Hormone Therapy for Prostate Cancer May Increase Risk of Depression

Posted by Brigham and Women's Hospital May 19, 2016

Paul Nguyen, MD, radiation oncologist

Paul Nguyen, MD, radiation oncologist

A new Brigham and Women’s Hospital (BWH) study has found a significant association between depression and patients being treated for localized prostate cancer (PCa) – cancer that has not spread beyond the prostate – with androgen deprivation therapy (ADT). Through drugs or surgery, ADT reduces a patient’s level of androgen hormones to prevent prostate cancer cells from growing.

“We know that patients on hormone therapy often experience decreased sexual function, weight gain, and have less energy – many factors that could lead to depression,” says senior author Paul Nguyen, MD, of Radiation Oncology at BWH. “After taking a deeper look, we have discovered a significant association between men being treated with ADT for PCa and depression.”

Nguyen calls this discovery “a completely under-recognized phenomenon.” Around 50,000 men are treated with ADT each year.

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Meningioma: Treatment Options for a Common Brain Tumor

Posted by Brigham and Women's Hospital May 12, 2016

Dr. Ian F. Dunn

Dr. Ian F. Dunn, BWH Department of Neurosurgery

Author: Ian Dunn, MD, neurosurgeon in the Department of Neurosurgery at Brigham and Women’s Hospital and an Associate Professor of Neurosurgery at Harvard Medical School. Dr. Dunn’s interests include surgery for meningiomas, chordomas and other skull base tumors.

People who have been diagnosed with a common brain tumor known as a meningioma have several treatment options. I recommend that patients and their families carefully evaluate and discuss the risks and benefits of each option with their physician. Other factors that will affect the choice of treatment are a patient’s age, overall state of health, and where the patient will receive treatment.

What is a Meningioma?

A meningioma is a type of tumor that develops from the meninges, the membrane that surrounds the brain and spinal cord. About 85 percent of meningiomas are categorized as benign tumors. Because most benign meningiomas grow slowly, they may reach a relatively large size before causing symptoms, such as headaches, blurred vision, seizures, numbness, weakness in the arms or legs, or speech difficulty.

Meningiomas are one of the most common brain tumors within the general population. They are more common among women and occur with increasing frequency as people get older. Meningiomas are found in about three percent of people over the age of sixty.

There are three treatment options for meningiomas: observation, surgery, and radiation. There are also clinical trials underway to identify new therapies.

Observation versus Surgery

Meningiomas that are smaller in size and are not causing symptoms may be observed by your physician. We commonly perform periodic CT or MRI scans at intervals of six to 12 months and consider medical intervention if growth is observed over time or if symptoms develop.

Surgery and Recovery

Surgery is the primary treatment for meningiomas. The goal of surgery is to remove all of the meningioma and the membranes from which it originates. The location of a meningioma determines the complexity of surgery to remove it. Meningiomas located at the surface of the brain (convexity) are more easily accessed than those at the skull base, those that involve the blood vessels in the brain (sagittal sinus or cavernous sinus), or meningiomas in the optic nerve sheath. Neurosurgeons at Brigham and Women’s Hospital have particular expertise treating meningiomas located in any area of the brain..

Recovery can vary according to the length and type of your surgery. Usually, patients are observed in the neurosurgery intensive care unit (ICU) overnight. The next day, they can expect to be transferred to a regular hospital floor, where they will be walking, eating, and drinking. A common hospital stay is between two to five days. Occasionally, patients may need to recover at a rehabilitation facility prior to returning home.

Once home, patients can expect to be walking and moving around, but they may be more tired than usual in the first seven to 10 days after surgery. Patients may resume normal activities, including driving, as soon as they feel strong enough. Patients should plan on being absent from work for four to eight weeks, depending on the type of surgery.

Radiation Therapy

Radiation is often used in combination with surgery, to more fully treat patients with aggressive types of meningiomas. Newer ways of delivering radiation, such as stereotactic radiosurgery, stereotactic radiotherapy, or intensity-modulated radiotherapy, deliver more focused radiation, minimizing radiation exposure to the normal brain tissue surrounding the tumor. Radiation may be given in one large dose (stereotactic radiosurgery) or in multiple small doses (stereotactic radiotherapy).

Meningioma Clinical Trials

There are no approved drugs for meningioma, although clinical research may lead to drug treatments for patients with recurrent meningiomas.

Researchers at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) are studying the genetic factors related to the growth of meningiomas. By studying our patients’ tumors, we and others have identified important new genes in meningioma growth. Two of these genes have formed the basis of a clinical trial for patients with specific genetic changes in their tumors.

In patients with more aggressive meningiomas, researchers at DF/BWCC are also conducting a clinical trial in which they are studying whether the immune system can be stimulated to kill tumor cells. This has approach has shown great promise in other brain tumor types.

Don’t hesitate to consult your doctor if you need more information about your diagnosis, treatment choices, or anything to do with your meningioma or related health issues.

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Adult Brain Tumors: The Latest Research and Treatment

Posted by Brigham and Women's Hospital May 5, 2016

Patrick Wen, M.D. and David Reardon, M.D. look at a computer with an image of an MRI. Photographed for BWH onclolgy advances.

Patrick Wen, MD, (left) and David Reardon, MD, are exploring new treatment options for adult Contrbrain tumors.

Contributor: David Reardon, MD, is Clinical Director in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center.

Historically, brain tumors have been some of the most challenging types of cancers to treat. A protective barrier around the brain – called the “blood-brain barrier” – can prevent cancer treatments from reaching the tumor. Recently, increased interest in immunotherapy has given new hope to overcoming this challenge.

“We know the immune system can get into the brain to fight infections and inflammatory conditions,” says David Reardon, MD, Clinical Director in the Center for Neuro-Oncology at Dana-Farber/Brigham and Women’s Cancer Center. “Our current research is moving forward to a level where we’re critically confirming that these immunotherapy drugs are getting into the brain and making a difference.”

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Breast Cancer – New Surgical Advances

Posted by Brigham and Women's Hospital May 3, 2016

Ann Partridge and Tari King,

Dr. Tari King, Chief of Breast Surgery, and Dr. Ann Partridge, Director of the Program for Young Women with Breast Cancer, discuss a case.

Current trends in breast cancer management incorporate a “less is more” approach in many cases. This includes surgical treatment for breast cancer.

“We are finding that we can perform less extensive surgery and offer easier approaches for many patients with breast cancer, while still achieving excellent outcomes,” says Dr. Tari A. King, Chief of Breast Surgery and a member of the Breast Oncology Center at Dana-Farber/Brigham and Women’s Cancer Center.

Previous surgical treatment plans, for example, included full lymph node surgery for the presence of any cancer in the lymph nodes located under the arm. This can result in long-term arm swelling, a condition known as lymphedema. Recent studies have shown that, in patients with a limited amount of cancer in the lymph nodes (cancer in one or two nodes), it is not necessary to remove all of the remaining nodes.  The lymph nodes can remain in place and the cancer can be successfully treated with other modalities, such as medical and radiation therapies.

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Melanoma – What You Should Know

Posted by Brigham and Women's Hospital April 28, 2016

Melanoma is the deadliest form of skin cancer and the most common of all cancers among 25- to 29-year-olds in the U.S. The American Academy of Dermatology designates the first Monday in May as Melanoma Monday®, a day to focus on raising awareness about this dangerous disease and other types of skin cancer.

 

Sun-SafetySun Safety – Reducing Your Melanoma Risk

Reducing your exposure to ultraviolet rays, from sunlight and artificial light, is one of the most significant ways to reduce your risk of developing melanoma. Although it isn’t summer yet, the effects of the sun now are similar to that of a mid-August day. Brigham and Women’s Hospital (BWH) dermatologist Dr. Deborah Scott offers some tips to help you stay safe in the sun.

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Preventive Mastectomy Rates Increase despite Lack of Survival Benefit

Posted by Brigham and Women's Hospital March 31, 2016

Patients and caregivers should weigh the expected benefits with the potential risks of .

Patients and caregivers should weigh the expected benefits with the potential risks of a contralateral (double) prophylactic mastectomy.

A recent Brigham and Women’s (BWH) study reveals that from 2002 to 2012, the number of women choosing to have both of their breasts removed as a strategy to prevent the recurrence of breast cancer – a procedure known as contralateral prophylactic mastectomy (CPM) – tripled in the U.S., but without a corresponding improvement in  survival. Researchers note that while CPM may have a survival benefit for patients that are at high risk of developing breast cancer, such as those with a genetic mutation, the majority of women undergoing CPM are at low risk for developing breast cancer in the unaffected breast.

“Our analysis highlights the sustained, sharp rise in popularity of CPM, while contributing to the mounting evidence that this more extensive surgery offers no significant survival benefit to women with a first diagnosis of breast cancer,” says senior author Dr. Mehra Golshan, Distinguished Chair in Surgical Oncology at BWH. “Patients and caregivers should weigh the expected benefits with the potential risks of CPM, including prolonged recovery time, increased risk of operative complications, cost, the possible need for repeat surgery, and effects on self image.”

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Prostate Cancer Screening – Who Recommends PSA Testing?

Posted by Brigham and Women's Hospital March 17, 2016

prostate-specific antigen (PSA) testing for the early detection of prostate cancer may depend on the type of physician a patient sees.

The likelihood of a patient getting a PSA test for the early detection of prostate cancer may depend on the type of physician he sees.

Dr. Quoc-Dien Trinh is a urologist at Brigham and Women’s Hospital (BWH).

Recent research led by Brigham and Women’s Hospital suggests that the likelihood of a patient getting prostate-specific antigen (PSA) testing for the early detection of prostate cancer depends on the type of physician he sees.

In October 2011, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against the use of PSA testing for prostate cancer screening for all men. In its assessment, the task force concluded that, overall, the harms of PSA testing outweigh its benefits. The study authors, however, hypothesized that adoption of the USPSTF recommendation would vary according to a physician’s specialty.

The researchers examined PSA testing use among primary care physicians (PCPs) and urologists in the year immediately before the recommendation was issued and the year immediately afterward. To focus on preventive care visits, men previously diagnosed with prostate cancer, an elevated PSA level, or other prostate conditions were excluded from the study.

The study found that PSA testing for men aged 50-74 years decreased significantly from 36.5 percent in 2010 to 16.4 percent in 2012 among PCPs. However, during those same years, such testing among urologists only decreased from 38.7 percent to 34.5 percent.

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Colorectal Cancer Prevention: Five Things You Need to Know

Posted by Brigham and Women's Hospital March 8, 2016

Jeffrey Meyerhardt

Dr. Jeffrey Meyerhardt

Contributor: Jeffrey Meyerhardt, MD, MPH, is clinical director of the Gastrointestinal Cancer Treatment Center at Dana-Farber/Brigham and Women’s Cancer Center and Associate Professor of Medicine at Harvard Medical School.

While one of the most common cancers in both men and women, colorectal cancer remains a very preventable disease, explains Dr. Meyerhardt.

“Most of these cancers develop over a period of years,” said Dr. Meyerhardt. “While not preventable in everyone, the earlier you detect the disease, the more curable it is.”

Below are five tips from Dr. Meyerhardt on ways to reduce your risk.

1. Live a healthy lifestyle.

“There are various dietary factors that play a role in colorectal cancer,” explained Dr. Meyerhardt. “The one that’s the most consistently shown in studies is red and processed meat.” To lower your risk, Dr. Meyerhardt recommends eating fewer than two servings of red or processed meat per week. This includes foods such as steak, hamburgers, and hot dogs.

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Names on Construction Beam Lift Spirits of Pediatric Cancer Patients

Posted by Brigham and Women's Hospital December 23, 2015

The names of two dozen pediatric cancer patients from Boston hospitals have been spray-painted on a construction beam that will soon support a new cafeteria at Brigham and Women’s Hospital.

Tucked away on Shattuck Street, facing the windows of Boston Children’s Hospital, the names “Brooklyn,” “Nicholas,” “Kevin,” and many others are spray-painted in bright orange, light blue, pink, and white on a steel beam that will support the new cafeteria at Brigham and Women’s Hospital (BWH), which is undergoing renovation.

The two dozen names belong to pediatric patients from the Dana-Farber Cancer Institute (DFCI), Boston Children’s Hospital, and the Department of Radiation Oncology at Dana-Farber/Brigham and Women’s Cancer Center, including 5-year-old Brooklyn, who was the first patient to have her name spray-painted on the 63-ton beam. After seeing a Facebook post written by Brooklyn’s mother, a family friend working on the construction site was inspired to begin spray-painting the children’s names.

“Seeing Brooklyn’s name on that steel beam is a feeling I will never forget,” says Kerrin Dooley, Brooklyn’s mother. “To me, the beam is a symbol of community, caring, support, strength, and teamwork – all critical aspects in the fight against cancer.”

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The Link between Processed Meat and Cancer: What You Need to Know

Posted by Brigham and Women's Hospital December 10, 2015

Recent research says that eating processed meat products, such as hot dogs and bacon, can increase a person’s risk for colorectal cancer.

Recent research says that eating processed meat products, such as hot dogs and bacon, can increase a person’s risk for colorectal cancer.

Eating processed meat products can increase a person’s risk for colorectal cancer, according to a report from the International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO). Processed meat is classified as meat that has been salted, cured, fermented, or smoked to add flavor or preserve the meat. These meats include ham, bacon, sausages, corned beef, hot dogs, canned meat, and beef jerky.

In its findings, the IARC also determined that red meat is “probably carcinogenic to humans,” based on “limited evidence.” Red meat consumption was mainly linked to an increased risk for colorectal cancer, but it also had associations with pancreatic cancer or prostate cancer. Red meat includes beef, veal, pork, mutton, lamb, or goat.

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