Spotlight on Clinical Research
September is Prostate Cancer Awareness Month, a great time to be aware of screening for early detection. Prostate cancer is the most common cancer diagnosed in men in the U.S., but early diagnosis and treatment often lead to better outcomes.
Men between the ages of 55 and 69, African American men over age 40 or those with a family history of prostate cancer have a higher risk of getting the disease. A high-fat, low-fiber diet may further increase the risk for these groups. If you fall into these categories, Yale urologist Dr. Charles Walker recommends that you talk to your doctor about screening. He also advises that all men have a PSA test done at age 45 to establish a baseline.
In order to boost awareness of the importance of early detection, Yale and Yale New Haven Hospital are sponsoring prostate screenings for employees, as well as for the public. Registration is encouraged, but walk-ins are welcome. Screenings will be held as follows:
• Thursday, September 18, 2014 at McGivney Center for Cancer Care, 659 George Street, New Haven
o 3:00 – 5:00 pm for Yale employees
o 5:00 – 7:00 pm for the general public
• Friday, September 19, 2014 at the Urology Center, 330 Orchard Street, New Haven
o 7:00 a.m. – 8:00 a.m. for Yale employees
To register, call toll-free 1-888-700-6543 or select an appointment time online at www.ynhh.org/events
Next Steps After a Screening
Follow-up appointments will be made at the screenings for those who need additional consultation with a urologist.
Depending on the PSA level, physical exam, and/or symptoms, your doctor may recommend a biopsy if prostate cancer is suspected. One way to determine the aggressiveness of prostate cancer is by the Gleason score. This scoring system assigns a number from 2 to 10 to describe cells biopsied from the prostate. The higher the number, the more abnormal cells appear to be under the microscope and the more aggressive the disease is.
Patients who are diagnosed with prostate cancer that is slow-growing are sometimes treated by active surveillance, meaning the cancer is closely monitored. This approach is used because treatment for prostate cancer, which normally involves surgery and/or radiation, can have significant side effects, including incontinence and erectile dysfunction.
Research to Develop New Treatments
Dr. Walker and other Yale doctors are conducting clinical research to find better treatments for prostate cancer. One trial currently underway is for patients who have been diagnosed with prostate cancer that is at high risk of progressing, spreading, or recurring. Another trial is for men on active surveillance. This study is investigating whether eating more fruits and vegetables helps prevent prostate cancer from progressing and affects whether men choose to remain on active surveillance. Both studies are taking place at the Veterans Affairs Medical Center in West Haven, but are open to both veterans and non-veterans.
"The only way to address illnesses like prostate cancer and develop new therapies is to make sure we are getting men enrolled in clinical trials," said Dr. Walker. This is especially true for African American men; besides having a higher risk of prostate cancer, they are more likely to be diagnosed at an advanced stage and are more likely to die from the disease. This may be partly due to disparities in screening and access to care, but experts think that prostate cancer in African American men may be more aggressive and may progress sooner. "We can’t answer these questions if we don’t know what explains these differences," said Dr. Walker.
Dr. Walker noted that treating aggressive prostate cancer that has spread beyond the prostate remains challenging. "The only way we can find out if promising treatments will work better earlier in the disease process is through clinical trials," he said. If you’re interested in participating in a clinical trial, visit www.yalestudies.org to learn more.