Tag Archives: Prostate cancer

New prostate surgery not necessarily better: study

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New prostate surgery not necessarily better: study

Men who have less invasive prostate cancer surgery — often done robotically — are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday.

Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association.

“We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction,” Dr. Jim Hu of Brigham and Women’s Hospital in Boston said in a telephone briefing.

Hu said use of minimally invasive surgery has taken off since the introduction and heavy marketing of robot-assisted surgery, such as the da Vinci system made by Intuitive Surgical Inc.

The system consists of robotic arms, controlled from a console, that allow surgeons to perform less invasive surgeries. Hospitals advertise the systems as being able to reduce trauma, blood loss, risk of infection, scarring and often pain.

Hu said so far, there have been few studies that compare minimally invasive surgery with open surgery.

To do that, he and colleagues used billing data from the Medicare insurance program for the elderly on procedures done from 2003 to 2007. During that time, use of minimally invasive surgery for prostate cancer increased fivefold.

While both approaches fared equally well as a cancer treatment, they found that men who got the minimally invasive approach had shorter hospital stays, were less likely to need blood transfusions, and had fewer breathing problems after surgery than those who got conventional surgery.

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Researchers find prostate cancer stem cell

Researchers find prostate cancer stem cell

Cancer stem cells (CSCs) are cancer cells (found within tumors or hematological cancers) that possess characteristics associated with normal stem cells, specifically the ability to give rise to all cell types found in a particular cancer sample. CSCs are therefore tumorigenic (tumor-forming), perhaps in contrast to other non-tumorigenic cancer cells. CSCs may generate tumors through the stem cell processes of self-renewal and differentiation into multiple cell types. Such cells are proposed to persist in tumors as a distinct population and cause relapse and metastasis by giving rise to new tumors. Therefore, development of specific therapies targeted at CSCs holds hope for improvement of survival and quality of life of cancer patients, especially for sufferers of metastatic disease.

Existing cancer treatments have mostly been developed based on animal models, where therapies able to promote tumor shrinkage were deemed effective. However, animals could not provide a complete model of human disease. In particular, in mice, whose life spans do not exceed two years, tumor relapse is exceptionally difficult to study.

The efficacy of cancer treatments is, in the initial stages of testing, often measured by the ablation fraction of tumor mass (fractional kill). As CSCs would form a very small proportion of the tumor, this may not necessarily select for drugs that act specifically on the stem cells. The theory suggests that conventional chemotherapies kill differentiated or differentiating cells, which form the bulk of the tumor but are unable to generate new cells. A population of CSCs, which gave rise to it, could remain untouched and cause a relapse of the disease.

Researchers have found a stem cell, a kind of master cell, that may cause at least some types of prostate cancer.

Their findings are only experimental — the stem cells were found in mice — but could explain at least some types of prostate cancer and eventually offer new ways to treat it, they reported on Wednesday in the journal Nature.

The findings also show a potential new source for prostate tumors — so-called luminal cells, which secrete various compounds used in the prostate.

“The role of stem cells in the development of prostate cancer has been a focus of speculation for many years,” Dr. Helen Rippon of Britain’s Prostate Cancer Charity said in a statement.

“Importantly, this new stem cell does not rely on androgens — the male sex hormones that control prostate growth — to survive and grow. This may give a clue as to why prostate cancer often becomes resistant to treatments designed to regulate these androgens in the later stages of the disease,” added Rippon, who was not involved in the research.

“This improved knowledge will also be a step forward in learning how we might help to prevent the disease from developing in men in the first place.”

Michael Shen of Columbia University Medical Center and colleagues named the new stem cells CARNs, for castration-resistant Nkx3.1-expressing cells.

They normally regenerate part of the tissue that lines the inside of the gland, which produces semen. But the cells can also form tumors if certain genes meant to stop out-of-control growth get turned off.

Shen said researchers had believed that tumors arise from a different layer of cells in the prostate, called basal cells.

“Previous research suggested that prostate cancer originates from basal stem cells, and that during cancer formation these cells differentiate into luminal cells,” Shen said in a statement. “Instead, CARNs may represent a luminal origin for prostate cancer.”

Prostate cancer is the second most common cancer in men worldwide after lung cancer, killing 254,000 men a year globally.

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Prostate cancer screening: More harm than good?

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Prostate cancer screening: More harm than good?

One meaning of screening is the investigation of a great number of something (for instance, people) looking for those with a particular problem or feature. For example at an airport many bags are screened by x-ray to try to detect any which may contain weapons or explosives, and people are screened by passing through a metal detector. If only part of a population is screened, screening is equivalent to sampling in statistics.

Screening can also mean preventing access of something by some sort of barrier. Particular cases:

Electromagnetic shielding in physics, the exclusion of electric, magnetic, or electromagnetic fields by a metallic screen or shield

In atomic physics and chemistry, the screening effect or atomic shielding is the reduction of effective nuclearcharge by intervening electron shells

Screening (printing), a process that represents lighter shades as tiny dots, rather than solid areas, of ink by passing ink through a perforated screen

The investigation of a large population is related; the members of a population are filtered by a metaphorical, rather than physical, screen

Screening is a process stage when cleaning paper pulp

Routine screening for prostate cancer has resulted in more than 1 million U.S. men being diagnosed with tumors who might otherwise have suffered no ill effects from them, U.S. researchers said on Monday.

They said prostate cancer screening is a double-edged sword, catching serious cancers in a few but causing needless worry and expense for the majority of men, who may be getting treatment for tumors growing too slowly to do any harm.

The team looked to see how many additional men have been diagnosed with prostate cancer since the introduction in 1986 of a widely used blood test for prostate cancer that looked for a prostate-cancer specific antigen, or PSA.

“Our estimate is that number is about 1.3 million people in the United States. That is a huge effect,” said Dr. H. Gilbert Welch of the VA Outcomes Group in White River Junction, Vermont, whose study appears in the Journal of the National Cancer Institute.

More than 1 million of those were treated, they found.

“These are men who could not be helped by treatment because their cancer was not destined to cause them symptoms or death,” Welch said in a telephone interview.

The increased diagnosis rate more than tripled in men aged 50 to 59 and increased more than a sevenfold in men under age 50.

And while prostate cancer deaths have declined since the introduction of PSA testing, Welch said about 20 men had to be diagnosed and treated for every one who benefited.

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