Prostate
Cancer Biopsy Technique Adds Information
Physicians Want
To Give Accurate Prognosis
Physicians may be
better able to determine the prognosis of prostate cancer patients
by changing the location of biopsies they take to check for
disease, according to a report in the medical journal Cancer. 
New research finds
biopsy results from the side of the prostate with the most advanced
tumors are more closely linked to the chances of the cancer
returning after treatment than are biopsy results from all over
the gland.
"In the old days,
we used to say you had cancer and that was the general information
you got," perhaps along with an analysis of how aggressive the
cancer is, says the study's co-author, Dr. Stephen Freedland,
a clinical instructor at Johns Hopkins University School of
Medicine.
"What studies like
ours are saying is it's no longer acceptable to [just] say that,"
Dr. Freedland says.
Biopsy
Result Guides Physician and Patient
Prostate cancer is
the most common cancer among men, excluding skin cancer. American
Cancer Society estimates for 2003 include 220,900 new
cases of prostate cancer in the US.
Year 2003 estimates
include 28,900 deaths occurring from prostate cancer in the
US alone, making it the second leading cause of cancer death
in men.
In the new study,
researchers examined the medical records of 535 men who had
their prostate gland removed surgically between 1988 and
2002. The researchers wanted to see how early biopsies predicted
how the men fared later.
According to study
co-author Dr. Christopher Kane, an associate professor of urology
at the University of California at San Francisco, physicians
typically take 10 biopsies from each prostate cancer patient
by sticking needles into the prostate and pulling out thin "cores."
The process is quick
and painless because local anesthetic is given, Dr. Kane adds.
If cancer exists,
pathologists can measure how advanced it is and how aggressive
the cells appear to be.
A prostate gland has
two lobes, and the researchers found the number of "positive"
biopsies on the side with the highest degree of cancer is a
better predictor of future problems than the number of positive
biopsies as a whole.
"The dominant tumor
tends to be driving patients' outcomes," Dr. Kane says.
While physicians
may not be able to immediately use the biopsy information to
help them decide which treatment to try, it should give patients
a better idea of their prognosis, Dr. Kane says.
It will also help physicians
understand which patients face the highest risk of recurrence
and may belong in research trials, he adds.
Biopsy
May Affect Treatment Choice
Dr. Lester Klein,
a urologist at Scripps Clinic in San Diego, says more research
needs to be done before physicians will accept the results.
But, he adds, the
research is important because physicians need more information
when they consider options for men with prostate cancer.
Physicians can choose
from a variety of treatments, but the side effects can include
incontinence and impotence. This leads many men to carefully
consider their choices.
"What we're trying
to figure out is which patients should be operated on and which
shouldn't be operated on," Dr. Klein says. "There's
no use operating on something if it's going to fail."
Radiation and surgery
remain the major treatments for prostate cancer, Dr. Klein says,
and patients make the final call.
Always consult your
physician for more information.
Prostate
Cancer Evaluation
If the result of a
digital rectal exam (DRE) or prosate-specific antigen (PSA)
test is unusual, a physician may repeat the tests or request
an ultrasound and other procedures.
These evaluation tools
may include:
transrectal
ultrasound (TRUS) - a test using sound wave echoes
to create an image of the prostate gland to visually inspect
for abnormal conditions such as gland enlargement, nodules,
penetration of tumor through capsule of the gland, and/or invasion
of seminal vesicles.
It may also be
used for guidance of needle biopsies of the prostate gland and/or
guiding the nitrogen probes in cryosurgery.
computed tomography
scan (CT or CAT scan) - a diagnostic imaging procedure
that uses a combination of x-rays and computer technology to
produce cross-sectional images (often called slices), both horizontally
and vertically, of the body.
A CT scan shows detailed
images of any part of the body, including the bones, muscles,
fat, and organs. CT scans are more detailed than standard
x-rays.
magnetic resonance
imaging (MRI) - a diagnostic procedure that uses a
combination of large magnets, radiofrequencies, and a computer
to produce detailed images of organs and structures within the
body.
radionuclide
bone scan - a nuclear imaging method that helps to
show whether the cancer has spread from the prostate gland to
the bones.
The procedure involves
an injection of radioactive material that helps to locate diseased
bone cells throughout the entire body, suggesting possible metastatic
cancer.
lymph node
and/or prostate biopsy - a procedure in which tissue
samples are removed (with a needle or during surgery) from the
body for examination under a microscope; to determine if cancer
or other abnormal cells are present.
The diagnosis of cancer
is confirmed only by a biopsy.
Always consult your
physician for more information.
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December 2003
Prostate
Cancer Biopsy Technique Adds Information
Biopsy
Result Guides Physician and Patient
Biopsy
May Affect Treatment Choice
Prostate
Cancer Evaluation
Strength
Training Pumps Up Seniors
Exercise
for Older Adults
Online
Resources
Strength
Training Pumps Up Seniors
Lifting weights and
other kinds of strength training help older adults fight the
loss of muscle mass and strength, and the resulting physical
disability and frailty.
But it is not clear
whether strength training helps keep older adults healthier
and alive longer, says a study in a recent issue of the American
Journal of Preventive Medicine.
A Tufts University
researcher reviewed 17 studies about strength training in older
adults and found some definite plusses.
"The benefits of strength
training include increased muscle and bone mass, muscle strength,
flexibility, dynamic balance, self-confidence. and self-esteem,"
says Dr. Miriam E. Nelson, at the Friedman School of Nutrition
Science and Policy at Tufts.
"Strength training
also helps reduce the symptoms of various chronic diseases such
as arthritis, depression, type 2 diabetes, osteoporosis, sleep
disorders, and heart disease and, when combined with balance
training, reduces falls," Dr. Nelson says.
But her study says
there is no clear evidence on whether the benefits of strength
training can actually delay the onset of disability, or on how
such training helps avert chronic diseases or their symptoms
in older adults.
She also notes questions
remain about appropriate frequency and intensity of strength
training for older adults.
The American
College of Sports Medicine recommends two to three
days a week of strength training, a schedule that Dr. Nelson
says is appropriate for the elderly.
"The key challenges
as this field of exercise science moves forward are to best
identify the most appropriate strength-training recommendations
for older adults and to greatly increase the access to safe
and effective programs in a variety of settings," Dr. Nelson
says.
Always consult your
physician for more information before starting an exercise program.
Exercise
for Older Adults
The National
Institute on Aging states that older adults should
consider the following:
Endurance
exercises increase your breathing and heart rate. They
improve the health of your heart, lungs, and circulatory system.
Having more endurance not only helps keep you healthier; it
can also improve your stamina for the tasks you need to do to
live and do things on your own. Endurance exercises also may
delay or prevent many diseases associated with aging, such as
diabetes, colon cancer, heart disease, and stroke.
Strength exercise
build your muscles, but they do more than just make you stronger.
They give you more strength to do things on your own. Even very
small increases in muscle can make a big difference in ability.
Strength exercises also increase your metabolism, helping to
keep your weight and blood sugar in check. Studies suggest that
strength exercises also may help prevent osteoporosis.
Balance exercises
help prevent a common problem in older adults: falls. Falling
is a major cause of broken hips and other injuries that often
lead to disability and loss of independence. Some balance exercises
build up your leg muscles; others require you to do simple activities
like briefly standing on one leg.
Flexibility
exercises help keep your body limber by stretching
your muscles and the tissues that hold your body's structures
in place. Flexibility also may play a part in preventing
falls.
Online
Resources
(Our Organization
is not responsible for the content of Internet sites.)
American
Cancer Society
American
College of Sports Medicine
Healthfinder,
US Department of Health and Human Services (HHS)
Healthy
People 2010
National
Academy of Sports Medicine
National
Cancer Institute (NCI)
National
Institute on Aging Exercise Guide
National
Institutes of Health (NIH)
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