Issue 5 / January 2016
It's that time again....for new beginnings and making resolutions. Improving one's diet and nutrition are often at the top of the list. To help facilitate that, our prostate cancer survivor's nutrition class will be starting a winter session on January 29th. This class teaches patients who have gone through prostate cancer treatment about ways to minimize their risk of recurrence through diet and healthy eating habits. There are still a few spots available if you'd like to sign up. Click here to register.  Class will be held every other Friday from 11:00 am to 1:00 pm through April 8th. You may register yourself and a guest. Spouses and significant others (especially those who prepare the meals for the household) are most welcome.
Happy reading and happy New Year! 
Best regards,
R. Alex Hsi, MD
New Clinical Trial for Recurrent Prostate Cancer After EBRT
Peninsula Cancer Center in Poulsbo, Washington, will initiate a new clinical trial for men with recurrent prostate cancer who have been previously treated with external beam radiation therapy.  
Prostate seed brachytherapy is very often used as a backup treatment if prostate cancer recurs within the prostate after external beam radiation therapy. Typically, the radioactive brachytherapy seeds are placed throughout the gland to make sure any recurrent tumor is destroyed. However, this can cause damage to the previously radiated normal tissues such as bladder and rectum. The clinical trial that will be initiated at Peninsula Cancer Center is entitled "Focal Salvage Brachytherapy for Local Recurrence after External Beam Radiation Therapy for Prostate Cancer". It will take advantage of a new MRI guided 3D mapping biopsy technique which can pinpoint the location of recurrent tumor within the prostate, allowing more focused treatment to just the part of the gland containing the tumor rather than retreating the entire gland. This will reduce excess radiation dose to the bladder and rectum, and therefore, reduce or hopefully eliminate any damage to these normal tissues.
If you, or someone you know, has had external beam radiation therapy for treatment of prostate cancer and now has a rising PSA blood test, you may be a candidate for this study.
Dr. Hsi is the author and one of the principal investigators of this study. For further information or to refer a patient, call 360-697-8000 or email Dr. Hsi at  
Impact of Obesity on Prostate Cancer Recurrence After Radiation Therapy
You can probably guess the answer to this one ....
While there is definite evidence that obesity is associated with more aggressive prostate cancer at diagnosis, there are less data on the impact of obesity on recurrence rates after men undergo treatment for prostate cancer. A recent study shed more light on this question.
Researchers from Fox Chase Cancer Center in Philadelphia, PA recently published a study which investigated whether BMI* was associated with a man's risk of prostate cancer recurrence after treatment with radiation therapy. In this study, 1,442 men with localized prostate cancer were treated with intensity modulated radiation therapy or IMRT (the most advanced external beam radiation treatment technique) between 2001 and 2010. The median follow up in this study was about 4 years and the median radiation dose was 7800cGy. One third of men had BMIs greater than 30, which is considered obese. Results showed that increasing BMI was associated with increased risk of PSA recurrence, distant metastasis rate, cause specific mortality and overall mortality.
The Bottom Line: The heavier you are, the higher your risk of cancer recurrence after prostate cancer treatment. Another good reason to stick with those New Year's resolutions!
*BMI is body mass index, a measure of body fat based on your height and weight. Here is a link to a BMI calculator: if you would like to calculate yours.     
Yoga Helps Quality of Life,
May Reduce Side Effects of Prostate Cancer Treatment  
It does a body good...
Researchers from the University of Pennsylvania in Philadelphia, PA recently reported the results of a study on the benefits of yoga for prostate cancer patients.  In this unique study, 68 men participated in a twice weekly 75 minute yoga classes during radiation treatments for prostate cancer.  Typical side effects of prostate radiation therapy such as fatigue, sexual dysfunction and urinary difficulties were measured.  Interestingly, fatigue was found to improve and other factors such as general quality of life, erectile dysfunction and urinary incontinence were stable and did not worsen during treatment.  The possible explanation for the benefits of yoga stem from physiologic data demonstrating yoga's ability to reduce muscle fatigue, as well as improve pelvic floor muscle strength and improve blood flow. 
In addition to helping combat the effects of radiation treatments, yoga makes sense for patients undergoing hormone therapy for prostate cancer as well.  Androgen deprivation therapy commonly causes fatigue and core (abdominal, back and hip) muscle weakness.  Yoga's core muscle strengthening moves seem like a perfect prescription for these effects.  Any athlete, especially golfers, can recognize the benefits of a strong core.
Other studies have shown similar improvements in side effects and quality of life in breast cancer patients who practice yoga, but few studies have been published on its effect on prostate cancer patients.  National statistics indicate that 72% of those who practice yoga are women and only 18% of all participants are over 55 years old.  Perhaps this is a statistic that needs to change!
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