DCIS Survival Benefit from Surgery Varies by Nuclear Grade

“Surgical management of ductal carcinoma in situ improved survival outcomes compared with non-operative management among patients with high-grade disease but not among those with low-grade disease, according to results of a SEER analysis presented at the ASCO Annual Meeting.

“Although the current standard of care for ductal carcinoma in situ (DCIS) includes lumpectomy or mastectomy, surgical benefit was never fully established in this setting, according to study background.

“ ‘Our objective was to investigate whether there is a survival benefit offered by surgical treatment in patients with DCIS based on nuclear grade,’ Yasuaki Sagara, MD, a research fellow in surgery in the department of surgery at Brigham and Women’s Hospital in Boston, said during his presentation.

“Sagara and colleagues identified 57,222 eligible cases of DCIS that occurred between 1998 and 2011 using data from the SEER database.”

Measuring the Malignancy of Prostate Cancer

The gist: Recent research could give rise to a new test to measure the grade of a patient’s prostate cancer (how aggressively it needs to be treated). Scientists found that people whose tumor cells had higher-than-normal levels of a protein called BAZ2A had more aggressive prostate cancer that would require more intensive treatment. More research needs to be done to determine just how helpful BAZ2A might be for helping patients make treatment decisions.

“A protein that influences the epigenetic characteristics of tumor cells is directly linked to the grade of malignancy of prostate cancer. This key discovery has been made by a team of scientists from the German Cancer Research Center (DKFZ), the University of Zurich, Hamburg-Eppendorf University Hospital, Heidelberg University, and other institutes in a study of 7,700 samples of tumor tissue. The detection of this biomarker may serve as an indicator of the likelihood that the disease may take an aggressive course, and may thus be helpful in choosing an appropriate treatment. The study was part of the ‘Early Onset Prostate Cancer’ project, supported by the Federal Ministry of Education and Research (BMBF) as part of the International Cancer Genome Consortium (ICGC).

“When cancer is diagnosed, the grade of its malignancy is a central concern for both patients and their physicians. This value is used to determine how intensively and how radically the cancer must be treated. Particularly in the case of prostate cancer, the disease can take widely varying courses in different patients. Therefore, cancer researchers have been looking for measurable, reliable biomarkers that give clues about the aggressiveness of a tumor in order to choose an appropriate therapy.

“In many types of cancer, alterations in a tumor’s genetic material indicate how dangerous the cancer is. Prostate cancer, however, exhibits far fewer of these mutations than other cancer types. ‘We have therefore suspected that prostate cancer is driven primarily by alterations in epigenetic characteristics, that is, chemical changes in the genetic material that do not affect the sequence of DNA building blocks,’ says Prof. Christoph Plass from the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ), who is one of the project leaders in the current publication.”

Study Finds Prostate Cancer Tests Underestimate Disease in Half of Cases

“A study published in the British Journal of Cancer suggests that tests to grade and stage prostate cancer underestimated the severity of the disease in half of men whose cancers had been classified as ‘slow growing’.

“Scientists from the University of Cambridge compared the staging and grading of cancer in over 800 men before and after they had surgery to remove their prostate. They found that of the 415 men whose prostate cancer was classified as slow growing and confined to just the prostate after an initial biopsy, half (209) had cancer which was more aggressive than originally thought when assessed again after surgery and almost a third (131) had cancer that had spread beyond the prostate.”

Finasteride Saves Men from Prostate Cancer, Doesn't Increase Risk of Death

“A long-term follow-up to a groundbreaking study led by the director of the Cancer Therapy & Research Center confirms that a drug shown to reduce risk of prostate cancer by more than one-third has no impact on lifespan, but further reduces the risk of prostate cancer. Reducing the risk of prostate tumors by about 30%—and low-grade tumors by 43%—means thousands of men can avoid a cancer diagnosis and subsequent treatments that significantly affect quality of life, said Ian M. Thompson Jr., MD, director of the CTRC at The University of Texas Health Science Center at San Antonio. “If you look at the number of prostate cancers that are diagnosed annually and multiply that by 30%, that’s the number of cancers we might be able to prevent each year,” Dr. Thompson said.”

Association Between Metformin Use and Risk of Prostate Cancer and Its Grade

“Metformin is commonly prescribed to treat type 2 diabetes. Recent evidence suggests that it may possess antitumoral properties. The aim of this study was to test the association between metformin use and risk of prostate cancer and its grade among men with diabetes.”