Bosox Boggs racks up another impressive stat--Gleason 7. But should he undergo AS rather than radiation?
By Howard Wolinsky
Boston Red Sox legend Wade Boggs, 66, compiled some impressive statistics in his time in the bigs: Batting Average, .328; Hits, 3,010; Home runs, 118; RBIs, 1014.
The former Red Sox third baseman and Hall of Fame now has a new stat: Gleason 7.
His wife, Debbie, told Boston’s Channel 5 that the prostate cancer was detected thanks to a routine physical. She said Bogg’s doctor was tracking his rising PSA score followed by an MRI and biopsy, No. 26 had a Gleason 7.
The reporting was incomplete.
We don’t know if Boggs was a Gleason 3+4 or 4+3. We don’t know if he was a candidate for Active Surveillance or whether he was offered that option.
Inquiring minds want to know. I wrote an email to Boggs to see if he is willing to share. I’ll let you know.
Boggs was optimistic in a post in X: "I've never been a goal oriented person but with the strength and support of my family and my faith in God I'm going to ring that damn bell.” He was referring to the bell ringing ceremony when patients are declared cancer-free.
Active Surveillance for prostate cancer – the past, the present, and the future
Peter Carroll, MD, MPH, of the University of California, San Francisco, one of the pioneers of Active Surveillance for low-risk prostate cancer, in the late 1990s, will be speaking to Active Surveillance Patients International at noon Eastern on Saturday Sept. 28, 2024.
His program is entitled “Active surveillance for prostate cancer – the past, the present, and the future.”
Carroll is the 2024 recipient of Active Surveillance Patients International’s Chodak Award honoring pioneers in the development of the Active Surveillance approach to managing lower-risk prostate cancer. The award is named for the late Gerald Chodak, MD, of the University of Chicago, he laid down the fundamentals for a more conservative approach to managing these patients. Chodak was ASPI’s first medical advisor.
The award winner receives a ceremonial bowl based on a design by Chodak, who was an artist.
The rest of the story on exercise and prostate cancer
By Howard Wolinsky
Hello, Americans.
Many in our generation will remember the catch phrases from Chicago-based ABC broadcaster Paul Harvey.
One of his favorite was: “And now the rest of the story.”
I recently profiled Rob Montgomery, PhD, a pioneer in exercise oncology, especially for prostate cancer in in MedPageToday
Rick Davis, founder of the AnCan Foundation, which offers peer support for patients with prostate cancer and other conditions, sent a note urgfing me to share me “the rest of the story” of patient involvement in getting researchers to study exercise and prostate cancer.
Here’s Rick’s response to the MedPage profile on Newton:
Is Exercise an Effective Treatment for Prostate Cancer?...
... yes, I freely admit I plagiarized that title from our Advisory Board Member, Howard Wolinsky and his Medpage Today article published this past Wednesday, Aug 28.
What Howard does not address in this article, is the role patients played catalyzing the research that has led to the generally accepted conclusion that the answer to the title question is most definitely - YES!
Allow me to take you back in time. While Rob Newton PhD established his exercise research institute in 2004, Howard does not mention when he first published on prostate cancer. I can cite research from early 2012 by renown exercise researcher Dr. Stacey Kenfield's mentor, Dr. June Chan that states Vigorous Exercise Linked to Gene Activity in Prostate.
But let's push further back in time to my own diagnosis with T3a prostate cancer in 2007. I was a devout, incorrigible endurance athlete. Sadly I had recently abandoned a somewhat illustrious 'vet' running career clocking +/- 2500 miles p.a. A serious cycling injury forced me to stop running, although the good news was I took up rowing.
My primary concern on PCa diagnosis was not survival, but what it would do to my exercise habits. That's absolutely the truth! There is much to read about PCa as we all know, and even then it included a fair amount on diet and nutrition. UCSF had a dedicated Registered Dietician, Greta Macaire with whom I shared a birth date. However, no one breathed a word about exercise through all my consults at UCSF and Kaiser Permanente.
When I dug into the literature, it predominantly addressed breast cancer, with pioneering work by Melinda Irwin at Yale on lymphedema in breast cancer mitigated with arm exercises and light weights.There was also a dedicated exercise program for breast cancer in the San Francisco area, Sunflower Wellness, led by Regan Fedrick. That was largely about it... nationally!!
I had the idea to create an exercise consult integrated with the clinical setting, much like the diet consult. I was fortunate to sit on a committee with two exercise fanatics, Drs. Peter Carroll and my own doc, Mack Roach, both avid runners. I also pitched iconic breast cancer surgeon Laura Esserman who was much in favor. We started by publishing a UCSF pamphlet on exercise, Moving Through Cancer. At the same time I collaborated with June Chan to pitch Dr. Carroll to submit a UCSF application for a Movember grant to study exercise in prostate cancer. That succeeded.
Meanwhile I worked with Sunflower, and personally located a grant to set up an exercise consult program at the UCSF Helen Diller CCC. It was exceptionally popular with patients and providers alike. Within 2 years, it had been adopted into the general budget and still exists today. I set up a website, MedaFit, to expand the program, but have never been to do so. MedaFit is now wrapped into AnCan. Click on the link and you'll see the exercise consult connects the patient, the provider, and the exercise program while functioning as a cheerleader.
One aspect of that program that was never innovated was the Exercise Buddy Finder - that still has legs, IMHO Sadly, medical institutions are leery of HIPAA implications.
Exercise for prostate cancer has come a long way since 2007, but those very early efforts catalyzed a lot of research and programming. You heard it here first!! “
So as the late Paul Harvey said, “That’s the rest of the story … Good day.”
Great. Sounds like boggs case is more complicated.
I’m happily doing AS right now but I’m never going to leave a Gleason 7 untreated.