New Test for Early Detection of Prostate Cancer Shows Promise

In the first clinical study of a new blood protein associated with prostate cancer, Johns Hopkins researchers have found that the marker, called EPCA or early prostate cancer antigen, can successfully detect prostate cancer in its earliest stages.

The traditional two-step approach of PSA testing and digital rectal examination has helped doctors identify prostate tumors early, but PSA testing, like many disease-screening procedures, misses some cases of cancer and in other cases erroneously highlights noncancerous conditions.

"This new blood test may help reduce the number of both unnecessary biopsies and undetected prostate tumors," said Robert H. Getzenberg, Ph.D., professor at the James Buchanan Brady Urological Institute at Johns Hopkins.

Currently, only one-quarter of patients who undergo biopsies because they have elevated PSA values are actually positive for prostate cancer, while as many as 15 percent of those with low PSA values were found to have prostate cancer as detected by biopsy, according to Getzenberg.

Larger clinical trials are under way to further refine the EPCA test, to make it more sensitive so it can pick up even the smallest traces of the marker, and to verify its usefulness for detecting prostate cancer in a larger sample of patients.

Prostate cancer is the most common type of cancer found in American men. The American Cancer Society estimates that there will be approximately 232,090 new cases of prostate cancer in the United States in 2005, and 30,350 men will die of this disease. For more information, visit our Centers of Excellence


Women's Concierge Service at Full Force

Since June 1, a new service has made it a breeze for women to schedule appointments with physicians across Hopkins Medicine. With the Women's Concierge Service, appointments in Gyn/Ob, heart and breast health, cosmetic surgery and other women's specialties can be made through one access line.

The concierge will coordinate appointments at the most convenient location and inform callers about related tests and educational opportunities. For more information, visit our Women's Health Center

Bones Don't Pay a Price When Fat is Lost Through Exercise

Researchers at Johns Hopkins have determined that for those age 55 to 75, a moderate program of physical exercise generally maintains bone mass and, in some cases, offers modest improvements.

The Johns Hopkins team showed in a study that after six months of aerobic exercise on a treadmill, bicycle or stepper, plus weightlifting, people experienced better overall fitness and fat loss without much change in bone mineral density.

"Older people are very concerned about how best to reduce their body fat as a means of preventing other health problems, such as heart disease and diabetes without increasing the risk of bone loss and fractures," says Kerry Stewart, Ed.D., a professor of medicine and director of clinical exercise physiology and heart health programs at Johns Hopkins.

In the study, an active group participated in a supervised series of exercises for 60 minutes, three times per week. The combination of exercises was designed to work all major muscle groups, the heart and circulation. Substantial improvements were observed in active participants' body fat, and muscle and fitness levels. The group that was not exercising had either no or significantly less improvement than the exercising group.

"Older people will likely have to exercise either harder or for longer than six months for there to be a substantial increase in bone density," says study co-author and endocrinologist Suzanne Jan de Beur, an assistant professor at Hopkins who specializes in bone health. Bones commonly break after a fall, a major risk factor for fractures in older people. But exercise makes bodies stronger and improves balance, thus preventing falls.


Fat Alone is Bad

If you have a family history of heart disease, simply being obese or overweight, without any of the other risks associated with it, increases your risk of heart disease by 60%. That's according to Diane Becker, professor of medicine at Johns Hopkins.

"What we showed was that there really is an additive and an interactive effect of being obese over and above what your cholesterol level is, your triglyceride, your blood pressure, and anything that might be associated with being obese.

What many times people have said is that the reason obesity carries extra risk is that you have a higher cholesterol, you may have higher blood pressure, you may get diabetes more often. We're saying over and above that diabetes carries extra risk" says Becker.

What is it about added weight that leads to increased risk? Becker says that's not known, but that people with heart disease in the family should keep a careful eye on their weight.

INTERNET RESOURCES

The Kennedy Krieger Institute: Learn more about this internationally recognized facility dedicated to improving the lives of children and adolescents with pediatric developmental disabilities.

PhilippeGailloud, M.D., a neuroradiologist and assistant professor at the department of radiology talks about the risk of stroke in children.

Do children have strokes?

Contrary to what is often assumed, stroke involves a fair amount of children and, as with adults, you only have a limited time to try to fix it. The problem is that children with stroke are often marginalized.

Why is that?

One of the factors that can play a role is that a stroke in an adult can be quickly recognized by symptoms such as numbness, weakness, loss of language, etc. In children, a stroke often presents as a seizure, and people think "it's just a seizure", and miss the window of opportunity for treatment.

In what situations do children have strokes?

There are several reasons why children have strokes. There is a disorder called Moyamoya, for instance, that typically causes strokes in children, and there's no cure available currently. However, there are neurosurgical options with excellent results.

Healthy children also have strokes, for example, after a trauma that damages a main blood vessel. These can be fixed before it results in a devastating stroke if diagnosed and referred quickly enough.

Is the treatment for strokes in children the same as in adults?

It should be, but it is difficult to understand why there is still some hesitation to treat children with the same successful treatments available for adults. At Hopkins we are prepared to offer this option to parents that bring their child, but one explanation could be, again, that children are generally marginalized when it comes to stroke. Doctors don't really expect to be able to treat a child with a stroke.

For a complete interview with Dr. Philippe Gailloud on pediatric interventional neuroradiology, visit Find an Expert page.

CHANGES AT JOHNS HOPKINS INTERNATIONAL

Our dear colleague Clara Marin, who has been sending this e-newsletter for our patients and friends for more than six years has left Johns Hopkins Medicine International for a position of Director of Content Development for the Johns Hopkins School of Medicine.

From this edition on, Claudia Costabile will be sending the monthly news. Please make sure that you include her e-mail in your list of preferred e-mails. If you have any questions, you can also email her at ccostab1@jhmi.edu.