Drug Cost Hikes Outpace Rise in Other Medical Costs

By Emily P. Walker, Washington Correspondent, MedPage Today

Prices for prescription drugs have risen faster than the cost of other medical goods and services since 2006, according to a new government report.

The prices for 100 commonly used drugs -- which included 55 brand-name drugs and 45 generics -- increased at an average annual rate of 6.6% from 2006 through early 2010, compared with a 3.8% average annual increase for other consumer medical goods and services.

Prices for brand-name drugs increased by an annual average rate of 8.3%, while prices for generics fell by 2.6% annually, according to the report prepared by the Government Accountability Office (GAO) and requested by five Democratic lawmakers.

Prescription drug spending totaled about $250 billion in 2009.

One of the biggest price increases in brand-name drugs was seen in tamsulosin (Flomax), a drug made by Boehringer Ingelheim to treat the symptoms of an enlarged prostate. From 2006-2007, the "usual and customary" price for Flomax increased by 9.8%, but from 2009-2010, it increased nearly 30%.
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Early Baldness May Have Link to Prostate Cancer

By Michael Smith, North American Correspondent, MedPage Today

Men who start to lose their hair at age 20 may be more likely to develop prostate cancer later in life, a case control study suggested.

The study, involving 388 men with a history of prostate cancer and 281 without, found that those with prostate cancer were twice as likely to have early balding compared with healthy controls, reported Philippe Giraud, MD, PhD, of the Hôpital Européen Georges Pompidou in Paris, and colleagues.

However, the study found no link between hair loss at age 20 and early diagnosis of prostate cancer or tumor aggressiveness, Giraud and co-authors reported online in the Annals of Oncology.

Noting that there's currently no evidence of benefit for general screening for prostate cancer, the investigators suggested that their finding may help identify a subgroup of men who would benefit both from screening and possible early treatment.

Walking May Lower Mortality Risk in Prostate Cancer

By Charles Bankhead, Staff Writer, MedPage Today

Prostate cancer survivors can literally walk themselves to a lower risk of dying of the disease -- with some men achieving an almost 50% lower mortality risk, data from a large cohort study showed.

The study, involving more than 2,000 survivors of nonmetastatic prostate cancer, found those who walked at a normal to brisk pace for at least 90 minutes a week had a 46% lower mortality hazard -- and three or more hours of vigorous physical activity each week lowered the hazard to 49%, according to Stacey A. Kenfield, ScD, of the Harvard School of Public Health, and colleagues.

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Age No Barrier to Prostate Cancer Tx

By Todd Neale, Staff Writer, MedPage Today

Decisions about prostate cancer treatment may rely too heavily on age, research suggests.

In a study of nearly 12,000 men, older patients were less likely to get local therapy, regardless of disease risk, Matthew Cooperberg, MD, MPH, of the University of California San Francisco, and colleagues reported online in the Journal of Clinical Oncology.


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Risks Top Benefits of Screening in Men With Low PSA - from MedPage Today

By Charles Bankhead, Staff Writer, MedPage Today

Men with low prostate-specific antigen (PSA) values may face more risks than benefits from aggressive approaches to prostate cancer screening and evaluation -- along with potential overtreatment -- data from a large cohort study suggest.
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Comorbidities May Be Key in Prostate Cancer Tx Decisions from MedPage Today

By Nancy Walsh, Staff Writer, MedPage Today

A questionnaire for men with prostate cancer that evaluates comorbidities may help in clinical decision-making about treatment by estimating their likelihood of dying from other conditions, researchers found.

A study of almost 3,000 responses to the Total Illness Burden Index for Prostate Cancer (TIBI-CaP) questionnaire found that those men who scored highest were 10 times more likely to die of causes other than prostate cancer compared with men with the lowest scores (HR 10.3, 95% CI 5.4 to 19.5), according to Timothy Daskivich, MD, of the University of California, Los Angeles, and colleagues.

These results suggest that the presence and severity of comorbidities should be a key consideration in clinical decision-making for prostate cancer because of the indolence of many early stage cases, Daskivich and co-authors wrote in a research letter published in the August 9/23 Archives of Internal Medicine.
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Bone Density May Predict Prostate Cancer in Old Age from MedPage Today

By John Gever, Senior Editor, MedPage Today

Bone scans might help identify men at high risk for aggressive prostate tumors as they age, researchers said.

Starting at about age 70, men in a long-term prospective cohort study who were diagnosed with high-risk prostate cancers tended to have relatively high levels of bone mineral content when measured up to 35 years earlier, reported Stacy Loeb, MD, of Johns Hopkins University, and colleagues.

The findings, from a longitudinal study of 519 men that began in 1958, were reported in the July issue of the British Journal of Urology International. "Although the biology underlying this association requires additional study, these findings suggest that host factors in the bony milieu may be related to prostate cancer development and the progression to advanced disease," Loeb and colleagues wrote.
They noted that the frequency of bone metastases in patients with prostate cancer suggested some biological association between these tumors and bone. The researchers also cited a previous study suggesting a link between higher bone mineral density and prostate cancer incidence, although the connection seemed weak.
In the current study, Loeb and colleagues looked at data from the Baltimore Longitudinal Study of Aging, in which participants have undergone comprehensive medical exams about every two years since 1958.
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Radiation Versus Watching a Toss-Up for Prostate CA - from MedPage Today

By Charles Bankhead, Staff Writer, MedPage Today

There is still not enough evidence to show that radiation therapy for localized prostate cancer is better than surveillance, according to a report prepared for the Centers for Medicare and Medicaid Services (CMS).

Only retrospective analyses have compared irradiation with no treatment or no initial treatment. Data comparing the relative efficacy of different types of radiation therapy also are insufficient to permit definitive conclusions regarding efficacy, safety, and toxicity, according to the report from investigators at Tufts University in Boston.
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More Prostate CA in Cold, Dry Climates from MedPage Today

By Kristina Fiore, Staff Writer, MedPage Today

Weather patterns may play a role in prostate cancer risk, researchers say.

Cold weather and low rainfall -- characteristic of more northern climes -- were associated with increased incidence of prostate cancer, Sophie St-Hilaire, PhD, of Idaho State University in Pocatello, and colleagues reported online in the International Journal of Health Geographics.
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Hormone may elevate PSA levels ... American Medical News

By Christine S. Moyer, amednews staff

A hormone found naturally in the body may elevate prostate-specific antigen levels in men, leading physicians to perform unnecessary biopsies, according to a study in the November issue of Cancer Epidemiology, Biomarkers & Prevention.
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Prostate Cancer Overdiagnosis in the United States: The Dimensions Revealed

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More than 1 million additional men have been diagnosed with and treated for prostate cancer since the introduction of prostate-specific antigen (PSA) screening in the 1980s. And the "vast majority of these additional 1 million men did not benefit from early detection," write the authors of a new study published online August 31 in the Journal of the National Cancer Institute.

"Prostate cancer screening has resulted in substantial overdiagnosis and in unnecessary treatment," Otis W. Brawley, MD, medical director of the American Cancer Society, writes in an editorial that accompanies the new study.

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Federal official quantifies Phila. VA problems | Philadelphia Inquirer | 07/23/2009

For the first time, a federal official yesterday quantified how many prostate cancer patients may face a poor prognosis as a result of substandard care at the Philadelphia VA Medical Center. Read More

Screening for Prostate Cancer among Men 75 Years of Age or Older

New England Journal of Medicine Volume 359:2515-2516 December 11, 2008 Number 24 Michael J. Barry, M.D. Prostate-cancer screening with the prostate-specific antigen (PSA) test remains one of the most controversial issues in modern medicine. The U.S. Preventive Services Task Force (USPSTF), an independent group of experts supported by the Agency for Healthcare Research and Quality under a mandate from Congress, recently revised its recommendations regarding prostate-cancer screening. The USPSTF concluded that "the current evidence is insufficient to assess the balance of benefits and harms of prostate cancer screening in men younger than age 75 years," but it now "recommends against screening for prostate cancer in men age 75 years or older."1 In its 2002 statement, the task force did not recommend for or against screening in either age group. The implication of the new recommendation for medical practice is that clinicians should discuss the potential benefits and known harms of screening with men between 50 and 74 years of age, but not necessarily with older men. Why change the recommendation for men 75 or older, at least given the continuing dearth of evidence from randomized trials that addresses the tradeoff between the benefits and harms of prostate-cancer screening in men of any age? The task force believes that at least a moderate amount of evidence now makes it possible to conclude that the known harms of screening outweigh the possible benefits for this age group. Link to full article

Prostate Cancer: Genes, Environment, Immunity and the use of Immunotherapy

Prostate cancer remains the most prevalent noncutaneous cancer, leading to almost 30 000 deaths every year in men in the United States. A large body of knowledge emphasizes a strong influence of epidemiological factors such as lifestyle, environment and diet, on the development of prostate cancer. Although risk reduction of prostate cancer has been somewhat successful, effective prevention is still lacking. Immunotherapeutic approaches, although moderately complicated, remain promising in an effort to control the progression and development of the disease. Taken together, the parameters of epidemiological studies and immunotherapeutic regimens might eventually be the most effective and preventive approach for prostate cancer. This review highlights some of the events associated with the development and prevention of prostate cancer. D Karan; J B Thrasher; D Lubaroff Prostate Cancer Prostatic Dis. 2008;11(3):230-236. ©2008 Nature Publishing Group

Regrets After Prostate Surgery

One in five men who undergoes prostate surgery to treat cancer later regrets the decision, a new study shows. And surprisingly, regret is highest among men who opt for robotic prostatectomy, a minimally invasive surgery that is growing in popularity as a treatment. The research, published in the medical journal European Urology, is the latest to suggest that technological advances in prostate surgery haven’t necessarily translated to better results for the men on which it is performed. It also adds to growing concerns that men are being misled about the real risks and benefits of robotic surgical procedures used to treat prostate cancer. New York Times

National Prostate Cancer Awareness Month, 2008

George W. Bush proclaims September 2008 as National Prostate Cancer Awareness Month.