Promising Research Results for Prostate Cancer Announced by Northwest Hospital

"This year has been an incredibly exciting time for our hospital in the area of prostate cancer research," said James Hart, hospital president. "Dr. Brawer just announced the results of two newly refined PSA tests. In addition, Dr. Ragde and Dr. Korb published the 10 year results for seed implants showing this treatment method is equal to or better than other treatment methods. And, Dr. Murphy's research to cure prostate cancer through a vaccine continues to show exceptional promise.

"Dr. Brawer's research on PSA improvements includes two kinds of PSA: the 'free PSA' and the cPSA. A 'free PSA' test is used as a follow-up test for men whose regular PSA showed slightly elevated results. The 'free PSA' helps physicians determine the cause of the elevation and thus eliminates the need for some biopsies. In addition, the study found the percentage of free PSA may be used by the physician to determine that man's cancer risk and, in case of cancer diagnosis, may be useful in determining the most appropriate treatment.

The cPSA is an improvement on the commonly used total PSA. The cPSA is able to detect molecules in the blood that are specific to prostate cancer alone.

Encouraging seed implant, or brachytherapy, results were announced in September by Haakon Ragde, MD and Leroy Korb, MD. Dr. Ragde said "These research results prove brachytherapy is an excellent option for treating early stage prostate cancer."

"Research conducted by Gerald Murphy, MD, to find a cure for prostate cancer through a "vaccine" continues to show promise, with a 49 year old man showing a complete recovery from metastatic disease.

Although these research results are very important in the battle against prostate cancer, the physicians at Northwest Hospital stress the urgent need for men to get an annual test for prostate cancer. "Annual testing saves lives," said Leroy Korb, MD. "Men whose prostate cancer is discovered in its early stage have a much higher survival rate."

Awareness Campaign Reminds Men to Get Tested Annually
In support of this important awareness need, Northwest Hospital has teamed up with sponsors Insight, Reed McClure Attorneys at Law, Mentor, KOMO ABC 4, and KVI radio in a month-long television, radio and print campaign reminding men to get annual testing. Throughout the month, KOMO ABC 4 and KVI radio will air public service announcements, television and radio spots. They're also committed to covering the latest news about prostate cancer research and treatment so that more people will understand the disease and how to fight it.

Please join us in fighting this disease. If you're a man over age 50, or in a high-risk group, remember to get a prostate cancer test every year.

For additional information, visit our website at www.prostatecancer.org.

Northwest Is First in the Pacific Northwest to Provide New "cPSA" Cancer Blood Test

A new blood test identified in the journal Urology as the most accurate and cost-effective single test for prostate cancer is now available for the first time in the Pacific Northwest, exclusively at Northwest Hospital.

In an improvement upon the commonly used total PSA test, the new complexed prostate specific antigen (cPSA) test is able to detect molecules in the blood that are specific to prostate cancer alone. Currently, no other single test can distinguish prostate cancer cells from those associated with benign prostate conditions.

"This is the most significant advance in prostate cancer in ten years," noted Michael Brawer, MD. "The cPSA test is the diagnostic tool men have been waiting for." Dr. Brawer is a board-certified urologist and director of the Northwest Prostate Institute at Northwest Hospital. He is the primary investigator of the article, "Measurement of Complexed PSA Improves Specificity for Early Detection of Prostate Cancer," which appears in the September 1998 issue of Urology. The study compares the accuracy of three prostate cancer blood tests: cPSA, total PSA and free to total PSA ratio. Samples were collected from 300 men, 25% of whom were previously show to have prostate cancer.

Unlike the total PSA blood test, which recognized an antigen associated with many prostate problems, the new cPSA test identifies molecules that are only found in prostate cancer. "The bottom line is that when the cPSA test comes up positive, there is a greater certainty that it is because prostate cancer is present, as compared with the traditional PSA test results," said Dr. Brawer.

According to Brawer's study, the cPSA test detected prostate cancer in all but one out of 75 men in the study who had the disease. The study group included 225 men whose biopsies were negative. Follow-up testing with the cPSA test alone showed that 35 of those men had no sign of prostate cancer and might have avoided the anxiety, discomfort, pain and cost of the biopsy procedure.

Research All Treatment Methods Before Making a Choice

If you are diagnosed with prostate cancer and are deciding which treatment option is best for you, start by doing your own research -- by talking with other men, reading literature on the subject or searching the Internet where a wealth of information awaits you. After you have the information you need, talk with a trusted medical provider before making a final decision.

There are four major treatment options for prostate cancer: surgery, hormone therapy, external beam radiation therapy and seed implant therapy. Physicians at Northwest Hospital believe one of the best treatment options for early stage prostate cancer is seed implants.

Surgery
For more than 30 years, the "gold standard" treatment for prostate cancer was radical prostatectomy —removal of the prostate gland. However, now other options may be better for some patients. Why? Surgical treatment requires a five to seven day hospital stay and a recovery period of several weeks. Also, it has several unpleasant long-term side-effects: chiefly, high rates of impotence and urinary incontinence.

External beam radiation
External beam radiation therapy kills cancer cells by decreasing their ability to grow and divide. External beam radiation involves up to eight weeks of daily treatments. A beam of radiation is directed at the prostate to destroy tumors. The procedure is painless, but it can cause temporary side effects including impotence and difficulty urinating.

Hormone therapies
Several hormone therapies are also used in the treatment of prostate cancer. The goal of hormone treatment is to reduce or halt the production of male hormones which feed prostate cancer.

One hormone option is LHRH, a compound that tricks the body into thinking testosterone is being produced in excess, thus making the body slow or stop actual production. This is usually administered as a monthly injection. Side effects include hot flashes and loss of sex drive.

Seed implant therapy
Brachytherapy—inserting small, radioactive seeds into the prostate—makes it possible to give high radiation doses to the cancerous tissue while sparing the nearby healthy tissue.

Dr. Haakon Ragde's team was the first in the United States to use ultrasound to guide placement of radioactive seeds into the prostate without open surgery. Today, seed therapy is one of the most talked about and effective treatment choices for early stage prostate cancer.

The most significant advantage is quality-of-life. For prostate seed implant patients who have not had prior surgery on their prostate, the incidence of incontinence is negligible. And in men under age 70 who receive the implants, the risk of impotence is greatly reduced. Another benefit of this outpatient procedure is the quick return to normal activities, usually in a day or two after the procedure.

A ten-year research study of men who underwent this seeding showed a 66% success rate, equivalent to surgery.

10 Year Study Shows Seed Implants Equal or Outperform Other Early-Stage Treatments

September 1998: Ten years after the first seed implant was conducted at Northwest Hospital, 66 percent of patients who received brachytherapy, or ultrasound-guided radioactive seed implants, remained disease-free and maintained Prostate Specific Antigen (PSA) levels of 0.5 ng/ml or lower.

The 66% results for seed treatment compare favorably to other treatment methods such as radical prostatectomy and external beam radiation. In studies at major cancer centers across the country, 10 year success rates for radical prostatectomy ranged from 47 to 73% and external radiation ranged from 13 to 38%.

Results of the Northwest Hospital brachytherapy study were published in the September 1, 1998 issue of Cancer. "An equal or better disease-free survival rate at ten years, combined with a lower risk of incontinence and impotence may make brachytherapy a procedure of choice in medicine's efforts to save lives and preserve life-styles," said Haakon Ragde, MD, primary author of the study. "This is especially true among men who have other life-threatening illnesses which prohibit them from being candidates for surgery." In 1985 at Northwest Hospital, Dr. Ragde pioneered the use of ultrasound-guided radioactive seed implants for prostate cancer in the United States. He has performed more than 2,000 of the procedures.

In the first study to report actual ten-year results, 152 patients were observed who had prostate brachytherapy, with or without additional external beam radiation, performed at Northwest Hospital between January 1987 and June 1988. Disease-free survival was determined by a PSA level of 0.5 ng/mL or less, clinical examination and prostate puncture biopsy results. Sixty-six percent of the patients demonstrated disease-free survival at ten years.

"What distinguishes the Northwest Hospital study from others," said Dr. Ragde, "is that we are using actual data from studying the patients themselves, rather than using projections.

"In seed therapy, a urologist and radiation oncologist inserts tiny low-level radioactive seeds into the prostate itself. The seeds irradiate and destroy the tumor from the inside without damaging adjacent healthy tissue. Incontinence and impotence can be significant complications for radical prostatectomy. These complications are much less prevalent among brachytherapy patients. Physicians believe that prostate brachytherapy is an excellent option because it is less invasive than surgery. Rather than an extensive hospital stay, the outpatient procedure is usually performed in less than one hour and patients return to normal activities in one to three days.

KOMO's Steve Pool Joins the Fight Against Prostate Cancer KOMO News 4 Weathercaster Steve Pool encourages men to get tested for prostate cancer in public service announcements airing exclusively on KOMO ABC 4 during the month of September. "As an African-American male, I am in the highest risk group for prostate cancer," notes Steve. "That is why the Prostate Cancer Awareness Project is of particular interest to me, and I know it will be of great interest to our viewers. It might even save lives. "Watch KOMO News 4 during the month of September for special reports on prostate cancer detection and treatment. KOMO viewers will be encouraged to visit the KOMO ABC 4 website at www.komotv.com to link with other websites providing the latest information on prostate cancer. KOMO ABC 4 is pleased to be part of Northwest Hospital's efforts to heighten awareness of the need for early detection and treatment of prostate cancer during the month of September and beyond.

Phase II Trials Show "Cure" for Prostate Cancer in 30% of the Cases Treated

The research group also has received two highly competitive grants from the Department of Defense/Army, research money set aside for prostate cancer. One went to Dr. Gerald Murphy for the study of prostate cancer cells in seminal fluid. This technique has been introduced at Northwest Hospital, and is under preliminary study. The grant will permit further expansion of this work. Another grant went to Dr. Michael Salgaller, who is working in the area of identifying and developing new antigens from prostate cancer cells. A small number of grants were awarded nationally in this program, (which is reportedly about 55). The researchers are quite delighted at Northwest Hospital receiving two of these awards. The Milken Foundation (CaPCURE) and other local foundations also support the research.