Prostate Cancer Symptoms Tips What is prostate cancer symptoms? We have tips about prostate cancer symptoms

More than 400 patients, friends and faculty of the Abramson Cancer Center celebrated the transformational gift from Jon and Mindy Gray to establish the Basser Research Center for BRCA in New York and Philadelphia this fall.

The Basser Center will focus on prevention and treatment options for those with a BRCA 1 or 2 mutation and will provide a place for people to discuss their options and participate in research studies.

From left:  Chi Van Dang, M.D., Ph.D., Susan Domchek, M.D., Jon Gray and Mindy Basser Gray, Amy Gutmann, Ph.D., and J. Larry Jameson, M.D., Ph.D.

View more photos from the Philadelphia and New York events on Penn Medicine's Facebook page.

About the Basser Research Center

A $25 million gift to the University of Pennsylvania from alumni Mindy and Jon Gray will establish a center focused on the treatment and prevention of cancers associated with hereditary BRCA mutations.

The Basser Research Center — BRC for BRCA — will support research on the BRCA1 and BRCA2 genes, harmful forms of which are linked to greatly increased risks of developing breast and ovarian cancer. The Center is named in honor of Mindy Gray’s sister, Faith Basser, who died of ovarian cancer at age 44.

Emphasizing outreach, prevention, early detection, treatment and survivorship, the Basser Research Center will contribute to all stages of research and clinical care related to BRCA-related cancers.

“We hope that the Basser Research Center will eliminate BRCA-related cancers and, in doing so, provide a road map for curing other genetic diseases,” Mindy and Jon Gray said. “We also want to make sure that families have a center dedicated to helping them with the complex issues arising from a BRCA diagnosis. As Penn graduates, we are fortunate that our alma mater has the world-class medical facilities and gifted researchers essential for this mission.”

The Center will be located within Penn’s Abramson Cancer Center at the Perelman School of Medicine. The gift will create an endowed professorship in the field of oncology to be known as the Basser Professorship, recruit additional faculty, enhance core technologies such as bioinformatics and DNA vaccine production, launch an annual lectureship and establish the Basser Prize to honor cutting-edge research.

The Grays’ gift will support research with a particular focus on interdisciplinary work and an acceleration of bench-to-bedside implementation of scientific findings.

Susan Domchek, associate professor of medical oncology and current director of the MacDonald Women’s Cancer Risk Evaluation Center at the Perelman School of Medicine, will serve as the founding executive director of the Basser Research Center and will lead its strategic direction.

If you're curious about prostate cancer rates, you may be wondering if prostate cancer risk increases with age. The answer is yes. Before the age of 40, it is uncommon, but prevalence increases rapidly in men over age 40 -- and continues to rise thereafter.

How Do We Know the True Prevalence of Prostate Cancer?

The only way to definitively diagnose prostate cancer is by taking some of the prostate tissue and looking at it under a microscope to determine if any cancerous cells are present.
This is mostly done with prostate biopsy when there is some reason to be concerned that prostate cancer may be present (such as an elevated PSA level, an abnormal digital rectal exam, or urinary symptoms).

In order to determine how common prostate cancer truly is, however, biopsies would have to be done on lots and lots of men -- regardless of whether they needed it or not. This plan obviously has some serious drawbacks and will likely never be done.
Instead, prostate tissue can be analyzed after death during an autopsy. It is through autopsy studies that scientists have been able to determine the actual prevalence of prostate cancer among men of various ages.

Prostate Cancer Rates by Age

One project that analyzed autopsy studies from around the world came to the following conclusion regarding the actual rate of prostate cancer in men of different ages:

• 20 to 30 years, 2% to 8%
• 31 to 40 years: 9% to 31%
• 41 to 50 years: 3% to 43%
• 51 to 60 years: 5% to 46%
• 61 to 70 years: 14% to 70%
• 71 to 80 years: 31% to 83%
• 81 to 90 years: 40% to 73%

Obviously, some of these age ranges show a large degree of variability in the prevalence of cancer. This variability is thought to be due to differences in the diagnostic techniques used by the various pathologists and to geographic differences. (Men in some parts of the world have much higher rates of prostate cancer than others.)

Overall, though, this gives a pretty good picture of just how common prostate cancer is and how dramatically its prevalence increases with age.

_Sources:

Delongchamps NB, Singh A, Haas GP. The role of prevalence in the diagnosis of prostate cancer. Cancer Control. 2006 Jul;13(3):158-68.
Hankey BF, Feuer EJ, Clegg LX, et al. Cancer surveillance series: interpreting trends in prostate cancer--part I: Evidence of the effects of screening in recent prostate cancer incidence, mortality, and survival rates. J Natl Cancer Inst 1999 Jun 16;91(12):1017-24.

Carly Roop RD, CSO, is a registered dietitian at the Joan Karnell Cancer Center (JKCC). She provides nutrition education and support to patients while addressing nutrition-related side effects from chemotherapy and radiation. Dietitians at JKCC provide educational nutrition programs that are open to patients as well as the community.

Can You Still Have a Merry Time Without Eating or Drinking?

It seems impossible to go anywhere or do anything without eating or drinking, especially, during the holidays. The calendar fills up with dinners, holiday parties or drinks after work and the morning talk shows feature gift ideas that are food-related as well, because I guess they figure we all have to eat.
However, if you know someone with cancer currently undergoing treatment or if you are going through treatment you know firsthand the effect it has on someone’s appetite or ability to eat.

I am amazed at the extent we are linked to food; food not only feeds us physically, but food feeds us emotionally, culturally, socially and psychologically. For some their aversion for food may only be temporary but for others they may never be able to eat normally again.

So what can you do at Christmas for someone with cancer who can’t or isn’t interested in eating? Hopefully, these ideas below will help you get your wheels turning:

• Bowling: I know that you can eat while you are bowling but when you think about all the people touching the balls…do you really want to?
• Paint your own pottery or take a painting class: I’ve seen painting classes on social coupon websites, and there is usually a BYOB option, if you are so inclined.
• Go to the Nutcracker: Unlike the movies, you are encouraged to finish your drink or snack before taking your seat.
• Have a spa day
• Make a book on tape or read someone to sleep: Who doesn’t like being read to?
• Make a mixed CD: This may sound high school, but your friend or family member will appreciate the time and thought you put into the gift and they may even like the songs!
• Go to amateurs’ night at comedy club: It’s a good time, and everyone loves to laugh.
• Take a walk or drive around to the neighborhood to take in the beautiful or garish Christmas displays
• Go to the museum
• Spend time putting together a gigantic jigsaw puzzle: I knew someone who would frame his puzzles after they were done and hang them as art
• Photography: Sometimes it’s more fun to be behind the camera
• Accessories: Shoes, for example, don’t have to be Louis Vuitton, but sometimes a new pair of shoes can make you feel like you have a new wardrobe.

Christine Wilson, cancer survivor, shares her experiences from the Abramson Cancer Center’s 2012- Focus on Brain Cancer Conference:
Discovery to Recovery. In this blog, she discusses treatments for brain cancer.

Neurosurgery:  The Crux of Treatment for Brain Cancer

"The neurosurgeon's goal is take out as much of the tumor as possible safely, " says Steven Brem, MD, conference chair, and director of neurosurgical oncology.

"Personalized medicine has become something of a buzz work in medicine, but it is true for brain cancer patients,” says  Donald O'Rourke, MD, associate professor of neurosurgery.

Penn neurosurgeons are using improved imaging techniques for "neuronavigation."  This approach provides real-time, 3D views for the surgeon as he operates - allowing for maximum safe resection of the tumor and avoiding normal tissue.  This is particularly crucial in preserving language function and motor skills.

Radiation Therapy:  The Full Spectrum of Options

"Penn has the largest, most advanced proton facility in the world, one of only 10 in the United States.  We also have the unique advantage of having all of our radiation facilities integrated under one roof, "
Robert Lustig, MD, professor of radiation oncology.

Radiation therapy plays a key role in the treatment of most brain cancers.  Penn offers the full range of treatment modalities including one of only 10 proton facilities in the country.  Patients often are unsure of the relative benefits or indications for different kinds of radiation therapy, for example, protons vs. the gamma or cyber knife. 

Radiation therapy treatment decisions for brain tumors are highly individualized and need to be made in the context of multidisciplinary planning. 

Briefly stated, protons:

• Are more precise than conventional radiation therapy and do less damage to normal tissue
• Reduce side effects both short and long term 
• Deliver slightly more radiation to the tumor on a dose by dose basis
• Are effective in treating tumors near sensitive structures such as the spinal cord
• Can be used to "retreat" some patients with brain cancers

Dr. Lustig noted that Penn is now conducting clinical trials using protons for high-grade glioblastomas, grade III astrocytomas and pituitary adenomas, and will participate in an NCI-RTOG national study on protons for glioblastomas expected to begin soon.

He also noted that many patients encounter insurance issues in trying to get approval for proton therapy, although Medicare pays for most indications.

Stereotactic radiosurgery using the Gamma Knife® is another option for treating brain cancers.  Michelle Alonso-Basanta, MD, PhD, assistant professor of radiation oncology, explained that the original Gamma Knife was not designed to treat cancers, but that advances in technology and technique have made this a useful therapy for some patients with brain cancers.

"As with protons," she says, "we can deliver a very high dose of radiation to the target with little or no exposure of normal tissue to the radiation.  And, as with protons, the decision as to who will benefit from this approach is very individual."

Both stereotactic radiosurgery and protons offer the possibility of retreatment for patients who have undergone a previous course of radiation therapy and whose tumors have recurred.  In the past, these patients were not eligible for additional radiation therapy. 

Targeted Therapies: Changing Cancer Treatment

Penn Medicine has been a leader in immunotherapy research and in developing targeted vaccines for cancer for many years.  Bruce Levine, PhD, facility director, clinical cell and vaccine production facility describes work currently underway that involves activating T-cells, one of the mainstays of the body's defense system, to fight cancers. 

"If I could design T-cells to fight cancer," he says, "they would be potent, have a good memory, be persistent and numerous."

A new approach, developed at Penn, known as CAR (chimeric antigen receptor) T-cell therapy promises to be all of those things.  CAR uses a complex process to remove cells from the patients and own body and activate them to attack the tumor.  Penn is now in the process of developing clinical trials that will study the effects of CAR T cell therapy on glioblastomas with the EGRF v III mutation.

That mutation is the focus of work aimed at improving brain cancer treatment using chemotherapy as well.  Arati Desai, MD, MAS, is using bevacizumab (Avastin), a drug that inhibits blood vessel formation, in combination with another drug in patients with recurrent glioblastomas.  Phase II studies have demonstrated improved response rates and survival, although Desai acknowledges that some controversy exists about what those responses mean in terms of actual survival times.

Other clinical trials are aimed at attacking cancer cells from both the inside of the cell and the outside. 

These include approaches using

• Immunotherapy
• Combinations of drugs that target multiple pathways
• Drugs that affect the environment around the tumor
• Drugs that block the critical M Tors pathway
• Drugs that target factors known to influence prognosis, such IDH1 and MGMT

"There isn't going to be a single drug or agent that is going to work for everyone," says Desai.  "It's not going to be the same answer for every patient."

A front-page story in the New York Times details the progress of a Perelman School of Medicine team in using genetically engineered versions of leukemia patients' own T cells to fight their cancer; an approach which has now been used in 12 patients, 9 of whom responded to the therapy -- including two children.

"Our goal is to have a cure, but we can't say that word," said the study's leader, Carl June, MD, the Richard W. Vague Professor in Immunotherapy in the department of Pathology and Laboratory Medicine and director of Translational Research in Penn's Abramson Cancer Center.

He hopes the new treatment will eventually replace bone-marrow transplantation, an even more arduous, risky and expensive procedure that is now the last hope when other treatments fail in leukemia and related diseases.

Carolyn Vachani, RN, MSN, AOCN, is an oncology advanced practice nurse at the Abramson Cancer Center. She has worked in the areas of medical hematology and oncology, bone marrow transplant, clinical research, radiation therapy and staff development. She is also the nurse educator for OncoLink.

Have you thought about holiday gifts for someone with cancer?

The holidays can be very stressful- particularly when you are already dealing with a cancer diagnosis or are the caregiver for someone with cancer. Perhaps you know someone in such a situation. Whether they are a family member, good friend or just the woman down the street you always pass when walking the dog, you may be thinking about their struggles this holiday season and want to show them you care. I encourage you to think outside the box of chocolates.

In my years of caring for and talking to people with cancer, I have never heard “so-and-so gave me the nicest box of chocolates.” What they do remember is the kind – and often free – gestures from people, no matter the time of year. A card with a kind note; a meal left on the front steps while they were at treatment; leaves raked when they just couldn’t do it themselves. Be the holiday helper who shops for and wraps all the kid’s gifts or decorates the house when the person had no energy to do it - remember to come back and un-decorate too! Deliver a holiday meal or invite them to yours.

You don’t need to spend money to show someone you care. Simple gestures can be so helpful - walk their dog, taking out the trash cans on trash day, call when you are going to the store and offer to pick up some items. A “gift” of your time and energy goes a long way to making someone feel cared about and special.

Have I got you thinking? Need more ideas? The OncoLink Holiday Survival guide has many more ideas for special gifts and shares survivor’s memorable gift stories.