Calls to screen men in their 40s for prostate cancer

Swedish researchers argue that men aged in their mid-to-late 40s should be offered a screening test for prostate cancer as this could detect almost half of potentially deadly cases of the disease, providing them with a chance to have necessary treatment before the cancer can develop.

However, the effectiveness of the screening process in question – prostate specific antigen (PSA) testing – has been widely open to debate for several years as the test cannot determine between slow-growing and fast-growing cancer, can cause needless worry and medical tests with a false positive result and has been known to occasionally miss the cancer and provide a false sense of reassurance.

The test can be done at your own GP surgery and involves measuring the level of the protein PSA in your blood. PSA is produced by the prostate gland. Some of the PSA manages to travel into the blood, with levels varying depending on prostate health and age. Currently there are no NHS routine screening programmes for prostate cancer in the UK but Men over the age of 50 are able to have a free PSA test on the NHS if they choose.

The results of which are published in the British Medical Journal, Professor Hans Lilia and colleagues from Lund University in Sweden, working together with researchers from the Memorial Sloan-Kettering Cancer Center in the U.S., found that if this screening was offered to men aged between 45 and 49, it could potentially spot prostate cancer in almost half of cases.

Their claim emanated from a thorough analysis of a study that was conducted between 1974 and 1984, comprising of 21,277 Swedish men aged between 27 and 52. At the beginning of the study period, every man had donated a blood sample and researchers went back to these samples to conduct PSA tests.

The PSA readings were compared against which men went on to develop prostate cancer, who survived and of what age each death occurred. It was calculated 1,369 of the men had prostate cancer; 241 being at an advanced stage and 162 men died.

With these figures being considered in great detail, they came to the conclusion screening under the age of 45 found very few cancers, screening after the age of 50 generally would be too late an age, whereas 44% of the deadlier cancers were detected through screening that was carried out between the ages of 45 and 49.

In their report, the researchers state: “At least half of all men can be identified as being at low risk and probably need no more than three PSA tests in a lifetime. This is likely to reduce the risk of over-diagnosis while still enabling early cancer detection among those most likely to gain from early diagnosis.”

Dr Anne Mackie, director of NHS screening programmes at Public Health England, says the organisation is considering the findings of the study, adding: “We are currently in the process of a scheduled review for a screening programme for prostate cancer and will make a recommendation towards the end of 2013.”

Scientific breakthrough in determining early cancer risk

A ground-breaking study could pave the way for the introduction of a quick and simple £5 saliva test to determine a patient’s risk of developing breast or prostate cancer, and it could be available within just five years.

The saliva test would find those who are genetically susceptible to the cancers and lead to thousands of lives saved each year with high-risk patients being monitored and even undergo treatment early enough to stop a cancerous tumour from even beginning to develop.

The research into early cancer prevention was conducted by scientists at the University of Cambridge and the Institute of Cancer Research (ICR) in London and funded by Cancer Research UK (CRUK) and the Wellcome Trust.

Researchers studied the DNA extracted from approximately 200,000 people; of which half were suffering from cancer and half were healthy. The massive project spanned four years of thorough genetic analysis by 1,000 scientists and they described their findings as the ‘single biggest leap forward’ in relation to the genetic causes of prostate cancer.

Each person is born with three billion pieces of code comprised of chemical letters: A, C, T and G; known as the ‘genome’ and is passed to us from our parents. A single nucleotide polymorphism is a single letter variation in DNA between people and we can have millions of these variations. Because cancer patients were compared with healthy individuals, scientists were able to see the genetic spelling mistakes that were prominent in the cancer group.

They discovered more than 80 genetic markers which are linked to the risk of somebody developing cancers. There were 49 for breast cancer, 23 for prostate cancer and 11 for ovarian cancer. Unfortunately, scientists were unable to ascertain around 60% of the genetic risk factors for the cancer types they focused, however their findings can still help increase knowledge of the inherited causes of the condition.

Interestingly, for the prostate cancer patients, 18 of the 23 variants were attributed to the most aggressive forms of the disease.

The next step for scientists is to create simple blood or saliva tests that can accurately obtain the future risk breast and prostate cancers. These samples would probably have to be sent off for a lab analysis but the hope is to have results available immediately at the doctors’ surgery.

New medicine for difficult-to-treat cancers could also be produced in addition to a new ovarian cancer test. It is thought that even bowel and lung cancers risks may be found with similar methods.
Dr Harpal Kumar, chief executive of Cancer Research UK, said: “It can help us identify exactly what is driving different types of cancer, which could enable us to develop new therapeutic approaches.”
He added: “By understanding why some people seem to be at greater risk of developing cancer we can look towards an era where we can take steps to reduce their chances of getting cancer or pick up the disease at its earliest stages. The principle is broad and the potential gains are huge.”

Professor Ros Eeles, from the Institute of Cancer Research, also commented: “These results are the single biggest leap forward in finding the genetic causes of prostate cancer yet made. The work could have a big impact on the number of people dying from the disease, which is still far too high.”

Cancer charity discuss Erectile Dysfunction risk after prostate cancer

The UK-based charity Macmillan Cancer Support have spoken on an already long-established subject and one which Medical Specialists Pharmacy have already covered several times – the relationship between prostate cancer and erectile dysfunction (ED).

Prostate cancer develops in the prostate, a gland in the male reproductive system and if left untreated it can kill – claiming roughly 10,000 lives every year in the UK alone.

ED (male impotence) is a common condition whereby a man struggled to achieve or maintain an erection satisfactory for sex and is believed to affect around four in 10 males over the age of 40.

Unfortunately, it is a typical inadvertent side effect not from the cancer itself, but from the resulting treatment methods for prostate cancer such as surgical removal of the entire prostate gland, radiotherapy (external via an external-beam or radioactive seed implants) and hormone therapy.

According to Macmillan, there are around 160,000 men in the UK who are currently being treated for prostate cancer that also suffer from ED, and many patients state as they underwent their cancer treatment it became difficult or even impossible to maintain their erection. In fact, Macmillan Cancer Support officials claim that two out of every three prostate cancer patients complain that their treatment has left them unable to get an erection. Rising cancer rates mean that by the year 2030, the number of cases of ED from such treatment could potentially double.

Professor Jane Maher, chief medical officer of Macmillan Cancer Support, said: “These figures highlight a major issue facing prostate cancer patients after treatment. The sheer volume of men affected shows the need for careful discussions before treatment. Many can be helped through early intervention and better support for men living with or beyond prostate cancer. Macmillan has worked closely with the NHS to develop a number of services to support cancer survivors after treatment. Some are already in place, but it is vital these services are implemented across the UK so men are not left isolated with this issue.”

To help these particular men, Macmillan now want a framework in place for the creation of a psychological support network in addition to specialised nurses –  trained to assist in issues related to ED. The charity also stress that there should be a higher number of physiotherapists being offered to patients.

Coincidentally, it was only a few months ago when a study emerged that suggested the ED medication Viagra could help sexual function for prostate cancer patients, with a daily dose of 50mg sildenafil citrate (Viagra’s active ingredient) being found to have ‘improved overall sexual function, including improved erectile function’ according to its lead author Dr Michael Zelefsky, vice chair for clinical research programs in the department of radiation oncology at Memorial Sloan-Kettering’s Cancer Center.

Dr. Daria Bonanno, a consulting clinical psychologist funded by Macmillan, commented on possible reasons why so many men who suffer with impotence problems still refuse to reach out for help, saying: “For many men with prostate cancer there is a certain stigma attached to talking about erectile dysfunction. Many may feel a sense of loss of masculinity and sadness around the inability to sustain an erection and will be reluctant to seek support. This can often cause them to emotionally isolate themselves from their partners and could make the issues worse.”

One in two men will develop cancer by 2027

As the number of men developing cancer is on the rise, UK health experts believe that by the year 2027 men will have a one in two chance of developing the disease.

The increase will change from the current 44 in 100 chance, to a 50 in 100 chance and is mostly because of the fact that people are generally living longer according to Cancer Research UK who teamed with Wolfson Institute of Preventative Medicine at Queen Mary, University of London to offer forecasts for the future.

Projections were formulated after studying previous information available about cancer incidence and mortality rates, in addition to projected population data for the UK.

In 2010 it was calculated that 324,000 people were diagnosed with cancer in the UK and this is expected to hit 416,000 by 2027. For men, the total is expected to reach over 221,000, up from 164,000 back in 2010.

The projections estimated that more than 194,000 women will be diagnosed with cancer in 2027, compared with 160,000 in 2010. Therefore, the predictions seem to be a similar pattern for women compared to men, with a lifetime risk which will increase from 40 to 44 out of 100 according to the researchers.

Cancer Research UK’s chief executive Harpal Kumar says that ‘it’s only through research that we will be able to beat cancer’, further adding: “We need to do more work to understand what drives cancer and how we can prevent it, as well as developing new treatments to reduce the number of people who will die from it.”

As mentioned previously, age is predicted to be the biggest risk factor for the disease and it is thought that the biggest increases in new cases will be seen in cancers of the bowel and prostate, as well as melanoma – the most dangerous type of skin cancer and most often brought on because of ultraviolet light (radiation) from the sun or excessive sunbed use.

Dr Kumar says the figures offer an outlook into the future and what challenges health authorities may face. One such challenge is developing an efficient and effective method of screening men for prostate cancer.

Not every cancer within the prostate gland is aggressive or potentially life-threatening and some can live with this all their lives and experience no health problems. Unfortunately though, doctors do not have a reliable testing procedure in their possession that can identify ‘safe’ tumours that are ok to leave alone.

Alan White, chairman of the Men’s Health Forum and professor of men’s health at Leeds Metropolitan University, argues that another problem will be persuading men to attend screenings for prostate cancer should an effective test ever be developed. Prof White says that even though men have a higher chance of developing bowel cancer than women, a lot less men than women actually bother to go for screening for this cancer.

Prof White says: “It’s desperately important that men take up any opportunity to go for cancer screening that they can. Some men are fatalistic about cancer and screening. But screening does make a difference. If cancers are spotted earlier they are easier to treat. We also know that men who discuss screening with their doctor or their partner are more likely to take up the offer.”

Viagra aids sexual function in prostate cancer patients

It was only eight days ago that Medical Specialists Pharmacy explained in detail just how high blood pressure and obesity can contribute to an increased prostate cancer mortality. Prostate cancer is our feature again today with news that the potent erectile dysfunction medication Viagra can drastically improve sexual function in patients both prior to and after their radiation treatment.

Though prostate cancer itself is not linked to the inability to achieve and maintain an erection, the treatments that are available have been connected to male impotence. The three main types of therapy for patients are: Removal of the entire prostate gland by surgery, radiation therapy (external via an external-beam or radioactive seed implants) and hormone therapy. All three can contribute to impotence in a varying degree of severity.

Prostate cancer develops in the prostate, a gland in the male reproductive system. It is the most common cancer diagnosed in men and each year in the UK there are 36,000 men who are diagnosed with prostate cancer. It was over two years ago that it was revealed that Sildenafil (Viagra’s active ingredient) may be used as a method of actually fighting the prostate cancer itself, but now research has been done which shows Viagra is massively beneficial in helping prostate cancer patients maintain healthy and happy sex lives.

The new research has been carried out by a team led by study lead author Dr Michael Zelefsky, vice chair for clinical research programs in the department of radiation oncology at Memorial Sloan-Kettering’s Cancer Center.

The team decided to analyse men suffering with prostate cancer that had not spread who had been treated by an external-beam radiation therapy and/or permanent implantation of radioactive seeds.
Over a six month time period, the participants were either given  a daily dose of 50mg of Viagra, or an ineffective placebo. Patients were asked to answer questionnaires prior to their initial radiation treatment, and again at six, 12 and 24 months after treatment. Questions were targeted as quizzing the men about any possible erectile function, intercourse satisfaction, orgasmic function, sexual desire and overall sexual satisfaction.

Dr Zelefsky commented on the findings of the study, saying: “Men who received the drug showed significantly improved overall sexual function, including improved erectile function. Results like this are important because they demonstrate that drug therapy used before and after radiation treatment may lessen the risk of impotence, a common side effect of radiation therapy. Future studies will be needed to further define the drug’s role and the optimal duration to prevent loss of sexual function after treatment.”

If you are suffering from erectile dysfunction, you do not have to suffer alone and in silence any longer. Medical Specialists Pharmacy offer a wide range of treatments for this condition and back in August  we ran a comparison of Viagra, Cialis and Levitra. This will hopefully equip men with the knowledge they need to understand the differences between the medications.

Viagra and other medications for male impotence such as Cialis or Levitra are obtainable with or without a prescription. If you do not have a prescription, you can undergo a private and confidential online consultation with one of our Doctors and if suitable, they will write you a prescription. This is passed to our in-house Pharmacists, and dispensed and dispatched to you at your home, your place of work, or where ever you choose, discreetly within 24 hours.

High blood pressure and obesity increase prostate cancer mortality

Prostate cancer is the second most common cause of cancer death, after lung cancer. Just in the UK alone, it is estimated that around 36,000 men are diagnosed with prostate cancer each year and it is responsible for a quarter of all newly diagnosed cases of cancer in men. Of this total of 36,000, just under a third will tragically die; usually because it has not been identified and treated early enough.
Unfortunately, prostate cancer will usually cause no symptoms until the cancer has become big enough to place pressure on the urethra. The symptoms are also incredibly similar to benign prostatic hyperplasia, and thus if you have such symptoms, it may not automatically mean you have prostate cancer. They include: having to urinate more frequently, problems actually beginning to urinate, a feeling that your bladder has not been fully emptied and a weak flow of urine.

The older you get, the chances increase of you developing prostate cancer, with it particularly being prevalent in people over the age of 70. However, a new study has come to light that sheds more light on the ‘high-risk’ groups, and what factors contribute to the deadly cancer.

Dr Christel Haggstrom, from Umea University, Sweden, and her team assessed nearly 300,000 males from Austria, Norway and Sweden over a duration of twelve years. Their aim was to analyse prostate cancer prevalence, how many deaths occurred, and what factors were contributing to prostate cancer incidence. The study was known as ‘The Metabolic Syndrome and Cancer (MeCan) project’.

Through the follow-up period of twelve years, a total of 6,673 men developed prostate cancer and of these, 961 unfortunately died from the disease. It was discovered that those who had among the highest BMI readings, had a 36% chance of dying from prostate cancer. For those with the highest blood pressure readings, the mortality rate was calculated as 62%.

Dr Haggstrom and colleagues looked at a wide range of risk factors, including high body mass index (BMI), high blood pressure, and high levels of sugar and fats in the blood, This is collectively known as ‘metabolic syndrome’. She said: “When we looked to see if the metabolic factors are related to an increased risk of getting or dying from prostate cancer we found a relationship with death from the disease and high blood pressure. There was also a link to high BMI but blood pressure had the strongest association to increased risk. The results for BMI are in line with previous findings in large studies. I can’t speculate on the reasons for the association between having high blood pressure and dying from prostate cancer. More research is needed to find out why this is the case but the results add further evidence to the hypothesis that high levels of metabolic factors separately or combined are related to an increased risk of dying from the disease.”

Pär Stattin, MD, PhD, from the Memorial Sloan-Kettering Cancer Center in New York City, led the study. He commented on its findings, saying: “These observations suggest that cardiovascular risk factors such as overweight and hypertension are involved in stimulating the progression of prostate cancer.”

If you are suffering with any symptoms mentioned earlier, you should visit your own GP as soon as possible for a check-up and do not delay in doing this. The earlier prostate cancer is spotted – the better chance of treatment being effective and a full recovery can be made. Alternatively, there is a chance you could be one of the 2.4 million men in the UK suffering from the previously mentioned condition, benign prostatic hyperplasia. Also known as an enlarged prostate gland, it can be treated through the use of effective medication such as Flomax Relief, which eases the symptoms associated with lower urinary tract symptoms (LUTS) of a BPH. Flomax works by relaxing muscles in the prostate gland, relaxing the muscles in the urethra (the tube from the bladder to the outside of the body).  This lets urine pass more freely through the urethra, making it easier to urinate. It is available today from the Medical Specialists Pharmacy chemist shop, costing just £8.75 for 14 capsules, or £15.95 for 28.

Cancer fatalities should drop as fewer people smoke

Just one week ago, Medical Specialists realise we may have painted a fairly gloomy picture of what life could be like in eighteen years’ time, when we reported how some were predicting obesity levels to soar by 2030 in both the UK and U.S.

However, maybe we should turn that frown upside down after all! With the ‘Stoptober’ campaign set to get underway next Monday, Cancer Research UK have released a whole set of estimations for the same year (2030), and they predict that the rates of many different types of cancer are set to decrease by this point. The positive statistics are also for the charities’ ‘Stand Up To Cancer’, a fundraising partnership between Cancer Research UK and Channel 4. The campaign’s finale will be live TV entertainment show to be broadcast on Friday October 19.

They say that more efficient diagnosis for cancers and treatment will result in a reduction in cancer death rates by up to 17% by 2030. Smoking is the cause of many cancers such as throat, lung, mouth, etc., and this harmful lifestyle choice was obviously the basis of their research. A main reason for the predicted 17% drop is because there are now less people smoking than previous years, which could be down to certain adverts depicting images of blackened lungs after the damaging long-term effects of smoking.

In 2010 it was calculated that for every 100,000 of the general population in the UK, 170 people died from cancer. By 2030 this figure is estimated to have dropped by then to 142 for every 100,000. Breast cancer death rates are predicted to decrease by 28%, bowel cancer should drop by 23% and prostate cancer by 16%. However the largest decrease appears to be ovarian cancer, which is forecast to nosedive by an impressive 42.6%.

Interestingly, some cancers could increase by mortality rates. Liver cancer appears to look to be the worst, with death rates expected to rise by 39%. That means there is an incidence increase from 4.2 to 5.9 per 100,000 people. Next is oral cancer, which may rise by 22%.  This is an incidence rise from 2.9 to 3.5 per 100,000 people.

Professor Peter Sasieni, Cancer Research UK epidemiologist at Queen Mary, University of London, spoke on the forecasts for 2030 and said, “Our latest estimations show that for many cancers, adjusting for age, death rates are set to fall dramatically in the coming decades. And what’s really encouraging is that the biggest cancer killers, lung, breast, bowel, and prostate, are part of this falling trend. Because old age is the biggest risk factor for cancer and more people are living longer, they have a greater chance of developing and, unfortunately, dying from the disease. But overall the proportion, or rate, of those who die from cancer is falling.”

Adding to Professor Sasieni’s comments was Dr Harpal Kumar, Cancer Research UK’s chief executive, who said, “These new figures are encouraging and highlight the huge progress we’re making. Research across many areas is having real impact. But we know there’s still so much more to do if we are to reach a day when no one dies prematurely from cancer. We continue to rely on the publics’ generosity to drive progress. This helps us turn discoveries made in our science labs into new treatments and to carry out clinical trials to find the best ways to treat patients. There are more exciting opportunities now to make a step-change than at any other time in history and we must grasp these.”

Viagra could treat prostate cancer

Lab tests on cells and mice found that when Viagra was combined with powerful chemotherapy it not only decreased the size of tumours but also protected the heart at the same time. The US team are now planning to carry out clinical trials on patients to see if the results are just as successful.

Doxorubicin is a standard chemotherapy medicine that works by triggering cancer cells to commit suicide but its use is linked with irreversible heart damage – often occurring several years after treatment stops.

So researchers have been working over the past 15 years to find a drug that prevents this without compromising the effectiveness of doxorubicin.

Professor Rakesh Kukreja and colleagues say they have shown Viagra, known medically as sildenafil, enhances the drug’s anti-tumour qualities in prostate cancer while simultaneously alleviating the damage to the heart.

The combination also did not harm any healthy prostate cells, according to the findings published online in Proceedings of the National Academy of Sciences.

Prof Kukreja, of Virginia Commonwealth University, said: “We believe sildenafil could be an excellent candidate for incorporation into cancer treatment protocols with the potential of enhancing the anti-tumour efficacy, while protecting the heart against both short term and long term damage from doxorubicin.”

Prof Kukreja said he is excited about the potential impact of the work and is keen to evaluate the combination in cancer patients.

He said: “My team and I are hoping to move the research forward to a clinical trial and plans are under way to do so.”

His laboratory is one of the first to explore the area of ‘pre-conditioning’ which involved treating mice with doses of sildenafil to increase therapeutic levels of nitric oxide in the heart.

This means the heart has an improved ability to produce nitric oxide which directly improves a patient’s outcome following a heart attack.

Generally, damage following a heart attack is related to an inability to recover from lack of oxygen.

Source: http://www.telegraph.co.uk/health/healthnews/8028038/Viagra-could-treat-prostate-cancer.html

Infertility linked to prostate cancer

Infertile men may have an increased risk of developing aggressive prostate cancer, researchers reported on Monday in what could be an important move toward identifying those who will benefit from screening for the disease.

Prostate cancer is one of the most common cancers in men, affecting about 160 per 100,000 every year and killing 26. While doctors can screen for it, many prefer not to do so because most tumours grow slowly and never cause any harm.
The researchers tracked more than 22,000 Californian men who had been evaluated for infertility between 1967 and 1998.

Over the decade following the evaluation, 1.2 percent of the infertile men developed prostate cancer, compared to only 0.4 percent of the fertile men. Both of those figures are higher than would be expected in the general population, possibly because these men are more likely to visit health-care professionals and get diagnosed.

After accounting for age, infertility increased the chances of being diagnosed with aggressive tumours 2.6 times. For slow-growing cancers, the risk climbed 1.6 times, the authors report in the journal Cancer.

"The absolute risk of men developing prostate cancer is still very small," said Dr. Thomas Walsh of the University of Washington, who led the research. "What is surprising is that we see this high rate of high-grade prostate cancer."
He said the specific effect on aggressive tumours was important for two reasons. First, it means the increased risk is not just a result of infertile men being screened more often because of their visits to the urologist. Had that been the case, researchers would expect to see the same increase in slow-growing cancers.
Second, infertility might point to more lethal cancers, singling out men who should give an extra thought to screening.

It is not yet clear what could account for the link between infertility and prostate cancer. But researchers speculate that damages to the male sex chromosome -- for instance through exposure to environmental toxins in the womb -- may be involved.
Other risk factors for prostate cancer include older age, being African American, family history and obesity.

The American Urological Association - of which Walsh is a member -- recommends screening for men aged 40 or older. However, Walsh said he did not believe that all young men with fertility problems should be screened.
Still, he said that if the findings are confirmed, doctors might consider lowering the screening threshold when seeing infertile patients.

Dr. Otis Brawley, chief medical officer of the American Cancer Society, agreed. The Cancer Society recommends that doctors discuss the pros and cons of screening with patients at age 50.

"A man who has infertility problems should take (the new findings) into consideration when thinking about prostate cancer screening," Brawley, who was not involved in the study, told Reuters Health.

The treatments for prostate cancer -- surgery or radiation -- may lead to incontinence and erectile dysfunction in about a third of patients.
"We treat a lot of prostate cancers that don't need to be treated," said Brawley. "We desperately need studies that will point to markers of aggressiveness."