TEX US TOO!

Education/Outreach

An Excellent Source of Information is the New York Times Blog on PCA

Free Prostate Screening Services For Houston, Texas

Meeting Announcement

Date: November 8, 2010
Time: 7:00 P.M
Place: St. Luke’s Methodist Church, 3471 Westheimer, Youth Chapel. 2 nd Floor (Refreshments will be served)
Topic: Finally: Advances You Can Believe In!
Speaker: Christopher John Logothethis, MD, Chairman, Dept. of Genito-Urinary Medical Oncology, U.T. M.D. Anderson Cancer Center
Interest Group Meetings : New Member Orientation & Recurring Cancer; Radical Prostatectomy & Radiation, Quality of Life and Women’s Groups will be assigned to Rooms B227 & B229. You can enter the building from the right side of the Courtyard and take the elevator that is in the Commons, to the second floor, turn left and head down the hall straight to the Youth Chapel. Women’s Group for Wives and Significant Others, Room B226. All these meetings take place immediately following the presentation.
Getting There: Park behind the church. Enter the building from the right side of the Courtyard and take the elevator that is in the Commons to the second floor, turn left and head down the hall straight to the Youth Chapel.

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NOTES AND QUOTES

Tex Us TOO Information Sharing:

The Houston Chronicle published and article and picture featuring our dear member Jay Master and his heroic fight with cancer. (Outdoor Section, Thu., Sept. 23rd, Page C9). To read the entire article online, please visit: http://www.chron.com/disp/story.mpl/sports/thingstodo/7213583.html
The Tex Us TOO Speaker‟s Bureau will give a prostate cancer awareness presentation on Saturday, October 9th, at a Health Fair sponsored by The Home Family Worship Center, in South Houston.
In Memoriam: Our long-time member Robert Partain passed away recently.
Quote from a letter recently received from Mr. Stan Ziegler, a Dad‟s Day 5K Run participant: “As a prostate cancer survivor I want to thank you for putting on this race. I was honored to be able to donate and to get my friends and co-workers to sponsor me at close to $1000. I will start soliciting earlier next year and have a goal of raising $2000 and of being the top survivor in the race.”

PSA SCREENING CAN LEAD TO OVERTREATMENT: MedPage Today, 30 July 2010.
Many men being treated aggressively for low-grade prostate cancer – particularly if it was detected during PSA screening – are unlikely to benefit from the intervention, a new study suggests. Men with screen-detected cancer and PSA levels below 4 ng/ml were less likely to have these clinical features: High-grade tumors, Disease outside the prostate, Tumor size larger than 0.5 cm3, . Yet they were 1.49 times more likely to undergo radical prostatectomy (RP) than men who had prostate cancer that was not detected by screening, and they were 1.39 times more likely to have radiation therapy (RT). Yu-Hsuan Shao, PhD, of the Cancer Institute of New Jersey in New Brunswick, and colleagues reported their findings in the 26 July 2010 issue of Archives of Internal Medicine (Vol. 170, pp. 1256-61, 2010). Because little is known about the risk profile of men whose PSA is below 4 ng/mL, Shao and colleagues looked at data from the Surveillance, Epidemiology, and End Results (SEER) database, which includes approximately one quarter of the US population. Among 123,934 men who received a diagnosis of prostate cancer from 2004 to 2006, 14% had PSA values below 4 ng/mL, 73.5% were between 4.1 and 20 ng/ml, and 12.5% were above 20 ng/mL. Approximately 54% of patients with PSA levels below 4 ng/ml had low-risk cancers, with risk being determined according to clinical stage, PSA level, and Gleason score, compared with 48% of those whose PSA levels were between 4.1 and 10 ng/ml A total of 44% of men whose PSA was lower than 4 ng/ml had a RP, as did 38% of those whose levels were 4.1 to 10 ng/ml and 24% of those whose values were between 10.1 and 20 ng/ml. RT was given to 33%, 40%, and 41.3% of the three groups, respectively. “Despite their lower risk of having clinically significant disease, treatment rates for men with PSA values of 4.0 ng/mL or lower were comparable to those of men presenting with PSA values between 4.0 and 20.0 ng/ml,” wrote Shao and colleagues. In an invited commentary that accompanied the study, Richard M. Hoffman, MD, of the University of New Mexico in Albuquerque and Steven B. Zeliadt, PhD, of the University of Washington in Seattle, argued in favor of active surveillance
Active Surveillance (AS) for patients at low risk. “Prostate-specific antigen testing has led to an epidemic of prostate cancer, but a substantial proportion of PSA-detected cancers will never be clinically significant, and continuing to aggressively treat most men with low-risk cancers will certainly do more harm than good,” Hoffman and Zeliadt wrote. They believe AS is an “acceptable alternative” for men with a PSA level of 10 ng/mL or lower, a Gleason score of six or lower, and clinical stage T1c or T2a.
William J. Catalona, MD, of Northwestern University Medical School in Chicago had a different view. He pointed out several failings in the study, including that information on how rapidly PSA levels were rising (PSA velocity), how large the prostate was in relation to the PSA level (PSA density), the percentage of free PSA (lower with aggressive cancers), or the number of cancer-positive biopsy cores was not available. “All of these are important indicators of tumor aggressiveness and determinants of treatment selection,” he wrote in an e-mail to MedPage Today and ABC News.
Catalona developed the PSA screening test. “The authors and the editorial comment strongly advocate AS,” Catalona continued. “However, with AS protocols, the „good news‟ comes early and the „bad news‟ comes late. It has already become clear that 30% to 50% of patients abandon AS for treatment within five years, and for these patients, AS has meant delayed cancer treatment,” he said. “There is no doubt that with AS, some patients will die of prostate cancer unnecessarily. In a sense, widespread adoption of AS in all patients who appear to have low-risk disease would be to say it is okay for some men to die of prostate cancer so that others may avoid treatment – a debatable choice,” Catalona warned.

Prostate Test Far from Perfect: Excerpts to an Answer From a Question about the New EPCA-2, to Dr. Paul Donahoue, in Orlando, FL. No one represents the PSA as being a foolproof test for the detection of prostate cancer. The reliability that the test will be positive if cancer is present is in the 70-80% range. The reliability that the test will be negative when there is no cancer is 60-70%. It is far from a perfect test. There is no perfect lab test for any illness. There is no perfect human testing. The PSA is the best screening that we have. Gland enlargement, inflammation, infections and even bike riding can elevate the PSA. Alternate tests can improve on the weaknesses of the PSA. The increase in PSA value over time, known as PSA Velocity, refines the test‟s accuracy.
Free-to-bound PSA is another way of improving the PSA predictability. Bound PSA is PSA attached to other blood substances. A low percentage of free PSA points to cancer. The EPCA-2 test is not yet on the market. It holds the promise of greater accuracy. It may be another year before it appears for general use. PSA testing leads to over-and under-diagnosing of prostate cancer. A positive test triggers the need for a prostate biopsy. A negative test lulls doctor and patient into thinking all is well when it may not be. All the same, the test has served a useful purpose. (from a newspaper article sent by our Tex Us Too member John Gealy).

"We Must Live Together as Brothers or Perish as Fools." – Dr. Martin Luther King, Jr.

We welcome suggestions, criticisms, and contributions to this publication. This Is Your Newsletter. Please contact Manny Vazquez at (936) 597-6646, or by E-mail, at manny@consolidated.net WEBSITES: Tex Us TOO www.texustoo.org Us TOO International: www.ustoo.org

Tex US TOO, INC. (a chapter of Us TOO International, Inc).

12335 Kingsride #237 713-623-4772

Houston, TX 77024-4116 www.texustoo.org

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FREE PROSTATE SCREENING

On an ongoing basis, M.D.Anderson Cancer Center does offer free prostate screenings every Tuesday. The appointments are limited to 10 patients each day and are held at 7:30 a.m. in the ACB (Mays Clinic) building. To schedule an appointment for a free prostate cancer screening, the patient would need to call 713-792-8924 to confirm.

For information or to speak to a prostate cancer survivor, please

contact the American Cancer Society at 409-938-3191