The challenge of finding new tools to fight prostate cancer | Hacker News Reader

The challenge of finding new tools to fight prostate cancer

arstechnica.com

51 pointsTomte16 comments

Super interesting read. I had prostate cancer 15 years ago at age 40 and had my prostate surgically removed, fully recovered now but it was stressful. It's great to see so much progress in the diagnostic field since the decision to have surgery is not an easy one. It's almost like there are two versions: the one you can live with for a long long time and the kind that kills you quick. Since the PSA test is so sensitive but not terribly specific a lot of men have to make a call based on pretty low-quality information, better diagnostics will go a long way toward helping in that area.

Paradoxically, for me the PSA test now is a great tool. Since it's very sensitive anything other than zero is a sign something is going on, if you still have your prostate PSA bounces around quite a bit even if you don't have cancer so it's a terrible first diagnostic.

As someone with low-grade prostate cancer, the thing I'm most hoping for (for now) is better imaging or other monitoring tools since I'm looking at getting a biopsy every other year or so. The biopsy itself isn't too bad as far as medical procedures, but each one has a risk of infection so I wish there were a less invasive way. I'll get MRI's too, but they don't work as well at detecting small cancerous areas, my MRI missed the cancer that a subsequent biopsy found.

Though I also wouldn't mind targeted immunotherapy that could target the cancer without any invasive procedures, chemicals or radiation.

"Where the prostate is located in the pelvis and close to organs important for sexual, urinary, and bowel function—mucking around there can impact the quality of life. They can lose sexual function. We definitely want to be really careful in terms of not over-treating cancers.”

It's unfortunate that proton radiation treatment was not mentioned in this interesting article. I personally know four men who were fortunate to have proton treatment, with no side effects (after the end of treatment). (search Bragg Peak)

If my insurance would cover the 50k USD price, proton treatment would be my choice (recently diagnosed with "very low risk" prostate cancer). Instead, I'll wait 3+ years for Medicare to cover it, and hope they continue to cover it.

Tip for men with PC: if you just get surgery and your PSA is high after that surgery, don't put off followup treatment (radiation usually). My brother did that and its now metastatic in his bones. 5 year survival rate for that in US is 30%.

Other commenters have mentioned better diagnostics / better imaging / other monitoring tools. I've always wondered why not increase the frequency of PSA testing to provide a time series and reduce noise, instead of examining single PSA results in isolation? I think the normal recommended frequency 2-3 years. A PSA test is noninvasive and very cheap compared to other screening methods, so why not repeat it every 3-6 months or even monthly when there's an elevated PSA level?

I've been having mild to discomforting prostate issues for the last 5 years, if anyone has advice, I'm listening.

Doctor still won't prerscribe medication since I'm young, only taking natural supplements, which do work when I'm not stressed.

You might want to figure out why they won’t give them to you (because you’re young seems odd to me), but you can buy all sorts of medications direct from India.

I hope your doctor has ordered a PSA test.

Get a PSA test, and if it's elevated, get another one in a few months. If you're young you probably do not have BPH but your Dr should know to rule that out.

There are a lot of overgeneralized statements here and facts that border on misleading. Metastatic prostate cancer is relatively rare and most patients with prostate cancer generally pass from other diseases long before pc progression

Isn't that what they said?

The 10-year life expectancy for localized prostate cancer is around 98 percent. It’s remarkably curable. Many prostate tumors are so slow-growing and nonthreatening, they’re not even treated—they’re simply monitored to make sure they stay nonthreatening. “You’re more likely to die with prostate cancer than of prostate cancer,” says Dr. Isla Garraway, director of research in the Department of Urology at the University of California, Los Angeles (UCLA).

It's not particularly rare. Even if prostate cancer will only kill a small percentage of men that have it, it's such a common cancer that it still ends up killing around 34,130 men a year in the US making it the second leading cause of cancer death in men in the US. Figures are similar for other countries.

source: https://www.cancer.net/cancer-types/prostate-cancer/statisti...

It has one of the highest early-stage survival rates of any cancer,

I guess it does if one has usable health insurance. The scores of millions of Americans who don't - I guess they make up a lot of that death rate.

I'm not sure that's true - for many (most?) people with low-grade prostate cancer, it's not going to end up being what they die of and can just be ignored. There's debate about whether or not PSA screening is leading to too much unnecessary cancer treatment.

So it's possible that doing nothing at all is as good as more screening and early treatment.

I wish I was joking, but those folks often don't make it into the "early-stage" cohort because they don't get the simple routine healthcare that would allow for early detection/diagnosis

This tends to be a true thing when it's a choice between healthcare or a place to live.

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