Understanding Prostate Cancer: Diagnosis and Stages

Being told that you have prostate cancer can be a frightening experience. When you are told of your condition, it's common to be so overwhelmed that you neglect to ask important questions, only to think of them once you've gotten home. Understanding your illness is often the first step on the road to recovery. Here's what you need to know about your diagnosis and how the cancer is staged:

1.Diagnosing Stages

Once a man has been diagnosed with prostate cancer, his physician will perform one or more additional tests to determine the stage of cancer. These tests may include a digital rectal examination, a blood test, an MRI of the prostate or skeleton, a CT of the pelvis and abdomen, or a surgical procedure to examine lymph nodes. While not all men will need each test, most men will undergo at least one of these tests in order for their physician to better stage the cancer.

2.Stage I

If you are diagnosed with stage I prostate cancer, this means that your cancer is microscopic and only located in the prostate. Your cancer will not be large enough for your doctor to manipulate digitally. Additionally, the cancer will not be able to be detected on any digital imaging of the prostate gland. Stage I cancer of the prostate will be discovered by a needle biopsy or in tissue that is removed during other surgical procedures.

3.Stage II

In stage II prostate cancer, the cancer is still located solely in the prostate. The cancer may be found in one-half or less of one lobe of the prostate, in more than one-half of one lobe or in opposite sides of the prostate gland. As in stage I prostate cancer, stage II cancers cannot be felt during digital rectal exams, nor will the cancer be visible on any type of imaging.

4.Stage III

In stage III prostate cancer, the cancer has spread outside of the prostate to nearby tissues. The prostate specific antigen, or PSA, score can be at any level and the Gleason score will range between two and ten. Your doctor may choose to treat you with external-beam radiation therapy, hormone therapy or suggest you for a clinical trial of new therapies. Alternatively, your doctor may suggest no treatment at all and, instead, adopt a watch and see approach to your cancer.

5.Stage IV

When your prostate cancer has metastasized, or spread, to other areas of your body, you are diagnosed with stage IV cancer. Your cancer may be found in your bones, liver, lungs or lymph nodes. Stage IV prostate cancer, like other cancers that have reached the fourth stage, is considered to be the most serious. Without immediate treatment, this type of cancer will likely prove fatal. Your doctor may prescribe chemotherapy, radiation therapy, hormone therapy or a radical prostatectomy combined with other therapies.

The better you understand your diagnosis and the stage of prostate cancer that has been discovered, the better equipped you will be to partner with your oncologist to aggressively tackle your disease. If you have been diagnosed with prostate cancer, do not hesitate to approach your doctor with any questions that you may have. Your gained knowledge may just save your life.

John Martin writes articles for several health testing sites and recommends having your prostate test in Dallas Tx done at one of these centers.

Smoking and Drinking People who smoke or drink heavily may develop pancreatic cancer

At an earlier age than folks who avoid those habits, a new study suggests.

It's long been known that smoking is a risk factor for developing pancreatic cancer - a disease that is rarely caught early and has a grim prognosis. Only about five of every 100 people diagnosed with the cancer are still alive five years later.

The evidence on heavy drinking has been more mixed, but some studies have suggested it's also a risk factor.

Now, the new results show the disease may strike smokers and drinkers earlier in life.

"If you do have these habits, and you're going to develop pancreatic cancer, the age of presentation may be younger," said lead researcher Dr. Michelle A. Anderson, of the University of Michigan Health System in Ann Arbor.

Her team also found that the effect disappeared for former smokers or drinkers if they had quit 10 years or more before being diagnosed.

On average, the risk of developing pancreatic cancer in your lifetime is about one in 71. And the average age at diagnosis is 72, according to the American Cancer Society.

But in this study, current smokers and heavy drinkers were diagnosed a decade earlier than that.

That could be an important motivator for people to quit smoking or curb their drinking, according to Anderson. "That's potentially an extra decade of life," she said.

The findings, reported in the American Journal of Gastroenterology, are based on 811 patients in a pancreatic cancer registry.

Those who were current smokers were typically diagnosed around age 62, versus age 70 among non-smokers. Heavy drinkers, meanwhile, were typically diagnosed at age 61 - almost a decade earlier than non-drinkers.

Heavy drinking was defined as roughly three or more standard drinks a day. A 12-ounce beer or five ounces of wine would equate to a standard drink.

The findings do not prove that smoking or drinking led to the earlier cancers.

But Anderson's team did account for a number of other factors, like body weight and family history of pancreatic cancer. And smoking and heavy drinking were still linked to earlier diagnoses.

What's more, Anderson noted, there was a "dose" effect.

Smokers who went through more than a pack a day were diagnosed at a younger age than people who smoked less than a pack per day. And once people had refrained from smoking or heavy drinking for a decade, the excess risk of an early cancer seemed to disappear.

According to Anderson, the findings could have implications in the future, if widespread screening for pancreatic cancer becomes a reality.

Right now, there's no test that reliably detects pancreatic cancer in people who have no symptoms. So even people with a strong family history of the disease are not routinely screened.

In order to move toward screening, doctors not only need good tests, but also to know who to screen and at what age to start, Anderson explained.

If smokers and heavy drinkers do tend to develop pancreatic cancer earlier, that could help experts figure out which people could benefit from screening, and when it should begin.

By Amy Norton

Cancer has become the leading cause of death among U.S. Latinos

Nosing past heart disease in 2009, researchers at the American Cancer Society reported Monday.

For most demographic groups and for the country as a whole heart disease is the top killer, claiming a total of 599,413 American lives in 2009, according to the Centers for Disease Control and Prevention. That same year, the most recent year for which statistics are available, 567,628 Americans died of cancer.

Among Latinos that year, the rankings were reversed: 29,935 died of cancer and 29,611 of heart disease, according to a study in CA: A Cancer Journal for Clinicians.

The change may be due to demographics, said Rebecca Siegel, an epidemiologist at the American Cancer Society in Atlanta and lead author of the study.

The average age of Latinos in the United States is 27 and of non-Hispanic whites is 42. In the overall population, cancer is the leading cause of death in people under 85 years of age.

"This is primarily driven by the young age distribution," Siegel said.

Cancer incidence and cancer deaths among Latinos remain lower than in non-Hispanic whites, and rates of both continue to fall due to improvements in lifestyle, early detection and treatment.

At the same time, advances in the treatment of heart disease have caused death rates to fall even faster, Siegel said.

"The overall message is positive," said Dr. Paulo Pinheiro, an epidemiologist at the University of Nevada who wasn't involved with the cancer society's report.

The American Cancer Society undertakes its analysis of cancer in Latinos every three years, compiling data from the National Cancer Institute, the CDC and other government sources.

Latinos are the fastest-growing demographic group in the U.S., the organization said, numbering 50.5 million in 2010 and making up 16.3% of the population.

Siegel and her colleagues estimated that 112,800 new cases of cancer would be diagnosed in Latinos in 2012, and that 33,200 Latinos would die this year from various forms of the disease.

They also examined incidence and mortality of the various cancer subtypes. Latinos are less likely than non-Hispanic white Americans to have the most common forms of cancer in the U.S.: breast, prostate, lung and colorectal.

But they are far more likely to develop forms of cancer that result from infection, including liver cancer (caused by the hepatitis B virus), stomach cancer (associated with the H. Pylori bacterium) and cervical cancer (caused by the human papilloma virus).

Incidence and death rates for cervical cancer, for example, are 50% to 70% higher among Latinas than among non-Hispanic white women, the report noted.

Siegel said the high rates of cervical cancer were a result of lower screening rates among Latinas.

"There's an opportunity there to reduce the risk," she said, adding that the cancer society wants to promote culturally appropriate interventions for Spanish-speaking people.

The longer Latinos are in the U.S., she said, the more they acculturate and the more their cancer risk should resemble that of non-Hispanic whites.

Pinheiro noted that U.S. residents from Mexico have lower cancer rates than people from Cuba or Puerto Rico, in part because they haven't been in the country as long.

He said he would like to see a cancer survey that compared like with like, matching Latinos who were born in the U.S. with their non-Hispanic white counterparts. However, birthplace data currently don't support such analysis.

By Eryn Brown

Type 2 diabetes boosts death risk from breast cancer

Sunday Sept 16, 2012 (foodconsumer.org) -- A new study in Cancer Causes and Control suggests that being type 2 diabetic potentially increases risk of death from breast cancer. Because having type 2 diabetes also means to have diabetes treatment, diabetes treatment can potentially be linked to higher risk for breast cancer death.

M. T. Redaniel of University of Bristol in Bristol, UK and colleagues conducted the case-control study and found women with breast cancer who also suffered type 2 diabetes mellitus were 40 percent more likely to die from all causes, compared with those with breast cancer only.

The association, which was derived already after adjustment for age, period, region, smoking status, body mass index, alcohol drinking and deprivation, was based on data from 52,657 women with type 2 diabetes diagnosed between 1987 and 2007 and 30,210 randomly selected women without type 2 diabetes.

This association can be easily understood. Type 2 diabetes mellitus patients have insulin insensitivity or insulin resistance and tend to produce more insulin than people without diabetes type 2 do. When insulin is produced, insulin-like growth factor-1 is also produced, which is known to promote cancer growth.

Type 2 diabetes mellitus was also associated with 29 percent increased overall risk for developing breast cancer. This association was attenuated after adjustment for other factors like age, period of cohort entry, region, and BMI. That is, women with type 2 diabetes were 12 percent more likely than those without the disease to develop breast cancer.

Diabetes treatments may make some difference in the risk of developing breast cancer. Compared with sulfonylurea, metformin monotherapy and insulin therapy were associated with 4 and 33 percent increased risk of developing breast cancer among women with diabetes. From the study report abstract, it is unknown whether using sulfonylurea would increase risk of breast cancer.

Of all the associations, the one between being diabetic and risk of breast cancer was the strongest, suggesting that it is important to maintaining adequate glycemic control alongside cancer treatment, the researchers concluded.

The findings suggest that type 2 diabetes may increase risk of developing breast cancer and death from the disease.

By David Liu, PHD

Avoid ovarian cancer tests

Tests commonly recommended to screen healthy women for ovarian cancer do more harm than good and should not be performed, a panel of medical experts said Monday.

The screenings -- blood tests for a substance linked to cancer, and ultrasound scans to examine the ovaries -- do not lower the death rate from the disease, and they yield many false-positive results that lead to unnecessary operations with high complication rates, the panel said.

"There is no existing method of screening for ovarian cancer that is effective in reducing deaths," said Dr. Virginia Moyer, chairwoman of the expert panel, the U.S. Preventive Services Task Force. "In fact, a high percentage of women who undergo screening experience false-positive test results and consequently may be subjected to unnecessary harms, such as major surgery."

The advice against testing applies only to healthy women with an average risk of ovarian cancer, not to those with suspicious symptoms or those at high risk because they carry certain genetic mutations or have a family history of the disease.

Other tests rejected, too
The recommendations are just the latest in a series of challenges to cancer screenings issued by the panel, which has also rejected routine PSA screenings for prostate cancer in men and routine mammograms in women younger than 50. The task force is a group of 16 experts, appointed by the government but independent, that makes recommendations about screening tests and other efforts to prevent disease. Its advice is based on medical evidence, not cost.

The recommendations against screening for ovarian cancer were published Monday in Annals of Internal Medicine. The warning is not new -- the panel is reaffirming its own earlier advice.

Although the task force has sometimes drawn fire in the past, particularly with its stand on mammograms, in this case it has plenty of support. Other medical groups, including the American Cancer Society and the American Congress of Obstetricians and Gynecologists, have for years been discouraging tests to screen for ovarian cancer.

But some doctors continue to recommend screening anyway, and patients request it, clinging to the mistaken belief that the tests can somehow find the disease early enough to save lives. A report published in February in Annals of Internal Medicine, based on a survey of 1,088 doctors, said that about a third of them believed the screening was effective and that many routinely offered it to patients. "We are fueled by hope," Moyer said.

Ovarian cancer is among the more rapidly fatal forms of cancer. This year, 22,280 new cases and 15,500 deaths are expected in the United States, according to the American Cancer Society.

In most cases, ovarian cancer is already advanced by the time it is diagnosed. Doctors say the only advice they can give women is not to ignore symptoms that may be the first warning of the disease: persistent bloating, pelvic or abdominal pain, feeling full early while eating and needing to urinate frequently.

For its latest recommendations, the panel relied heavily on a large study published last year in the Journal of the American Medical Association of 78,216 women from ages 55 to 74. Half were screened and half not, and they were followed for 11 to 13 years. The screening consisted of ultrasound exams and blood tests for elevated levels of a substance called CA-125, which can be a sign of ovarian cancer.

Many false positives
The death rate from ovarian cancer was the same in the two groups. But among the women who were screened, nearly 10 percent -- 3,285 women -- had false positive results. Of those women with false positives, 1,080 had surgery, usually to remove one or both ovaries. Only after the operations were done was it clear that they had been unnecessary. And at least 15 percent of the women who had surgery had at least one serious complication.

To find one case of ovarian cancer, 20 women had to undergo surgery.

By DENISE GRADY @ New York Times

Treatments for Dry-Eye

1. Artificial Tears
Best for: Everyday burning or stinging brought on by too much computer use, say, or a late night.

How they work: Made of ingredients such as glycerin and natural oils, these over-the-counter drops can temporarily restore moisture to the eyes, says ophthalmologist Robert Latkany, the director of the Dry Eye Clinic at the New York Eye and Ear Infirmary, in New York City.

How to use them: Put a drop or two in each eye when you feel discomfort. However, if you need to use them more often than four times a day, see your eye doctor. He may suggest that you switch to preservative-free drops, which are better for more frequent use. If you're a contact-lens wearer, look for drops labeled "re-wetting drops." That means they're safe for contacts.

2. Omega-3s
Best for: People who don't like drops.

How they work: Omega-3 fatty acids may help reduce inflammation that can contribute to dry-eye syndrome (DES), a common condition that's easily diagnosed by an eye doctor. A 2005 study published in the American Journal of Clinical Nutrition, led by investigators at Harvard Medical School, found that women who consumed the highest levels of omega-3's in their diet had a 34 percent lower risk for DES than did others. And a 2010 study at the University of Texas Southwestern Medical Center at Dallas showed that people who took a daily omega-3 fish-oil supplement that contained 450 milligrams of the fatty acid EPA and 300 milligrams of DHA, plus 1,000 milligrams of flaxseed oil, produced more tears.

How to use them: Add a few servings of fatty fish, such as salmon, to your weekly diet, or talk to your doctor about taking daily fish-oil and flaxseed supplements. Take omega-3 supplements with food, as they can cause stomach upset.

3. Prescription Drops
Best for: Treating chronic DES.

How they work: Sold under the brand name Restasis, prescription drops contain the drug cyclosporine, which can help increase natural tear production. In a 2010 study published in the Korean Journal of Ophthalmology, a majority of patients reported few dry-eye symptoms or none at all after using the drops for three months.

How to use them: Apply one drop per eye twice a day. Experts note that these drops can be used indefinitely, as long as you're under the care of an eye doctor.

4. Warm Compresses
Best for: Dryness that drops can't seem to tackle.

How they work: Tears, your eyes' own lubrication, are made up of water and an oily substance produced by glands along the eyelids. "If cells in the glands harden and plug the opening, it can keep the oil from getting into the tear film," says Stephen Pflugfelder, an ophthalmologist in Houston. "Without that oil, the water in tears evaporates too quickly, leaving eyes feeling dry." A warm compress helps liquefy plugs so the oil can flow into tears.

How to use them: Place a warm, wet washcloth over your eyelids for up to 10 minutes once a day as needed.

5. Eyelid Washes
Best for: Dry eyes that are accompanied by flaking along the lids, which could be a sign of blepharitis, a dandrufflike inflammation of the eyelash follicles.

How they work: "People with blepharitis tend to overproduce oil, which can block the glands and cause tears to evaporate too rapidly," says Christopher Gelston, an assistant professor of ophthalmology at the University of Colorado School of Medicine, in Aurora. An over-the-counter eye wash contains mild cleansing agents to dissolve oil and remove flakes (as well as irritants and allergens that can exacerbate the problem).

How to use them: Rinse or massage over the lash line once a day, typically at night (some washes come with a cup for application). If your symptoms don't clear up after several days, see your doctor.

6. Ophthalmic Inserts
Best for: Relieving dryness that doesn't respond to other remedies.

How they work: Available only by prescription, Lacrisert inserts are tiny cellulose beads that you place in the pocket of each lower eyelid. "They dissolve slowly and mix with your tears to provide ongoing lubrication throughout the day," says Pflugfelder.

How to use them: Insert a bead once or twice a day. Like prescription drops, inserts are safe for long-term use, as directed by your doctor.

By: Amanda Pressner