All posts by Albert Mak MD

Smoking & Prostate Cancer

Quit Smoking to Improve Your Prostate Cancer Treatment Outcomes

Smoking during prostate cancer treatmentAccording to the results of a new study, men who smoke during prostate cancer treatment are not only more likely to experience treatment side effects, they’re also more likely to experience a recurrence or even die from prostate cancer.

While men who have never smoked before in their lives run the least risk of experiencing prostate cancer treatment side effects, cancer recurrence, or death, the study found that even men who quit smoking right before beginning cancer treatment enjoyed better treatment outcomes than those who continued smoking throughout treatment.

Smoking Makes Prostate Cancer Treatment Less Effective

The study, performed by researchers from New York City’s Memorial Sloan Kettering Cancer Center and published in the journal BJU International, examined the effects of smoking history among a group of 2,358 patients who received external beam radiotherapy for prostate cancer between 1988 and 2005. 2,156 of the study participants had some kind of smoking history. Researchers divided the patients into four categories: never smokers, current smokers, former smokers, and current smoking status unknown. Even those participants who quit smoking right before beginning prostate cancer treatment were included in the “former smoker” category.

The researchers followed up with the study participants eight years after they received treatment. They found that patients who smoked during the cancer treatment had a 40 percent higher risk of relapse. Those who smoked during treatment were also twice as likely to experience prostate cancer metastasis and to die from prostate cancer, when compared to those who had never smoked.

prostate cancer treatmentPatients who were considered former smokers under the terms of the study also had a slightly elevated risk of cancer recurrence, metastasis, and death, but their risks were somewhat lower than those of patients who smoked throughout cancer treatment. Ten years later, only about 52 percent of patients who smoked throughout treatment had not suffered a recurrence of prostate cancer, while 63 percent of former smokers and 66 percent of never smokers were still in the clear.

While today’s patients can choose from a far wider range of prostate cancer treatment options, external beam radiotherapy remains one of the oldest treatments for the disease. There is no reason to believe that the impact of smoking on the efficacy of other prostate cancer treatments, like stereotactic body radiation therapy (SBRT), would be any different than its impact on the efficacy of external beam radiotherapy. The study authors believe that smoking could contribute to the formation of more aggressive cancer tumors. They also speculate that smoking during cancer treatment could interfere with treatment by lowering oxygen levels within tumor cells, making them less susceptible to the effects of radiation.

In addition to an enhanced risk of cancer recurrence, metastasis, and death, current and former smokers involved in the study also experienced a greater risk of a range of urinary side effects. These side effects included urinary incontinence, urinary toxicity, bladder hemorrhage, and urinary retention.

If you want to improve your chances of a good treatment outcome for prostate cancer, you might want to consider quitting smoking. While researchers don’t yet fully understand the relationship between smoking and prostate cancer, new evidence suggests that smoking during treatment can make treatment less effective. If you’re a smoker who’s already been diagnosed with prostate cancer, it’s not too late — quitting smoking can still make a difference, even if you do it right before you start treatment.


Physical Changes After Cancer Treatment

How to Deal With Physical Changes After Cancer Treatment Ends

After cancer treatmentEven after cancer treatment ends, you may find that you are still coping with physical changes related to treatment. These changes can range from reduced strength and endurance to lasting fatigue, pain, weight changes, and sexual changes.

While you may be able to counteract many of these lasting side effects with regular exercise, good nutrition, and other positive lifestyle changes, many side effects may linger for months or years after treatment ends, and it’s important to know how to cope.


No matter what kind of cancer you’ve suffered or what kind of treatment you’ve received, you may experience fatigue for a long time after your treatment ends. This kind of fatigue doesn’t go away with sleep. Though researchers don’t yet understand what causes treatment-related fatigue in cancer patients, it may occur due to poor nutrition, dehydration, anemia, pain, and depression.

Gentle exercise, relaxation, pain control, good nutrition, and drinking more fluids can help combat fatigue. Ask your treatment team about ways to fight fatigue. The causes of fatigue in people who have finished cancer treatment are different from the causes of fatigue in people who are still receiving treatment, so if you experienced fatigue during treatment, don’t be surprised if the solutions change.


Lingering pain may occur due to nerve damage caused by chemotherapy or damage to the skin caused by radiation therapy. Surgery scars can also cause pain after treatment ends. Some therapies for post-treatment pain include:

  • Antidepressants or narcotic painkillers
  • Acupuncture
  • Physical therapy
  • Braces
  • Yoga
  • Meditation
  • Hypnosis
  • Nerve blocks or other surgery

You can lower your risk of post-treatment pain with SBRT, a form of radiation therapy that minimizes damage to healthy tissue to reduce or eliminate complications.

After cancer treatmentWeight Changes

Some kinds of cancer therapy can cause weight gain, and after treatment, survivors find that it’s even harder than it should be to lose the weight because normal methods of weight loss don’t work. Chemotherapy can cause patients to lose muscle tissue and gain fatty tissue. Other survivors struggle with the opposite problem — they lose weight and can’t gain it back.

If you’re trying to lose weight after cancer treatment, you may want to try a combination of strength-training exercises and a healthy, low-calorie diet. If you want to gain more weight after cancer treatment, you may want to try:

  • Eating several smaller meals instead of three larger ones.
  • Eating more of your favorite foods.
  • Making your meals look attractive.
  • Using sauces, savory vegetables, and other seasonings to add flavor to foods.

Sexual Changes

Sexual changes are common after cancer treatment, especially among people who have had breast, prostate, or other reproductive cancer treatment. Survivors report losing interest in sex because of changes in body image, fatigue, pain, or simply a lowered sex drive. Others experience physical problems that make it harder to be intimate. Whatever the problem, it’s important that you ask your doctor about medication, counseling, or other therapies that can help resolve it. A sex therapist may also be able to help you and your partner come up with solutions.

Physical changes like pain and fatigue can persist for months after cancer treatment ends — some changes may last even longer. While it’s easy to get discouraged in the face of lingering cancer treatment side effects, try not to let these physical changes get you down. With time and a little creativity, you’ll soon find ways to enjoy yourself in spite of any lasting treatment side effects — and you may even find that most side effects do go away eventually, even if it takes a while.


SBRT for Lung Cancer

10 Years of Use Proves the Safety and Efficacy of SBRT for Lung Cancer

SBRT for Lung CancerAccording to researchers from the Cleveland Clinic Foundation, a decade of lung cancer treatment with SBRT has proven that this focused radiation therapy is not only effective for controlling the growth and spread of lung cancer, it can also limit radiation exposure for the patient. The researchers tracked the results of SBRT for inoperable, early-stage lung cancer from 2003 to 2013. During that time, a mere 13 percent of the patients studied demonstrated any side effects, and even among those that did, symptoms were usually minimal.

50-in-5 Regimen

For the purposes of the study, patients received what the researchers dubbed the “50-in-5 regimen” of SBRT, which consists of a total of 50 Gy of focused radiation delivered over the course of five sessions. Between October 2003 and December 2012, 300 patients received the 50-in-5 regimen to treat a total of 340 non-small cell lung cancer lesions. The average patient was 74 years old and over half the patients studied were women. A little more than 18 percent were cigarette smokers, although most of the patients were considered inoperable for other reasons.

The majority of the patients only needed a single course of SBRT for lung cancer treatment. Treatments were administered daily over a five-day period. Fifteen percent of the patients needed one or more additional courses of SBRT because their cancer came back. The short course of treatment with SBRT and the effectiveness of the treatment are why so many patients now choose CyberKnife for non-invasive lung cancer treatment.

SBRT for Lung CancerHigh Efficacy, Low Toxicity

Though researchers did find that SBRT was effective at treating non-small cell lung cancer, they did point out that only 47 percent of the patients were alive at the five-year follow-up, largely due to patients’ advanced age and the occurrence of other diseases that affect survival. While SBRT did eliminate the cancer within the lung, a significant percentage of patients experienced a return of cancer in another part of the body.

Nevertheless, Cleveland Clinic Foundation radiation oncologist Dr. Gregory Videtic called the treatment “an amazing technology for a population of patients who previously had no other options.” He believes that this non-invasive, focused radiation treatment could extend the life spans of up to 20,000 people each year by giving those who aren’t healthy enough for surgery another option.

Furthermore, SBRT is one of the safest forms of cancer treatment. A mere 13 percent of the patients studied exhibited any side effects at all due to the treatment, and all of those were low-level, minor side effects. In 75 percent to 80 percent of the cases, side effects were minor enough to heal on their own, and within a short time frame. Previous studies seemed to suggest that SBRT was very safe, but this study is important because side effects from radiation treatment can sometimes appear several years after treatment ends. The length of the study period allowed the researchers to evaluate the long-term safety of the procedure.

According to the results of a new 10-year study from the Cleveland Clinic Foundation, SBRT is effective and remains safe, even in the long term. If you or someone you love is suffering from inoperable lung cancer, this non-invasive procedure could help you overcome cancer with just one short round of treatment.


5 Trigeminal Neuralgia Surgeries Compared

5 Trigeminal Neuralgia Surgeries Compared

Trigeminal Neuralgia SurgeriesTrigeminal neuralgia pain most often occurs when a blood vessel compresses the trigeminal nerve near the bottom of the brain. The resulting malfunction causes pain to shoot through the teeth, jaw, cheek, gums, lips, eye, or forehead on one side of the face. While episodes may be mild and brief, they are known to become more frequent and more severe with time.

Medications may be used to relieve the symptoms of trigeminal neuralgia, but they can come with side effects that include double vision, nausea, dizziness, confusion, or drowsiness. Even if you don’t experience side effects, medications may lose their effectiveness eventually. Fortunately, there are multiple surgical options you can choose to permanently reduce or eliminate trigeminal neuralgia.

1. Radiosurgery With CyberKnife

CyberKnife radiosurgery for trigeminal neuralgia pain delivers focused radiation to the trigeminal nerve, damaging it and reducing or altogether, eliminating its ability to malfunction and cause pain. The procedure is one of the least invasive surgeries for trigeminal neuralgia pain, and, unlike some other procedures, it can be repeated if necessary. That’s important, because trigeminal neuralgia pain can return after surgery. CyberKnife for trigeminal neuralgia is gaining popularity because it’s an effective, non-invasive treatment that requires no incisions. More trigeminal neuralgia sufferers than ever are using radiosurgery with CyberKnife to relieve symptoms.

2. Microvascular Decompression

In this more invasive procedure, a surgeon makes a small incision near the base of the trigeminal nerve and then opens up your skull in order to physically move aside any blood vessels that may be compressing the nerve. It may be necessary to ensure that the blood vessels don’t come back into contact with the nerve by separating them from the trigeminal nerve with a small implant. It may also be necessary to remove a vein or sever the trigeminal nerve itself. Though microvascular decompression is usually successful, it carries risks, including:

  • Facial numbness
  • Hearing loss
  • Double vision
  • Facial weakness
  • Stroke

3. Balloon Compression

In this procedure, the surgeon uses a hollow needle and catheter to insert a balloon near your trigeminal nerve where it protrudes from the base of your skull. Once the balloon is inflated, it causes enough damage to the nerve to stop the pain signals it sends. Like other invasive procedures for trigeminal neuralgia, balloon compression can cause facial numbness. You may also experience weakness in the jaw, which can be permanent.

Trigeminal Neuralgia Surgeries4. Glycerol Injection

A glycerol injection for trigeminal neuralgia pain involves inserting a needle through the face and into the skull where the trigeminal nerve passes through it. Once the needle is inserted, your doctor will inject sterile glycerol in order to damage the trigeminal nerve and relieve any pain. The pain can return, however, and numbness of the face or tingling can occur.

5. Radiofrequency Thermal Lesioning

For the first part of this procedure, you’ll be sedated as your doctor guides a hollow needle into the opening through which your trigeminal nerve emerges from your skull. He or she will insert an electrode through the needle and administer an electric current. Your doctor will then bring you out of sedation so you can identify when and where the electric current causes a tingling sensation. The information you give will help the doctor determine which specific nerve fibers to damage in order to eliminate your symptoms. You may need to repeat the procedure and there may be some facial numbness afterward, but it usually isn’t permanent.

If you’re thinking of getting surgery for trigeminal neuralgia pain, you need to know all your options. Many of the procedures carry risks, just like any surgery. But with CyberKnife, you can experience non-surgical relief of trigeminal neuralgia pain with minimal recovery time and fewer side effects.


Prostate Cancer Diets

Can a Prostate Cancer Diet Improve Your Treatment Outcome?

Prostate Cancer DietsNutrition is always important when you’re going through cancer treatment, whether it’s for prostate cancer or another kind of cancer. But there’s some evidence to suggest that eating certain foods may increase the risk that your prostate cancer will grow or spread, while eating other foods may help to keep your prostate cancer in check.

In general, you should avoid red meat and eat a diet low in calories and fat. Some specific foods you can eat to help improve your prostate cancer treatment outcome includes fish, soy, tomatoes, cruciferous vegetables, poultry, liver, and pomegranate juice. Let’s take a look at some of the dietary guidelines that can help you overcome prostate cancer.

What You Should Eat During Prostate Cancer Treatment

You should eat a generally healthy diet and limit your consumption of alcohol while you receive prostate cancer treatment. Eat plenty of fruits and vegetables, including:

  • Mushrooms
  • Tomatoes, especially cooked or processed
  • Brazil nuts
  • Sweet potatoes
  • Carrots
  • Cruciferous vegetables like cauliflower, kale, broccoli, and cabbage
  • Grapes
  • Pomegranates and pomegranate juice
  • Avocados
  • Citrus fruits
  • Berries, especially blueberries and raspberries

These foods contain plenty of antioxidants, polyphenols, and other substances shown to fight cancer. You should also eat plenty of vegetable protein in the form of beans and legumes. According to WebMD, a traditional Japanese-style diet that is high in soy, green tea, and oily fish can help you fight prostate cancer. Alternatively, you may switch to a more Mediterranean-style diet, and begin eating more fruits, vegetables, grains, garlic, olive oil, fish, poultry, and red wine. Drink plenty of water and green tea. Eat whole foods as much as possible.

Prostate Cancer DietsSome Foods Can Hold Your Treatment Back

Just as there are some foods that can complement your prostate cancer treatment, there are also some foods that may encourage the spread of prostate cancer and make treatment less effective. Minimize your consumption of these foods while you’re going through prostate cancer treatment, or avoid them altogether:

  • Flax seed or flax seed oil, which can cause prostate cancer to grow
  • Canola, corn, or soybean oils
  • Red meat
  • Excessive amounts of dairy products, since calcium can cause prostate cancer to spread
  • Pickled, salted, or otherwise preserved foods
  • Burned, toasted, or charred foods
  • Fried foods
  • Foods that contain trans fatty acids
  • Sugary foods
  • Alcohol

While your body will still need some fat in order to function properly, you should keep your fat intake to a minimum during prostate cancer treatment. Quit smoking, if you haven’t already, and make sure to get plenty of sleep and exercise regularly. The better you care for your body’s physical and nutritional needs, the better you will be able to fight prostate cancer.

If you’re going through prostate cancer treatment, certain foods may make it easier to overcome the disease. Eat plenty of fresh fruits and vegetables, fish, soy, olive oil, grains, and poultry. Drink a little red wine once in a while. Eating a healthy diet can help you look and feel your best during and after treatment.