Top Prostate Cancer News of 2016

November 18, 2016

This slide show highlights some of the top prostate cancer news of 2016, including studies on aspirin use and cancer risk, the increased incidence of colorectal tumors in prostate cancer patients, hormone therapy and a link to depression, and more.

Aspirin May Lower Risk of Dying From Prostate Cancer:

A study found that regular aspirin use in prostate cancer patients, defined as taking aspirin more than three times a week, was associated with a 39% lower risk of dying from the disease compared with men who reported less frequent aspirin use or no aspirin use (hazard ratio, 0.61). The study evaluated data from 22,071 men who took part in the Physicians’ Health Study. Men enrolled in this cohort were tracked from 1982 until 2009. After more than 27 years of follow-up, 3,193 men were diagnosed with prostate cancer and, of those, 403 developed either metastatic prostate cancer or died from the disease.

. Image © Shane Maritch / Shutterstock.com

Liquid Biopsy Cell Diversity Could Indicate Poor Prostate Cancer Prognosis:

A study of 150 prostate cancer patients found that those who have a more heterogeneous set of detectable circulating tumor cells (CTCs) are more likely to develop resistance to anti-androgen therapy. Patients with the high heterogeneity score prior to enzalutamide or abiraterone treatment had a median progression-free survival of 5 months compared with 17 months in patients with a low heterogeneity score (hazard ratio [HR], 2.2;

= .00182). The high heterogeneity score patients also had shorter median overall survival compared with patients with a low heterogeneity score (9 months vs not reached; HR, 5.51;

< .0001).

. Image © science photo / Shutterstock.com

Radiation Therapy in Prostate Cancer Linked With Low Risk of Secondary Cancers:

Men who receive radiation therapy as treatment for their prostate cancer may have an increased risk of developing a subsequent, secondary cancer, according to a meta-analysis of 21 observational studies. Among the prostate cancer patients who underwent radiation therapy, the highest absolute rates of bladder, colorectal, and rectal cancers were 3.8%, 4.2%, and 1.2%, respectively. The lowest reported rates for the same cancers were 0.1%, 0.3%, and 0.3%, respectively. The results do not warrant changes to current therapeutic regimen decisions for most men with high-grade prostate cancer. There was no consistent link between radiotherapy for prostate cancer and secondary lung cancer or hematologic malignancies.

. Image © Alex Tihonovs / Shutterstock.com

PSA Testing Declining Faster With Primary Care Physicians Than Urologists:

The 2012 change in guidelines regarding prostate-specific antigen (PSA) testing for prostate cancer had a different effect on testing rates depending on which physician specialty was doing the testing. Primary care physicians (PCPs) showed a marked decline in PSA tests administered, while urologists had only a slight drop. The study included 113 patient visits to urologists and 1,109 to PCPs. Among the PCP visits, the use of PSA testing declined from 36.5% in 2010 to 16.4% in 2012, for an odds ratio of 0.43 (

= .009). The rate only decreased among urologists from 38.7% to 34.5%, for an odds ratio of 0.34 (

= .09). The difference between physician-specific testing practices was statistically significant (

< .001).

. Image © science photo / Shutterstock.com

Prostate Cancer Survivors Have Elevated Colorectal Cancer Risk:

A large cohort study showed that the risk of colorectal cancer is increased following a diagnosis of prostate cancer. This suggests colorectal cancer screening should be considered following a prostate cancer diagnosis, especially among those undergoing radiotherapy. The researchers conducted a historical cohort study based on data collected in Manitoba, Canada, covering a total of 14,164 men with prostate cancer and 69,051 controls without prostate cancer. Over the course of the follow-up period, 2.8% of the prostate cancer survivors were diagnosed with colorectal cancer, compared with 2.6% of the non–prostate cancer cohort. The hazard ratio (HR) for prostate cancer survivors being diagnosed with colorectal cancer was 1.14 (95% CI, 1.02–1.27;

= .021), with the highest risk seen within the first 30 days of diagnosis (HR, 3.04; 95% CI, 1.42–6.51;

= .004).

. Image © Sebastian Kaulitzki / Shutterstock.com

Hormone Therapy for Prostate Cancer Linked to Depression:

An analysis of the Surveillance, Epidemiology, and End Results (SEER) database found that men who receive androgen deprivation therapy (ADT) as part of their treatment for prostate cancer may be at higher risk for depression. The researchers analyzed a cohort of men with stage I–III prostate cancer who were over the age of 65. Longer exposure to ADT resulted in an increased risk of depression, from 12% among patients with less than 6 months of therapy to 26% in those with 7 to 11 months of therapy, and up to 37% among those treated for 12 months or longer (

< .001). Cumulative incidence of newly diagnosed depression from 6 to 36 months after a prostate cancer diagnosis was higher among the men who were treated with ADT (7.1% vs 5.2%;

< .001).

. Image © Photographee.eu / Shutterstock.com

Maintaining High Physical Activity Improves Prostate Cancer Survival:

A study found that prostate cancer patients who kept up a moderate to high level of physical activity had better survival prognoses compared with their more sedentary counterparts. After a prostate cancer diagnosis, men who exercised for 17.5 or more metabolic equivalent of task (MET) hours per week prior to their diagnosis had a 30% lower risk of prostate cancer mortality compared with men who exercised for fewer than 3.5 MET hours per week (comparable to less than an hour of moderately paced walking per week). Men who were the most physically active had a 34% lower risk of dying from prostate cancer compared with men who exercised the least.

. Image © sportpoint / Shutterstock.com

Decrease in Prostate Cancer Mortality Mirrors Declines in Cigarette Smoking:

Declines in the rates of cigarette smoking in several states (California, Kentucky, Maryland, and Utah) mirrored declines in prostate cancer deaths between 1999 and 2010, according to an epidemiologic analysis, suggesting prostate cancer mortality reduction is an added beneficial effect of reduced smoking rates. Smoking rates declined in all four states studied. In Maryland, for example, smoking prevalence declined by 3% per year from 1999 through 2010 (from 20.9% to 15.6%), while prostate cancer mortality declined by 3.5% per year (from 68.4 per 100,000 to 43.6 per 100,000). The authors noted that this study was an “ecological analysis” and was thus unable to conclude any causal association between smoking and prostate cancer mortality.

. Image © BanTasutStock / Shutterstock.com

Robotic Surgery On Par With Open Surgery for Prostate Cancer:

A randomized controlled trial found that robot-assisted and open radical surgeries for prostate cancer have similar outcomes for patients at 3 months. Patients who underwent robotic surgery or open surgery had similar quality-of-life outcomes at 3 months, including sexual and urinary function. These results are the initial results of a 2-year follow-up of patients on the trial. Urinary function was not different between the two surgical groups. At 6 weeks after surgery, urinary function scores were 74.50 and 71.10 in the open and robotic surgery arms, respectively (

= .09). At 12 weeks, urinary function scores were 83.80 and 82.50, respectively (

= .48). Sexual function scores were also similar between the two surgical groups: at 12 weeks, the scores were 35.00 and 38.90 in the open and robotic surgery arms, respectively (

= .18).

Reserve ADT for African-American Men With High-Risk Prostate Cancer?

Androgen-deprivation therapy (ADT) is associated with shortened survival in African American (AA) men with favorable-risk prostate cancer, according to a study in

Cancer

, suggesting that ADT should be reserved for those with higher risk disease. The new study included 7,252 men with low- or favorable intermediate-risk prostate cancer treated with brachytherapy and ADT or no ADT. In total, 869 men died during the follow-up period (median, 8.04 years), 48 from prostate cancer. On a multivariate analysis, AA race was significantly associated with an increased risk of all-cause mortality (adjusted hazard ratio, 1.77;

= .028) and other-cause mortality (HR, 1.86;

= .024) among men who received ADT.

Test Can Predict Post-Op Radiotherapy Outcomes in Prostate Cancer:

A study showed that a 24-gene signature called the Post-Operative Radiation Therapy Outcomes Score (PORTOS) can predict outcomes following postoperative radiotherapy (RT) in patients with prostate adenocarcinoma who underwent radical prostatectomy. The study included a training cohort of 196 patients and a larger validation cohort. In the training cohort, among patients with a high PORTOS, those who had RT had a 10-year distant metastasis rate of 5%, compared with 63% in those who did not receive RT, for a hazard ratio (HR) of 0.12 (

< .0001). Among those with a low PORTOS, the opposite was seen. Those who underwent postoperative RT had a 10-year distant metastasis rate of 57%, compared with 31% in those who did not undergo RT (HR, 2.5;

< .0001). The validation cohort confirmed these findings.