of disease and early or late recurrence," said Dr. Claus Roehrborn, chairman of urology at UT Southwestern and one of the study’s authors. "In the future, once we can reliably identify those patients, we may be able to offer additional treatment to counteract that risk and give those men a better chance for a permanent cure. The panel of biomarkers is an important step in this direction."
For nine years, Dr. Shahrokh Shariat, who is now a resident in urology at UT Southwestern and the study’s lead author, has been collaborating with basic-science researchers and clinicians to find a comprehensive group of biomarkers associated with prostate cancer that could more accurately predict the biological behavior of the disease.
Using commonly available blood testing methods, Dr. Shariat and his team measured the levels of seven biomarkers in 423 patients who were subsequently surgically treated with a radical prostatectomy and bilateral lymphadenectomy.
Of the study participants, 75 had a recurrence of their cancer. All 75 had elevated levels of at least several of the seven biomarkers. Dr. Shariat’s seven-biomarker model was able to accurately predict the risk for recurrence 86.6 percent of the time.
"We found that a combination of independent yet complementary markers may provide a more accurate prediction outcome compared to single markers," Dr. kaufen viagra Ohne Rezept Shariat said. "This could help physicians provide individualized care and targeted therapy for patients. It will also allow us to design clinical trials to target these individual biomarkers."
Prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in men in the United States. Although prostate-removal surgery and radiation therapy have been successful in controlling the disease, up to 40 percent of patients experience a relapse.
"A prediction tool based on the biomarkers we tested could improve the accuracy of standard models and help doctors counsel patients better about their risk for prostate cancer recurrence and help to determine the course of treatment," Dr. Shariat said. "There is no doubt that we are approaching a time when use of proper biomarkers will help detect, monitor and manage the progression of this disease, as well as assist with therapeutic decisions."
The next step is to explore the role of these biomarkers in patients treated with other therapies, such as radiation, and patients with a different range of disease severity.
Currently, the seven-biomarker panel is being externally validated in a clinical trial at two medical institutions, one in the United States and the other in Europe.

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New research has shown that 1 in 10 men experience erectile dysfunction
(ED) and as many as 1 in 5 men suffer a loss of libido, as a result of
work-related stress.
These latest figures suggest that 90% of men have shown at least one
clinical feature of stress due to work but only 54% of men know that
stress from work may be the cause of their ED. Stress, either at work or
home, is a known cause of ED and prolonged stress is associated with low
testosterone levels.
Unfortunately 44% of men would not go to their GP if they experience
erection problems, and those who do go to their GP about their ED wait on
average 17 months before going for a consultation. But there’s no need to
delay - oral treatments for ED (PDE5 inhibitors), such as Levitra,
Viagra and Cialis, have revolutionised the treatment of men with ED
and are now widely prescribed as a first option for treatment.
Dr David Edwards, an Oxfordshire GP comments: "Work-place stress clearly has
a strong impact on the incidence of ED in men. Men should think about the
underlying cause of their ED, including how to combat their stress levels;
not staying too late at work, a balanced and healthy diet, and regular
exercise. We know that oral treatments usually work well for men with ED,
but 1 in 3 men with ED are not able to have satisfactory sex the first time
they take a tablet and consequently a third of them do not return to their
doctor. These men could still be successfully treated by simply switching to
a different tablet or increasing the dose, and should be encouraged to
return to their GP."
Men have recently ranked ‘high success rate with first tablet’ as one of the
most desirable attributes that a treatment can have. It is important for
men with ED not to give up on their treatment too soon and return to their
GP to ensure that they have tried the range of treatments available.
Low testosterone levels (which may be stress-related) can cause ED and also
prevent PDE5 inhibitors working properly. All men with ED should ask
their GP to test their testosterone levels. If low, this can be treated
successfully alongside treatments for Buy propecia without prescription ED.
The SortED in 10 Campaign supported the research and highlighted that
erection problems are very common, affecting half of all men between the age
of 40 and 70. Given the range of oral treatments now available men should
waste no time in asking their GP or nurse about what help is available.

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