Cancer Archive

In the journals

If you have suffered a heart attack and plan to undergo prostate cancer treatment, you may want to weigh the risks and benefits of androgen deprivation therapy (ADT). ADT decreases the amount of androgens in the body, which prostate cancer needs to grow and survive. It is also often used along with radiation therapy, and the combination has been shown to prolong survival in men with unfavorable-risk prostate cancer—defined as cancer with two or more high-risk factors, like a PSA level between 10 and 40 ng/mL, a Gleason score of 7 or higher, or biopsies with 50% or higher cancerous cells.

But a study in The Journal of the American Medical Association suggests that men who had a prior heart attack can increase their risk of a fatal one if they undergo both radiation therapy and ADT. Researchers compared overall survival and death from prostate cancer, fatal heart attack, and other causes in a group of 206 men with unfavorable-risk prostate cancer. The men received either radiation alone, or radiation and six months of ADT. The researchers also categorized the men into subgroups based on other health conditions, including heart disease.

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Being checked for hidden colorectal cancer is a smart bet, though it's hard to say whether it will ultimately extend your life span.

Recently, the National Colorectal Cancer Roundtable—a national organization of medical groups, health care providers, government agencies, and patient advocates—launched the "80% by 2018" initiative. The goal is to convince more people to get screened for hidden colorectal cancer. Right now, about 65% of Americans do so.

Ask the doctor

Q. I'm a 48-year-old woman, and I've never had a mammogram. Different guidelines seem to say different things. What do you recommend?

A. You're right, there are several different guidelines. Probably the two most often consulted by doctors are those of the U.S. Preventive Services Task Force (USPSTF) and the American Cancer Society (ACS). Recent changes by the ACS bring its recommendations nearer to those of USPSTF. They disagree slightly about you. ACS says you should have a mammogram (because you are over 45), but USPSTF says to begin at age 50. Both expert committees stress that these recommendations apply only to women who are not at extra risk of breast cancer (extra risk includes, for example, having a parent, sibling, or child who's had breast cancer). If a woman is at extra risk, she should start getting mammograms earlier.

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Ask the Doctor

Q. I had a vasectomy many years ago, at age 45. I recently read that this increases my risk of prostate cancer. Should I be concerned?

A. Despite the reports you've heard about the connection between vasectomy and prostate cancer, the evidence is weak for a cause-and-effect relationship. Right now, this hypothetical risk should not cause you undue concern.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

A new study confirms that active surveillance is a safe and reasonable alternative to immediate treatment for prostate cancer. In recently published study that followed 1,300 men, the prostate cancer survival rate after 10-15 years of active surveillance, was 99%. For some men, a strong discomfort with “living with cancer” may steer them away from postponing treatment in favor of careful monitoring.

The purpose of treating ductal carcinoma in situ (DCIS)—the earliest, noninvasive form of breast cancer (often called "precancer")—is to prevent those lesions from becoming invasive and thereby greatly reduce the risk of dying from breast cancer. As mammography has become more precise, it has detected more DCIS, and more women get treatment with surgery and often radiation as well. An analysis published online by JAMA Oncology on Aug. 20, 2015, adds to increasing questions about the best way to manage DCIS in most women diagnosed with it.

Canadian researchers analyzed 20 years of data from 108,000 women with DCIS in a database maintained by the National Cancer Institute. Most women were treated with lumpectomy, often followed by radiation, or mastectomy. The researchers found that treatment with radiation or mastectomy did not lower the overall breast cancer death rate in women with DCIS. It remained at 3.3%—the average death rate from all breast cancers. However there were some groups—including African American women and women under 40—in whom the death rate was higher (7% to 8%).