ADDITIONAL INSIGHTS ON THE 2008

PCRI SYMPOSIUM IN LOS ANGELES

KEN MALIK – EXECUTIVE DIRECTOR

PROSTATE AWARENESS FOUNDATION

Lectures:

Dietary Supplements From A-Z. What Works and What’s Worthless – Mark Moyad, MD

· Provenge – Immunotherapy drug therapy. The newest research will be out in November

· Caloric Reduction has an impact on lowering PSA values

· Exercise including aerobic and weight lifting is the best pill for overall health

· Cholesterol levels have an impact on PSA and disease progression. Safe ranges are:

LDL – less than 100, HDL – around 60, Triglycerides – less than 150, cholesterol less than 200.

· Men suffering from fatigue after radiation and other cancer therapies should consider weight lifting and the supplement L-Carnitine.

Monitoring Prostate Cancer Without Immediate Treatment – Peter Carroll, MD

· Only about 3 % of men diagnosed will die from prostate cancer. Mortality has declined 31% over the past 13 years.

· The relative contributions of factors responsible for this decline including PSA screening, improved detection strategies, and improved treatments are unknown.

· Over detection and over treatment is becoming a major concern. There has been a large increase in very low risk prostate cancer. We still cannot differentiate between men who will progress and men who will not.

· The anxiety factor – a large percentage of men (92%) who would do well with active surveillance opt for more aggressive treatment. We need to find away to reduce the anxiety factor.

· A rise in Gleason score from biopsy to biopsy is a “red flag” for disease progression.

· Delaying treatment does not change the outcome.

Selecting Men for Active Surveillance with PCA-3 testing – John W. Davis, MD

· The PCA3 urine test is showing promise.

· The test can be used to reduce reliance on invasive biopsies to determine disease progression

Focal Cryotherapy: “Lumpectomy for the Prostate – Duke Bahn, MD

· The risk of receiving a prostate cancer diagnosis has doubled from 9% to 18% since the introduction of PSA testing.

· Conventional treatments can cause unexpected side effects and jeopardizes quality of life.

· Minimally invasive Focal (partial) cryotherapy is a realistic middle ground choice between active surveillance and radical prostatectomy and other invasive conventional options

· Potency preservation is upwards of 85-90% for focal cryotherapy patients.

State of the Art Scanning for Prostate Cancer – Daniel Margolis, MD

· The big question – Is it still in the prostate? There is still no definitive test available here in the United States. All the doctors at the conference agreed that the Combidex test available in Holland, but not here, needs to be fast tracked by the FDA.

Suppressing Relapsed Disease With Intermittent ADT – Stephen Strum, MD

· Dr Strum has become a vocal advocate for triple Androgen Deprivation Therapy as originally adopted by Robert Leibowitz.

Suppressing Relapsed Disease Without Blocking Testosterone – Mark Scholz, MD

· Men with relapsed disease usually not die from prostate cancer.

· Treatments that he has used with success include:

o Leukine

o Low Dose Cytoxan

o Celebrex

o Thalidomide

o Avastin

o Provenge

o Modified Citrus Pectin

o Pomegranate Juice

An Aggressive Approach to Metastasic Disease – Charles Myers, MD

· There are prostate cancer cells all over the body but they have not necessarily metastasized. They can even be in the bone marrow but they don’t spread. The experts do not know why this is!

· He feels that stem cells are the key and the problem. The trick is to learn how to eliminate these cells.

· These stem cells can be made to go into dormancy using some of the treatments advocated by Dr Scholz above.

Round Table discussions:

· IGF-1 plays a major role in cell transformation and growth of pc cells. Insulin levels have an impact on prostate cancer and it’s progression.

· Diabetics seem to be immune to prostate cancer disease progression but they do not know why.

· Avastin curtails the hormone called VEGF2, which stimulates cancer cell growth and angiogenesis.

· Pomegranate juice: the latest 5-year study of 200 patients showed a dramatic reduction in PSA doubling time.

· Current ADT pharmaceuticals do not totally stop pc cell growth. There is still testosterone being created in the tumor. A second generation of these drugs curtails this process and will soon be available.

· Add the PCA3 Urine test to your testing protocol. The reading should be 35 or less.

· Dr Myers feels that prostate cancer tends to become more aggressive with time.

· All agree that Gleason scores can change with time. A new biopsy should be performed periodically.

· A PAP score of 3.3 or higher usually indicates disease progression.

· A good tool to help patients determine their best treatment option is www.prostatecalculator.org