Preventing Prostate Cancer

Prostate Cancer is a disease of aging and at this time there is no vaccine or sure fire way to completely prevent prostate cancer. However, there are steps you can take to reduce your risks.

• Advanced age increases your risk. Despite this, prostate cancer is not an “old man’s disease:” 35 percent of those affected are younger than 65.
• Family history may play a role. A strong family history of prostate cancer can increase your chances of developing the disease. While these factors are beyond our control, having awareness of increased risk can motivate us to focus on the areas we can affect.
• If there are factors that put you at higher risk, it’s important to be vigilant in areas you can control, including regular screenings. Talk with your doctor about the pros and cons of prostate screening. For African-Americans or those with a family history of prostate cancer, ask if screening should begin earlier.
1. Eat healthy. Avoid foods high in sodium, saturated fat, cholesterol, refined sugar and trans fat, which contribute to cancer risk. Instead, choose foods high in Omega-3 fatty acids (salmon, almonds) and monounsaturated fats (olive oil, peanuts) as well as fruits, vegetables and whole grains. Eating right doesn’t just lower your risk for prostate cancer, but prevents weight gain and improves your overall health.

2. Be active. Participate in 75 minutes of vigorous activity, or 150 minutes of moderate activity, weekly. This can include walking, swimming, biking or any exercise your doctor recommends.

3. Get screened. The National Comprehensive Cancer Network recommends baseline PSA screening for healthy men ages 50 to 70 every one to two years, and a majority of the panelists recommend baseline testing for men ages 45 to 49, too especially for men with a family history of prostate cancer or are of African American heritage.

Bottom line: Prostate cancer affects 250,000 men each year and causes 40,000 deaths making it the second most common cause of cancer death in men. Eating a healthy diet, exercising regularly and getting tested with a digital rectal exam and a PSA test on a regular basis is the best prevention strategy available today.

Medical Tests That You Can Do Without

I just had my annual physical examination. I am without any symptoms; take a baby aspirin and a vitamin; have no co morbid conditions. I asked myself did I really need a chest x-ray when I am exposed to so much radiation during my work at the hospital or did I need an EKG with no symptoms and a negative family history? I found my answer in a recent AARP article about “10 Tests To Avoid”.

1. Nuclear stress tests, and other imaging tests, after heart procedures
If you have had heart bypass, stent or other heart procedure, you don’t need nuclear stress test or other tests that their hearts are beating strong and the results rarely change the plan of management. Instead, patients and doctors should focus on what does make a difference in keeping the heart healthy: managing weight, quitting smoking, controlling blood pressure and increasing exercise.

2. Yearly electrocardiogram or exercise stress test
Someone at low risk for heart disease could be 10 times more likely to get a false-positive result than to find a true problem with their heart. The stress test could lead to unnecessary heart catheterization and stents. Instead, it is important to have your blood pressure and cholesterol checked at least once a year. And if you’re at risk for diabetes, have your blood glucose level checked as well.

3. PSA to screen for prostate cancer
Cancer is always scary, but the PSA test often finds slow-growing cancers that won’t kill men. An estimated 75 percent of tests that show high PSA levels turn out to be false alarms.
The American Urological Association, of which I am a member, supports the use of PSA testing, but should be considered mainly for men ages 55 to 69. I also believe that no testing is required in the man without any symptoms if the man is more than 75 years of age. However, men with a positive family history of prostate cancer and African American men should have an annual PSA test and a digital rectal examination.

4. PET scan to diagnose Alzheimer’s disease
In the last few years, doctors have begun using PET scans with a radioactive dye to look for beta-amyloid protein that is found in the brains of people with the Alzheimer’s disease. Even if a PET scan could accurately diagnose the disease, it’s untreatable. If you’re concerned about your memory, the better course is to have a complete medical evaluation by a doctor who specializes in diagnosing and treating dementia.

5. X-ray, CT scan or MRI for lower back pain
Back pain is incredibly common — 80 percent of people will suffer from back pain some time in their lives. It can be both excruciating and debilitating. Naturally, people want to know what’s wrong. Here’s the catch: The best imaging machines in the world often can’t tell them. Many older people with no back pain can have terrible-looking scans.
Most back pain goes away in about a month and imaging tests tend to lead to expensive procedures that often don’t help or shorten recovery. If you don’t feel better in a month, talk to your doctor about other options such as physical therapy, yoga or massage. But if your legs feel weak or numb, you have a history of cancer or you have had a recent infection, see your doctor.

6. Yearly Pap tests
The yearly Pap smear is a common part of women’s health checklists, but it doesn’t need to be. Women at average risk only need them every three years, since cervical cancer generally takes 10 to 20 years to develop. If women have also had negative tests for the human papillomavirus (HPV), which is now known to cause the cancer, they only need a Pap test along with the HPV test every five years. And women older than 65 who have had several normal Pap tests in a row can stop having them altogether. Also, if you have had a total hysterectomy for a benign condition such as uterine fibroids and the entire uterus and cervix have been removed, you do not need any further Pap test. Do note, however, that a yearly visit to an ob-gyn stays on the to-do list.

7. Bone density scan for women before age 65 and men before age 70
For the estimated 10 million people — mainly women —in the United States who have osteoporosis, bone-strengthening medications can lower the chances of breaking a bone. But many experts argue that for those ages 50 to 65 who have osteopenia — mild bone loss — testing and subsequent drug prescriptions may be a waste of time and money. Not only is the risk of fracture often quite low, medications such as Fosamax (alendronate) and Boniva (ibandronate) have been linked to throat or chest pain, difficulty swallowing, heartburn, muscle pain, bone loss in the jaw and thigh-bone fractures. And there’s scant evidence that people with osteopenia get much benefit from the drugs.
To help keep your bones strong, try walking and weight-bearing exercises,. Get enough calcium, 1000mg\day, and vitamin D, 1000IU\day, in your diet. If you smoke, quit.

8. Follow-up ultrasounds for small ovarian cysts
Many women receive repeated ultrasounds to verify that ovarian cysts have not become cancerous, but current research says that these tests aren’t necessary. For one thing, premenopausal women have harmless ovarian cysts regularly. For another, about 20 percent of postmenopausal women also develop harmless cysts.
The likelihood of these small simple cysts ever becoming cancer is exceedingly low.

9. Colonoscopy after age 75
Most people should have screening for colon cancer at 50 and then every five to 10 years after that, if the first test is normal. By age 75 — if you’ve always had normal colonoscopies — you can stop taking this test altogether. That should be good news, because a colonoscopy can cause serious complications in older people.
To protect your colon, eat plenty of fruits, vegetables and whole grains for fiber. Cut down on fatty foods, red meat and processed meats. Lose weight if you’re overweight and exercise. Sound familiar? It should, because that’s the best advice for protecting the rest of your body — and mind — as well.

10. Yearly physical
There’s little evidence that having an annual checkup can keep you healthy. Now I they tell me! Many tests that doctors regularly perform — to diagnose anemia, liver disease or urinary tract infections, for example — don’t make sense unless there’s a reason to suspect a problem.
Certainly, if you have an illness that needs treatment, you should see your physician. And do talk to your doctor about how often you need to have your blood pressure and cholesterol tested.

Bottom Line: Use good judgment about your health and your visit to the doctor. Ask the doctor if the test is really necessary and if the results will change how he\she is taking care of you. My message is that patients, including myself, need to become involved in their healthcare.
This article was inspired and modified from AARP, 10 Test to Avoid, by Elizabeth Agnvall, http://www.aarp.org/health/conditions-treatments/info-2014/choosing-wisely-medical-tests-to-avoid.3.html

How Often Do You Need To See Me?

You may wonder how the decision is made to making the next appointment for a patient. Is there a book, or now a website with guidelines, that guide physicians on when to make the patients’ next appointments? No, there is not. It is not something we learn in medical school but is something that is part of the art of medicine. Some patients really need to be seen in a few days or a few weeks such as the patient with a urinary tract infection where the urine has to be checked to be sure the infection has cleared even after the symptoms have subsided. Then there is the asymptomatic patient who is on no medications and probably needs to be seen only for a screening annual or even a biannual exam. Then there is the majority that fall somewhere in the middle of those two extremes.

What if you had diabetes, coronary disease, hypertension, high cholesterol, and sleep apnea, but no symptoms to indicate any acute problems? You’d probably see your primary doctor fairly routinely (mostly for management of diabetes) and maybe your cardiologist every six months or so.

Here’s the big question: When you’re coasting along pretty well with no actively changing symptoms but with chronic medical problems, how often do you need to see your doctors? Let’s take the example above: with those particular problems, should you see your cardiologist yearly, biannually, quarterly, monthly, or what? In the non-hypothetical world a patient’s follow-up is likely to be dictated by the doctor and set at the end of each appointment. “Okay, Mrs. X, it looks like you’re doing well. Let’s plan to see you again in 6 months.”

How does the doctor know when to see you next? There are a few ground rules to take into consideration. The pharmaceutical industry doesn’t allow us to write prescriptions with refills that extend past 12 months, and many clinics have a policy of not providing new prescriptions after the 12-month mark unless they’ve at least laid eyes on the patient (apparently to make sure the patient is indeed alive), and so most people with chronic problems will likely have to be seen at least once a year. It is amazing how many men using erectile dysfunction drugs will keep that annual appointment in order to obtain a refill of their medications! The other ground rule is common sense.

So, routine follow-up will most likely fall somewhere between “less often than weekly” and “at least once yearly or more frequently.” But within those limits, as a doctor I’m pretty much free to choose whatever I like.

I don’t know how other doctors do it, but I like to burden healthy patients with as few doctor visits as possible, so I mostly try to set my return appointments for a year. This works well for most people, but there are clearly exceptions. I see a lot of men with prostate cancer. Many of them are on medications to decrease the testosterone level and receive injections every 3-6 months. If it is possible, I try to convert these men to injections that can be given once a year. Most of the men with prostate cancer like the idea of getting a yearly injection and coming in every six months for a blood test, a PSA level. However, there are some men that want that more often and I allow them to make appointments to be seen more frequently. This, again, is where the art of medicine is used to guide how often a patient returns for an appointment.

There are patients with certain conditions like bladder cancer that should have a cystoscopy or look into their bladder with a lighted tube every 3 months. This guideline is written in all urologic textbooks and is good medicine to see these patients on a frequent basis.

I commonly ask certain patients to see me more frequently. Any patient who is on medications that is having side effects is asked to come back more frequently until I can get the dosage or the medication straightened out that provides them with the beneficial effect and with manageable side effects.

Bottom Line: How often should you be seeing your doctor? I have no clue. Between you and your doctor you’ll come up with some type of balance that works. Just understand that none of this is written in stone….i.e., a kidney stone!

This blog was inspired and modified from a blog by Dr. Eric Van de Graaf, which appeared in Patient on January 17, 2011.

Warren Buffet And Prostate Cancer Screening

I have been asked multiple times today about Warren Buffet’s diagnosis and treatment of prostate cancer. The questions include: Why was Mr. Buffet even screened for prostate cancer? and Why would Mr. Buffet be treated for prostate cancer with radiation therapy.

Mr. Buffett has disclosed that he will undergo radiation treatment for the cancer, but he is at greater risk for harm from the treatment than from the cancer itself. Long-term side effects of radiation treatment include erectile dysfunction, frequent urination, bleeding and rarely urinary incontinence.
Let’s look at the facts: The risks of screening are greater for an 80-year-old than a 60-year-old. If a healthy 82-year-old has a life expectancy to 94, and he is informed of the potential risks and benefits, then screening might be appropriate.
The longer a man lives, the more likely it is that he will develop prostate cancer. Autopsy studies among men in their 50s (who died of unrelated causes) showed that 10 percent had prostate cancer but didn’t know it. By the time men reach their 80s, autopsies show that nearly all of men will have prostate cancer. Thus older men are likely to die with prostate cancer and not from prostate cancer.

And in older men, even when cancer is found as a result of a P.S.A. test, the cancer typically is so slow-growing that it will never cause harm, and the man will die of another cause. There is no evidence that P.S.A. testing of men 75 or older saves lives, but the test increases the risk of harm from invasive biopsies and treatments that can cause pain, impotence and loss of urine.

So what to do? If you are over age 75, have no urinary symptoms, have multiple co-morbid conditions such as heart disease, diabetes, or hypertension, you may discuss the situation with your doctor and decide not to have the PSA test. Also, if you find out that you have prostate cancer but would not undergo treatment such as surgery or radiation, then you probably don’t need to do a PSA test.

Bottom Line: This is a situation where a discussion with your doctor is important. A thought out decision is really the best decision. For more information, please go to my website, http://www.neilbaum.com

Screen Tests Are Not Just For Male Movies Stars

Getting the right screening test at the right time is one of the most important things a man can do for his health. Screenings find diseases early, before you have symptoms, when they’re easier to treat. Early colon cancer can be nipped in the bud. Finding diabetes early may help prevent complications such as vision loss and impotence. The tests you need are based on your age and your risk factors.

Prostate Cancer
Prostate cancer is the most common cancer found in American men after skin cancer. It tends to be a slow-growing cancer, but there are also aggressive, fast-growing types of prostate cancer. Screening tests can find the disease early, sometimes before symptoms develop, when treatments are most effective.
Screenings for healthy men may include both a digital rectal exam (DRE) and a prostate specific antigen (PSA) blood test. The American Cancer Society advises men to talk with a doctor about the risks and limitations of PSA screening as well as its possible benefits. Discussions should begin at:
• 50 for average-risk men
• 45 for men at high risk. This includes African-Americans.
• 40 for men with a strong family history of prostate cancer
The American Urological Association recommends a first-time PSA test at age 40, with follow-ups per doctor’s orders.

Testicular Cancer
This uncommon cancer develops in a man’s testicles, the reproductive glands that produce sperm. Most cases occur between ages 20 and 54. The American Cancer Society recommends that all men have a testicular exam when they see a doctor for a routine physical. Men at higher risk (a family history or an undescended testicle) should talk with a doctor about additional screening. I suggest that most men learn how to do a self-examination. You can gently feeling for hard lumps, smooth bumps, or changes in size or shape of the testes. If you find an abnormality, contact your doctor. For more information on testis self-examination, please go to my website: http://www.neilbaum.com/testes-self-examination-tse.html

Colorectal Cancer
Colorectal cancer is the second most common cause of death from cancer. Men have a slightly higher risk of developing it than women. The majority of colon cancers slowly develop from colon polyps: growths on the inner surface of the colon. After cancer develops it can invade or spread to other parts of the body. The way to prevent colon cancer is to find and remove colon polyps before they turn cancerous.
Screening begins at age 50 in average-risk adults. A colonoscopy is a common test for detecting polyps and colorectal cancer. A doctor views the entire colon using a flexible tube and a camera. Polyps can be removed at the time of the test. A similar alternative is a flexible sigmoidoscopy that examines only the lower part of the colon. Some patients opt for a virtual colonoscopy — a CT scan — or double contrast barium enema — a special X-ray — although if polyps are detected, an actual colonoscopy is needed to remove them.

Skin Cancer
The most dangerous form of skin cancer is melanoma (shown here). It begins in specialized cells called melanocytes that produce skin color. Older men are twice as likely to develop melanoma as women of the same age. Men are also 2-3 times more likely to get non-melanoma basal cell and squamous cell skin cancers than women are. Your risk increases as lifetime exposure to sun and/or tanning beds accumulates; sunburns accelerate risk.
The American Cancer Society and the American Academy of Dermatology recommend regular skin self-exams to check for any changes in marks on your skin including shape, color, and size. A skin exam by a dermatologist or other health professional should be part of a routine cancer checkup. Treatments for skin cancer are more effective and less disfiguring when it’s found early.

High Blood Pressure (Hypertension)
Your risk for high blood pressure increases with age. It’s also related to your weight and lifestyle. High blood pressure can lead to severe complications without any prior symptoms, including an aneurysm — dangerous ballooning of an artery. But it can be treated. When it is, you may reduce your risk for heart disease, stroke, and kidney failure. The bottom line: Know your blood pressure. If it’s high, work with your doctor to manage it.
Blood pressure readings give two numbers. The first (systolic) is the pressure in your arteries when the heart beats. The second (diastolic) is the pressure between beats. Normal blood pressure is less than 120/80. High blood pressure is 140/90 or higher, and in between those two is prehypertension — a major milestone on the road to high blood pressure. How often blood pressure should be checked depends on how high it is and what other risk factors you have.

Cholesterol Levels
A high level of LDL cholesterol in the blood causes sticky plaque to build up in the walls of your arteries (seen here in orange). This increases your risk of heart disease. Atherosclerosis — hardening and narrowing of the arteries — can progress without symptoms for many years. Over time it can lead to heart attack and stroke. Lifestyle changes and medications can reduce this “bad” cholesterol and lower your risk of cardiovascular disease.
The fasting blood lipid panel is a blood test that tells you your levels of total cholesterol, LDL “bad” cholesterol, HDL “good” cholesterol, and triglycerides (blood fat). The results tell you and your doctor a lot about what you need to do to reduce your risk of heart disease, stroke, and diabetes. Men 20 years and older should have a new panel done at least every five years. Starting at 35, men need regular cholesterol testing.

Type 2 Diabetes
One-third of Americans with diabetes don’t know they have it. Uncontrolled diabetes can lead to heart disease and stroke, kidney disease, blindness from damage to the blood vessels of the retina (shown here), nerve damage, and impotence. This doesn’t have to happen. Especially when found early, diabetes can be controlled and complications can be avoided with diet, exercise, weight loss, and medications.
A fasting plasma glucose test is most often used to screen for diabetes. More and more doctors are turning to the A1C test, which tells how well your body has controlled blood sugar over time. Healthy adults should have the test every three years starting at age 45. If you have a higher risk, including high cholesterol or blood pressure, you may start testing earlier and more frequently.

Human Immunodeficiency Virus (HIV)
HIV is the virus that causes AIDS. It’s in the blood and other body secretions of infected individuals, even when there are no symptoms. It spreads from one person to another when these secretions come in contact with the vagina, anal area, mouth, eyes, or a break in the skin. There is still no cure or vaccine. Modern treatments can keep HIV infection from becoming AIDS, but these medications can have serious side effects.
HIV-infected individuals can remain symptom-free for many years. The only way to know they are infected is with a series of blood tests. The first test is called ELISA or EIA. It looks for antibodies to HIV in the blood. It’s possible not to be infected and still show positive on the test. So a second test called a Western blot assay is done for confirmation. If you were recently infected, you could still have a negative test result. Repeat testing is recommended. If you think you may have been exposed to HIV, ask your doctor about the tests.
Most newly infected individuals test positive by two months after infection. But up to 5% are still negative after six months. Safe sex — abstinence or always using latex barriers such as a condom or a dental dam — is necessary to avoid getting HIV and other sexually transmitted infections. If you have HIV and are pregnant, talk with your doctor about what needs to be done to reduce the risk of HIV infection in your unborn child. Drug users should not share needles.

Glaucoma
This group of eye diseases gradually damages the optic nerve and may lead to blindness — and significant, irreversible vision loss can occur before people with glaucoma notice any symptoms. Screening tests look for abnormally high pressure within the eye, to catch and treat the condition before damage to the optic nerve.
Glaucoma Screening
Eye tests for glaucoma are based on age and personal risk:
• Under 40: Every 2-4 years
• 40-54: Every 1-3 years
• 55-64: Every 1-2 years
• 65 up: Every 6-12 months
Talk with a doctor about earlier, more frequent glaucoma screening, if you fall in a high-risk group: African-Americans, those with a family history of glaucoma, previous eye injury, or use of steroid medications.

Bottom Line: There’s a saying New Orleans that if ain’t broke, don’t fix it. Well that doesn’t apply to maintaining your car and it certainly doesn’t apply to your health and well-being. Men need to have screening tests in order to detect disease states early when they are treatable and curable.

Prostate cancer test promising- A Simple urinalysis might lead to more-precise diagnoses

Prostate cancer test promising
Urinalysis might lead to more-precise diagnoses.

Researchers said Thursday they are closer to developing a urine test that can better detect which prostate cancers are aggressive and potentially life-threatening.
Such a test would be welcome. More than half of prostate cancers are slow growing and unlikely to kill, and experts say watchful waiting is the best option for many patients — especially if doctors were better able predict their course.
Currently, biopsies — in which several small tissue samples are taken from different parts of the prostate — are used to try to identify large, aggressive tumors.
The hope is that an accurate urine test might in some cases replace the need for biopsy, while easing fears in men who opt to delay or forgo treatment.
The study included 401 men, about 70 from San Antonio, who were picked because doctors thought their cancers were low-risk and good candidates for watchful waiting. Of those, the urine test found about 10 percent had more aggressive disease, making them candidates for surgery — results that were confirmed by biopsy.
Prostate biopsies are invasive and don’t always pick up all of the cancer. Post-digital-rectal exam urine collection is much less invasive. If a urine-based diagnostic test could be developed that could predict aggressive disease or disease progression as well as or better than a biopsy, that would be ideal.
The urine tests, PCA3 and T2-ERG, together provide a kind of genetic profile of the cancer. Added to the current PSA test, a digital rectal exam and factors such as age, race and family history, they could help doctors make more accurate predictions if the results are confirmed in the larger study.

Bottom Line: Ultimately, doctors would like to be able to have these tests and be able to confirm the man has a low-risk cancer which means less treatment, less complications, less side effects, and longer survival. Instead of seeing the patient every six months and doing a biopsy every two years, your doctor might tell men with low risk cancers: “You have a low-risk cancer, see you in five years.”

Read more: http://www.mysanantonio.com/news/local_news/article/Prostate-cancer-test-promising-2969055.php#ixzz1lbdmooJc

To Screen Or Not Screen-That’s the Question, What’s the Answer?

Annual cancer tests are becoming a thing of the past. New guidelines for cervical cancer screening have experts at odds over some things, but they are united in the view that the common practice of getting a Pap test for cervical cancer every year is too often and probably doing more harm than good.
A Pap smear once every three years is the best way to detect cervical cancer. Recently it was recommended against prostate cancer screening with PSA tests, which many men get every year.
Two years ago, it said mammograms to check for breast cancer are only needed every other year starting at age 50, although the American Cancer Society still advises annual tests starting at age 40. A large study found more false alarms for women getting mammograms every year instead of every other year.
It’s a fact that the more tests that you do, the more likely you are to be faced with a false-positive test that leads to unnecessary biopsies and possible harm. We see an emerging consensus that annual Pap tests are not required for us to see the benefits that we have seen from screening.
Those benefits are substantial. Cervical cancer has declined dramatically in the United States, from nearly 15 cases for every 100,000 women in 1975 to nearly 7 per 100,000 in 2008. About 12,200 new cases and 4,210 deaths from the disease occurred last year, most of them in women who have never been screened or not in the past five years.
The cancer society and other groups say using Pap smears together with tests for HPV, the virus that causes cervical cancer, could improve screening. Instead, reaching women who are not being adequately screened now probably could save more lives.
Bottom Line: Patients need to be informed about the benefits vs. the risks of screening. By being knowledgeable about the screening tests and having a discussion with your doctor is the best way to come to a decision about screening in your situation.

Watchful Waiting May Be An Option for Low-Grade Prostate Cancer

A recent report coming from research at Johns Hopkins University demonstrated that men with very low-grade prostate cancer may be able to be observed closely for any progression and avoid or delay treatment.  The study included over 700 men with localized prostate cancer that was very low-grade or not very malignant who were followed every six months with PSA testing and a rectal exam and a prostate biopsy every year.  Since 1995 none of the men has died from prostate cancer.  One-third of the men had to undergo subsequent treat five or even 10 years later because their PSA increased for their biopsy showed a more aggressive form of cancer was present in the prostate gland.

Nearly 60 percent of men enrolled were able to defer treatment for 5 years or longer and > 40 percent were able to defer treatment for 10 years or longer. This means they were also able to defer all risks associated with active treatment (incontinence, erectile dysfunction, bowel problems associated with radiation therapy, etc.).

Bottom Line: This study offers good evidence that watchful waiting may be an option for older men diagnosed with a very low-grade prostate cancer.  However, these men must be committed to regular follow up.

When Getting The Finger May Just Be A Good Thing-Finger Length Used to Detect Prostate Cancer

A recent study from England identified another predictor for prostate cancer.  Men with index fingers longer than the ring finger have a significantly less likelihood of developing prostate cancer.

The study demonstrated that men with the long index fingers were one-third less likely to develop prostate cancer.  This could be a very simple test for prostate cancer risk.  So the next time your doctor checks your prostate, don’t be surprised if he\she checks out the length of your index finger compared to your ring finger.  Or if you are a do-it-yourselfer, measure your index and ring finger lengths as shown in the accompanying figure and share the results with your doctor.

Men with long index fingers have a lower risk of prostate cancer, British scientists said on Wednesday, a finding that could be used to help select those who need regular screening for the disease.

The article appear in British Journal of Cancer in the November 30, 2010 issue.

 

The Colon and the Prostate Just Got Closer-Treatment for Prostate Cancer Increases the Risk for Colon Cancer

There are hundreds of thousands of men with prostate cancer who are receiving therapy that decreases their testosterone levels either by taking injections (Eligard, Lupron, Zolodex, or Trelstar) that decrease the production of testosterone by the testicles or by having the testicles surgically removed.   These treatment options have several side effects including osteoporosis, diabetes, and heart problems.  Added to that list is the slightly increased risk of colon cancer.

A recent report from the Journal of the National Cancer Institute reported a small increase in colon cancer of 2.2% for men who have been treated with drugs to lower the testosterone level or who have had castration for the treatment of their prostate cancer compared to 1.8% of colon cancer in men who did not receive hormone deprivation treatment.

With this new revelation, men on hormone deprivation should obtain routine screening for colorectal cancer and adopting a healthy lifestyle, complete with plenty of exercise.

Bottom line: Men with prostate cancer receiving hormone deprivation need to be aware of the risks associated with this treatment which now includes a slight increase in colon cancer.