News Updates in Prostate Cancer
Newsletters from Dr. Charles K. Metzger, MD, MBA (retired)
One of the most important things we do at the Forum is educate patients and others about detection and treatments that have powerful potential to save their lives and/or prevent further damage to their bodies. Better detection leads to important, lifesaving changes in treatment. These newsletters provide up-to-date summaries of current research and links to detailed articles.
April 26, 2025
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I want to share a short, patient friendly article that you will find important, especially if you are over 70 years old or so. If you’ve regularly attended our Support & Information groups, you’ve heard fellow prostate cancer patients discuss how their treatments are affected by other medical conditions. Good medicine strives to cure or reduce the impact of ailments without creating bigger problems. “First, do no harm."
April 12, 2025
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Medical history is full of obsolete treatments and some never worked. Next in line for the history books is using a bone scan to find prostate cancer in the skeleton according to Professor Daniel Spratt, M.D. a radiation oncologist with Case Western Reserve University Comprehensive Cancer Center in Cleveland, Ohio.
April 5, 2025
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Let’s look at two pharmaceutical firms whose products may provide precision cancer therapy soon. There are two reasons we are looking in the neighbor’s yard tonight. Frist, variations of these drugs may someday fight prostate cancer. And many of us know someone close to us fighting blood or breast or other cancers and they are looking for answers beyond what has been presented
March 29, 2025
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Researchers wanted to know the effect of adding ADT’s to SBRT to treat oligometastatic disease. They found their patients receiving two therapies at once delays Mets for more than twice as long as the group treated with SBRT only.
March 22, 2025
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How does robotic HIFU stack up against radical prostatectomy? According to Pascal Rischmann,
MD, PhD, a urologist and president of the Surgical Society of France, HIFU is at worst
“noninferior” and at best superior to surgery as far as its ability to kill intermediate risk cancer in
the gland without long term side effects of impotence, urinary leakage and damage to the
rectum and other tissues surrounding the prostate.
March 15, 2025
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A study at the Juravinski Cancer Centre in Canada indicated that patients with a simultaneous high dose brachytherapy with external beam radiation had a high enough rate of progression free survival and low enough rate of toxicity to make this treatment the new standard of care at the Centre.
March 8, 2025
Ira and I are keen on second opinions for prostate cancer biopsies. We are considering advocating second opinions on MRI’s as well. Pathology and radiology are the same as other skilled fields. Some know more than others and are better at picking up subtle differences. That difference in skill might make a huge difference in the quality of treatment you get. Here's a link to a simple and straightforward article.
February 22,2025
What if a take-home urine test could quickly and inexpensively eliminate the need for prostate
biopsies in men with indolent cancer? The accuracy of the My Prostate Score test was validated once again in a clinical study of men with known grade cancers. This test detects biomarkers for serious cancers like the PROMISE saliva test we’ve been urging our support group members to take.
February 8,2025
Dr. G . Chiarelli and his team assessed mortality associated with active surveillance. They examined the medical records of 546 men, 75 years and younger who were diagnosed between 1995 and 2022. They decided on a criterion for compliance with active surveillance guidelines.
January 25,2025
A study led by Dr. Amar Kishan of UCLA, a recent presenter to the Forum, found that MRI guided SBRT does in fact protect healthy tissues outside of the margins. Those treated with MRI radiation did significantly better with bladder and bowel toxicity and sexual function than with CT.
January 18,2025
Here’s some potentially good news for those of us who want to spend less time in an MRI machine, cut MRI costs, or are concerned about contrast media side effects.
January 11,2025
We discuss genetic testing’s value in creating a personalized treatment plan resulting in metastasis - free survival without additional side effects and costs. The above article discusses the value of using androgen deprivation therapy (hormone therapy) with an androgen receptor inhibitor. Let’sunderstand how Metastatic P Ca grows.
December 14, 2024
A controlled study involving 13,000 Swedish men aged 50-60 shows that MRI use REDUCES THE NEED FOR BIOPSIES OF CLINICALLY INSIGNIFICANT (Gleason 3 + 3) CANCERS.
December 7, 2024
Recent City of Hope research on mice demonstrated that white button mushroom extract increased the number of T cells and natural killer cells in mice infected with prostate cancer tumor components and reduced the tumor’s ability to fight off T Cells.
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Professor Cary Presant, MD presented updates to the Forum in a Guest Chat in June 2023.
November 30, 2024
Data is now available from the PREVENT study from a research team headed by Jim C Hu, MD,
MPH, a professor of urology at Weill Cornell Medicine / New York-Presbyterian Hospital, in which the researchers want to know if trans perineal biopsies (TP) provide better cancer detection with fewer infections than traditional trans rectal biopsies (TR).
November 16, 2024
I found something exciting for our friends on the East Coast. Memorial Sloan – Kettering Centers have MRI Guided SBRT developed by a 50-year-old Swedish corporation, a worldwide
leader in oncology radiation market, called “Elekta”.
November 2, 2024
Check out this concise, well-written article by CNN Health about next year’s Medicare Advantage changes. Some changes you may like and some not so much.
October 26, 2024
We know that the sooner we spot Mets post-surgery, the better the chances of controlling its spread. Testing is the name of the cancer treatment and recovery game. Click on the link for good news coming from a small study of men with low PSAs after surgery.
October 12, 2024
Dr. Metzger talks about a detection process called a Prostate Specific Membrane Agent Positron Emission Tomography. It’s something he and Ira talk about at nearly every meeting for our visitors who have high Gleason scores, high prostate stimulating antigen labs, or who may be experiencing biochemical recurrence.
October 5, 2024
Decipher is a painless, no fuss means of detecting genetic aberrations that could lead to cancer spread and treatment challenges. Researchers discovered that patients with a high Decipher genetic test score did better with docetaxel than those with a low Decipher score.
September 21, 2024
We look at a study from across the pond that compares post operative treatment modalities
commonly used to promote metastasis free survival for prostate cancer patients.
September 7, 2024
Tonight, we examine a link between prostate cancer and virus particles that entered our collective DNA some 30 million years ago.
August 31, 2024
Fluorine-18 prostate-specific membrane antigen (PSMA)-1007 PET/CT improves locoregional staging compared with MRI in patients undergoing surgery for intermediate and high-risk prostate cancer.
August 3, 2024
Centers for Medicare & Medicaid Services proposed rule change will cover payment for PET imaging agents for Prostate Cancer and more.
July 6, 2024
The tumor-seeking radiopharmaceuticals are charting a new course in oncology, with promise for targeted treatments with fewer side effects.
June 8, 2024
Last week I told you about Micro-Ultrasound and how it may replace MP-MRI as a diagnostic
tool. Now, another exciting development suggests the medical community will have a smaller,
more portable, more affordable MRI machine to use on a variety of diagnostic tasks once it’s
approved by the United States Food and Drug Administration.
Developments in the use of Micro Ultrasound (MUS) as a Diagnostic
and Biopsy Tool
June 1, 2024
The advantages of ultrasound (US) over MRI pushed researchers towards developing an US that can create images that are 3 to 4 times higher resolution than traditional US and at least as clear as MRI images. The result of their labor is Micro-Ultrasound (MUS). And not too far away, Artificial Intelligence enhanced Micro-Ultrasound (AIMUS). The latter will lead to more accurate and complete reading of the sound generated image.
May 18, 2024
Remarkable article about a study done on men after radical prostatectomy that had Gleason 8,9, 0r 10. The biochemical recurrence rate was zero at 24 months using mostly Erleada and Relugolix.
May 4, 2024
Metastasis Directed Therapy is used with all kinds of cancers. It can be done with surgery and /
or radiation delivered by external beam (IMRT, SBRT) or via Theranostics. Sometimes chemotherapy or hormone blockers are added. The objective is to stop cancer from spreading by either taking out what is “feeding” the cancer and / or preventing the Mets from creating more Mets. Hormone therapies have side effects that vary depending on the patient and the drug. Chemotherapy has side effects too.
April 27, 2024
New treatment option for prostate cancer shows successful outcomes. MRI Guided Transurethral Ultrasound Ablation has a high success rate without side effects associated with surgery.
April 20, 2024
Something old is new again. Years ago, men with Mets. were treated with estrogen instead of ADTs to deprive prostate cancer of testosterone. The study says patients who opted for treatment with estradiol skin patch had fewer side effects such as hot flashes, mood swings, blood pressure, blood sugar and cholesterol issues, reduced bone density and so forth than those who got ADTs.
April13, 2024
Targeted radiation therapy via MRI guided SBRT can be an effective control of various oligometastatic cancers even without chemotherapy and / or ADTs. That’s a quick summary of some of the exciting discoveries discussed in the above article.
April 6, 2024
The clinical trial scene is evolving and changing, and we are in an exciting time for such treatments. I want to share a list of contacts you can ask about clinical trials.
March 30, 2024
Click on the link in the newsletter to find out more about NEW clinical trials going on around the nation See if you qualify.
March 23, 2024
Genetic screening panels can alert patients to their potentially higher cancer risks. While they are not yet 100% reliable they can communicate the need for increased watchfulness going forward.
March 9, 2024
I wanted to share a study that correlates lower Alzheimer’s Disease risk in men with specific risk factors with the use of Viagra or Cialis. The connection between these drugs and Alzheimer’s is particularly interesting to P Ca patients as many of you are using them for ED and / or controlling urinary incontinence. Thus the question: are there unintended benefits to using these meds and if so, what dosages are needed to obtain benefits in men and maybe women with an increased risk of Azheimer’s?
March 2, 2024
Here’s a link to a quick, patient friendly video discussing research that suggests your prostate
cancer fight will be more successful with moderate exercise and good nutrition. Moderate wine intake is also good, and I am glad to hear that.
February 17, 2024
I found a ten yearlong study of 2455 men with cancer in the prostate only that underwent
surgery or external beam radiation treatment or active surveillance in 2011 to 2012 here in the USA. The research team wanted to know about side effects of treatment (or maybe no treatment in active surveillance) and compare post treatment risks side by side. Here's what they found.
February 10, 2024
Black men are at greater risk for serious prostate cancer and at greater risk for discovering it later and experiencing it earlier in their lives. That’s consensus among prostate cancer researchers and practitioners.
February 3, 2024
Giving the finger to the finger?
In this study, the Digital Rectal Exam (DRE - the finger) is found to be less effective that some more recent diagnostic techniques.
January 20, 2024
Medicare/Medicaid sets pay schedule for artificial intelligence assistance to P Ca testing, and that's just a start...
December 16, 2023
While not a holiday present, assistance with medication cost is welcome this time of year and
throughout the year. I see many drug companies offering help with patient drug costs and for a wide variety of illnesses. So, ask your pharmacist or heath care provider about financial relief for the Meds you and your loved ones take.
November 25, 2023
We may be as close as five years to having an injection for most if not all genetically based
diseases according to F. Perry Wilson M.D., M.S.C.E., of Yale Medical School.
November 4, 2023
Scanxiety is the stress you may feel around your cancer tests. There are several things that you can do to manage scanxiety.
October 28, 2023
PSMA-PET scans are more selective and more sensitive than conventional imaging. Here, four expert physicians discuss how these scans are changing the way they practice medicine, criteria for ordering PSMA-PET scans and how PSMA-PET scans can better serve patients and doctors.
October 7, 2023
Dr. Spratt, author of this article, will join us on Thursday, October 26th at 5:00 p.m. Pacific Time on zoom to address the role of artificial intelligence in treating prostate cancer.
September 30, 2023
The title says it all. OTC alternative to ED drugs will be available soon in the US.
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Added 10/10/2023: check eroxongel.com for availability in the US.
September 23, 2023
Medicare can be a confusing business. Dr. Metzger presents an article that describes a tool that helps you choose a Part D plan that meets your needs, and follows up with some further advice for navigating Part D.
August 12, 2023
Links to a podcast and discussion of the effectiveness of flotufolastat F 18.
July 29 2023
Report in the Orange County Register tells how top quality medical care is growing rapidly in Orange County.
July 8, 2023
Tonight, we will look at the Mark Cuban Cost Plus Drug Company (“Cost Plus”) and other options for holding down drug costs. Cost Plus is a mail order pharmaceutical house that manufacturers one hundred prescription drugs. Its business model saves money and passes savings onto consumers.
July 1, 2023
Dr. Calais of UCLA reports on a study that suggests we are getting closer to real time evidence that PSMA Guided (precision) radiation is the real deal and will make treatment of early metastatic disease more accurate and ready for prime time!!
June 17, 2023
“Would a heart healthy, vegan or vegetarian diet improve my P Ca outcome?” This question gets asked a lot at our meetings. This article answers that some of the cancer or drug related side effects may be improved, but since it was not controlled for pure vegan vs vegetarian, it is still not known what a true vegan diet may do for prostate cancer patients. Heart healthy diet still remains the diet of choice since men are usually in the heart risk age when prostate cancer is diagnosed.
June 10, 2023
Tonight, Dr. Metzger shares a list of current clinical trials with you. The clinical trial scene is evolving and changing and we are in an exciting time for such treatments. He also shares a list of contacts in Orange County that you can ask about clinical trials.
May 27, 2023
Here’s strong evidence that the medical community is looking at standardizing detection and treatment modalities for low grade prostate cancer and is moving towards international consensus. This is exciting news for AS patients who hear so many different things about detection and treatment of Gleason 3+3 and low grade 3+4 P Ca.
May 20, 2023
Here’s some good news. In a promising US study, patients who got both intermittent hormone therapy and radiation saw a 75 % reduction of P Ca progression or death over their counterparts who only got intermittent hormone therapy.
15-Year Follow-Up of the ProtecT Trial: Discussing Results and Changes in Prostate Cancer Management
May 13, 2023
The ProtecT trial was a UK-based study where 1600 men were randomized to either active monitoring, prostatectomy, or radiotherapy. The trial followed up on these men for 15 years and found that there were no significant differences in mortality between the groups.
May 6, 2023
Several United Kingdom researchers demonstrated that prostate cancer treated or not has low mortality. Keep in mind we are primarily discussing mortality.
April 29, 2023
In tonight's newsletter, Dr. Metzger looks at a study of 55,432 European men who were followed for 16 years to determine if the quantity of PSA in a first routine draw can predict the likelihood of developing a Gleason 7 or more serious cancer. The results are encouraging.
April 15, 2023
A recent Canadian study demonstrates how well a Prostate Specific Membrane Antigen called “Piflufolastat F 18” or “Pylarify” used with PET / CT scan can locate metastatic prostate cancer in post treatment patients with low PSA levels.
April 1, 2023
Summary and analysis of a study called Patient Reported Outcomes 12 Years After Localized Prostate Cancer Treatment.
March 25, 2023
Patients with prostate cancer whose diets included the highest amounts of plants had a lower risk of disease progression and recurrence, according to findings shared during the 2023 ASCO Genitourinary Cancers Symposium.
March 18, 2023
This paper discusses the results from the PACE-A trial, comparing quality of life outcomes from surgery vs stereotactic body radiotherapy (SBRT) among patients with intermediate-risk localized and low-risk prostate cancer.
March 4, 2023
Sign up for the PROMISE Registry. Help yourself. Help your family. Help other P Ca fighters.
To learn more, visit ProstateCancerPromise.org
February 16, 2023
This non-invasive means of determining presence of high risk Prostate Cancer will become easier to get via Iso-PSA Blood Test and may eliminate the need for some biopsies.
February 4, 2023
MRI-guided SBRT reduced both acute toxicity effects and decrements in quality-of-life measures when compared with CT-guided SBRT, according to findings published in JAMA Oncology
October 29, 2022
A little change of pace. Here's the Fall 2022 UCLA Urology Newsletter featuring our Nov. presenter Professor Leonard S. Marks, M.D. and his coworkers. We hope it will help you prepare for the Nov. presentation.
August 12, 2022
Just a brief glimpse of the literature regarding MRI before a biopsy. Not all studies agree but the consensus is in favor of the pre biopsy MRI fused to the ultrasound. Standard of care, to be sure.
August 6, 2022
This is a big step toward treatment intensification for men with both oligometastatic disease as well as more advanced metastatic disease.
June 24, 2022
This keeps coming up at our meetings, Dr Fuller endorses this as does UCLA. Makes a lot of sense to prevent rectal issues with radiation.
June 18, 2022
This is a good reminder that androgen deprivation after salvage radiotherapy is the way to go, especially if the new drug is used (relugolix). Here are two articles for review.
June 3, 2022
An example of how modern technology is helping surgeons do a better job of finding proper anatomic margins to know they have resected all of the cancerous prostate.
May 14, 2022
This is the nail in the coffin for the mri vs ultrasound debate. Not only will it get the process back into the urologist office, away from the radiologist there will be less reluctance to do guided biopsies.
May 7, 2022
Here is a current update from Johns Hopkins to their 2011 original article regarding active surveillance for prostate cancer.
April 22, 2022
The FDA officially approved these agents which will be discussed in our next talk, on Thursday, April 24, 2022 at 7 pm. Please attend and find out how all this fits together.
April 9, 2022
An extensive review of the literature about pre treatment of advanced disease with different therapies (neoadjuvant) prior to surgery or radiation
March 26, 2022
Here are two exciting new developments for the prostate cancer world. The first is treatment for men with metastatic prostate cancer that is hormone sensitive. Really impressive results. The second is the use of LU PSMA for treatment of end stage disease and its approval for use by the FDA in castrate resistant prostate cancer.
March 13, 2022
This very informative video presentation by Dr. Eric A. Klein, MD is another example of progress in the decision about how to use PSA and who needs more testing.
March 5, 2022
This is a very interesting review of the history of PSA. Lots of twists and turns in its life as a screening tool. Using it wisely is really the key to its existence.
February 26, 2022
Although controversial, the trend is to treat the main tumor even if there is oligometastasis (less than five sites).
January 29, 2022
This is the near future of prostate imaging.
January 10, 2022
German hospitals are offering a 3-4 day inpatient treatment called Lutetium 177.
January 4, 2022
The FDA has approved piflufolastat F 18 injection, a prostate-specific membrane antigen–targeted positron emission tomography imaging agent to identify suspected metastasis or recurrence of prostate cancer- it is finally official.
November 13, 2021
The Exablate system, which uses high intensity ultrasound to control locally-confined prostate cancer, is very precise for the treatment of focal prostate cancer.
November 13, 2021
This is another step forward in the theranostics arena.
November 1, 2021
This is a succinct look at the field of immunotherapy as it relates to prostate cancer. It’s a great overview of current and future treatment options.
October 11, 2021
This article answers a question at the advance meeting of the value of pre op multi parametric MRI (this was pre PSMA work) in determining if surgery is the way to go.
September 26, 2021
The PSMA-PET imaging agents Piflufolastat F 18 and Gallium 68 PSMA-11 are approved by the FDA for managing patients with prostate cancer
September 11, 2021
This very long article really is the answer to where MRI fits into the diagnostic scheme of elevated PSA.
Sept 3, 2021
It was just a matter of time before another promising agent was added to the PSMA.
July 31, 2021
The following articles help put to rest the value of MRI fused biopsy and compares it to the regular ultrasound guided biopsy
July 17, 2021
These articles show the amazing advances in the treatment of advanced prostate cancer.
April 27, 2021
Experts in prostate cancer discuss considerations for initiating ADT therapy after definitive treatment in patients with prostate cancer in the context of biochemical recurrence.
April 10, 2021
ORGOVYX, the drug that will eventually replace Lupron or Zoladex for the treatment of advanced prostate cancer, is now readily available. This is the only androgen deprivation therapy (ADT) medicine that is not given in the form of an injection.
April 3, 2021
The use of MRI guided transurethral approach to just treat a solitary lesion is now gaining traction as a way to do a more directed minimally invasive treatment.
March 18, 2021
A really good review of the use of active surveillance in all age groups. Emphasis on clinical guidelines and non-medical factors, like Vitamin D, low-dose statin, and frequent biomarkers for disease status.
March11, 2021
Scientists are making great strides when it comes to the gene editing technique known as CRISPR. Scientists are confident that the treatment and prevention of prostate cancer using CRISPR technique holds tremendous potential.
February 25, 2021
Scientists are making great strides when it comes to the gene editing technique known as CRISPR. Scientists are confident that the treatment and prevention of prostate cancer using CRISPR technique holds tremendous potential.
February 25, 2021
The incidence of prostate cancers that have spread to the bone at diagnosis has increased since the PSA test was taken off the guidelines of the U.S. Preventative Services Task Force (USPSTF). Some modification of this recommendation needs to be considered on a case-by-case basis.
February 16, 2021
A shorter course of stereotatic body radiotherapy (SBRT) has been shown to be effective in high-risk prostate cancer. The toxicity has been favorable and the cost is competitive.
