Do Second Opinions Matter in Prostate Cancer Care?

Excerpt:

“A new analysis indicates that many men with prostate cancer obtain second opinions from urologists before starting treatment, but surprisingly, second opinions are not associated with changes in treatment choice or improvements in perceived quality of prostate cancer care. Published early online in CANCER, a peer-reviewed journal of the American Cancer Society, the findings also explore motivations for seeking second opinions, and suggest that second opinions may not reduce overtreatment in prostate cancer.”

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More American Men with Early-Stage Prostate Cancer Could Opt Out of Immediate Treatment

Excerpt:

“A new report on Swedish men with non-aggressive prostate cancer suggests that a lot more American men could safely choose to monitor their disease instead of seeking immediate radiation treatment or surgery.

“Published online October 20 in the Journal of the American Medical Association (JAMA) Oncology, the report shows that well over half of 32,518 men in Sweden diagnosed with prostate cancers least likely to spread chose monitoring during a recent, five-year period over immediate treatment.”

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New Prostate Cancer Tests Aim to Reduce the Death Rate

Excerpt:

“About a dozen new medical tests are coming to market that aim to more accurately diagnose prostate cancer and go well beyond the standard PSA (prostate-specific antigen) blood screenings used today. Several of them may even allow men to forego getting a biopsy that more than 1 million men diagnosed with prostate cancer undergo each year. That’s because these new tests will help doctors distinguish between aggressive disease and slow-growing tumors.”

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70-Gene Signature as an Aid to Treatment Decisions in Early-Stage Breast Cancer

Excerpt:

“This was a randomized phase III trial including 6693 women with early-stage breast cancer designed to assess whether patients at high clinical risk (via Adjuvant! Online) and low genomic risk (via MammaPrint) would have similar metastasis-free survival if treated without chemotherapy. A total of 1550 patients (23.2%) were deemed to be at high clinical risk and low genomic risk. No significant difference in the 5-year metastasis-free survival rate was noted in women who received chemotherapy compared with those who did not (95.9% vs 94.7%).

“These findings suggest that nearly half of women at high clinical risk may not need chemotherapy for breast cancer.”

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Benefit of Radiation Boost in DCIS Validated

Excerpt:

“A radiation boost to the tumor bed led to a small but statistically significant reduction in breast cancer recurrence after breast-conserving therapy for ductal carcinoma in situ (DCIS), a randomized study showed.

“Women who received the radiation boost had a 15-year freedom from ipsilateral recurrence of 91.6% compared with 88.0% for patients who had lumpectomy and adjuvant irradiation but not boost to the tumor bed. The additional protection afforded by the radiation boost encompassed both DCIS and invasive recurrence.”

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Treat or Monitor Early Prostate Cancer? 10-Yr Survival Same

Excerpt:

“Men with early prostate cancer who choose to closely monitor their disease are just as likely to survive at least 10 years as those who have surgery or radiation, finds a major study that directly tested and compared these options.

“Survival from prostate cancer was so high—99 percent, regardless of which approach had—that the results call into question not only what treatment is best but also whether any treatment at all is needed for early-stage cases. And that in turn adds to concern about screening with PSA blood tests, because screening is worthwhile only if finding cancer earlier saves lives.”

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Gene Tests Identify Breast Cancer Patients Who Can Skip Chemotherapy, Study Says

Excerpt:

“When is it safe for a woman with breast cancer to skip chemotherapy?

“A new study helps answer that question, based on a test of gene activity in tumors. It found that nearly half of women with early-stage breast cancer who would traditionally receive chemo can avoid it, with little risk of the cancer coming back or spreading in the next five years.

“The so-called genomic test measures the activity of genes that control the growth and spread of cancer, and can identify women with a low risk of recurrence and therefore little to gain from chemo.”

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ADT Decreases Survival Among Black Men With Favorable-Risk Prostate Cancer

Excerpt:

“Definitive treatment with androgen deprivation therapy increased the risk for death among black men with low- or favorable-risk prostate cancer, according to study results published in Cancer.

“ADT should be reserved for black men with high-risk disease, according to the researchers.

“ADT is frequently combined with radiation therapy for the treatment of men with intermediate- or high-risk prostate cancer. No evidence suggests that this treatment platform benefits patients with low- or favorable-risk disease.”

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Cancer Surgeons Advise Against Removal of Healthy Breast

Excerpt:

“Only certain women with cancer in one breast should have their healthy breast removed in an attempt to prevent cancer, a leading group of breast surgeons maintains.

“The new position statement from the American Society of Breast Surgeons comes at a time when more breast cancer patients are asking doctors to remove the unaffected breast — a procedure known as contralateral prophylactic mastectomy.

” ‘Contralateral prophylactic mastectomy is a growing trend that has generated significant discussion among physicians, patients, breast cancer advocates and media,’ said position statement lead author Dr. Judy Boughey. She is professor of surgery at Mayo Clinic in Rochester, Minn.”

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