Monthly Archives

June 2015

Western diet heightens risk of death after prostate cancer

By | Cancer, Exercise & Nutrition, Prostate Cancer, Uncategorized | No Comments

In addition to fireworks displays and downtown parades, the Fourth of July is a celebration of the American diet.

But before you pile burgers and hot dogs on the grill this holiday weekend, consider this recent study: Among men who had been diagnosed with prostate cancer, those with a diet focused on processed meats, red meats and high fat dairy products had a higher risk of death than those whose diets were oriented around fruits, vegetables, fish, legumes and whole grains.

Pass the lettuce and tomato, please.

The Harvard study, published in the journal Cancer Prevention Research, followed 926 men participating in Harvard University’s Physician’s Health Study who had been diagnosed with non-metastatic prostate cancer, asking them to fill out questionnaires approximately 5 and 10 years after their diagnosis. The study showed that this animal-based western pattern of eating contributed to earlier death both from prostate cancer and other causes.

The research underscores a growing body of evidence that diets that avoid red meat and are rich in fruits, vegetables and other plant-based sources result in prevention or reversal of chronic disease and longer life expectancies. Less is known about the specific connections between diet and cancer, and the Harvard study sheds more light on the way diet may significantly impact long-term outcomes for cancer patients.

“Because cardiovascular disease is one of the top causes of death among prostate cancer survivors, our findings regarding all-cause mortality are what we anticipated and closely align with the current knowledge of the role of diet on cardiovascular disease. Our findings with Western diet and prostate cancer-specific mortality, however, were surprising, in part because there are very little data regarding how diet after diagnosis may impact disease prognosis,” said Jorge E. Chavarro, study senior author and assistant professor of nutrition and epidemiology at the Harvard T.H. Chan School Public Health.

This isn’t Harvard’s only research foray into the effects of diet on prostate cancer. In another national study, Harvard Medical School is following men with small, low-grade tumors who have opted for “active surveillance” rather than immediate treatment. One group will eat nine servings of fruits and vegetables each day, two servings of whole grains and one serving of beans or other legumes compared to a group that will eat according to standard American dietary recommendations.

In the meantime, grab an extra piece of watermelon, opt for salad and baked beans, and celebrate the freedom of a long and healthy life!


Men should have open dialogue about screening, treatment for prostate cancer

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Prostate cancer survivor Dick Guyton anticipates he’ll be taking care of business for a long time. The 75-year-old executive director of the Elvis Presley Birthplace will mark the one-year anniversary of completion of his cancer treatment next week.

“It was scary, and it scared me,” Guyton said.

But after being diagnosed in May 2013, Guyton found a way to get past his fear and find the best treatment option for him. After careful research and consultation with physicians, he chose proton therapy, a type of radiation therapy at a Knoxville, Tennessee center.

“This was my first experience with cancer,” Guyton said. “It’s important to gather all the options from multiple sources.”

After skin cancer, prostate cancer is the most common cancer among U.S. men. The American Cancer Society estimates more than 220,000 new cases of prostate cancer will be diagnosed in 2015, and it will kill nearly 28,000 U.S. men. The walnut-size gland that makes a component of semen is located just underneath the bladder. If prostate cancer is found before it spreads to distant parts of the body, the five-year survival rate is nearly 100 percent. It’s extremely rare for men under 40 to develop prostate cancer, but the risk increases substantially as men age. African-American men and men whose fathers or brothers developed prostate cancer are at increased risk.

“It’s more common after the age of 50,” said Tupelo urologist Dr. Hughes Milam. “It’s most common in men in their 60s.”

Screening Debate

Universal prostate cancer screening recommendations – which apply to men with no symptoms of prostate problems – continue to be a topic of much debate. The American Urological Association, American Cancer Society and Mayo Clinic continue to recommend screening with prostate specific antigen test, commonly referred to as the PSA, and a physical exam. The urological association guidelines call for men to be screened between ages 55 and 70 if they have more than a 10-year life expectancy. Screening for people at higher risk should be individualized. The U.S. Centers for Disease Control currently recommends screening only for men at high risk for developing prostate cancer. U.S. Preventive Services Task Force discourages the use of PSA screening in the general population, and men and their physicians should go forward with screening only after a comprehensive discussion. The PSA blood test is very good at detecting changes in an antigen associated with prostate problems; however, it can’t distinguish between cancer and other prostate conditions.

“It’s a simple test,” Milam said. “It’s a complicated analysis when it comes with what to do with the results.”

The blood test can’t differentiate between aggressive and slow-moving malignancies; that requires a biopsy. Urologists usually look closely at how the PSA results have changed over time when considering a biopsy. If the biopsy finds cancer, it can be difficult for patients to opt for watchful waiting, even if the results indicate a slow-growing tumor.

“When I tell a patient they have cancer, it’s like telling them they are on fire,” Milam said. “They want a fire extinguisher.”

Even though the PSA has limitations, Milam feels screening is saving lives.

“In the 1980s, we didn’t have prostate cancer screening,” Milam said. “When patients did present, they usually had metastatic disease, and there wasn’t much we could do for them.”

With the advent of the PSA blood test in the 1990s, cancers were found earlier and the survival rates shot up dramatically. However, because prostate cancer often moves very slowly, concerns about overtreatment of cancers that would have remained silent have led some public health organizations to change their recommendations on universal screening.

Treatment Options

Once prostate cancer is diagnosed, men and their physicians have a number of tools to consider. Generally, men who are diagnosed at the earliest stages have the most options.

“We try to customize the treatment plan to the patient,” Milam said.

Watchful waiting: Depending on the results of the biopsy, watching to see how the prostate cancer develops may be the recommended course of action. Some prostate cancers grow so slowly they will never cause any symptoms in a man’s lifetime. Usually, men are followed with a PSA and exam every three to four months, Milam said.

  • Pros: None of the complications or side effects connected with other treatments.
  • Cons: May need a repeat biopsy; long-term worry over cancer.

Surgery to remove prostate gland: Men can opt for an open procedure or a laparoscopic surgery using a surgical robot. It’s very effective at removing localized cancer. There is a shorter hospitalization and less bleeding with the minimally invasive procedure, but otherwise, the outcomes and complication rates are similar, Milam said.

  • Pros: Cancer is definitively removed.
  • Cons: Irritation of the nerves can cause incontinence and erectile dysfunction that may take from weeks to months to improve.

External beam radiation: This is one of the most common choices for treatment, especially for men in their 70s and 80s. A linear accelerator is used to target the tumor.

  • Pros: Cure rates similar to surgical treatment.
  • Cons: Radiation usually requires 30 treatments, usually done five days a week. It can irritate the bladder and the rectum, although those side effects are typically not permanent. Erectile dysfunction can develop gradually after the treatment.

Internal therapy: This allows physicians to treat prostate cancer from the inside. Brachytherapy uses radioactive seeds inserted with needles to deliver radiation inside the prostate. Cryotherapy uses a similar technique to brachytherapy but delivers very cold gases to freeze the tissue in the prostate.

  • Pros: Less invasive than surgery.
  • Cons: These procedures are typically reserved for men with smaller prostates. Requires spinal or general anesthesia. Can cause problems with bladder and rectum. Cryotherapy has a higher rate of erectile dysfunction than surgery.


Guyton’s Experience

Guyton settled on proton therapy – a form of radiation therapy – after consulting with his Tupelo urologist and a Birmingham surgeon and doing extensive research.

“I knew I didn’t want surgery,” Guyton said, because of the rates of problems with incontinence and erectile dysfunction.

Proton therapy is delivered in a similar way to external beam radiation, but the protons don’t release their energy until they reach the target, minimizing damage to healthy tissue. Proton therapy was first used to treat cancer 25 years ago, but it is still a relatively new option for prostate cancer. Currently, there are fewer than 20 centers offering proton therapy around the country. The research is still ongoing to see how proton therapy compares to traditional treatments for prostate cancer, Milam said. It remains much more expensive than other treatments and patients must travel to receive it. For Guyton, Medicare and his supplement covered the cost of the procedure. Because his brother lives in Knoxville, he didn’t have the extra living expenses others would face. The procedure was a success for Guyton. He had no side effects and his PSA levels are essentially zero.

“It’s an eerie feeling to know I had cancer and that 12 months later, I don’t have it,” Guyton said.

After his experience, Guyton is an advocate for annual screening and for wider access to proton therapy.

“I would like to see more conversations about proton therapy,” he said.



This article is from the Northeast Mississippi Daily Journal in Tupelo, MS.

Provision patient enjoys “summer camp” experience with protons

By | Cancer, Culture of Care, Dr. Marcio Fagundes, Patient Experience, Patient Hospitality, Prostate Cancer, Proton Therapy, Stories, Uncategorized | No Comments

 We welcome today’s guest blog by patient and Provision graduate Michael Swiatek. Today he completed treatment for prostate cancer.

This has been a very different experience than what I expected. I’m here for medical treatment in a facility that seems more like a social hall. My wife Maureen was down here the first week helping me set up the apartment and I felt like I was being checked into a summer camp. I was, it’s called Camp Proton.

At Camp Proton I arrive at the main lodge each morning and start my first activity of puzzle building. Later the camp counselors (Jennifer and Sheri) escort me to the next activity. They teach me a new way to wear my bathrobe and take me over to the gantry ride. There they have stickers for me that I can wear. We also get to play with balloons, but it’s not what I expected. I then lay down on the motion table for a ride where I get to see the laser light show, watch the gantry spin around and try to guess when the pop up targets will come out of the wall. This of course is all done to a music score emanating from the walls.

Before you know it you come back to rest from where you started. Now it’s time to go back to the main lodge for a hot drink and animal crackers.

There is plenty of time to socialize with the other campers before lunch is served in main lodge loft. There are many camp directors, mine is Dr. Fagundes. They will sit down and talk with you about how you are enjoying and participating in the camp activities.

There are also weekly talk sessions with science professor Niek Schreuder who will challenge your imagination with images of protons racing about. I was surprised to find out that the Bragg Peak was not one of the Smoky Mountains.

For me, my stay is over and now I get to go back home and tell all the neighborhood kids how I spent my summer vacation.

Goodbye camper buddies.


Letter to the Editor – Knoxville Lucky to have Proton Therapy

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Letter to the Editor
June 16, 2015

Knoxville lucky to have proton therapy 

The Provision Center for Proton Therapy at Dowell Springs off Middlebrook Pike is a feather in our collective cap. We should be aware of what an honor it is to have one of the 14 such centers operating in the nation. I understand that St. Jude Children’s Research Hospital is changing to proton therapy for its patients. In this day of Internet research, we can easily educate ourselves and be our own advocates when faced with decisions about treatment. In our case, proton treatment for a tumor was met with some resistance, but we persisted. We are fortunate that we did.


Our family physician recommended we obtain a second opinion from the radiation oncologists at Provision. Knoxville’s proton therapy center was not ready, so we traveled to the MD Anderson Cancer Center in Houston. Our experience was gratifying and successful. Two and a half months of pinpoint radiation in small, daily doses produced no rash, no burns and no discomfort. The tumor was dissolved. We observed the same comfort level in the hundreds of patients we came to know. We are hopeful that legislation before the Tennessee House will be approved so insurance companies will be mandated to help with proton therapy. It is a shame that our neighboring states already have such mandates and we do not. It is helpful to know that the centers will provide help with travel plans, financial issues and housing. I personally have nothing to gain from promoting our local facility. There is just a warm place in my heart because our community was chosen for this type of treatment.



Mary Helen Jost,

Employee snapshot: Hospitality coordinator is a cancer survivor herself

By | Breast Cancer, Cancer, Culture of Care, Patient Experience, Patient Hospitality, Uncategorized | No Comments

There’s a reason hospitality coordinator Sharon Bishop is a favorite with Provision patients: She’s walked in their shoes.

In 2006, Bishop was diagnosed with Stage 3 breast cancer.

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Sharon has had a bi-lateral mastectomy, chemotherapy and conventional radiation—a treatment regimen that lasted five years. The chemotherapy caused cancer to develop in her uterus, requiring a radical hysterectomy. And the radiation left scars on her heart, requiring long-term follow-ups with specialists.

“Honestly, I’m never done,” Bishop says.

She was 42, with two teenage sons. And as she fought for her life, two sisters also were diagnosed with breast cancer.

Through it all, however, she maintained a positive spirit—joking with her sister about applying mascara to three remaining eyelashes so she could flirt with an officer should she get pulled over—and channeling her experience into a story of support she shared with others. Bishop has been involved with cancer support groups and had lots of one-on-one connection with cancer patients as a mastectomy fitter at Thompson Cancer Survival Center, the University of Tennessee Medical Center and Knoxville Comprehensive Breast Center. She also serves on the steering committee for the American Cancer Society’s “Making Strides Against Breast Cancer” initiative and is a member of the Young Survivors Coalition.

Bishop discovered Provision when her friend, Talbott Paynter, came to work here and encouraged her to apply. Her job lets her to get to know patients, offering a sympathetic ear and her own experience with cancer.

“When I started working here, I spent more time in the lobby than behind the desk,” she says.

Graduating patients get hugs from Bishop. Many confide in her their struggles and even medical issues they’re experiencing through the treatment. Patients often mention her when listing the things they appreciate about the Provision Center for Proton Therapy.

Her daily motivation comes from a picture on her bedroom dresser. It’s a black and white photo, snapped by her older son as she, hairless and weak, prays with her younger son in the midst of her battle with breast cancer. The image keeps her focused on why she comesto work here.

“Everyone that walks through that door, they matter to me,” she says. “I know what they’re going through.”

Men’s health awareness should include cancer screenings

By | Cancer, Insurance Coverage, Prostate Cancer, Provision Diagnostic Imaging, Screening, Uncategorized | No Comments

June is Men’s Health Awareness month—a time to remember that keeping tabs on your health can pay long-term dividends.

Cancer screenings can play an important role in health awareness, particularly for those at risk of certain types of cancer, because catching and treating cancer in its early stages improves the prognosis for remission and long-term survival.

This is particularly true for lung cancer patients.

For example, in lung cancer patients, those who have stage 1 cancer experience a 45-49 percent five-year survival rate—that is, 45-49 percent of patients are still alive five years following treatment. That compares to a 5-14 percent five-year survival rate for stage 3 and a 1 percent five-year survival rate for those with Stage 4 lung cancer. That’s according to statistics from National Cancer Institute.

Lung screenings are now covered by Medicare as well as state and private insurers for those at high risk for lung cancer. Medicare, for example, pays for the test for those between ages 55 and 77 who’ve smoked 30 pack-years—or the number of cigarettes smoked per day divided by 20 (1 pack has 20 cigarettes)—as well as those who currently smoke or quit smoking within the past 15 years.

Provision Diagnostic Imaging offers lung screenings, a low dose CT scan that would cost $300-$500 without health insurance reimbursement. Call (865) 684-2600 to schedule a lung screening.

Unlike lung cancer, prostate cancer has a much higher survivability rate—but it affects a much higher percentage of the population. Prostate cancer is the third most common cancer. In 2015, there will be an estimated 220,800 new cases diagnosed in the U.S., and approximately 14 percent of men will be diagnosed with prostate in their lifetimes, according to the National Cancer Institute.

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