Man To Man News

Issue 1, 2013
Welcome to Man To Man News, a publication of the American Cancer Society Man To Man prostate cancer education and support program. Whether you are newly diagnosed, currently in treatment, or one of the growing number of survivors, you will find that Man To Man News contains timely, practical, and trustworthy information on topics that really matter to you such as the latest medical research, clinical trials, support groups, treatment options and their possible side effects, nutrition and fitness, and the inspirational stories of men who have survived this disease. For more help in your personal battle with prostate cancer, or to find out if there is a Man To Man support group near you, please contact your local American Cancer Society or call 1-800-227-2345. Together with our millions of supporters, the American Cancer Society saves lives and creates a world with less cancer and more birthdays by helping people stay well, helping people get well, by finding cures, and by fighting back against the disease.

Living with Prostate Cancer

If youre living with prostate cancer, you may be able to live longer and healthier by making some changes to your eating and exercise routine. Increasingly, studies show that healthy eating and maintaining an active lifestyle after a prostate cancer diagnosis can lower the chances of the cancer coming back, and can improve the chances of staying diseasefree. Healthy habits, such as not smoking, can also improve survival. Benefits may also include a lowered risk of heart disease. About 2.8 million men in the United States were estimated to be living with prostate cancer in 2012. Except for skin cancer, it is the most common cancer among American men. It can be a serious disease, but most men diagnosed with prostate cancer do not die from it. More than 90% of men have their

prostate cancer found early, when its easiest to treat. At 10 years after diagnosis, their survival rate is very close to that of other men the same age. In fact, more prostate cancer survivors die from heart disease than from their cancer. Lifestyle changes can lower risk of recurrence The American Cancer Society recently updated its recommendations for cancer survivors with some specific guidance for men with prostate cancer: 1. Achieve and maintain a healthy weight.

Avoid weight gain during prostate cancer

treatment, whether you are at a healthy weight or overweight.

Weight loss after recovery from treatment

may benefit survivors who are overweight or obese. risk of death from prostate cancer.

Research has linked obesity to a greater

See Living with... next page

Living with... continued

Talk to your doctor first to make sure youre healthy enough

3. Eat a healthy diet, with an emphasis on fruits, vegetables, and whole grains.

to begin an exercise routine, especially if you havent exercised in a while. Then, start slowly and work your way up.

The most health benefits are associated with a diet high

in fruits, vegetables, whole grains, poultry, and fish; low in refined grains, beef, pork, lamb, and processed meat (such as hot dogs, sausage, and bacon); and low in high-fat dairy products. and lamb) and high-fat dairy products, has been linked to an increased risk of prostate cancer.

A diet high in saturated fat, including red meat (beef, pork,

2. Be physically active.

4. Check with your doctor before taking any supplements.

Studies show that exercise is safe during prostate cancer

Studies show that taking vitamins, herbs, and other

treatment and can improve many aspects of health, including muscle strength, balance, fatigue, cardiovascular fitness, and depression. to living longer and a reduced risk of the cancer returning.

nutritional supplements often does not help cancer patients live longer and may even shorten life. men shows that those who took vitamin E supplements were more likely to develop prostate cancer. The study didnt look at men who had prostate cancer already, but the findings arent encouraging.

A follow-up study from a clinical trial that included 35,000

Physical activity after a prostate cancer diagnosis is linked In a study, men with localized prostate cancer who engaged
in at least 3 hours of vigorous activity per week were nearly 60% less likely to die from the disease.

Loss of Appetite during Treatment

During treatment for prostate cancer, eating right is important. Some men continue to enjoy food and have a normal appetite throughout their treatment. Others have days when they dont feel like eating as much or dont feel like eating at all. This is because treatment may change your sense of taste or cause nausea. You may even lose weight when you dont want to. You may find these tips helpful from the American Cancer Society book What to Eat During Cancer Treatment :

Eat your biggest meal of the day when you feel hungriest, even if that means having a
sandwich for breakfast or eggs for dinner.

Consider adding finely chopped meats, cheese, or hard-boiled eggs to soups, sauces,
or casseroles for extra calories and protein.

Package leftovers in single-serving containers for convenient re-serving later; large

servings can seem overwhelming when your appetite is poor.

If drinking seems easier than eating, sip hot cocoa, milk, milkshakes, smoothies, soups, or canned nutritional supplements. Eat small, frequent snacks throughout the day. Eat food cool or cold to decrease its smell and taste.
Appetite problems caused by treatment usually get better over time and tend to go away after treatment. But you may want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you more ideas on how to deal with these treatment side effects. Find What to Eat During Cancer Treatment and other American Cancer Society books at cancer.org/bookstore.

Key words
Localized cancer: Also called local cancer. A cancer that is confined to the organ where it started; that is, it has not spread to distant parts of the body.

From the News Desk

For the latest prostate cancer news, visit cancer.org.

Study: Surgery No Better Than Observation for Most with Localized Prostate Cancer
A study by researchers from across the US found that men with prostate cancer that has not spread lived just as long whether or not they had prostate-removal surgery. The study appears in the New England Journal of Medicine. The Prostate Cancer Intervention Versus Observation Trial (PIVOT) enrolled 731 men with localized prostate cancer diagnosed through PSA tests and biopsies. About half the men were randomly assigned to receive radical prostate surgery, which removes the entire prostate gland and some of the tissue around it. The other men were assigned to the observation group. After 12 years of follow-up, the researchers found little difference in the number of men who died from prostate cancer between the 2 groups. Researchers classified trial participants as having low-, intermediate-, or high-risk prostate cancer (risk refers to the chance that the cancer will spread and become lifethreatening). They found that men in the low-risk category those with PSA levels less than 10 and Gleason scores less than 7 were least likely to benefit from surgery. The researchers say the studys findings support observation over surgery for men with localized prostate cancer, especially those who have low-risk disease. In the study, 21.4% of men in the surgery group had a complication within 30 days after surgery, including 1 death. The most common complication was infection. Two years after the surgery, urinary incontinence and erectile dysfunction were much more common in the surgery group than the observation group. Managing prostate cancer through observation has evolved since this study was begun. Until recently, observation or watchful waiting was widely used to mean waiting until the cancer caused symptoms before starting any treatment. Now, it is more common to monitor the patients cancer closely with regular PSA tests, rectal exams, and biopsies. If the cancer is worsening, the doctor can still recommend treatment aimed at cure. This approach is commonly referred to as active surveillance.

Weighing the Benefits and Risks of PSA Screening

Men deciding whether to have a screening test for prostate cancer must weigh the desired benefits of potential treatment living longer against the risk of harms (side effects that may include bowel and sexual problems and urinary incontinence). Dutch researchers have attempted to measure the benefits versus the risks in a study that uses data from a large European trial. The European Randomized Study of Screening for Prostate Cancer (ERSPC) found that men ages 55 to 69 who had PSA screening every year were 29% less likely to die from prostate cancer, but lost some quality of life years due to side effects of diagnosis and treatment. To measure what they call qualityadjusted life-years, the Dutch researchers came up with a model to weigh how the men in the ERSPC study felt about the state of their health over their lifetime. The Dutch study appeared in the New England Journal of Medicine. The study found that some men gained and some men lost quality-adjusted life-years, depending on how they felt about living as long as possible, even if it meant living with unpleasant side effects. Overall, the study found a small average gain 56 years for every 1,000 men regularly tested. That calculates to just a few weeks per man. The American Cancer Society recommends that, starting at age 50, men should talk to a doctor about the pros and cons of testing, so they can decide if testing is the right choice for them. If they are African American or have a father or brother who had prostate cancer before age 65, they should have this talk with a doctor starting at age 45.

The American Cancer Society, Inc. adheres to the Better Business Bureaus strong standards for charitable giving.

Survivors Needed for American Cancer Society Survivorship Study

The end of cancer treatment can be both stressful and exciting. To help survivors adjust to life after treatment, Stanford University has an online workshop called Cancer: Thriving and Surviving. The American Cancer Society is conducting a 1-year study to see how well it works, and we need your help. During the 6-week workshop, you will connect with other post-treatment survivors to share your experience. You will also learn ways to manage fatigue, difficult emotions, and effects of cancer treatment. Its done entirely online you choose the days and times that are most convenient for you. You should log on at least twice a week for a total of 2-3 hours each week. You will also be asked to complete 3 online surveys one when you agree to participate in the study, one 6 months later, and one 12 months later. Enrollment is limited. To learn more, visit cancer.org/smp.

Your Prostate Cancer Questions Answered

If you have a question about prostate cancer, we can help you find answers. Call us anytime, day or night, at 1-800-227-2345 to speak with a trained Cancer Information Specialist. Or go to cancer.org and click Contact Us at the bottom of the page to email us your question. Question: My doctor told me about a urine test to help determine whether I need another biopsy. Can you tell me more about it? Answer: The US Food and Drug Administration (FDA) has approved a test called Progensa PCA3. This is a urine test that measures prostate cancer gene 3 (PCA3) molecules. If the Progensa PCA3 test result is negative, there is less chance that a prostate biopsy will find cancer. Its another tool to help doctors decide whether men who have had a biopsy that found no cancer need a repeat biopsy later. The test is used in men 50 years of age or older who have already had 1 or more negative prostate biopsies, in cases where the doctor is considering another biopsy. The doctor uses the test along with other clinical information to decide if the repeat biopsy is needed. As a result of the test, some men who would otherwise be recommended for a biopsy may be able to skip it, thereby avoiding the risk of complications from the biopsy.

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Diet, exercise, smoking, and other lifestyle choices can affect your health and risk of cancer. Thats why we produce HealthyLiving, a free monthly newsletter with useful information on eating right, staying active, and other healthy behaviors. To sign up, visit cancer.org and search for HealthyLiving newsletter or call us at 1-800-227-2345.

Prostate Cancer Survivor Does His Homework

When Kent Lawrence, now 77, was diagnosed with prostate cancer in 2004, he didnt know much about it. He jokes that he didnt even know how to spell it. But he and his wife quickly got up to speed by reading books, articles, and Web sites that described the many different options in prostate cancer treatment. By the time they met with the team of doctors at Massachusetts General Hospital in Boston, they were prepared. The treatment recommended by the team matched what the Lawrences had already determined would probably be best. That helped them feel confident in their decision. Lawrence never expected to get cancer because it didnt run in his family. (But the truth is, only about 5% to 10% of all cancer is inherited.) It was at the doctors suggestion that he began getting an annual prostate-specific antigen (PSA) blood test in 1993. Hed been having the test for 11 years when his PSA level jumped to 5 times what it had been the year before. Additional tests confirmed that he had an aggressive kind of prostate cancer. But there was also good news: it probably had not yet spread to other parts of his body. Aggressive treatment for aggressive cancer The Lawrences and the medical team agreed on an aggressive treatment to battle his fast-moving cancer and to lower the risk that it would come back: a combination of radiation and hormone therapy. The treatment plan would take about 2 years.

The radiation made Lawrence feel tired and caused some bowel and bladder issues. The hormone injections gave him a half-dozen or more hot flashes every day that were severe enough to wake him up at night. Hormone therapy for prostate cancer reduces testosterone in men, which can also lower the sex drive and cause impotence. But Lawrence said, Oh, well. The ultimate goal is to knock out the cancer and stay alive. A guy whos walked the walk A year ago, Lawrence gave the kickoff speech at his local Relay For Life event. Recently, the American Cancer Society recognized him with the Quality of Life Award for his outstanding leadership and service, and for enhancing the quality of life for cancer patients and their families in the community. Today, Lawrence has no signs or symptoms of cancer, and he continues to have regular tests to make sure it hasnt come back. He volunteers with the American Cancer Society Man To Man program to counsel and mentor other men who are dealing with prostate cancer. Lawrence said, So many of them like to talk to a guy whos walked the walk. I can tell them about my side effects and how the cancer affected me.

Wish

by Andrew Bannecker

I focused my design on the magic moment right after you blow out a birthday candle. It represents the birthdays that cancer survivors are celebrating thanks to cancer research.
Inspiration The American Cancer Society is the largest private funder of cancer research in the United States. Buy artist wrapping paper, prints and more at morebirthdays.com

2010 Andrew Bannecker used with permission 2010 American Cancer Society, Inc.

2012, American Cancer Society, Inc. No. 045340 Models used for illustrative purposes only.