Recommendations for Genetic Counseling, Genetic Testing for Hereditary Prostate Cancer

Excerpt:

“To date, there have been few recommendations to guide physicians about when to offer men genetic consultation for prostate cancer risk. Now, an international and inter-specialty panel of experts convened at the Sidney Kimmel Cancer Center (SKCC) at Thomas Jefferson University have developed a comprehensive set of recommendations. This consensus statement, published December 13th in the Journal of Clinical Oncology, will help physicians and stakeholders make sense of a rapidly evolving field of practice.”

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Does Sex Protect Men Against Prostate Cancer?

Excerpt:

“Men who ejaculate often may have a lower risk of prostate cancer than their peers who don’t do it as frequently, a U.S. study suggests.

“Researchers followed about 32,000 men starting in 1992 when they were in their 20s and continuing through 2010. During this period, almost 4,000 of the men were diagnosed with prostate cancer.

“Men who ejaculated at least 21 times a month in their 20s were 19 percent less likely to be diagnosed with prostate cancer than men who ejaculated no more than seven times a month, the study found. Men who ejaculated more often in their 40s were 22 percent less likely to get a prostate cancer diagnosis.”

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Tests to Gauge Genetic Risks for Prostate Cancer Now Are Feasible

“Men with an elevated, genetically inherited risk for prostate cancer could be routinely identified with a simple blood or urine test, scientists at UC San Francisco and Kaiser Permanente Northern California have concluded, potentially paving the way to better or earlier diagnosis.

“The study, which compared 7,783 men with prostate cancer to 38,595 men without the disease, is available online and will be published in an upcoming issue of the journal Cancer Discovery.

“The new study is one of the first to come out of the collaboration between UCSF and Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH), which analyzed genetic samples and health records from more than 100,000 volunteers, making it one of the largest research projects in the United States to examine the genetic, health and environmental factors that influence common diseases such as prostate cancer.

“The researchers modeled using 105 specific bits of DNA that commonly vary among individuals and that they confirmed are associated with prostate cancer risk. While they estimated that each of these genetic variants only modestly alters risk, they determined that men with combinations of these DNA variants that placed them among the highest 10 percent for risk were more than six times as likely to be diagnosed with prostate cancer compared to the men who ranked among the lowest 10 percent for prostate cancer risk.”


Best Evidence Yet!: Ejaculation Reduces Prostate Cancer Risk

“Good news, men: you may be able to decrease your risk for prostate cancer by ejaculating — frequently, according to research presented here at American Urological Association 2015 Annual Meeting.

“The frothy advice is not new but is now backed up by the ‘strongest evidence to date’ on the subject, according to lead author Jennifer Rider, ScD, MPH, an epidemiologist at the Harvard T.H. Chan School of Public Health in Boston.

” ‘There is no modifiable risk factor for developing prostate cancer,’ Dr Rider told Medscape Medical News. ‘It would be exciting to tell men that there was a way to modify their risk.’ ”

“However, she noted that these are observational data and urged caution when ‘interpreting them.’ “


Meta-analysis: Testosterone Is Not a Risk for Prostate Cancer, But…

“Testosterone, whether occurring naturally or taken as replacement therapy, does not cause prostate cancer or spur increases in prostate-specific antigen (PSA) levels in men, according to a new meta-analysis.

“The results are ‘encouraging,’ but longer-term data from randomized trials are needed to strengthen the finding, said lead author Peter Boyle, PhD, DSc, who is president of the International Prevention Research Institute in Lyon, France

” ‘You need 15 to 20 years of follow-up to see true prostate cancer risk,’ he told Medscape Medical News here at the American Urological Association 2015 Annual Meeting.

“The average follow-up in the studies included in the meta-analysis is ‘much less’ than what is needed, he said.”


Obesity Significantly Increases Prostate Cancer Risk in African-American Men, Study Finds

“Obesity has a profoundly different effect on prostate cancer risk in African-American as compared to non-Hispanic white men. Obesity in black men substantially increases the risk of low- and high-grade prostate cancer, while obesity in white men moderately reduces the risk of low-grade cancer and only slightly increases the risk of high-grade cancer, according to the first large, prospective study to examine how race and obesity jointly affect prostate cancer risk. The findings, published April 16 in JAMA Oncology, were based on a nationwide study led by researchers at Fred Hutchinson Cancer Research Center and the University of Washington.

“The research team, led by senior author Alan Kristal, Dr.P.H., a member of the Fred Hutch Public Health Sciences Division, and first and corresponding author Wendy Barrington, Ph.D., M.P.H., an affiliate public health investigator at Fred Hutch and an assistant professor at the University of Washington School of Nursing, found that black men who are obese (a body-mass index of 35 or higher) had a 122 percent increased risk of low-grade and an 81 percent increased risk of high-grade prostate cancer compared to those who were of normal weight (a BMI of 25 or lower). In contrast, among non-Hispanic white men, those who were obese had a 20 percent reduced risk of low-grade and only a 33 percent increased risk of high-grade prostate cancer compared to those of normal weight.

” ‘For unknown reasons, African-American men have a much higher risk of prostate cancer than non-Hispanic white men. Different effects of obesity might explain at least some of the difference in risk and, more importantly, preventing obesity in African-American men could substantially lower their prostate cancer risk,’ Kristal said.”


Increased Risk of Aggressive Prostate Cancer in Testicular Cancer Survivors

“Men with a history of testicular cancer had a nearly fivefold higher risk for later  developing prostate cancer than did men without a history of testicular cancer, including an increased risk for developing intermediate- and high-risk disease, according to the results of a case control study.

“ ‘Based on these findings, men with a history of testicular cancer should consider a discussion regarding the risks and benefits of prostate cancer screening with their physicians,’ said Mohummad Minhaj Siddiqui, MD, an assistant professor of surgery at the University of Maryland School of Medicine and director of urologic robotic surgery at the University of Maryland Marlene and Stewart Greenebaum Cancer Center.

“Siddiqui presented the results of the study (Abstract 177) at a press conference held in advance of the 2015 ASCO Genitourinary Cancers Symposium.

“Previous research has demonstrated that there is an increased rate of prostate cancer in men with a history of testicular cancer. Siddiqui and colleagues sought to determine if men with a history of testicular cancer also had an increased risk for intermediate- to high-risk prostate cancers.”


Long-Term Testosterone Therapy Does Not Increase the Risk of Prostate Cancer

“Testosterone (T) therapy is routinely used in men with hypogonadism, a condition in which diminished function of the gonads occurs. Although there is no evidence that T therapy increases the risk of prostate cancer (PCa), there are still concerns and a paucity of long-term data. In a new study in The Journal of Urology, investigators examined three parallel, prospective, ongoing, cumulative registry studies of over 1,000 men. Their analysis showed that long-term T therapy in hypogonadal men is safe and does not increase the risk of PCa.

“Lead investigator Ahmad Haider, MD, PhD, urologist, Bremerhaven, Germany, states, ‘Although considerable evidence exists indicating no relationship between testosterone and increased risk of developing PCa, decades of physician training with the notion that testosterone is fuel for PCa made it difficult to dispel such fallacy and the myth continued to persist. Nevertheless, in the absence of long-term follow-up data demonstrating reduced risk of PCa in hypogonadal men who are receiving T therapy, considerable skepticism remains throughout the medical community and this is an expected natural and acceptable path of medical and scientific discourse. In view of the current evidence, clinicians are compelled to think this over and cannot justify withholding T therapy in hypogonadal men, also in men who have been successfully treated for PCa.’ “


The Risk Factor – New Evidence on Obesity and Prostate Cancer

“Casting an eye over our cancer prevention infographic it’s noticeable that there’s no mention of prostate cancer. That’s because, until now, researchers haven’t been able to uncover much about what causes the disease, and what people can do to reduce their risk.

“Yesterday, as part of its Continuous Update Project, the World Cancer Research Fund (WCRF) published an in-depth look at the latest evidence on preventing prostate cancer, with some new and interesting conclusions that you may have seen in the media.

“The organisation grades evidence based on the strength and reliability of all the research combined. Its top two categories are ‘convincing’ and ‘probable’, when the evidence is so strong that it can be talked about confidently, and even lead to recommendations for the public.

“So what has it found?

“Its most significant finding is that men who are overweight or obese are at greater risk of ultimately developing an aggressive form of prostate cancer.

“It also found that fully grown adults’ height ‘probably’ affects risk, but because this is determined by early life and genes, men can’t do much about it (although it does give clues for more research into how the disease develops).”