Radiation Tx Boosts Survival in Triple Negative Breast Ca in Older Women

“Adjuvant radiation therapy (RT) after lumpectomy for elderly women with early stage triple negative breast cancer (TNBC) improved overall survival (OS) and disease specific survival (DSS), a retrospective analysis of cases from the Surveillance, Epidemiology, and End Result (SEER) database has shown.

“The review showed that adjuvant radiation was associated with an overall six-fold decrease in any death, as well as death from breast cancer, Sean Szeja, MD, of The University of Texas Medical Branch at Galveston, and colleagues reported in a poster session at the American Society of Clinical Oncology (ASCO) Breast Cancer Symposium (Sept. 25-27).

“Some 23 months after diagnosis, 98.2% of women who received lumpectomy and radiation were alive, compared with 85.6% of those who received lumpectomy alone, the investigators said. In addition, the analysis revealed that breast cancer-related deaths were more common in the lumpectomy only group (6%) compared with the lumpectomy and radiation group (1%).”

Bone Turnover Markers Predict Prostate Cancer Outcomes

“Biomarkers for bone formation and resorption predict outcomes for men with castration-resistant prostate cancer, a team of researchers from UC Davis and their collaborators have found. Their study, published online in the Journal of the National Cancer Institute, also found that the markers identified a small group of patients who responded to the investigational drug atrasentan. The markers’ predictive ability could help clinicians match treatments with individual patients, track their effectiveness and affect clinical trial design.”

Editor’s Note: Biomarkers are substances produced in the body that can be detected through blood tests or other tests. They give doctors a more complete picture of what is going on in the body, which can help make sure a patient is given the treatment most likely to work for them.

Prostate Surgery Comes Out Slightly Ahead of 'Watchful Waiting' in New Study (see Editor's Note)

“When it comes to prostate cancer, aggressive surgery saves lives and leads to a better quality of life, according to a new study that could inflame the debate over how best to treat the disease — and in some cases, whether to treat it at all.

The paper, published in the New England Journal of Medicine, is an update on a study that was launched in Sweden, Finland and Iceland a quarter-century ago. Nearly 700 men newly diagnosed with prostate cancer were split into two groups: half had their prostate gland fully removed — a radical prostatectomy — and half were followed through a protocol of “watchful waiting,” where doctors only treated them if symptoms progressed.”

Editor’s Note: In the U.S., “watchful waiting” means that patients are offered treatment once the prostate cancer changes behavior in a way that raises concern. However, in this study, patients in the watchful waiting group were NOT part of a program that involved monitoring and treating the cancer if it got worse. We agree with this article, which states, “this study should not be used to encourage surgery for every man diagnosed with prostate cancer.”

Article Offers Guidance on Discussing PSA with Patients

“Discussion of prostate-specific antigen (PSA) screening should focus on current guidelines and emphasize shared decision making, according to an article published Feb. 11 in the Urology Times.

“Noting that there has been an increase in discourse relating to the controversy surrounding PSA testing in the lay press, John M. Hollingsworth, M.D., from the University of Michigan Medical School in Ann Arbor, outlined his patient discussions concerning PSA screening.”

Younger Men Benefit Most from Surgery for Localized Prostate Cancer

“More than 230,000 men will be diagnosed with prostate cancer this year in the United States, but determining their course of treatment remains a source of considerable debate. A new study by researchers from Uppsala University Hospital, Sweden, Harvard School of Public Health (HSPH) and colleagues—which draws from one of the few randomized trials conducted to directly address this issue—finds a substantial long-term reduction in mortality for men with localized cancer who undergo a radical prostatectomy. While the benefit on mortality appears to be limited to men less than age 65, surgery did reduce the risk of metastases and need for additional treatment in older men.”

OncoBriefs: Lung Trial Ended, Gene Test Helpful

“Results of a gene test for prostate cancer led to a change in treatment plans in two-thirds of cases, investigators reported.

“Physicians involved in a community-based study said results of the cell cycle progression test led them to reduce the intensity of treatment in 40% of 305 patients and increase the intensity in 25%, according to E. David Crawford, MD, of the University of Colorado in Denver, and colleagues…

” ‘[The test] is an absolute game changer for urologists because it adds meaningful new prognostic information in terms of risk assessment for prostate cancer patients that will improve their care,’ Crawford said in a statement.”

Editor’s Note: This is a two-part article; scroll down to find the prostate cancer news: a gene test may help keep doctors from subjecting people with prostate cancer to unnecessary treatments.

Reliable Pretreatment Information Assists Prostate Cancer Patients in Decision-Making

“Men who have been diagnosed with prostate cancer need to assimilate information rapidly in order to weigh the treatment options and make informed decisions. Although patients consult a variety of information sources, outcome information that is specific to the treating physician leads to greater patient satisfaction following treatment, according to a new study published in The Journal of Urology.

“The benefits of patient information are broad. For many people confronted with a cancer diagnosis, information translates to greater involvement in management decisions, improved ability to cope, reduced anxiety and distress, better communication with family members, and increased satisfaction with treatment choices.”

Gene Tests May Hold the Key to Halting Deadly Prostate Cancer, Study Suggests

“Men should be genetically screened for prostate cancer in the same way women are for breast cancer, researchers said after they found a range of gene mutations which identify those at high risk.

“Scientists at the Institute of Cancer Research, London, screened men who had several relatives with prostate cancer and found they were able to spot 13 mutations in genes that predicted the development of the disease.

“The findings are important because they demonstrate not only that some men have a genetic profile that puts them at higher risk of prostate cancer, but that mutations in certain genes will lead to a much more aggressive form of the disease.”

3-D Mapping Biopsy Finds 3x Prostate Cancer of Ultrasound-Guided Biopsy

“Ultrasound-guided biopsies miss prostate cancers that are detected by the slightly more expensive and slightly more invasive 3D mapping biopsies. For example, in a 2006 study of 180 men diagnosed with early stage prostate cancer via ultrasound-guided biopsy, nearly a quarter were upgraded to a more clinically significant stage of disease after 3D mapping biopsy found pockets of cancer the first technique had missed. Now, a University of Colorado Cancer Center study reports the locations of these most-missed pockets of prostate cancer.

” ‘There are three major reason we perform these 3D mapping biopsies in the clinic: first, a man may have rising PSA despite a series of negative biopsies and so want a more detailed opinion; second, a man may prefer additional reassurance that watching and waiting rather than treatment is the best course of action; and third, a man may pursue focal therapy in which only the cancerous sections of the prostate are removed and so need accurate information on the position of his cancer,’ says Al Barqawi, MD, investigator at the CU Cancer Center, associate professor at the CU School of Medicine, and the paper’s senior author. Barqawi is a pioneer of the 3D mapping biopsy technique, in which needle biopsies are taken 5mm apart across the x, y and z axes of a three-dimensional grid through the prostate, and has performed over 600 of the procedures.”