More than ever, prostate cancer outlook is optimistic


More than ever, prostate cancer outlook is optimistic

There has never been a time than now for such an optimistic outlook for prostate cancer. This news is according to the annual symposium of the Institute for Prostate Cancer Research held at the Fred Hutchinson Cancer Research Center in Seattle, Washington. The day long symposium had several experts in prostate cancer provide their insights about the current knowledge and recent discoveries in prostate cancer risk reduction, screening, imaging, treatment, and more.

Out of this gathering, there were five takeaways all men should know about prostate cancer:

1. Exercise can counter many of the side effects of prostate cancer treatment

All patients with different types of cancer can benefit from exercise including men with prostate cancer. In the last year, a growing body of evidence has shown that moderate exercise of any type is an excellent antidote to many unwanted side effects of androgen-deprivation therapy, or ADT. Many men can suffer muscle loss, fatigue, and weight gain as side effects from ADT therapy.

ADT is a standard treatment for men with advanced prostate cancer and includes drugs such as Lupron and others that work through a similar mechanism while, another drug called Firmagon, works differently. ADT blocks the testicles’ production of androgens, or the male hormones such as testosterone that is likely to fuel prostate cancer growth. By removing this fuel source, this causes cancer to stop growing or to shrink.  But the downsides of using ADT therapy are the side effects.

To combat the side effects of ADT, more and more physicians are recommending exercise.  It is well-known that exercise can improve a man’s masculinity, body image, and quality of life while receiving ADT or other prostate cancer treatment. Exercise can improve muscle performance, a man’s fat-to-lean ratio after ADT is done while maintaining cardiovascular health and metabolism.

Muscle mass is better maintained when a man exercises – this is important as loss of muscle mass is a normal byproduct of aging that can lead to falls and fractures which is accelerated by ADT. Improving bone health is another benefit exercise provides particularly for men with prostate cancer that has metastasized to the bones. It can improve physical function and strength without causing bone pain or other side effects.

2.  Treatment options for erectile dysfunction after prostate cancer therapy have increased

One common issue after prostate cancer treatment affecting sexual functioning is erectile dysfunction (ED). In order for a man to achieve an erection, there must be good blood flow to the penis.  But for men who have had both surgery and radiation, these treatments can result in harm to the nerves, blood vessels, and tissues in the penis necessary for erections.

The good news is today, there are many different options helping men and their partners to still have a fulfilling sex life. Any man experiencing ED needs to discuss this with his doctor. Together, depending on what problem a man is having, a plan can be worked out to improve the situation.

Lifestyle changes may be in order before ED will improve; this could include changes to their diet, exercise and reducing blood pressure. If those changes do not result in better improvements, then a discussion on ED medications such as Viagra or Cialis may be warranted. A third option could be therapies such as hand-operated vacuum pumps and medication that increase blood flow to the penis.  Another option is a penile prosthesis. A surgeon implants an inflatable device in the tissues of the penis and hides the attached pump inside the scrotum. The man is able to squeeze the hidden pump to cause an erection.

3.  Black men are still at a disparity compared to white men

Even though it is becoming less common and less deadly, black men are still more likely to get prostate cancer and to die from it than white men. One suggestion made at this conference is that black men might benefit from screening for this cancer 10 years earlier than the current national screening guideline recommends at age 55. The screening test used is the prostate specific antigen test or PSA which involves testing a man’s blood for levels of markers of PSA which can indicate the presence of cancer.

4. Better treatments for newly diagnosed metastatic prostate cancer

Metastatic prostate cancer is cancer that has spread beyond the prostate gland. Men who are diagnosed with metastatic prostate cancer often have very little cancer outside of the prostate.  Emerging research is pointing toward potential new treatment strategies to help men with this cancer to have better health outcomes.

Surgery and radiation have been found to not likely cure metastatic prostate cancer. But studies in mice have been showing evidence that controlling the growth of the primary tumor might help these men. The reason is by eliminating or greatly reducing the size of the primary tumor, it may disrupt a process called “self-seeding,” through which metastatic tumor cells that are moving back to the primary tumor through the bloodstream, release signals that make the cancer even more aggressive.

There are numerous other ongoing clinical trials in the U.S. and Europe which are testing treatment strategies specifically for men with newly diagnosed metastatic prostate cancer.  These include large trials called STAMPED and PEACE1.

5. Emerging research on whether high-dose testosterone could treat prostate cancer

An area of active research is whether prostate cancer could be treated with high-dose testosterone.  ADT therapy is a common therapy for treating prostate cancer but it doesn’t work forever. Eventually prostate tumors learn how to get around the lack of testosterone and fine a way to grow anyway. But researchers have discovered that once a tumor has adapted to growing with little testosterone, high levels of it can poison it.

This strategy is called “bipolar androgen therapy.” What happens with this therapy is that a patient will alternate between ADT and high-dose testosterone therapy with the idea of staying one step ahead of the cancer so it doesn’t get used to either a high- or low-testosterone environment. More research is being conducted on this theory which could prove to be another alternative in the fight against prostate cancer.