Today’s news reports are focused on issued around epidemiology, prevention, diagnosis, treatment decisions, and the role of humor in prostate cancer support group interactions.
Benbrahim-Tallaa and Waalkes have reviewed data related to the possibility that inorganic arsenic may play a significant role is the risk for development of prostate cancer. They do not appear to reach any definitive conclusions.
Redman et al. have provided data to support an updated model explaining why finasteride (when used as a preventive agent) does not increase the risk of high-grade prostate cancer. Their revised model is based on careful analysis of data from the original Prostate Cancer prevention trial. This group of authors again encourages the idea that men undergoing regular prostate cancer screening or who express an interest in cancer prevention should be informed of the opportunity to take finasteride for prevention of prostate cancer.
Loeb and Catalona have discussed an original study by Gosselaar et al. from 2008. Gosselaar and colleagues reported on the performance characteristics of digital rectal examination (DRE) in men from the Rotterdam cohort of the European Randomized Study of Screening for Prostate Cancer. In this study, the positive predictive value of DRE for detecting the presence of prostate cancer was 48.6 percent in the first round of screening, decreasing to 29.9 and 21.2 percent in the second and third rounds, respectively. An abnormal DRE was associated with a significantly increased risk of very high-grade disease during all screening rounds, indicating that it provides useful additional prognostic information. Loeb and Catalona comment that this study adds to a considerable body of evidence supporting a role for DRE in early detection of prostate cancer.
Davison et al. have studied decision-making influences on men who decide to manage their low-risk prostate cancer with active surveillance. This was a small study, but it clearly indicated that the physicans’ descriptions of the cancer was the most influential factor on men choosing active surveillance. Patients did not consider their prostate cancer to be life threatening and, in general, were relieved that no treatment was required. Avoiding treatment-related suffering and physical dysfunction and side effects such as impotence and incontinence was cited as the major reason to delay treatment. Few men actively sought treatment or health-promotion information following their treatment decision. Female partners played a supportive role in the decision. The authors recommend that oncology nurses should work collaboratively with specialists to ensure that men are able to make fully informed treatment decisions.
Oliffe et al. have studied the relationships between male health, masculinity and humor in the specific context of prostate cancer support groups and how they function. They had previously noted that humor was central to many prostate cancer support group interactions. Individual interviews were completed with 54 men who attended support groups to better understand their perceptions about the use of humor at group meetings.Four themes were drawn from the analyses (disarming stoicism, marking the boundaries, rekindling and reformulating men’s sexuality, and “when humor goes south”). They note that humor is used to promote inclusiveness, mark the boundaries for providing and receiving mutual help, and develop masculine group norms around men’s sexuality. Although there appeared to be many benefits to humor there were also some instances when well-intended banter caused discomfort for attendees.The importance of group leadership was central to preserving the benefits of humor.
Filed under: Diagnosis, Living with Prostate Cancer, Management, Prevention, Risk | Tagged: active surveillance, arsenic, DRE, finasteride, humor, masculinity, Prevention, support groups
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