From The Daily Dose
Treating a prostate tumor can CAUSE deadlier cancers

Congratulations!

Your prostate cancer’s been “cured” and you’ve got absolutely nothing to worry about.

Nothing, that is, except for bladder cancer… colon cancer… and rectal cancer.

Yes, gents, a new review of 21 studies reveals that the radiation therapy you believed would cure one form of cancer can actually CAUSE at least three others. And while prostate cancer probably won’t kill you, these other forms of the disease can turn deadly in a heartbeat.

But hey, look on the bright side: The researchers say the risk of facing those other cancers is pretty small when you compare it to the risk of the OTHER side effects caused by common prostate treatments.

Many men end up springing a leak after their treatment. Sometimes, the incontinence is temporary… but in other cases, you’d better sign up for a warehouse club membership and stock up on adult diapers.

You’ll be in them for the rest of your life!

If there’s anything more humiliating than a leaky man-part, it’s the frustration of one that’s gone limp — and yet that’s what you also risk here.

Again, in some cases it’s temporary. But far too many men can pretty much kiss their sex lives goodbye, since common prostate cancer treatments involve either chemical or surgical castration.

The shame of it is most guys don’t HAVE to face any of those risks, because prostate tumors are usually so slow and lazy that you’re pretty much guaranteed to die of something else long before the cancer itself could ever get a chance to do you in.

You’re better off not even knowing it’s there so you’re not tempted into a potentially life-ruining treatment.

Even the researchers behind the new study say that when you consider all the side effects of treatment, most guys are better off leaving low-risk tumors alone.

It’s true that some prostate tumors really can kill you… but the sad reality is that by the time those aggressive cancers are found, it’s almost always too late anyway.

Don’t lose too much sleep over that one; those tumors are pretty rare, and there are a few tricks of the trade that can help you cut the risk of prostate cancer of any form.

One of them is a classic case of “use it or lose it,” because a study published last year found that having more sex can cut the risk of prostate cancer by 20 percent.

And if you have a rare high-risk tumor, don’t mess around with therapies that will ruin your life without actually saving it.

Speak to a naturopathic medical doctor who has experience in cancer care. I recommend a member of the American College for Advancement in Medicine.

With a radiation reality check,
Jack Harrison

Hypofractionation Therapy: Enough Evidence Yet?

Gerald Chodak, MD

August 29, 2016

Hello. I’m Dr Gerald Chodak for Medscape. Today I want to talk about hypofractionation of radiation therapy for men with clinical localized prostate cancer. A nice summary of four prospective, randomized, clinical trials^[1-4] is available on the Prostate Cancer Infolink website.

In the first trial,^[1] “[Conventional Versus] Hypofractionated High-Dose–Intensity-Modulated Radiotherapy for Prostate Cancer,” traditional radiation at a dose of 74 Gy in 37 fractions was compared with two hypofractionated schedules: 60 Gy in 20 fractions or 57 Gy in 19 fractions. The goal was to test for noninferiority. The 60-Gy dose was not inferior to traditional radiation. However, at 57 Gy, the results did not reach statistical significance. So we cannot say that the lower dose of 57 Gy was not inferior.

A second study,^[2] from Fox Chase Cancer Center, compared men receiving 76 Gy in 38 fractions with 70 Gy in 26 fractions, and disease-free survival was not significantly different. A third trial^[3] compared patients receiving 74 Gy in 41 fractions with 70 Gy in 28 fractions. Again, there was no significant difference showing noninferiority of the hypofractionated dose.

A fourth trial^[4] was slightly different. The HYpofractionated irradiation for PROstate cancer (HYPRO) trial randomized patients to receive either 78 Gy in 39 fractions or 65 Gy in 19 fractions. But they received 3D conformal therapy rather than intensity-modulated radiation therapy (IMRT). The goal was to show that hypofractionation was superior, but it did not reach statistical significance and there was a slightly higher rate of side effects. So, if patients receive hypofractionation, it probably is better if it is done with IMRT rather than 3D conformal radiation.

The question is whether hypofractionated radiation should be a paradigm for changing management. Editorials^[5,6] accompanying two of the articles claimed that hypofractionated irradiation was not ready to be used as a routine therapy. It does offer patients some advantages, but my concern is that the outcomes are not based on survival; they are only based on prostate-specific antigen (PSA) recurrence or disease-free survival. And the Radiation Therapy Oncology Group (RTOG) 0415 trial randomized patients receiving radiation and showed differences in PSA recurrence compared with overall survival. There was an inconsistency. Basing decisions on PSA or biochemical disease-free survival, rather than overall survival, could result in different conclusions.

For now, I think hypofractionated radiation may become an option for patients who are going to get radiation therapy, but more data are needed to prove that this will deliver the same survival as traditional radiation therapy. I look forward to your comments. Thank you.