Cancer ABCs From Surviving To Thriving - How to Thrive with Cancer

Written Transcript at
 https://www.cancerabcs.org/transcript-racial-disparities-in-prostate-cancer-clinical-trials

Joel T Nowak interviews Emily Rencsok, an MD/PhD student at the Harvard T.H. Chan School of Public Health.  They discuss the findings of a recent publication which she was the first author that analyzed 59 prostate cancer clinical trials based in North America and Europe.

Overall, Rencsok and colleagues looked at 72 global phase 3 and 4 prevention, screening, and treatment clinical trials for patients with prostate cancer that enrolled patients between 1987 and 2016. Of the 72 trials, 59 had race data available; corresponding with a total of approximately 844,000 participants.

When the researchers analyzed the diversity of enrollment over time, they found that the proportion of black men who were enrolled in prostate cancer clinical trials decreased from 11.3% in 1995 to 2.8% in 2014. Even further, the investigators found that the proportion of white participants in these clinical trials has primarily remained above 80% since 1990.

Joel and Emily also discussed the Iron Man study that has been making strives to reverse this trend.  They also discussed implicit racial bias in both clinical trials and treatments offered to black black individuals

 (Rencsok EM, Bazzi LA, McKay RR, et al. Diversity of Enrollment in Prostate Cancer Clinical Trials: Current Status and Future Directions. Cancer Epidemiology Biomarkers & Prevention. doi:10.1158/1055-9965.EPI-19-1616.)

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Written Transcript at:
https://www.cancerabcs.org/transcript-pc-treatment-in-the-covid19-era

Joel Nowak discusses how one doctor, Dr. Emmanuel Antonarakis from The Johns Hopkins Hospital has modified his prostate cancer treatments in the era of the coronavirus.  Joel shares how Dr. Antonarakis has moved to using telemedicine when possible, the changes he has made for his patients on hormone therapy (ADT), and how he  is using chemotherapy differently for those men who need it as well as how he is avoiding using chemotherapy when possible.

Listening to this podcast will help you better understand the possible changes you too might be able to discuss with your own doctor about your own treatment.  It will help you ask better questions at your own medical appointments.

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Written Transcript at:
https://www.cancerabcs.org/transcript-provengesurvivaladvantage

Dr. Tim Richardson talks with Joel Nowak talk about the real survival advantages that the immunotherapy known as Provenge (sipuleucel-T) offers to men, especially men who get the therapy while their PSA is low (Schellhammer data) and men with an African-American background.  

Along the way, they also talk about what is immunotherapy, how it works, how Provenge is actually administered, its side effects and who should get the treatment and where in their treatment schedule would it be best to get the treatment.  

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Written Transcript at:
https://www.cancerabcs.org/transcript-urinary-incontinence-post-radical-prostatectomy-solutions

Joel Nowak discusses why men who have a radical prostatectomy, or the surgical removal of their prostate gland to treat prostate cancer often suffer urinary incontinence.  Urinary incontinence negatively affects a man's quality of life so it is important that men know about their options so they can discuss them with their urologists.  

Surgically induced urinary incontinence can be dealt with when you have an RP to treat your prostate cancer, learn about your options as well as the risks and the rewards.

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Written Transcript at:
https://www.cancerabcs.org/transcript-oncotype-prostate-sore-and-active-surveillance

Mr. Anson Tharayanil, a Medical Science Liaison from Genomic Health rejoins Joel Nowak from Cancer ABCs to talk about another test for men diagnosed with low or favorable medium risk prostate cancer, the Oncotype DX Genomic Prostate Score.

The test should be used along side the traditional measures we use like biopsy Gleason Grade and scans to help a man decide if he is a good candidate for Active Surveillance (AS) as opposed to having surgical or a radiation intervention.  

Biopsies only sample 1% of a man's prostate gland, so as a stand alone measure it does not provide us with an accurate understanding of the aggressiveness of a man's prostate cancer.  When added to the other measures, we traditionally still fall far short of accurately knowing which prostate cancers need immediate treatment and which can be monitored.  

Research shows that at least 20% of men who qualify for AS using the traditional measures if they go on and have surgery they find that their cancer is actually a lion in sheep's clothing, or is very dangerous. 

The Oncotype DX Genomic Prostate Score has been well validated and should automatically be used by any man who is trying to decide if they are a good candidate for Active Surveillance. 

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Written Transcript at:
https://www.cancerabcs.org/transcript-using-the-genomic-health-arv-7-test-when-you-arev-aking-xtandi-zytiga-or-erleada

In this podcast Anson Tharayanil, a Meical Science Liaison from Genomic Health, Inc. talks with Joel Nowak about their test, the Oncotype DX ARV-7 Nucleus Detect Test for men with castrate resistant metastatic prostate cancer.  

The test is used to determine if the second line hormone therapies like Xtandi, Zytiga and Erleada will be an effective treatment for men who have the diagnosis of prostate cancer that has left the gland (if they have metastases) and are no longer responding to the first line hormone (ADT) treatments like Lupron, Eligard, Prostap and Casodex.  

Initially, Anson gives an explanation about what is castrate resistant metastatic prostate cancer so that everyone can clearly understand the disease process that happens as prostate cancer progresses.  Afterwards, he describes how the Oncotype DX ARV-7 Nucleus Detect Test works so that you can know if you are a candidate for any of the new second line hormone therapy drugs (Zytiga, Xtandi and Erleada). 

Anson also describes how it might be possible to re-sensitive some men who have stopped responding to thee drugs.  

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Dr. Ken Pienta from The Johns Hopkins Hospital explains all about metastatic prostate Written Transcript at:
https://www.cancerabcs.org/transcript-dr-ken-pienta-discusses-what-is-metastatic-prostate-cancercancer and how it spreads or metastasizes.  

He Includes in his discussion how prostate cancer is staged, how cancer migrates from the prostate gland to distant sites that can then develop into tumors.  In this discussion He clarifies the  difference between local invasion and metastatic disease.  

He also talks about the current reality of our scanning technology, including the  new Axumin and PSMA scans and how large, or how many cells, need to be present in a tumor in order for it to be visualized.  

Dr. Pienta describes the current treatment issues surrounding oligometastatic prostate cancer (just a few tumors in the pelvic area) as well as the role of the tumor micro-environment in supporting the metastatic process.  

He also shared two clinical trials, the TED1 and the TED2 Trials (Total Obliteration Disease Trials) which he is conducting for newly diagnosed men with five or less metastatic lesions.     

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Written Transcript at:
https://www.cancerabcs.org/transcript

Mark Hall was diagnosed with metastatic prostate cancer with a PSA of 4,400 and a Gleason Score of 8.  Despite these terrible numbers he has been thriving the last four years with an undetectable PSA and a fantastic quality of life!

Mark shares his journey, where under the guidance of Dr. Charles (Snuffy) Meyers he went through a heavy regime of hormone therapy treatments as well as the immunotherapy Provenge (sipuleucel-T). 

Mark has been experiencing a profound four year remission of his probate cancer.  Mark attributes his remission to the Provenge treatment as well as Dr. Meyers guidance. 

The Cancer ABCs podcast program receives support from Genomic Health, which transforms treatment decisions in cancer by delivering clinically actionable diagnostics.  

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Hearing that someone you know or a loved one has been diagnosed with cancer is often scary.  Not only are you concerned about their health, but many of us are not sure how to speak with them or offer them help.  

We want to reach out to them, but we don't  know if we should talk about their cancer.  We also don't know how we can help them.  

Joel T. Nowak, a five time Cancer Thriver offers some insights into how you can know how to talk to someone with cancer as well as how you can provide them with the help and support they really need. 

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Joel T Nowak from Cancer ABCs along with oncology nurse Fran Fanning (co-owner of Heavenly Hash) participated in a prostate cancer patient conference sponsored by Prostate Cancer International.  The conference was held in Ft. Meyers Florida in March of 2019.

They offered a live presentation that described how hormone therapy worked, how it is achieved, its side effects as well as some "grassroots" methods used by men to control the side effects caused by ADT (hormone therapy).  Fran's presentation included information and a discussion about the role of CBD and THC (marijuana) in cancer care.

Both Fran and Joel also answered many questions that were asked by the men and their support givers who were in attendance at the conference.  Although most of the questions were about ADT, they also fielded other related questions about prostate cancer treatments as well as Cancer Thrivership.  

Voice over introduction by Amber Bloom.

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