Monthly Archives: June 2017

4 Facts Senior Men Need to Know about Prostate Cancer

Most senior men are not getting the correct therapy for prostate cancer.

“I had to worry about prostate cancer only when I was young.”

Quality of Life Matters when making decisions.

  1. Not true.  Most of the deaths from locally advanced prostate cancer occur in men 75 years or older.

“If I have prostate cancer when I’m old, I only need a hormone shot if anything.”

  1. Again, not true.  In the past several years, two landmark clinical trials have clearly shown there is better survival for men with locally advanced prostate cancer if radiation is added to hormonal therapy versus hormonal therapy alone.  These trials have become the “Gold Standard for cancer care.” The effects of radiation therapy were huge-a 50% decrease in prostate cancer deaths.

“Aren’t radiation and hormones only for men in those fancy clinical trials at big centers?”

  1. Dr. Justin Bekelman of the University of Pennsylvania School of Medicine recently completed a study of over 31,000 Medicare seniors  that led him to conclude that “Men with aggressive prostate cancer regardless of age – where they are in their 50s, 60s, 70s, or 80s – should know that radiation with hormone therapy save lives.” (HemOnctoday: 2015, March, p 24).

“Do I really need to see a radiation specialist too?  Can’t my urologist just do everything.”

  1. I wish it were that simple.  In Bekelman’s study, 49% of men older than 65 years and 61% of men older than 75 years had hormone therapy only, and not radiation plus hormone therapy. That means 1 of 2 men older than 65 years and 3 of 5 men older than 75 years, are not getting the correct therapy.

Dr. Dean Shumway and Dr. Daniel Hamstra, both from the University of Michigan Radiation Oncology Department, commented on Dr.Bekelman’s study and wrote “it is also critical to note that the use of primary androgen deprivation therapy has been found to be highly related to which practitioner a patient sees rather than to the patient or tumor characteristics.”  In short, many urologists continue to just prescribe hormone therapy and not radiation, despite the overwhelming evidence for radiation and hormonal therapy.

For more information or to get advice on a specific patient case, feel free to call me, Edward Hughes, M.D., PhD at 855-Dayton1.

1 in 4 Lung Cancers are in Never Smokers

When every extra day counts, turn to the CyberKnife.

Did you know that “never smokers” make up 28% of new diagnosis of early stage non-small cell lung cancer patients?

 Dr. Eric Lim and colleagues from London looked at 2,170 British men and women who had  lung cancer surgery from March 2008 to November 2014.   

The remarkable finding was that “never-smokers” with lung cancer increased each and every year from 13% in 2007 to 28% in 2013.  And the trend was due to a dramatic increase in the absolute numbers of “never smokers” with lung cancer.   Fifty five percent of those patients with lung cancer were found “incidentally.”  That is to say, their lung cancers were found by CT scans, PET-CT scans, X-rays, or MRI’s ordered for other reasons-not because their physicians suspected lung cancer.  Only 14% of patients had symptoms of lung cancer-like coughing up blood or profound shortness of breath. 

Like many good medical studies, Dr. Lim’s article raises more questions than answers.  Were these lung cancer patients who were “never smokers” exposed to second-hand smoke at home or in the workplace?  What about other exposures, like chemical toxins, in the workplace?  Are there differences in “never-smokers” who live in the city versus out in the country?  What about family history?  Do the same trends hold for people in the US? 

So whether it’s family history, genetics, race or just bad luck remains to be seen.  But the good news is that lung cancer caught early is highly curable.  Cure rates are now in the 80-90% range for 5 years.  And you may not need surgery at all.  Many studies have now shown that Cyber Knife radiosurgery is equal to or even better than open surgery for patients with early stage lung cancer.  And Cyber Knife is done as an outpatient-no incision, no pain, and no long hospital stays; eliminating the complications that go along with surgery.

So if you have any questions about your lung cancer, please free to call me, Dr. Edward Hughes