Prostate Cancer Study Halted! Vitamin E and Selenium Don’t Prevent Prostate Cancer…

On October 28th the National Cancer Institute has halted its $114 million study of whether vitamin E and selenium can prevent prostate cancer.  A safety panel for the 35,000 man study halted the program when an early look at the data showed no benefit for the treatment.

According to an article in WebMD -

There were slightly more prostate cancers in men taking vitamin E alone, and slightly more diabetes in men taking only selenium. But neither finding was statistically significant, meaning they were likely due to chance.

“The data to date suggest, but do not prove, that vitamin E may slightly increase the chance of getting prostate cancer, and that selenium may increase the chance of getting diabetes mellitus,” warns a letter sent to study participants by the Southwest Oncology Group, which ran the NCI-funded study.

The letter sent to men in the study is reproduced here.

Dear SELECT Participant:

We are writing to give you important information about SELECT.

The Study leadership now has enough data to be able to tell you to stop taking the Study supplements, although SELECT will continue. We have found that it is unlikely that selenium or vitamin E will prevent prostate cancer even if you continue to take Study Supplements.

SELECT is not over. There is valuable information to be gained from your continued participation in SELECT.  We would like for you to continue to visit your study site and provide health and medical information to study staff. As one of the largest medical studies of men, the study will help us answer many critical questions about men’s health and will assist scientists in the future.

The data to date suggest, but do not prove, that vitamin E may slightly increase the chance of getting prostate cancer, and that selenium may increase the chance of getting diabetes mellitus. We want to emphasize that these findings are not proven. We will learn more about the effects of the Study Supplements as we continue to monitor your health. Your safety is our priority.

Here is what we would like you to do: Please stop taking your Study Supplements but keep your Study Supplement bottles. Bring your Study Supplement bottles and any remaining Study Supplements to your next study site visit. You may continue taking the Study Multivitamin.

You will get more information at your next study site visit. You may also visit the SELECT website, http://www.crab.org/select, for more information.

We now know that selenium and vitamin E do not prevent prostate cancer. This important public health finding is a result of your contribution to SELECT. The SELECT National Participant Advisory Board and the leadership of SELECT appreciate your ongoing commitment. We all share the same goal – to reduce the burden of cancer.

Initially it was thought that both Vitamin E and Selenium would be helpful in the prevention of prostate cancer.  Previous studies had indicated that since vitamin E and selenium, both antioxidants, might help control the cell damage caused by free radicals that can lead to cancer.  A published study in the Journal of the American Medical Association (JAMA) in 1996  suggested prostate cancer incidences were reduced by two-thirds in men taking selenium on a daily basis.

Another study on vitamin E found a one-third reduction in prostate cancer incidence.  Selenium is a nutritionally essential element that occurs in the soil and is absorbed by our bodies through plant and animal products.  Organ means and brazil nuts are especially high in selenium. The soil of the southeastern U.S. is poor in selenium.  Vitamin E is a fat-soluble vitamin present in foods in small quantities such as vegetable oils, nuts, vegetables, milk fat and egg yolk.

Needless to say, had the study proven the link, it would have been an easy solution to take something that is easily found over the counter.

There are those who feel that the halted study is a manipulation of data to support the medical machine.  I can’t express and opinion on that one way or the other.  What I can say is that I am here today – a PROSTATE CANCER SURVIVOR – living due to the benefits of Western medicine.  But for those who want an opposing opinion…click here.

Prostate Cancer Treatment Options – Talking About A Deep Freeze?

First, don’t get your hopes up on this treatment, there are some issues that will take some time to warm up (pun intended) here.

A report in a Scottish newspaper reveals some startling ideas about the treatment of prostate cancer.  According to the report, GLASGOW (Scotland) doctors have introduced a revolutionary cancer treatment using ice to kill cancer.

Today, a Glasgow man became the first patient to opt for an advanced technique that promises fewer side-effects and an even chance of a cure.

Professor Hing Leung leads the National Specialist Prostate Cryotherapy Service, which carried out its first procedure at the New Beatson cancer centre at Gartnavel.

The surgery, under a general anaesthetic, involves inserting between six and 12 hollow needle-like probes into the prostate gland before passing Argon gas through them, rapidly freezing the organ to -40C.

The surgical team monitors the ice formation using ultrasound and, as soon as the organ is frozen, they defrost the area with another gas before repeating the procedure.

Professor Leung said: “Placing the probes is a bit like playing the old game battleships. The strategy is to cover the whole area using only a few points.

“The critical thing is the speed at which you bring the temperature down.”

The rapid freezing kills prostate and tumour cells, but the fact the frozen area is thawed soon after, coupled with passing warm fluid through the tube from the bladder, helps prevent damage to the surrounding area, reducing side-effects.

For those Americans who read this…the process is not new.  This is what has commonly been referred to as Cryotherapy which has been done since the early 1990’s.  The primary difference here is the method used to freeze the prostate.  Cryotherapy uses ultra-thin needles to produce ice balls of extreme sub-zero temperatures. The doctor uses ultrasound to accurately guide insertion of the needles, precisely control the size and shape of the ice balls and monitor the freezing.

According to the Prostate Cancer Institute:

Cryotherapy is an option for prostate cancer patients who want to avoid major surgery or the risks of “watchful waiting.” Cryotherapy can treat prostate cancer patients in the intermediate and high risk groups (stage T2c or above) as well as those who have failed previous radiation treatment.

Recent publications showing 10-year data demonstrates safety and durable efficacy of cryotherapy for treating prostate cancer. Morbidity following the procedure is mild in comparison with other treatments, with the exception of sexual function impairment.

The most significant questions that men would have regarding this form of treatment (assuming the cancer is gone) relates to the side effects – Incontinence and Impotence. An excellent article is featured on emedicine from Web.MD that I’ll summarize here.  The link will be provided below…

Cryotherapy impairs the penile arterial blood supply (Aboseif, 1997) and damages the cavernosal nerves responsible for erectile function (El-Sakka, 1998). This combined neurovascular insult results in impotence in 40-100% of treated patients (Bahn, 2002), depending on such factors as the use of multiple freeze-thaw cycles, the size of the ice ball generated, preoperative potency, the instruments used to assess potency, and the follow-up interval since treatment. Greater nerve regeneration is possible after cryotherapy than after surgery or radiation therapy; accordingly, some patients have reportedly recovered erectile function as many as 2 years after treatment. One report indicated that 95% of subjects who were potent before cryotherapy became impotent and that 5% regained their potency at a mean of 16 months (Bahn, 2002).

Ouch… Postprocedural potency is the quality-of-life domain for which cryotherapy remains clearly inferior relative to other local treatment modalities for prostate cancer. Until the return-of-potency rate improves, the risk of impotence will likely continue to be an impediment to wider use of this treatment approach among patients for whom erectile function is important.

SUMMARY:  If prostate cancer has been effectively treated and erectile function is important…don’t use this route!

Issues with incontinence are essentially the same…significant problems.

CONCLUSION: The recent release is an old treatment with a repackaged method of delivery.  It could be VERY EFFECTIVE as a follow up treatment method for me who have had a primary treatment method that failed.  But, I would certainly seek multiple medical opinions if you are considering this for your primary treatment following an initial diagnosis for prostate cancer.

YOUR COMMENTS ARE WELCOME!

LINK PROVIDED HERE

Prostate Cancer Research – Data for a new Book – Your Help Needed!

Let me be clear from the beginning – I am not a physician, not a part of the medical community, nor associated with any organization that profits from cancer or it’s treatment.  Rather, I am a man who is a prostate cancer survivor.  I have been through what, if you are reading this, you are going through or someone you love is going through and I know the ropes.  That does not mean I have the answers to all your questions, but more than likely I have asked them.

I have dealt with the emotions associated with the initial diagnosis.  I have researched and researched treatment options and feel, that from a layman’s perspective, I have a good grasp on the benefits and detriments of most common treatment approaches.  Most importantly, I know what the side effects are and have, within reason, been able to overcome them.

Search this site, if you have not already done so, and read the entries as they have become well read by men and women alike.  Then if you have questions, feel free to e-mail me.  I will respond.  I am blessed to be cancer free and feel that if I can share what I have come to understand with others I will, in my own way, pay it forward.

Likewise, I am writing a book about my experience and the experience of others in this arena.  If you would like to become a part of this work, please e-mail me at chuck@chuckgallagher.com – we will then set up a time for an interview.  Believe me your input will help.  You and the experience you have had can make a difference.

My best to you and don’t hesitate to make contact.

Sex Following Prostate Cancer – The Real Truth from a Prostate Cancer Survivor!

Before reading this post…if you have been diagnosed with Prostate Cancer or are a Prostate Cancer survivor, I would appreciate your help. I am writing a book, from a layman’s perspective, about Prostate Cancer and how to find solutions to improve our lives. I am conducting interviews during the months of October 2008 through December 2008. The interviews are confidential and your name will not be revealed. If you are willing to discuss your experience…please contact me at chuck@chuckgallagher.com. From there we can set up a time for a phone interview. Likewise, this disease no only affects the man diagnosed but also his family, so I am interviewing spouses and/or significant others. Thank you in advance for your help. Now I hope this article is of some benefit to you.

First, if you are reading this you, like I, have had the unpleasant experience of being diagnosed with Prostate Cancer. Just like a diagnosis of breast cancer to a woman, prostate cancer to a man is devastating to hear and begins a long physical and emotional road to a life changing phase of life.

Allow me to make certain assumptions:

(1) You are alive and have survived. If you have just been diagnosed then this article, while informative, will be a bit premature. Yes, I know the issue of sex following successful treatment for prostate cancer is on your mind, but your priorities must first be – what is the best treatment that will cure this cancer and eliminate the issue of mortality from my mind.

(2) The therapy you chose allowed for the physical nerves to be spared and hence allow for the potential resumption of sexual function. All the research for years has shown that removing or substantially damaging the nerves eliminates the ability to achieve an erection and hence resume a “normal” sex life.

(3) Lastly, you recognize that you have undergone a substantial change in your body and accept that sexual function may never be quite the same. That does not mean that sexual function can’t be quite good, approaching normal, but more than likely by the time you’re diagnosed and have gone through treatment, you are middle aged. Face it, middle aged men aren’t quite as viral as they were when, say they were seventeen.

In an earlier blog entry I wrote about my experience with sexual function following a highly successful prostate cancer surgery. The article is referenced here. For clarity and convenience, allow me to restate a portion of that article here:

Sexual Function: Candidly, that returned much slower than I expected.

• Within three weeks of the catheter being removed I wanted to test sexual function. To my pleasant surprise with physical and visual stimulation I was able to achieve a marginal erection and orgasm. I was elated. However, I soon found out that my first experience was not sustainable on a regular basis.
• Like most men, I was given prescriptions for Viagra and informed about other alternatives.
• Within three to six months, I found that achieving an erection was difficult and that any mental distraction would prove to be an impairment.
• Viagra would provide some help, but the side effects were bothersome – especially the flushed feeling I felt in my chest and nasal cavity. Even with Viagra or the other alternatives, I did not feel that the result was successful.
• By the seventh month I was concerned about the lack of consistence in sexual function. That took it’s toll emotionally. While women may not completely understand, men will get it. We are sexual beings and, while we don’t define ourselves by sex, we certainly understand the important role sexual function has in our lives. Inability to perform can have direct effects in other areas of ones life.
• I was told there would be no ejaculate. That was true and false. There was no ejaculate as men generally know it. However, I did leak a fair amount of urine. I think the urine leakage surprises and disturbed me more than it did my partner She understood that urine is harmless. I soon learned that I should empty my bladder before sex otherwise, there would generally be urine leak when orgasm was reached.
• By the ninth month I woke to a nocturnal erection. I must admit I was surprised and elated. However, the natural erection was still missing.
• There had been no significant change from the sixth month through the tenth month, so I was becoming a bit concerned. I sought help in an unusual way, I sought Hypnotherapy as a possible solution. Wow…now that was worth it.

Hypnotherapy: Perhaps for the skeptics I had just healed enough to experience a change, but when I sought help I had the same results. Not knowing what to expect, I was open to anything that would provide some normalcy. I had come to know that things would never be the same. For one thing, I wasn’t 17 years old any more. I had to know that with age sexual performance will change. Likewise, I knew that without a prostate (the old plumbing if you will) I would never have an ejaculation – although an orgasm is quite normal without ejaculation. In any event, I elected this alternative form of therapy. What did I have to lose?

I went through the process feeling quite relaxed. The female hypnotherapist wasn’t sure that it would be comfortable for a man. Frankly, in my mind, if I got the result I didn’t care who provided the service. The process lasted and hour to and hour and one-half.

Within three days it was time to test the program. To my great surprise, I had an erection with less effort than it took over the prior 10 months and the orgasm was powerful. Since that point, there has been a marked difference in sexual function. Why? I’m not sure I know. I feel that two things converged at the same point. One – I had taken time to heal physically and with practice one can achieve a return to normalcy. Two, I feel the hypnotherapy allowed me to by pass my conscious emotional fears and empower my subconscious to know that I was fine and fully functional (within the physical confines of surgery). Either way…the process worked.

Three Years Later

There is a reality for us all. For now all I can speak for is myself. (I am conducting research into this area – see the tab “Prostate Cancer” if you are willing to help). There are three areas that I feel need to be exposed as men and those who love them deal with the very real and significant issue of sexual function after prostate cancer. There is no order to the issues listed below – each are important in their own way.

Issue One: Psychological ramifications of sexual function after prostate cancer surgery. Following my earlier articles and blogs I received a number of e-mails and calls from men and women who appreciated the candid discussion and insight. As time has moved on I have come to understand that sexual function, especially following prostate cancer, is as much (if not more) about the mind than it is about the body.

Women/Partners - I am not yet sure that you know just how much a man’s identity is tied up in his sexual function. Now, I can hear two responses as this is being read: (1) you think I didn’t know that? and (2) it can’t be that important. At the risk of sounding preachy – ladies – No you don’t really know that and, yes it is more important you’ll ever conceive.

While a man is far more than his sexual ability, the lizard brain in us all sends messages that we cannot control – to a man it is to procreate. So to eliminate that possibility means that the subconscious mind diminishes the worth and value of the being. On the outside he may seem invincible, but on the inside he is crumbling, but rarely will he be emotionally connected enough to show it or willing to show it. Showing that pain (emotional pain) is a form of weakness to most men and revealing that would only slide him further into a downward spiral.

What to do? The less pressure there is to sexually perform the easier it is to perform. Now, by that statement, I do not mean reduce the frequency of sexual attempts. First, create an environment that will allow for play, fun and all the joy that comes from being sexually with your partner.

Secondly, be willing to become more active in order to help the recovery process. I have been told by several physicians that muscles grow if they are used. Basically they were telling me to use my penis (sexually of course) and do so whether through masterbation or with a partner. I will be blunt here. I have found that masterbation produces a more consistent result. For a while I wondered why, then it hit me – I can take all the time I want to with myself. There is no pressure and I can image that where ever my thoughts may take me, the person I imagine myself with is patient, willing and engaged.

Let me be clear, I am married and my wife has encouraged me to continue this writing knowing that others may, very well, be feeling the same thing or experiencing the same issues. That said, while sex with my wife is very pleasing, I find that while I can gain an erection, often the sexual experience does not result in an orgasm. As we have spent time discussing this, it has become clear that my inability to achieve a satisfactory sexual result was psychologically connected to my wife’s attitude and engagement in the process. It takes more effort to achieve what used to be easy. Hence, in order for the experience to be satisfying to me – my wife has to, bluntly put, work harder. Not only is that a substantial change for her, but it puts pressure on me and the more pressure the less performance.

Issue Two: Bodily Function. As I mentioned in the first article, it took me time to recognize that my body was different. While sex was more difficult following surgery, it became clear that there was a greater than likely chance that urine would be released sometime during the act of sex. Hence, I have discovered three things: (1) the less you drink before attempting sex the less chance of leakage; (2) urination immediately before sexual intercourse (or whatever method of sex is selected) reduces the chance for any substantial leakage; and (3) since urine is sterile and effectively harmless, allow it to be used as a form of lubricant or play. I can hear many scoffing at the third suggestion, but going back to Issue One – if a man is concerned about what might happen (urine leak) during sex, he will be constrained physically (because of that mental state) and hence have a much more significant problem with achieving an erection or achieving a sexually satisfying experience.

Issue Three: Practice…Practice…Practice. Now, as I write those words, it occurs to me that some may interpret this as applying pressure and increasing the sexual anxiety associated with prostate cancer. I don’t mean “practice” in that sense. Rather, it means either love yourself or love your partner (that will depend on who is reading this – you or your partner) enough to provide any and all outlets necessary to heal. I would suggest that you consider spicing up your sex life so that the stimulation (whether visual, auditory or by feeling) is enhanced. Having talked with others I know that sexual healing can take place, but it does come with a cost – and in most cases that cost is increased effort.

Question: If your dog broke his or her leg in an accident and the vet told you that he had to walk at least two mile each day and do other physical activities in order to heal – would you do what was necessary to help your dog heal? If you answer no – “I’d put him to sleep,” please quit reading this article – it’s hopeless. But, I think most would agree that we’d all say, “I love my pet and would do what ever.” Strange example, but we need to do whatever is necessary to heal, both physically and emotionally. No one said it would be easy – physical therapy is hard.

Simply put, sexual healing from prostate cancer is physical therapy that heals on both a physical and emotional plain. If sex is still a struggle…hang on and keep trying. It may never be what it was, but in most cases you can sexually recover from prostate cancer. I did and so have countless others.

Prostate Cancer Treatment Using the daVinci Robotic System

Unlike normal blogs dealing with Choices, Ethics, and Consequences – my topics as a professional motivational speaker – it seemed appropriate today to speak of my complete recovery from prostate cancer hoping that it might help others who are faced with decisions on prostate cancer treatment.

Discovering I had prostate cancer at the age of 47 was almost an accident and certainly not something that in any way I expected. I had no symptoms – none whatsoever. In layman’s terms, everything seemed to work fine. So the discovery of prostate cancer was quite accidental. It seems I had gone to my doctor simply requesting a pill (propecia – a drug to reduce hair loss). She required I have a blood test, as this drug would have an effect on my PSA. Frankly, all that was greek to me…as I didn’t know what PSA was and had never had it checked. I hated needles – had always said I was allergic to them – hence I avoided being stuck as much as I could. But on this day in November 2004 I decided to take the plunge – have my blood checked – and get the prescription.

Two days later I got a call while out of town saying that all the lab work was fine except that my PSA was a bit elevated – it was 4.58 and for someone my age that was high. My doctor referred me to a Urologist. The appointment was set.

Of course I had some concern, but after all, all the plumbing seem to work fine and I had no symptoms, so surely there was no problem. The Urologist’s exam was routine – in fact he said he thought I had nothing to worry about as he felt nothing abnormal. But, to be on the safe side he schedule a biopsy. Being fearful of needles (and a biopsy is the ultimate needle) I asked if it would hurt. His response, “Most men don’t really feel a thing.” That was a lie! Looking back, I would have asked for good drugs as that was the most painful experience I can recall.

Several days following the biopsy I received the results. Prostate Cancer! I had a Gleason score of 6 and 30% of one side of my prostate was cancerous. My heart sank as I received the news. How could I, a 47 year old healthy male, with no other medical issues have prostate cancer? And, how amazing that it was caught by a simple test that my well versed female doctor required. Looking back, her diligence saved my life.

What next?

My local doctor wanted to schedule surgery immediately. He said I had four options: (1) Radical prostotectemy (traditional surgery); (2) Radiation; (3) Hormone therapy and/or (4) Watch and wait. Again, he recommended surgery. My immediate question was how many of the surgeries that he was suggesting did he do weekly or monthly. The number was low. In the back of my mind I thought, “Hum, maybe I need someone who isn’t so surgery happy and who does this delicate removal frequently.” I was like learning to play golf – I would prefer to learn from someone who plays daily than learn from a weekend hacker. Maybe that analogy seems harsh, but after all the decision made would have lasting and profound effects.

Following the meeting with the Urologist, and after telling my family (who thought I was joking), I spent some time in research. First thing I found – based on my diagnosis – I had time to consider carefully my options. Not that nothing should be done, but I didn’t have to rush into any hasty decisions. Prostate cancer generally is slow in it’s progression. CAUTION – do not use my experience as a crutch to avoid treatment (I witnessed my father-in-law die from complications from prostate cancer), rather, seek competent medical help in making your treatment decisions.

Options Considered:

Watch and wait. Well for several months I did just that. I researched – changed my diet – considered the possibility that I could reverse what existed and even reduce the cancer. I began a regiment of daily intake of cottage cheese and flax seed oil. For a short time I actually saw a decrease in my PSA; however, that was short lived. What I did learn was that diet was important – not only for general well being – but an effective tool in promoting a cancer free body. This was valuable time in that it gave me the opportunity to consider all my options.

Radiation Therapy. Not really an option for me. While I talked with a man in his late 60’s to early 70’s who had outstanding results using focused radiation (proton therapy I think it was called), the reality is – once you opt for radiation and the tissue is destroyed, if prostate cancer returns, it cannot be surgically removed. Hence the best advice I received was, in my case, this would not be a practical option. By the way information on proton treatment can be found at www.protons.com or at www.llu.edu. The people I talked with who had used this treatment were extremely pleased with the level of care they received and the overall outcome.

High Intensity Focused Ultrasound (HIFU). In my search for the right treatment, I spent much time in considering this alternative. There were three practical objectives I wished to accomplish with whatever treatment I selected: (1) Cancer elimination, (2) Minimal issues with incontinence (preferably none) and (3) minimal issues with erectile function (again, preferably none). Based on my Gleason score and prostate cancer diagnosis, it seemed that this treatment would be viable. For research information visit www.ushifu.com. As part of my consideration I met with Dr. George Suarez, Medical Director for USHifu. He reviewed my medical background and was kind in taking the time to discuss with me my options using this new prostate cancer treatment. Dr. Suarez took the time to explain all my options and how, if I elected, HIFU could be effective while meeting my three objectives. My only resistance was, at the time, it was not an option yet approved by the FDA in the United States, hence I would have to seek the treatment outside the scope of my medical insurance outside of the country. While I gave this serious consideration, I ultimately decided to go another route.

Radical Prostatectomy. All of the possibilities above, brought me back to the original suggestion – SURGERY. The issue I had was what kind and who would perform it. Since I had the time to research I discovered (through the wonder of the Internet) this, then, new procedure called a robotic-assisted radical prostatectomy. Hum…seemed that needed more study. Of course, at the time, Johns Hopkins Brady Urological Institute was recognized as one of the best in the world for prostate cancer research and study. After careful consideration I contacted Johns Hopkins inquiring about this seemingly new procedure – using the daVinci Surgical System. www.urology.jhu.edu/MIS/daVinci/ The folks at Johns Hopkins could not have been more caring and helpful as I sought all my treatment options. Of course, they reviewed my file carefully and spent all the time I wanted and needed to evaluate my options. Dr. Li-Ming Su was my surgeon and my hat is off to him and his skill and patience. In the end, one thing was clear – all other options being equal – surgical removal was still the “gold standard” in the fight against prostate cancer. Likewise, it appeared that this robotic assisted laparoscopic radical prostatectomy would meet my three objectives.

The surgery went fine – of course I don’t remember a thing – so all I can base it on what the Doctor’s report. Initially the report indicated that the cancer was contained in the prostate and the removal should yield me “cancer free.” Of course this was to be confirmed later from lab reports. The first several days following surgery were not pleasant, but tolerable. Within three days, I boarded a plane and flew home to North Carolina – travel was not a big issue. The most discomforting thing following surgery was the catheter – which remained in for three weeks.

Outcome. Within four weeks following surgery I boarded a plane to Dallas, TX to begin a new job. My energy level was back and I had minimal incontinence isses with subsided within another three weeks. Within seven weeks of surgery incontinence was not an issue. Erectile function returned within three months (with the aid of medication) and returned to full function (without medication) within twelve months.

Now it’s been three years since surgery and all three objective have been achieved. Life is normal. I am cancer free. My sincere thanks to all who were there for me as I sought out the treatment that was right for me. I would not have the opportunity to function as a motivational speaker today if it were not for the skill and help of the fine folks at Johns Hopkins. While printing such personal items for all to read may seem (to some) out there! I feel that, perhaps, others who find themselves diagnosed with prostate cancer may learn from my experience. If you find this helpful, but still need to talk – please visit my web site: www.chuckgallagher.com and contact me through that portal. I’ll be happy to talk with you via e-mail or phone.

Chuck Gallagher is an international speaker and author who shares his life experience in a way that is meaningful for his audiences. For information on Chuck’s presentations or how to subscribe to his free ezine…visit http://www.chuckgallagher.com