My Friend Will has quite a story. He is the most active hunter of new information concerning prostate cancer of anybody I know. He is the only layman I know that receives calls from physicians asking for his information. For example, I mentioned to Will that worm wood had some history of eliminating several different types of cancers. Will got on the ball and found a lot of information about wormwood and located an ongoing clinical trial at the University of Washington (three versions of wormwood (Artemisinnin, Artesunate, and Artemether). Will is more active in this area than any layman I know. R.B. Subject: Prostate cancer/I am so happy Date: Thu, 7 Nov 2002 12:29:32 -0500 I started a finance club, (CITMAG) 12 years ago, we are 35 strong, and sent the below message to them. I thought others may enjoy reading the message also. Will Henderson __________________________________________________________________________ To: The CITMAG group From: Will Henderson Subject: Prostate cancer/I am so happy I wanted to share with you my good news. No return of my prostate cancer after eight years. I just can't believe it, and am very happy. Few of you know that I am a victim of prostate cancer. To try to make a long story short I got the bad news eight years ago on a general physical at Mayo Clinic. My twin brother had prostate cancer two years before me. Mayo did surgery taking out my prostate gland. They found it in my lymph nodes, which they took out. A very aggressive kind they said. I asked to see an oncologist, and asked for early chemo. The doctor said no, not yet, "but I would go home and get my house in order." I fooled him, and myself. I went home, got on the Internet, did my own investigation, got with groups of other prostate cancer people and learned. I took research to my family doctor, and he prescribed what I asked for. Eight years ago everyone waited for the PSA (cancer marker) to rise after surgery before prescribing medication; I said no, I want medication right after surgery. This saved my life. Now, most doctors prescribe medication right after surgery. They finally learned. My odds were 80% the cancer would return in 5 years, I was told by the Mayo people. I recently went to the I. U. Med center for a check-up and the doctor wrote, after my treatment plan, and eight years going by with no return, my odds are now 80% that it will never come back. He wanted me to stop my medication, and I told him no, I was worried about the 20%. We retired at age 60 with a pretty good portfolio, moved to Florida (Camelot), for our "better years." It did not work out that way. Wanda developed uterus cancer, shortly after the move. She beat that. So we moved back to Indiana and built a new house. Then a year and one-half ago Mayo found a lump on her breast. They took the lump and nodes out. One node had cancer, so she had 4 weeks of chemo, and 5 weeks of radiation. Her hair has all grown back and she is back to normal. (Camelot still not on the horizon). Few of my CITMAG friends knew about this. I remember making a presentation in Tom's building on the Airport in Columbus when we first started, with a catheter in and a bag of urine strapped to my leg. I told my good friend Rick Weber about my cancer; later Rolf, and Tom. So now is like a time to "come out of the closet." I never intended to hide this information, but did not want to bother anyone with my problem. So I am still on much medication, and my cancer may come back tomorrow, but today I am happy. I have spent many hours on prostate cancer research, which has taken away from my investment time. I have spoken at several prostate cancer seminars; traveled to different parts of the country to get special treatment; attended seminars in different parts of the country; and am on the advisory list to council with new prostate cancer people. I am on an advisory panel at I. U. Med center. I am busy. Demos, a 15-year friend in Florida, called a couple of weeks ago with prostate cancer. I sent him a lot of information. He was treated with seeds. I told him the first rule to learn is to try to continue to have fun. We have been on 14 cruises over the years, the last one being last year. So in keeping with the first rule, Wanda and I are leaving Saturday for a 7-day cruise on the "Mississippi Queen", going from New Orleans to Memphis. I like jazz music and cajun food. What have I really learned. Grasp every day with both hands. Will P.S. I must add that my walk with Christ I feel led me in the right direction for my treatment. (Before I got cancer I was a deacon and elder in two different churches; but NOW I am a better Christian).

CARCINOMA EXTENT IN PROSTATE NEEDLE BIOPSY TISSUE IN THE PREDICTION OF WHOLE GLAND TUMOR VOLUME IN A SCREENING POPULATION

Am J Clin Patho1118(3):442-450, 2002 Increasing prostate tumor volume has been shown to correlate with numerous adverse prognostic indicators for patients with prostate carcinoma. The ability to predict tumor volume from pretreatment parameters is potentially critical in the stratification of patients for different management strategies. Findings highlight the importance of reporting quantitative measures of tumor amount in prostate needle biopsy specimens; several measures of tumor extent (vs l measure) provide maximal information on prostate cancer size.

MISONIX ANNOUCES FOCUS SURGERY'S POSITIVE PROSTATE CANCER RESULTS USING HIGH INTENSITY FOCUSED ULTRASOUND -HIFU

Misonix, Inc. announced that Focus Surgery has released outstanding interim results for the treatment of 'prostate cancer using the Sonablate(R) High Intensity Focused Ultrasound (HIFU) device. Results have been obtained in both Japanese clinical trials of approximately 100 patients at 10 locations, and 15 patients in the U.S. clinical trials at Indiana university School of Medicine in Indianapolis, Indiana. Misonix currently owns approximately 20% of Focus and has the right to produce its products. The Sonablate(R) system, developed by Focus Surgery, Inc. of Indianapolis, IN, is capable of killing deep-seated cancer tissue by rapidly elevating the temperature in a precise focal zone, without affecting the intervening tissue, and without side effects such as ionization or radiation. The treatment is precise, bloodless and has minimal complications. The treatment is guided by ultrasound imaging that also combines HIFU technology. Dr. Toyoaki Uchida, MD in Tokyo, Japan released results at the September Societe Intemationale d'Urologie (S1U) Meeting in Stockholm, Sweden indicating that patients in a 50 patient study with pre-treatment prostate specific antigen (PSA) scores of less than 20ng/ml have a 95% success rate and a 100% negative biopsy. Narendra Sanghvi, President of Focus Surgery, said, "Patients in the 10 to 20ng/ ml PSA range represent much higher risk patients and we were still able to get good results. Even more encouraging is the low rate of complications for the patients after the treatments. Adverse effects of most prostate cancer treatments include significant blood loss, incontinence and total impotency. "With HIFU, we have a bloodless, outpatient procedure". Mike McManus, President of Misonix, said. "It is encouraging to know that our results in the United States are similar to Dr. Uchida's in Japan. Currently, the 15-patients treated in the U.S. are experiencing a quick PSA drop and a mean PSA level of 0.44ng/ml at 180 days for an outpatient treatment with no blood loss or incontinence."

Bob Dole may have been the first person to discuss erectile dysfunction openly on TV, but family physicians are the ones who need to talk openly and routinely about sexual activity and sexual dysfunction with their patients in everyday practice. Many patients, especially men, rarely initiate clinical conversations about such sexual concerns as low libido, arousal difficulties, and problems with early ejaculation or lack of orgasm. But studies show that most patients want to talk about these problems with their physicians. Satisfying sexual activity, it has been shown, enhances quality of life and self-esteem. "Family physicians need to be proactive in discussing sex. Satisfying sexual activity can enhance relationships, and good relationships are good for overall health. Richard Sadovsky, M.D., associate professor of family practice at the State University of New York Health Science-Downstate Medical Center, Brooklyn, also indicated that sexual dysfunction may provide family physicians with a clue to associated medical problems, such as endothelial dysfunction in the form of coronary artery disease. Some types of sexual dysfunction, especially erectile dysfunction, are associated with depression. Sexual dysfunction is common in men and women, Sadovsky said. About 31 percent of men have some form of sexual dysfunction. The most common complaint is premature ejaculation (21 percent), followed by erectile dysfunction and low sex drive. The major causes of sexual dysfunction include co-morbidities, such as cardiovascular disease, diabetes and cancer; psychotropic medications for depression and anxiety; antihypertensive medications; hypogonadism; and alcohol abuse. Low libido .may be associated with psychosocial issues, such as misconceptions about sex, cultural or religious taboos, relationship issues, and loss of job or income. FPs should advise patients that improved communication between sexual partners about their needs and difficulties will likely improve sexual satisfaction and resolve some problems, Nusbaum and Sadovsky said. Healthy lifestyle choices, especially exercise, will also improve sexual function.

THREE PROSTATE CANCER MONOTHERAPIES PROVIDE EQUIVALENT RELAPSE FREE SURVIVAL

Three monotherapies for treating Tl/2 adenocarcinoma of the prostate provide similar rates of five-year biochemical relapse-free survival, suggesting that side effects, not efficacy, should be the main consideration in selecting a therapy. Dr. Louis Potters, chief of radiation oncology at Memorial Sloan-Kettering Cancer Center's Mercy Hospital, New York, United States, and colleagues presented their findings at the American Society for Therapeutic Radiology and Oncology (ASTRO) 44th Annual Meeting, in New Orleans, Louisiana. The researchers reviewed the biochemical relapse-free survival in 1,866 consecutive patients receiving permanent seed implantation (PI), external beam radiotherapy (EBRT) to a minimum 70 Gy, or radical prostatectomy (RP). All patients had clinically localized stage T1/T2 prostate cancer treated between 1992 and 1998. Three (hundred? Ed.) and forty eight of the patients were treated with EBRT, 783 were treated with RP, and 735 were treated PI. Over 90 percent of the patients in each treatment group were stage T1-T2a, and the rest were T2b. About three-fourths of the patients in each treatment group had an initial prostate-specific antigen (PSA) level of 10 ng/ml or less and a Gleason score of six or less. Median follow-up time was 54 months for all cases. Biochemical relapse was defined as any detectable PSA value greater than 0.2 ng/ml for patients receiving RP, or three consecutive PSA value rises for those receiving EBRT or PI. The 5-year biochemical re!apse-free survival rates for cases treated with EBRT, and RP were 82 percent, 77 percent, and 83 percent, respectively [p = 0.082); the 7-year biochemical relapse-free survival rates were 74 percent, 77 percent and 79 percent, respectively. multivariate analysis identified initial PSA (p<.001), Gleason score (p<0.001), and clinical T stage (p=0.035) as independent

predictors of biochemical relapse-free survival. In contrast, treatment modality, age, and race were not predictors. "We are encouraged, that our results confirmed that of these other studies," Dr. Potters told Doctor's Guide. "Further, our study examined only monotherapy so that our results are unencumbered by adjuvant therapies such as hormones or the addition of radiation," he added. Dr. Potters continued to say that the treatment decision for a man with prostate cancer may be better based on side effects rather than that of biochemical outcome. "Further, the results imply excellent biochemical control regardless of which therapy is chosen," he added.

Henri Plunkett, our program director, spends a great deal of time keeping up with the latest and greatest in prostate cancer therapies. And one new area is cryosurgery which only has three year results, but reports a greater than 95% cure rate for Gleason 6 or less. However Henri has found that the procedure has a 100% chance for erectile disfunction (impotence), since the procedure kills critial nerves.

You can find news you can use at the USToo International web site: http://www.ustoo.org/. Check it out for the latest references.

*Date & Time:*	Tuesday, November 19, 2002, 7:00 PM
*Place:*	Wilson N. Jones, North Senior Health Center
*Attendance:*	Est. 20 attendees


*Vol. 2, No. 1*	*January 2003*