High Risk of Prostate Cancer in Parkinson’s Patients Taking STALEVO : By Dr. De Leon

Painting by Jorge Jm Lacoste

This is the age of knowing….when a urine flow is more than just a flow.”

Aside from the fact that Parkinson’s disease is proving to be a systemic disease affecting mind and body certain treatments as well as carrying certain Parkinson’s genes like the LRRK2 and PARKIN gene which seem to predispose those who carry these mutations to have an increase in certain types of cancers like breast, prostate and melanoma.

As I have discussed previously in previous blogs- http://www.defeatparkinsons.wordpress.com  – concerning dopamine effects “Dopamine: Friend or Foe?” and “Parkinson’s disease and melanoma”, Parkinson’s patients have a higher risk of melanoma 2-4 x the risk which according to some studies appears to be higher in men. This effect is both due to medications as well as genetic predisposition by those who have PD. Concomitantly, men with PD also have an increase risk for prostate cancer (2.4 % vs.  .5%) This increase risk extended to first, second and third degree relatives. This came from the Stride PD (STALEVO reduction in dyskenesia evaluation) study (14 countries participated including France, Australia, & the U.S. with over 300,000 patients) which suggested an increase risk of prostate cancer in men among those taking STALEVO (carbidopa/levodopa/comtan) vs. those taking Sinemet (carbidopa/levodopa) alone.

Since Parkinson’s disease is associated with pain, stiffness along with bladder dysfunction along with urgency and frequency the signs and symptoms of prostate cancer may be difficult to distinguish unless you are aware of it and actively thinking about it. So make sure you discuss with your primary care doctor, neurologist, and/ or urologist about the increase risk if you are taking this medication so they can follow appropriate protocol and do more careful and frequent screening than otherwise recommended particularly since guidelines for screening have changed.

Symptoms of prostate cancer include:

  • Need to urinate frequently especially at nighttime
  • Difficulty starting or stopping urine
  • Weak or interrupted flow of urine
  • Painful or burning with urination
  • Difficulty with a erection
  •  Painful ejaculation
  • Blood injuring or semen
  • Frequent pain or stiffness in low back or  upper thighs or hips

At present there are no guidelines from Academy of Neurology, that I am aware; thus, my personal recommendations are to follow the Academy of Urology recommendations.

According to the urology guidelines, PSA (prostate specific antigen) is no longer necessary recommended for men under age 40, nor for ages 40 to 54 unless at high risk ( e.g. family history or in this case intake of Stalevo which gives a fivefold  increase in risk)-the mortality rate due to this cancer in this age group is 1:1000. Thus, the greatest screening benefit using the PSA test is in the age group of 59 to 65 years old according to Academy of Urology. Furthermore, in men over 70, screening is no longer recommended either unless life expectancy assumed to be greater than 15 years ( i.e. male is in extremely good health). Even when screening is done, recommendation is to do test every 2 years.

Keeping in mind the increase risk of prostate cancer particularly if you have family history of this disease if you are taking Stalevo make sure to discuss with your physician to ensure appropriate follow up particularly if you are a young man.

Remember, Prostate cancer is a treatable disease if caught early!


Dr. M. De Leon is a movement disorder specialist on sabbatical, PPAC member and research advocate for PDF (Parkinson’s Disease Foundation); Texas State Assistant Director for PAN (Parkinson’s Action Network). You can learn more about her work at http://www.facebook.com/defeatparkinsons101 you can also learn more about Parkinson’s disease at www.pdf.org or at www.wemove.org; http://www.aan.org, http://www.defeatparkinsons.blogspot.com All materials here forth are property of Defeatparkinsons. without express written consent, these materials only may be used for viewers personal & non-commercial uses which do not harm the reputation of Defeatparkinsons organization or Dr. M. De Leon provided you do not remove any copyrights. To request permission to reproduce release of any part or whole of content, please contact me at defeatparkinsons101@yahoo.com contributor http://www.assisted-living-directory.com Contributor http://www.lavozbrazoriacounty.com


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