Cultural Factors Affect Prostate Cancer Treatment
Researchers say social and cultural factors play a significant role in patients' prostate cancer treatment decisions, according to a report in the medical journal Cancer.
The researchers found that non-medical variables, such as marital status, high school education, and race/ethnicity may play a larger role in patients' treatment decisions than previously believed.
Prostate cancer is now detected earlier than ever because of the introduction of a simple blood test in 1987 called the Prostate Specific Antigen (PSA) test.
Prostate cancer is the most common cancer, excluding skin cancers, in American men. The American Cancer Society (ACS) estimates that during 2005 about 232,090 new cases of prostate cancer will be diagnosed in the US. About one man in six will be diagnosed with prostate cancer during his lifetime, but only one man in 33 will die of this disease.
Prostate cancer is the second leading cause of cancer death in American men, exceeded only by lung cancer. The ACS estimates that 30,350 men in the US will die of prostate cancer during 2005. Prostate cancer accounts for about 10 percent of cancer-related deaths in men.
However, the treatment options for prostate cancer - radical prostatectomy, external beam radiation, and brachytherapy - have no evidence of clear mortality benefit over merely a watch and wait approach.
Moreover, some treatments may lead to serious side effects, including urinary incontinence, impotence, and bowel problems.
Experts say it is widely assumed that men make treatment decisions based on medical considerations, such as age, other existing conditions, and the grade of the tumor.
Researchers, led by Dr. Thomas Denberg of the University of Colorado at Denver and Health Sciences Center in Denver, reviewed data from 27,920 Hispanic, non-Hispanic, Caucasian, and African-American men without underlying conditions who were registered in the Surveillance, Epidemiology, and End Results (SEER) cancer database.
The researchers found that sociocultural and racial factors independently predicted treatment.
Caucasian, African-American, and Hispanic patients were equally likely to receive curative treatments over "watchful waiting," while Caucasian and Hispanic men were more likely to choose prostatectomy, and African-American men were more likely to be treated with radiation.
Independently, marriage was also an important predictor of treatment. Married men in all three groups were much more likely than unmarried men to receive curative treatment over watchful waiting, and they were also more likely than their unmarried counterparts to receive prostatectomy compared with radiation.
Always consult your physician for more information.
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Male sex hormones may explain why men are four times more likely than women to develop abdominal aortic aneurysms, according to a study presented at the Experimental Biology 2005 meeting.
Abdominal aortic aneurysms are dangerous ruptures in the main artery carrying blood from the heart to the lower body.
An abdominal aortic aneurysm, also called AAA or triple A, is a bulging, weakened area in the wall of the aorta (the largest artery in the body) resulting in an abnormal widening or ballooning greater than 50 percent of the normal diameter (width).
The aorta extends upward from the top of the left ventricle of the heart in the chest area (ascending thoracic aorta), then curves like a candy cane (aortic arch) downward through the chest area (descending thoracic aorta) into the abdomen (abdominal aorta). The aorta delivers oxygenated blood pumped from the heart to the rest of the body.
These aneurysms are estimated to be the main cause of death in 4 percent of people over age 65 in the US.
For reasons that have remained unclear, men are much more likely than women to die from abdominal aortic aneurysms.
This new lab study may help clear up that mystery. Researchers at the University of Kentucky found that by removing circulating male sex hormones - including testosterone - from male mice, they reduced the level of aneurysm to that seen in female mice.
On the other hand, giving female mice those same male sex hormones increased their aneurysm risk to the level of males.
The researchers plan to conduct more research to try to identify possible targets for the development of medications to reduce the incidence of aneurysms.
According to the National Institutes of Health (NIH), if the aneurysm is small and there are no symptoms (for example, if the aneurysm is found during a routine physical examination), a physician may recommend periodic evaluation, usually with annual ultrasound examination, to watch for changes.
Symptomatic aneurysms usually require surgical treatment to prevent complications. Antihypertensive medications may be prescribed before surgery to reduce blood pressure. Other medications may include analgesics to relieve pain.
Surgical repair or replacement of the section of aorta is recommended for patients with symptoms, as they are at high risk of fatal rupture, states the NIH. Repair is also recommended for patients with aneurysms greater than 5 centimeters (about one inch) in diameter. Stenting may also be a treatment option. The goal of treatment is to perform surgery before complications develop.
The risk of complications increases as the size of the aneurysm increases. Because surgery for abdominal aortic aneurysm is risky, the surgeon may wait for the aneurysm to expand to a certain size before operating (that is, when the risk of complications exceeds the risk of surgery).
Always consult your physician for more information.
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