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By John Schieszer
Medical Minutes 

Doubling up on prostate cancer therapy


Combating prostate cancer in a new way

Investigators in Belfast, Northern Ireland at Queen’s University are now testing a whole new approach to treating aggressive prostate cancer. They are conducting the world’s first ever trial of a new combination of cancer therapies for men with advanced prostate cancer with the hope of prolonging their lives. If the trial goes well, this two-pronged approach may be adopted for men in Alaska.

The researchers are conducting a trial with 30 patients and it includes men with advanced prostate cancer, where the cancer has spread to the bones at the time of diagnosis. This accounts for around 10 percent of prostate cancer patients. Men with advanced prostate cancer are normally treated with hormone therapy, which aims to shrink a tumor by limiting the amount of testosterone reaching the cancer cells.

The new approach is the first to combine two existing forms of radiotherapy: Volumetric Modulated Arc Therapy (VMAT) to target prostate cancer cells in the pelvis, along with Radium 223 to target the disease in the bones. If successful, it has the potential to completely change the way in which prostate cancer is treated and potentially extend the life expectancy of patients with the advanced stages of the disease.

VMAT is an advanced type of radiation therapy which manipulates radiation beams to conform to the shape of a tumor, delivering precise radiation doses to a tumor, while minimizing the dose to surrounding normal tissue. It is delivered externally, using a radiotherapy machine called a linear accelerator.

Radium 223 is a relatively new ‘bone-seeker’ drug. It is a type of internal radiotherapy, which is given intravenously. Once it is in the bones, Radium 223 releases radiation which travels a very short distance (between 2 and 10 cells deep), which is less than a millimeter. This means it delivers a high dose of radiation close to the tumor deposits in the bone, killing the cancer cells and minimizing damage to the healthy cells.

“It is hoped that combining the two forms of radiotherapy will be more effective than existing hormone treatment in targeting prostate cancer cells at multiple sites and extend the life expectancy of men whose treatment options are otherwise limited. We expect results from the initial trial within two years, with the view to then embarking on a larger trial with a greater number of patients,” said study investigator Professor Joe O’Sullivan from Queen’s University’s Centre for Cancer Research and Cell Biology and Clinical Director of Oncology at the Northern Ireland Cancer Centre at Belfast City Hospital.

Don’t buy into fad diets

Many people have mistaken ideas about what foods may be healthier than others, according to registered dieticians and nutrition experts. They report that social media may help spread many diet myths that can do more harm than good.

“Gluten-free desserts are not healthier than normal desserts,” said Lisa Mallonee, a registered dietician with the Texas A&M University Baylor College of Dentistry. “In fact, gluten substitutes may actually increase calorie content and contribute to weight gain. With that being said, gluten-free food is great to consume by those diagnosed with celiac disease or who are gluten-intolerant, but gluten-free desserts should be eaten in moderation and with a balanced diet.”

She said don’t be fooled by the words ‘sugar free’ or ‘fat free’. Fat free and sugar free do not mean foods are calorie free. The fat content in many of these ‘sugar free’ items can be extremely high. Similar to gluten-free desserts, when nutrients like fat are removed from food, artificial ingredients may be added back to the food to account for taste. This filler may lead to more calories.

Mallonee said many people mistakenly think that carbs make you fat. Carbs alone do not cause weight gain. Instead, it’s the type of carbs you choose to consume that leads to more fat cells in the body.

“We need carbs because they are the body’s main source of fuel,” said Mallonee. “The real problem with carbohydrates lies in the American diet rich in refined carbs and processed foods. Bingeing on these carbohydrates will contribute to weight gain.”

She recommends eating a balanced diet higher in complex carbs and lower in simple or processed carbs. Mallonee said the average American needs to be consuming more fruits, vegetables and whole grains and less processed foods, refined carbohydrates and white flour products.

You’ll gain weight if you eat late at night is another myth. Mallonee said it doesn’t matter what time you’re eating. She said what matters is how much you are eating.

“This is more about portion control and how you’re expending calories,” she said. “It doesn’t matter what time of day you eat as long as you are eating a balanced diet, consuming foods in moderation and burning off more calories than you consume.”

John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute. He can be reached at

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John Schieszer is an award-winning national journalist and radio and podcast broadcaster of The Medical Minute.

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