Prostate cancer news reports: Friday, June 26, 2009

Today’s prostate cancer news report summary includes items dealing with:

  • The epigenetics of prostate cancer and their potential importance
  • Selenium + vitamin E + lycopene (in mice)
  • Gleason 7: 4 + 3 versus 3 + 4 — it’s important
  • Proton beam radiotherapy — a topical review
  • EBRT + low dose, permanent seed brachytherapy

Schultz and Hoffman have reviewed data on the potential significance of epigenetic mechanisms to the underlying biology of prostate cancer — at therefore to its diagnosis, prognosis, and management. (The term “epigenetics” refers to inheritable changes in the phenotype or physical expression of a specific gene caused by mechanisms other than changes in the underlying DNA sequence.)

Data from a Canadian research group continue to suggest that specific combinations of micronutrients (selenium, vitamin E, and lycopene, when all used together) can have an impact on the prevention and progression of prostate cancer, at least in mice — if treatment is started when the animals are no more than 8 weeks old.

Stark et al. have published data from a pathological analysis on > 800 biopsy and radical prostatectomy specimens clearly suggesting that prostate cancer tumors with a Gleason score of 4 + 3 = 7 are three times more likely to be lethal than cancers with a Gleason score of 3 + 4 = 7. In other words, the predominance of Gleason pattern 4 in Gleason 7 cancers is a critically important prognostic factor.

Cohn and Zeitman have reviewed data on the current status of proton beam radiotherapy as an appropriate option for the treatment of patients with prostate cancer. They note that, “Clear dosimetric superiority of protons in the high-dose region has not yet been demonstrated. A dosimetric advantage may emerge as pencil-beam scanning replaces passive scanning, and intensity-modulated proton therapy becomes possible.”

Koontz et al. have reported data on the effectiveness and safety of external beam radiotherapy (EBRT) combined with low-dose, permanent seed brachytherapy in a series of 119 low, intermediate, and high risk patients with supposedly localized prostate cancer at a single institution. It is clear that this type of combination therapy is effective and safe in appropriately selected patients.

2 Responses

  1. The report of Gleason score 4 + 3 likely three times more lethal than 3 + 4 is important to be recognized when being only advised that one has Gleason 7 prostate cancer. More attention is required to further testing to determine aggressiveness and appropriate treatment.

  2. Which is, of course, why one should ALWAYS ask for a copy of one’s pathology reports — so that one can see what the pathologist actually said and not what the urologist (or other specialist) said that he’d said!

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