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Archive for the ‘Bone cancer’ Category

URO TODAY: An experiment that combines a standard advanced prostate cancer drug treatment with a vaccine to assist the immune system has just begun in the US. READ MORE>

Looking to harness the body’s own immune system to target prostate cancer that has spread to the bones (metastatic) and is unresponsive to standard treatment, investigators have just launched a clinical trial combining vaccine and radiation drug therapy.

The goal is to see if disease progression will be further delayed by adding two different experimental injections to the standard treatment.

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IN-SCIENCES.ORG: Fucosylations – structures on the surface of prostate cancer cells – trigger prostate cancer cell adhesion inside a blood vessel wall in bone tissue, greatly increasing the prospect of prostate cancer cells metastasizing to bone. READ MORE>

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JohnMary1JULY 10: PROSTABLOG NZ: “It’s sad that medical professionals in NZ are so scared of possible side effects from a treatment like Ketoconazole, that they refuse to even acknowledge it, even if it has been proven to be effective overseas.”

These words were written today by Mary – a Kiwi whose partner has advanced prostate cancer – as she describes the frustration of being unable to persuade NZ doctors to move outside what seem to her to be inflexible approaches to treatment.

“I produced prostate cancer digests from people I know who have had large drops in PSA on Keto, but I was told I know only a few people and trials showing side effects have been done on thousands,” she says.

“When I said I would like to see the papers on this, I was told I was not a doctor…and to this I respond “no, but I am the partner of a man with advanced cancer.”

READ the second chapter of Mary’s struggle to save her man.

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JUNE 30: URO TODAY: In selected patients with prostate cancer metastases to the spine, aggressive surgical decompression and spinal reconstruction is a useful treatment option. The results show that on average, neurological outcome is improved and use of analgesics is reduced. Gleason score, metastatic burden, and degree of spinal canal compression may be associated with survival following surgery, and thus should be considered carefully prior to opting for surgical management. READ MORE>

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JUNE 16: URO TODAY: Preventive measures against adverse effects and careful assessment of a patient’s baseline health status should be considered when using androgen deprivation therapy, say researchers in Texas. They found ADT is associated with an increased risk of skeletal fracture, incident diabetes, and cardiovascular-related mortality, although the absolute risk of these events is low. READ MORE>

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JUNE 13: CANCER CONSULTANTS.COM: Researchers report that treatment with human antibody denosumab significantly reduces the incidence of bone fracture in prostate cancer patients on androgen deprivation therapy. READ MORE>

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MAY 30: PROSTABLOG NZ:  The partner of a NZ man with advancing prostate cancer says the public health system can’t test him for bone deterioration for at least year.  FULL STORY HERE>

Meantime, he goes untreated for osteoporosis, a well-known side effect of treatment he has been receiving for two years for his prostate cancer, which is now showing signs of spreading.

He was diagnosed in 2007 and hormone therapy since then kept signs of cancer spread in check.

But hormone therapy (as well as possibly causing bone deterioration) works for only a limited time, and now his prostate specific antigen levels are rapidly increasing, a sign the treatment is no longer effective.

The couple was told by his public health doctor a bone test could not be done for at least a year because 0f the long waiting list in the public health system.

Despite not being wealthy, they have abandoned the public system in desperation to get help from a private specialist.

In her story – published in full on the page titled John and Mary’s prostate saga - she tells of her quest for empowerment in dealing with the medical system.

Recently, she joined the US-based New Prostate Cancer Info-Link social network, where the expert sitemaster has offered some advice.

While he says the doctors were undoubtedly doing their best, one conclusion to be drawn is NZ is way behind the US when it comes to treating prostate cancer.

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MAY 22: PROSTABLOG NZ:  How many questions did you ask your doctor when you got the news you have prostate cancer? A dozen? More?

I can’t remember now, even though it was less than six months ago, but I’m guessing it would barely have broken double figures, even by the time I was on my third visit to the urologist.

Did you know there are at least 28 queries you should probably make, and another 22 if you’re looking at brachytherapy?

I know this from an excellent new book on prostate cancer just published by the Michael Dattoli and his colleagues in Florida - The Dattoli Blue Ribbon Prostate Cancer Solution:  How to survive and thrive without surgery (February, 2009).

DattoliBk 1It’s a 260-page manual on the latest techniques for treating prostate cancer, most of it written by Dattoli, whose pen portrait in the back says he is “a board-certified oncologist with more than 20 years of brachytherapy experience and has performed thousands of prostate implant procedures…a noted author and speaker in this complex field of medicine.”

Aha, perhaps I hear you say:  he’s biased towards radiotherapy and hence the tilt at surgery in the book title.

Maybe. I’m hardly in a position to judge, being merely a humble prostate patient, although one who has done a fair bit of journalistic investigation into the topic during recent recovery “downtime”.

This book seems to me to be very thorough in its examination of prostate treatments, research, survival and success rates, issues and dilemmas, and refers to every branch of the burgeoning field of treatment I’ve so far come across.

The case he puts for radiotherapy/brachytherapy and combined drug treatments (if needed), in the second half of the book, seems convincing to me.

Essentially, he’s saying that advances in radiotherapy equipment and techniques make its use so accurate and effective that people with aggressive tumours and/or cancer that’s got out of the prostate box are better served by his approaches than surgery or some of the many experimental but unproven (long-term) therapies now on offer (in the US, anyway).

The book reinforces for me how crucial it is to discover prostate cancer at the earliest possible time, since it is one version of cancer that can conceivably be “cured” when discovered at its least developed and aggressive stage.

At that point, it seems surgery is still as good an option as Dattoli’s approach, although he attacks the notion that getting it cut out is an end to the matter. It may not be, even with contained, low-aggression varieties like mine.

The book explores, and partially dismisses, many of the newer approaches, such as cryotherapy (freezing the tumour), hyperthermia (heating it), HIFU (high intensity focused ultrasound), many new drugs (because there is no long-term research done yet) and most versions of surgery.

He strongly advocates the latest approach to radiotherapy – four dimensional (the fourth is motion) intensity modulated (rather than short, high dose) radiation therapy (4D IG IMRT) - which he uses at his clinic, the Dattoli Cancer Center and Brachytherapy Institute of Sarasota, Florida.

With this complex treatment mode, he says the centre can achieve a very precise radiation attack on the tumour(s) with little collateral damage and few long-term after effects (depending, of course, on the patient).

It sounds very expensive. Pictures in the book show space-age technology, which obviously doesn’t come cheaply.

In a couple of discussions in the book, Dattoli borders on the disingenuous when he says centres using other kinds of expensive gear push its efficacy partly because they have big investments to recover.

That said, his record seems impressive, and 14 years of results are highly praised in an “independent” review by Charles E. Myers Jr MD, founder and director of a body called the American Institute of Diseases of the Prostate:

“Many men with intermediate to high-risk cancer treated [by Dattoli] with radiation to the prostate gland and pelvic lymph nodes with external beam radiation and seeds remain free of disease out to 14 years…Radiation therapy is consistently more effective when combined with androgen withdrawal. Faced with these facts, I can only conclude that radiation therapy can kill prostate cancer stem cells or in some way arrest their ability to go on to establish metastatic disease.”

Even ignoring the book’s main thesis (the superiority of 4D IG IMRT), it contains usefully detailed outlines of all aspects of prostate cancer, written in superbly accessible language. Everything is explained and translated for the layperson.

That alone makes it worth the read, although it’s not a quick read, given the fact-heavy nature of the explanations.

It contains other helpful material, including a guide to the foods we should eat (out goes my four-red-meat-meals-a-week diet) and a rundown on the latest drugs being trialled and/or used.

As a footnote, I should add that nothing I read in this up-to-date resource on prostate cancer makes me think I made the wrong decision electing radical prostatectomy. For me, it still feels 100% the right way to go. I believe I was well advised.

Further footnote: I’m interested to know how many of the treatment techniques canvassed by Dattoli are available in NZ. I suspect we trail by a long way, but perhaps there’s some advantage to that: we can observe how various developments pan out in what is undoubtedly the prostate capital (well, country) of the world.

And those 28 questions? I’ve reproduced them here, for those many men in the future who are going to get the bad news:

 Dattoli 1

Dattoli 3Copies of the book can be obtained from:

Dattoli Cancer Foundation, 2803 Fruitville Road, Sarasota, Fl 34237, US.

They cost about $US23 with postage included.

Read a 15-page extract from the book where Dattoli discusses hormone therapy: HERE>

Go to the Dattoli website HERE>

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MAY 14: MEMPHIS DAILY NEWS:  Memphis company GTx expects to receive approval from the US Food and Drug Administration on Octopber 30 to begin selling a drug to prevent bone fractures in men undergoing hormone therapy to treat bone cancer. The company also has other drugs in the pipeline related to the prevention and treatment of prostate cancer and to build body mass in people with cancer-induced muscle loss. READ MORE>

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