“A new study published in The Journal of Urology revealed that African American men with Gleason score 3+3=6 prostate cancer (PCa) produce less prostate specific antigen (PSA) and have significantly lower PSA density (PSAD) than Caucasian men. These findings could have important implications when selecting patients for inclusion in active PCa surveillance programs.
“Prostate cancer remains the second leading cause of cancer death among men in the U.S., with nearly 30,000 deaths annually. According to the latest recommendations by the American Urological Association, PSA remains the only screening test to select men with unremarkable digital rectal examination in whom prostate biopsy should be considered. Deaths from prostate cancer have declined by about 40% since the advent of PSA screening in the late 1980s, and 40-70% of that decline may be attributable to screening. For early stage low grade disease, active surveillance, commonly called watchful waiting, is considered appropriate.”
“The number of younger men diagnosed with prostate cancer has increased nearly 6-fold in the last 20 years, and the disease is more likely to be aggressive in these younger men, according to a new analysis from researchers at the University of Michigan Comprehensive Cancer Center.
“Typically, prostate cancer occurs more frequently as men age into their 70s or 80s. Many prostate cancers are slow-growing and many older men diagnosed with early stage prostate cancer will end up dying from causes other than prostate cancer.
“But, the researchers found, when prostate cancer strikes at a younger age, it’s likely because the tumor is growing quickly.
” ‘Early onset prostate cancer tends to be aggressive, striking down men in the prime of their life. These fast-growing tumors in young men might be entirely missed by screening because the timeframe is short before they start to show clinical symptoms,’ says Kathleen A. Cooney, M.D., professor of internal medicine and urology at the University of Michigan.”
“Despite technological improvements in sperm banking, many patients undergoing cancer treatments are unaware of their options for fertility preservation and providers are uncomfortable counseling them, according to a presentation at the joint meeting of the International Congress of Endocrinology and the Endocrine Society.
“ ‘Most of us realize that the focus used to be primarily on survival alone, but at this point in time, we’re seeing a change with survivorship issues really taking a foothold not only in the world of oncology but in the overlay with reproduction,’ Robert E. Brannigan, MD, assistant professor of urology at the Feinburg School of Medicine at Northwestern University, Chicago, said in his presentation. ‘Patients are indeed very often living beyond their cancer and they expect to lead full, happy, productive lives. We know, though, that after cancer treatment, male infertility is a common consequence. … Many of these patients before they receive one drop of chemotherapy or one ray of radiation therapy, come to us with presenting with impaired fertility’ .”
“Brannigan presented examples of cases — ranging from an adult man attempting conception after chemotherapy to a teenage male undergoing cancer treatment and no longer producing sperm — that showed the long-lasting effects of oncology treatments on male fertility.
“He listed the excuses often given for not banking sperm: favorable treatment protocols, no time to bank due to acute health issues, poor semen parameters and the priority of survival.”
“While rare, breast cancer does occur in men and is often diagnosed at a later age and stage than in women, experts say.”Each year in the United States, about 2,000 cases of male breast cancer are diagnosed and about 500 men die from the disease. It can strike at any age, but is most often diagnosed among men at ages 60 to 70, which is five to 10 years later than in women.
“Breast cancer in men is typically diagnosed at a later age and stage than in women because men don’t believe they’re at risk for the disease, said Dr. Tatiana Prowell, a medical oncologist and breast cancer scientific lead at the U.S. Food and Drug Administration’s office of hematology and oncology products.
” ‘You’d think that because men have smaller breasts they would notice a lump instantly. But men don’t expect a breast lump to be cancer, whereas most women who feel a breast lump immediately assume the worst,’ she said in an FDA news release.”
“Approximately 12% of patients with melanoma developed subsequent squamous cell carcinoma, and the occurrence was more common among men, whites, older patients and those with a history of nonmelanoma skin cancer, according to recent study results.
“Researchers studied 6,378 Kaiser Permanente Northern California (KPNC) members (mean age, 60.9 years; 56.6% men) who received a melanoma diagnosis between 2000 and 2005. The patients were followed through 2009, with 1,462 meeting criteria for squamous cell carcinoma (SCC) pathology review. There were 766 patients with defined SCC (69.7% men).”
Two chemotherapy drugs may be better than one against melanoma, according to results from an ongoing clinical trial that were presented at the 2013 meeting of the International Society for Melanoma Research. The drugs were dacarbazine, which is U.S. Food and Drug Administration (FDA)-approved for melanoma, and paclitaxel, which is FDA-approved for breast, lung, and pancreatic cancers. In a phase III trial of 529 melanoma patients, the drug combination kept tumors from growing two times longer than dacarbazine alone (4.8 vs 2.5 months, respectively). The subgroups that did best included men and people with melanomas that had spread to the liver or brain. This is particularly encouraging for the latter group because they have the worst prognosis.
Young men are 55% more likely to die of melanoma than young women, according to a recent study that followed more than 25,000 white adolescents and young adults with melanoma. About 95% of skin melanomas occur in non-Hispanic whites. The disparity between the sexes held across melanomas matched for thickness, suggesting a biological basis. But even so, young men can reduce their risk with sun protection and skin checks. Another large study suggested that using sunscreen regularly could cut the incidence of melanoma by half. In addition, men are less likely to get skin checks and young adults are less likely to go to doctors, period. Dermatologists recommend professional skin exams for people with changing moles or ‘ugly duckling’ moles, which don’t match the others. Ugly duckling moles tend to grow up, can be small and uniform in color, and may bleed.
Older men are less likely to survive melanoma than women; new research shows that the same holds for younger men. Melanoma is the third most common cancer in adolescents and young adults. The researchers followed 26,000 white individuals aged 15 to 39 years who had skin melanomas. About 7 years after diagnosis, men were 55% more likely to die than women of same ages and melanoma thicknesses. Moreover, even though melanomas less than 1 mm thick are linked to lower risk, men with these thin melanomas were twice as likely to die as women of the same age. The researchers call for more outreach to alert young men to their heightened risk of melanoma and for more research to find out why.
Malvezzi M, Bosetti C ... Negri E, La Vecchia C, Lung Cancer, Feb 20, 2013
Lung cancer mortality in men from the European Union (EU) peaked in the late 1980s at an age-standardised (world standard population) rate over 53/100,000 and declined subsequently to reach 44/100,000 in the early 2000s. To provide a comprehensive picture of recent trends in male lung cancer mortality in Europe, we analyzed available data from the World Health Organization up to 2009 and predicted future rates to 2015.