Prostate Cancer: My Takeaway from the AUA 2019 meeting

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This is some of the takeaways from the AUA meeting this past week. Today we focus on prostate cancer.

Is metabolic syndrome a risk factor of prostate cancer (PrCa)?

Cosimo De Nunzio, Department of Urology, Ospedale Sant Andrea, Sapienza University, Rome, Italy presented a study of 309 patients with a median age of 68 of which109 patients had a diagnosis of metabolic syndrome. Patients with metabolic syndrome were shown to have a higher rate of PrCa, and PrCa patients were also shown to have a higher rate of metabolic syndrome.

Laslty, metabolic syndrome was shown to be an independent predictor of PC and particularly of high-grade PrCa.

My thoughts:

Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke, type 2 diabetes and now we see PrCa.

These conditions include

  • Waist circumference more than 40 inches in men and 35 inches in women
  • Elevated triglycerides 150 milligrams per deciliter of blood (mg/dL) or greater
  • Reduced high-density lipoprotein cholesterol (HDL) less than 40 mg/dL in men or less than 50 mg/dL in women
  • Elevated fasting glucose of l00 mg/dL or greater
  • Blood pressure values of systolic 130 mmHg or higher and/or diastolic 85 mmHg or higher

Having just one of these conditions doesn’t mean you have metabolic syndrome, but having three or more does.

Also, your urologist will not measure MS associated biomarkers, like triglycerides or HDL. That would be done by your general practitioner, internal medicine physician or cardiologist.

The bottom line is to get all the above measured as metabolic syndrome is the most direct contributor to virtually all urological conditions.

Can Germline Mutations predict more aggressive prostate cancer?

Dr.Todd Morgan, MD, from the urologic oncology department at the University of Michigan cited several showing that of 11% of patients men with prostate cancer were shown to harbor germline mutations. BRCA one and two showed more aggressive prostate cancer and ATM was associated with upgrade of cancer status in men on active surveillance

My Thoughts:

All men should know their genetic status with regards to prostate cancer

HERE is a post I recently wrote on how to do so.

In men deemed candidates for active surveillance but with ATM, BRCA 1 or 2 mutations, should follow up more closely and adhere to strict lifestyle practices.

Does Androgen Deprivation Therapy (ADT) for prostate cancer impact cognitive decline?

Dr. Cheng-Yu Huang from Chung-Shan Medical University, Taichung City, Taiwan confirms from other studies that in a group of Taiwanese men ADT was associated with a high risk of overall cognitive dysfunction, dementia, and Parkinson’s disease.

My Thoughts:

My clinical focus with men on ADT is to improve, if not maintain their quality of life as they manage their disease with the treatment. Lifestyle practices work.

With regards to keeping a strong brain while on ADT, exercise and a few nutrients help: Bacopa is an excellent herb for brain function as well as Acetyl-L-Carnitine. I developed this packet specifically for men on ADT and I think it works well. But these nutrients complement a good diet and exercise program, it does not replace it.

Source:

American Urology Meeting 2019 attendance

Urotoday

Medscape Urology

Lastly, check out the new and improved XY Wellness website.

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by Dr. Geo

2 comments… add one
  • Lucas 05/07/2019, 1:01 PM

    Any recent news about genetic testing to identify type and source of PC?

    Reply
    • Dr. Geo 05/15/2019, 6:33 AM

      There are numerous genetic mutations that can tell if one is at risk of prostate cancer, and more importantly, potentially aggressive prostate cancer. That would include BRCA2, ATM and SPOP mutated genes, but none that I know of to determine the source or the actual cause of the disease.

      Reply

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