HOW RELIABLE IS PSA TESTING? (source: NIH/NCBI)

PSA (prostate-specific antigen) testing (for elevated levels) is designed to detect prostate cancer at its early stages. But to clarify, reports indicate that a wide range of men with high PSA levels does not preclude cancer. At best, shows a possible alert to get an ultrasound scan (or a prostate biopsy).

Prostate cancer, now considered the most common cancer in men, especially African-Americans (6-NIH), was rare until the 1950’s. Earlier, a blood test identifying prostate specific antigen (PSA was developed for use in “rape kits” to provide criminal evidence in court) was never designed as the screening tool for prostate cancer that it has become today. Our national guidelines recommend screening with PSA for men age 55 to 69, a recommendation that 40% of men follow. But what happens after a PSA test is termed positive?

CALLING FOR A DIAGNOSTIC UPGRADE
The strategy of relying on a (PSA) blood test as the precursor to a biopsy required significant reassessment.  Though approved by the FDA in 1986 as the gold standard for monitoring cancer relapses, increasing reports continue to indicate that elevated PSA levels in over 70% of men show a false positive reading- and does not conclude a malignant cancer. (NIH ref). Because of the inaccuracies of the PSA test and the risk of side effects, many centers are now using imaging solutions like ultrasound 3-D Doppler and MRI before considering a biopsy. (see complete article)

According to the American Cancer Society, prostate cancer is the second most common cancer in American men. Estimates for prostate cancer in the United States for 2019 are estimated at about 174,650 new cases of prostate cancer and about 31,620 deaths are expected from prostate cancer. About 1 man in 9 will be diagnosed with prostate cancer during his lifetime. The average age at the time of diagnosis is about 66.Prostate cancer is the second leading cause of cancer death in American men, behind lung cancer. About 1 man in 41 will die of prostate cancer. Prostate cancer can be a serious disease, but most men diagnosed with prostate cancer do not die from it. In fact, more than 2.9 million men in the United States who have been diagnosed with prostate cancer at some point are still alive today.

Most prostate cancers found by screening are small and slow growing and may not be fatal. Some men may have a faster growing prostate cancer and will benefit from early treatment. Older men, African-American men, and men who have a family history of prostate cancer have a greater risk for developing prostate cancer. If you are concerned that you may have a greater risk for prostate cancer, talk to your doctor about screening. One screening test for prostate cancer is a blood test, which can be abnormal (not normal) for several reasons besides prostate cancer. The only way to know if an abnormal test is due to cancer is to do a biopsy. A biopsy is a surgery to get small pieces of the prostate to look at under a microscope. If the biopsy shows there are cancer cells, then your doctor will discuss treatment options. (Source: CDC.gov)

WHAT IS SCREENING?

See complete article at the NIH (National Cancer Institute) Website
Screening is looking for cancer before a person has any symptoms. This can help find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread. Scientists are trying to better understand which people are more likely to get certain types of cancer. They also study the things we do and the things around us to see if they cause cancer. This information helps doctors recommend who should be screened for cancer, which screening tests should be used, and how often the tests should be done.

It is important to remember that your doctor does not necessarily think you have cancer if he or she suggests a screening test. Screening tests are given when you have no cancer symptoms. Screening tests may be repeated on a regular basis. If a screening test result is abnormal, you may need to have more tests done to find out if you have cancer. These are called diagnostic tests.

Different factors increase or decrease the risk of developing prostate cancer.
Anything that increases a person's chance of developing a disease is called a risk factor. Anything that decreases your chance of getting a disease is called a protective factor.For information about risk factors and protective factors for prostate cancer, see the PDQ summary on Prostate Cancer Prevention.

KEY POINTS of Prostate Cancer Screening
• Tests are used to screen for different types of cancer when a person does not have symptoms.
• There is no standard or routine screening test for prostate cancer : Digital rectal exam or Prostate-specific antigen test
• A prostate cancer gene 3 (PCA3) RNA test may be used for certain patients.
• Screening tests for prostate cancer are being studied in clinical trials.

Tests are used to screen for different types of cancer when a person does not have symptoms.
Scientists study screening tests to find those with the fewest harms and most benefits. Cancer screening trials also are meant to show whether early detection (finding cancer before it causes symptoms) helps a person live longer or decreases a person's chance of dying from the disease. For some types of cancer, the chance of recovery is better if the disease is found and treated at an early stage.

There is no standard or routine screening test for prostate cancer.
Although there are no standard or routine screening tests for prostate cancer, the following tests are being used or studied to screen for it:

Digital rectal exam
Digital rectal exam (DRE) is an exam of the rectum. The doctor or nurse inserts a lubricated, gloved finger into the lower part of the rectum to feel the prostate for lumps or anything else that seems unusual.

See complete article at the NIH (National Cancer Institute) Website

TODAY'S RADIOTHERAPY: CYBERKNIFE TECHNOLOGY (part 1)

Demo video courtesy of www.CancerScan.com

MEETING TODAY’S CHALLENGES FOR CANCER THERAPY
Since the advent of radiation therapy (and the invention of the x-ray) over a century ago, the noninvasive treatment approach of radiotherapy continues to be recognized as one of the most forward-thinking technologies in the pursuit of targeting cancer tumors. The CyberKnife® Robotic RadioSurgery System represents the latest performance innovation in this modality for treating benign and malignant tumors as well as other chronic disorders. To review the CyberKnife technology, we approached the Perlmutter Cancer Center at NYU Winthrop Hospital—the top radiotherapy and CyberKnife cancer treatment center in the country. Michael C. Repka, MD, a radiation oncologist there, shared his extensive insight and firsthand experience about CyberKnife technology including its performance and patient benefits.

THE INTEGRATIVE REVOLUTION
The CyberKnife® system combines three different technological advances. The first is x-ray based or photon based radiation, the standard form—and vast majority—of medically induced radiation. This is delivered by a linear accelerator, a device that generates high energy x-rays that are far higher in intensity than a CT scan or a conventional x-ray. The CyberKnife combines a miniaturized linear accelerator (rather than the typical oversized linear device), to allow room for a second technological advance—the integration of a robotic arm, known as a manipulator. The third advance is equipping CyberKnife with an interactive image-guidance system that acquires stereoscopic kV images during treatment. (see complete article)

Source: NYCRA News

INNOVATION REPORT: The Power Doppler Sonography

When imaging detects a region of interest or suspicion, it can also be used to direct selective biopsies to obtain very small tissue samples for further laboratory analysis (pathology). The use of imaging together with pathology gives the most accurate information about the size, location and aggressiveness of any cancer thus identified.

Until recently, standard prostate cancer screening consisted of a PSA blood test (Prostate Specific Antigen) and DRE (Digital Rectal Exam). In 2017 a U.S. Government Panel released a statement suggesting such screening had a high cost with doubtful survival advantage. In other words, too many men whose screening revealed a suspiciously high PSA or abnormal DRE were rushed into multi-needle biopsies that entailed risks of false negatives, infection, and sexual side effects. The Panel recommended discontinuing routine PSA screening unless men had known risk factors for prostate cancer; and the American Urological Association recommended that doctors discuss the costs of PSA screening with their patients before administering the blood test.

Introducing the Power Doppler Sonography of the prostate, a non-invasive way to screen for prostate tumors with their abnormal blood vessels. It actually shows any suspicious area so it can be selectively targeted for biopsy. This eliminates the so-called blind biopsy (Transrectal Ultrasound or TRUS-Guided biopsy) which often misses cancer because ordinary ultrasound can’t distinguish tissue with accuracy. The precision of a targeted biopsy eliminates the need for a large number of random needles. Histogram volumetric tumor vessel analysis on a dedicated workstation correlates with microscopy and is used as a substitute tumor marker to quantify tumor virulence noninvasively. 3D Doppler imaging offers the following advantages:

• Accuracy 95% (greater than MRI at 80-90%)
• 1000-1500 images obtained in 5-10 minutes painlessly
• 2 x more accurate for detecting spread of tumor outside gland than MRI
• Optional 3D Histogram Analysis of Vessel Density indicative of tumor aggression
• Non-invasive non-biopsy modality to verify tumor treatment response
• Submitted MRI, bone and CT scans reviewed as part of the consultation

Source: CancerScan.com

Hey Fellas... WHAT TIME IS IT?

If you are with that age range of 45-50, it may be time to start a regimen of Prostate Cancer Screening as part of EARLY DETECTION. Staying regular witrh checkups greatly decreases the risk of getting malignant cancers, while improving the chances of success for those under treatment. In the ongoing battle against cancer, it is common knowledge that most cancers in their early stages are far more likely to be treated with positive results. Moreover, a thorough checkup of one's physiological analyses, heredity review and personal data gathering (from blood & dna tests) are all strong info-gatherings for early warning signs that someone may be a candidate for cancer. Being PROACTIVE starts with AWARENESS, EDUCATION & SCREENINGS.

Mr. James Hunt- researcher and educational advocate for Prostate Cancer Survivorship www.AwarenessforaCure.org

WINNING MY BATTLE WITH PROSTATE CANCER
STARTS WITH A SECOND OPINION

PROACTIVE CANCER RESEARCH & THE DIGITAL BIOPSY by: James Hunt (see full interview at: Survivor Stories / Awareness for a Cure)- originally published - March 14, 2018)

I want to tell my story so that I can help others diagnosed with prostate cancer. This all started with a routine physical with blood work. My primary care physician called to say everything looks good except a slightly elevated PSA and suggested I make an appointment to see a urologist. After spending months on antibiotics to treat a possible infection of the prostate due to bike riding, my urologist suggested a biopsy. The biopsy was one of the worst things I’ve ever experienced in my life. The biopsy results showed a Gleason 6 cancer in one of the 12 tissue samples taken from me.

The urologist suggested active surveillance where we would monitor the cancer with blood tests, MRI’s and biopsies. He mentioned that I would eventually need surgery- probably within a year or two. I reached out to one of my chiropractor friends for some advice (Dr. Mark Jones of Wading River) who is quite knowledgeable in Holistic medicine and he suggested; Pomi-T a dietary supplement that was used in a study (in prison) that was proven to slow the growth of prostate cancer. He also told me about Chaga Tea - brewed from the Chaga mushroom that grows on birch trees in Canada. I connected with Debbie Falborn from Chaga Island who told me "we will beat this". They helped me put together a plan that consisted of drinking 24oz of chaga tea a day along with daily supplements of Glutathione, Vitamin B complex and Magnesium powder (Calm). See 2021 Video Interview.

(see full interview at: Survivor Stories / Awareness for a Cure)

Digital Imaging Can Reveal Links to Testicular Cancer & Recurrence 4/D DOPPLER ULTRASOUND view of Cancer in the Testis 3/9/2020- This image (L) is of a 28 year old man who just got married and was revealed to have a mass in his testis. The sonogram showed a black area indicating a 9mm focal vascular tumor biopsied proven as high grade adenocarcinoma. The digital scan maps the orange and red vessels feeding the testicular cancer. What makes this a case of concern are the numerous WHITE DOTS (calcification) around the black area which are micro-calcifications, otherwise called testicular microlithiasis (TM) or micro-stones. According to a 2018 study, this uncommon condition of micro-stones is being linked to testicular cancer (as well as male infertility) increasing one's risk as much as 1200%. While this is not technically a precancerous condition, any man with these micro stones should be checked periodically whereby small tumors can be treated focally if caught early. Since this 9mm tumor cannot be felt by itself, the simplest way to accurately identify the cause of the enlarged testis is with a high resolution sonogram. Aftermath: Standard treatment for this condition is typically surgery (or cut out the entire testis). The patient refused this treatment solution and was instead treated focally with various nonsurgical options, later resulting in cancer recurrence. Recurrence in the lymph glands is readily diagnosed by sonogram technology. Since the metastases usually spread around the abdominal aorta, the mass is commonly misdiagnosed as an aortic aneurysm. Periodic abdominal sonography screening is recommended. Courtesy of: www.CancerScan.com Additional source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6202617/

When a first treatment for localised prostate cancer isn’t enough
Source: ProstateCancerUK.org

When Martin was first treated for his localised prostate cancer, he still felt like something wasn’t right. Years of anxiety later, he got the news he was dreading: his cancer had come back. Now, Martin’s trying to stay positive, and we’re making sure men in the future won’t have to go through the same ordeal he did.

I was 54 when I was first diagnosed with prostate cancer. Initially, the doctors thought they’d caught the cancer early, and that it was contained within my prostate. But somehow, even after I had the prostatectomy, I had a feeling that it wasn’t over. So, on one level it wasn’t really a surprise to find out five months later that I'd need further treatment. Statistically, I knew that even then it wasn’t over, and the cancer would one day come back again. With hindsight, I feel like I’ve spent the last ten years waiting to hear bad news. In the last two years especially, I got more and more depressed; became more reclusive and withdrawn. It wasn’t the sort of acute depression that I felt I needed to act on. It was just a dull, subconscious heaviness that didn’t really come to the fore until I found out that the cancer was back. (Please visit Prostate Cancer UK for complete article)

Also see HOT TOPICS in prostate cancer research & recurrence

HIFU: THE NEXT WAVE OF NON-INVASIVE CANCER TREATMENT Pursuing the concept of safe, non-surgical alternatives, the principle of HIFU is based on controllable high energy sound waves, which leads to coagulation necrosis at the focal point. It can be applied for different indications: complete ablation of prostatic tissue is attempted in whole gland HIFU in the primary treatment of localized prostate cancer. [1] The first therapeutic trial of high intensity ultrasound beams was carried out in 1942. The Fry brothers are credited with the first application of HIFU for neurologic disorders in humans. Early attempts to generate HIFU lesions in the brain through the intact skull bone were unsuccessful. Jan 10, 2011 - see complete article from MODERN DIAGNOSTIC SCIENCE

GENETIC BREAKTHROUGH IN AGGRESSIVE PROSTATE CANCER RESEARCH Cancer researchers at the Thomas Jefferson University in Philadelphia have zeroed in on a specific type of gene loss that sets off large-scale genetic changes that could make prostate cancer both resistant to treatment and more likely to spread. The discovery concerns the retinoblastoma (RB) susceptibility gene, the first “gatekeeper gene” discovered for cancer. RB is a tumor suppressor gene whose dysfunction has been found in many cancers. Under normal circumstances, this gene restricts a cancerous cell’s ability to replicate DNA by preventing its progression from the first gap phase (the first of four stages of cell division) to the synthesis phase where DNA is replicated... - see complete article from the National Foundation for Cancer Research

URINE TEST CAN HELP DIAGNOSE AGGRESSIVE PROSTATE CANCER Recent research has revealed that a new urine test can detect aggressive prostate cancer cases that need treatment up to 5 years sooner than other diagnostic methods. Research has assessed the effectiveness of a new urine test for prostate cancer. Researchers from the University of East Anglia (UEA) in Norwich, United Kingdom, and the Norfolk and Norwich University Hospital (NNUH) carried out the study. They revealed that an experimental urine test, called Prostate Urine Risk (PUR), can distinguish who will and who will not require treatment within the first 5 years of diagnosis... - see complete article from www.MedicalNewsToday.com

ARCHIVED NEWS: • FINANCIAL TIMES: "The Mounting Case for Annual Prostate Cancer Testing" • 3D/4D Ultrasound: Fighting Prostate Cancer in Real time: RADIOLOGY TODAY (Originally Published 1/2004)