Luisel Ricks-Santi, University of Florida

“Me encontraron càncer en la pròstata,” my father told me. “They found cancer in my prostate.”

As a cancer researcher who knows very well about the high incidence and decreased survival rates of prostate cancer in the Caribbean, I anguished over these words. Even though I study cancer in my day job, I struggled to take in this news. At the time, all I could muster in response was, “What did the doctor say?”

“The urologist wants me to see the radiation oncologist to discuss ‘semillas’ (seeds),” he said. “They are recommending treatment.” Many men, including former President Joe Biden, whose case is advanced, do choose with their doctors to treat prostate cancer.

However, I understood from my work that not undergoing treatment was also an option. In some cases, that is the better choice.

So I took it upon myself to educate my father on his disease and assist him with the life-changing decisions he would need to make. Our journey can give you a preview of what a cancer diagnosis can be like.

Prostate cancer diagnosis

Prostate cancer was not a new topic for my father and me. His battle with his prostate health started over 10 years ago with an initial diagnosis of benign prostate hyperplasia, or BPH.

The prostate gets bigger with age for a number of reasons, including changing hormone levels, infection or inflammation. Two of the most frequent symptoms of BPH are difficulty urinating and a sudden, urgent need to urinate, both of which my father experienced.

Although research suggests that the factors that contribute to BPH similarly contribute to prostate cancer, there is no evidence that an enlarged prostate will necessarily develop into cancer.

Upon my father’s initial BPH diagnosis, I asked about his PSA levels, the amount of prostate-specific antigens in his blood. PSA is a protein that both normal and cancerous prostate cells produce, and elevated amounts are considered red flags for prostate cancer. When combined with a digital rectal exam, a PSA test can allow doctors to more accurately predict a person’s risk of having prostate cancer.

My father said his PSA levels were elevated but that the doctors would begin active surveillance, what he called “watchful waiting,” and monitor his PSA every six months to see if it rose.

After several years of monitoring his PSA, doctors found my father’s PSA level had doubled. He then got a biopsy that indicated he had intermediate-risk prostate cancer.

Cancer risk categorization

After his diagnosis, my father was faced with the decision of how to proceed with treatment. I explained that categorizing how aggressive the cancer is and how far it has spread can help determine the best course of treatment.

Prostate cancer can be grouped into four stages. Stages 1 and 2, when the tumor is still confined to the prostate, are considered early-stage or intermediate risk. Stages 3 and 4, when the tumor has spread beyond the borders of the prostate, are considered more advanced and high risk.

Some patients with early-stage or intermediate-risk prostate cancer undergo additional treatment, including surgery, radiation or radioactive seed implants called brachytherapy. Patients with late-stage prostate cancer typically undergo hormone therapy along with surgery or radiation, or chemotherapy with or without radiation.

Although I was not surprised by my father’s diagnosis, given his advanced age and his battle with prostate disease over the past decade, I still struggled emotionally. I struggled with our conversations about what “curing” his cancer meant and how to explain his treatment options to him. I wanted to ensure he would have the best outcome and could still live his best life.

Our initial inclination was to undergo active surveillance. That meant we would monitor his PSA every six months instead of immediately starting treatment. That is appropriate for patients with early-stage and less aggressive tumors.

Prostate cancer screening problems

My father was leaning on me to help him decide how to proceed. I felt overwhelming anxiety because I did not want to fail him or my family. Even with all my expertise studying cancer genetics and working with cancer patients, I couldn’t help second-guessing our decisions, and I sometimes questioned our decision not to immediately treat his cancer.

Some people diagnosed with prostate cancer don’t immediately start treatment, because many of the tumors found through PSA testing grow so slowly that they are unlikely to be life-threatening. Detecting these slow-growing tumors is considered overdiagnosis, because the cancer ultimately will not harm the patient during their lifetime. Nearly half of all patients with prostate cancer are overdiagnosed, often leading to overtreatment.

Research suggests that many prostate cancer patients undergo unnecessarily aggressive treatments, which are often associated with significant harms, like urinary and bowel incontinence, sexual impotence and, in some cases, death. Several studies in the U.S. have shown that patients with early-stage prostate cancer generally have a good prognosis, and the cancer rarely progresses further. With careful observation, most will never need treatment and can be spared the burdens of unnecessary therapy until there are clear signs of progression.

Overdiagnosis and overtreatment of prostate cancer led the U.S. Preventive Services Task Force to recommend against PSA-based screening in 2012, with caveats for high-risk groups including African American men and those with a family history of prostate cancer. The recommendation was updated in 2018 to make screening a personal choice after discussion with a clinician.

Those recommendations have resulted in reduced screening and increased prostate cancer diagnoses. Given that Black men are more likely to see the cancer progress to aggressive forms of the disease after initial diagnosis, this may worsen existing health disparities.

Developing tests that better identify patients at risk of dying from prostate cancer can decrease overtreatment. In the meantime, educating patients can help them decide if screening is appropriate for them. For underserved and marginalized communities, community outreach can help improve health literacy and enhance awareness and screening.

When I looked through my father’s stack of medical records, I found a beacon of light that eased my apprehension. His doctor had ordered a genetic test that estimates how aggressive a tumor may be by measuring the activity of specific genes in cancer cells. An increase in gene activity linked to cancer would indicate that it is likely to grow fast and spread.

The test predicted that my father’s risk of dying from the disease in the next five years was less than 5%. Based on these results, we both understood that he had adequate time to make a decision and seek additional guidance.

My father ultimately decided to continue active surveillance and forgo immediate treatment.

Surviving prostate cancer

I still worry about my father’s diagnosis, because his cancer is at risk for progression. So every six months, I inquire about his PSA levels. His doctors are monitoring his PSA levels as part of his survivorship plan, which is a record of information about his cancer diagnosis, treatment history and potential follow-up tests.

My father’s decision to undergo active surveillance was controversial among our friends and family. Many were under the impression that prostate cancer required immediate treatment. Several shared successful treatment stories, sometimes followed by stories of adverse treatment-related side effects.

To date, my father believes that active surveillance was the best decision for him and understands that this may not be the same for someone else. Talk to your doctor to see what the best options are for you or your loved ones.

This is an updated version of an article originally published on Aug. 8, 2023.

Luisel Ricks-Santi, Senior Associate Vice President Community Health, Education and Training, Old Dominion University; Associate Professor of Pharmacy, University of Florida

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Anne Schmitz, University of Wisconsin-Stout and Daniel Freedman, University of Wisconsin-Stout

Three-dimensional printing is transforming medical care, letting the health care field shift from mass-produced solutions to customized treatments tailored to each patient’s needs. For instance, researchers are developing 3D-printed prosthetic hands specifically designed for children, made with lightweight materials and adaptable control systems.

These continuing advancements in 3D-printed prosthetics demonstrate their increasing affordability and accessibility. Success stories like this one in personalized prosthetics highlight the benefits of 3D printing, in which a model of an object produced with computer-aided design software is transferred to a 3D printer and constructed layer by layer.

We are a biomedical engineer and chemist who work with 3D printing. We study how this rapidly evolving technology provides new options not just for prosthetics but for implants, surgical planning, drug manufacturing and other health care needs. The ability of 3D printing to make precisely shaped objects in a wide range of materials has led to, for example, custom replacement joints and custom-dosage, multidrug pills.

Better body parts

Three-dimensional printing in health care started in the 1980s with scientists using technologies such as stereolithography to create prototypes layer by layer. Stereolithography uses a computer-controlled laser beam to solidify a liquid material into specific 3D shapes. The medical field quickly saw the potential of this technology to create implants and prosthetics designed specifically for each patient.

One of the first applications was creating tissue scaffolds, which are structures that support cell growth. Researchers at Boston Children’s Hospital combined these scaffolds with patients’ own cells to build replacement bladders. The patients remained healthy for years after receiving their implants, demonstrating that 3D-printed structures could become durable body parts.

As technology progressed, the focus shifted to bioprinting, which uses living cells to create working anatomical structures. In 2013, Organovo created the world’s first 3D-bioprinted liver tissue, opening up exciting possibilities for creating organs and tissues for transplantation. But while significant advances have been made in bioprinting, creating full, functional organs such as livers for transplantation remains experimental. Current research focuses on developing smaller, simpler tissues and refining bioprinting techniques to improve cell viability and functionality. These efforts aim to bridge the gap between laboratory success and clinical application, with the ultimate goal of providing viable organ replacements for patients in need.

Three-dimensional printing already has revolutionized the creation of prosthetics. It allows prosthetics makers to produce affordable custom-made devices that fit the patient perfectly. They can tailor prosthetic hands and limbs to each individual and easily replace them as a child grows.

Three-dimensionally printed implants, such as hip replacements and spine implants, offer a more precise fit, which can improve how well they integrate with the body. Traditional implants often come only in standard shapes and sizes.

Some patients have received custom titanium facial implants after accidents. Others had portions of their skulls replaced with 3D-printed implants.

Additionally, 3D printing is making significant strides in dentistry. Companies such as Invisalign use 3D printing to create custom-fit aligners for teeth straightening, demonstrating the ability to personalize dental care.

Scientists are also exploring new materials for 3D printing, such as self-healing bioglass that might replace damaged cartilage. Moreover, researchers are developing 4D printing, which creates objects that can change shape over time, potentially leading to medical devices that can adapt to the body’s needs.

For example, researchers are working on 3D-printed stents that can respond to changes in blood flow. These stents are designed to expand or contract as needed, reducing the risk of blockage and improving long-term patient outcomes.

Simulating surgeries

Three-dimensionally printed anatomical models often help surgeons understand complex cases and improve surgical outcomes. These models, created from medical images such as X-rays and CT scans, allow surgeons to practice procedures before operating.

For instance, a 3D-printed model of a child’s heart enables surgeons to simulate complex surgeries. This approach can lead to shorter operating times, fewer complications and lower costs.

Personalized pharmaceuticals

In the pharmaceutical industry, drugmakers can three-dimensionally print personalized drug dosages and delivery systems. The ability to precisely layer each component of a drug means that they can make medicines with the exact dose needed for each patient. The 3D-printed anti-epileptic drug Spritam was approved by the Food and Drug Administration in 2015 to deliver very high dosages of its active ingredient.

Drug production systems that use 3D printing are finding homes outside pharmaceutical factories. The drugs potentially can be made and delivered by community pharmacies. Hospitals are starting to use 3D printing to make medicine on-site, allowing for personalized treatment plans based on factors such as the patient’s age and health.

However, it’s important to note that regulations for 3D-printed drugs are still being developed. One concern is that postprinting processing may affect the stability of drug ingredients. It’s also important to establish clear guidelines and decide where 3D printing should take place – whether in pharmacies, hospitals or even at home. Additionally, pharmacists will need rigorous training in these new systems.

Printing for the future

Despite the extraordinarily rapid progress overall in 3D printing for health care, major challenges and opportunities remain. Among them is the need to develop better ways to ensure the quality and safety of 3D-printed medical products. Affordability and accessibility also remain significant concerns. Long-term safety concerns regarding implant materials, such as potential biocompatibility issues and the release of nanoparticles, require rigorous testing and validation.

While 3D printing has the potential to reduce manufacturing costs, the initial investment in equipment and materials can be a barrier for many health care providers and patients, especially in underserved communities. Furthermore, the lack of standardized workflows and trained personnel can limit the widespread adoption of 3D printing in clinical settings, hindering access for those who could benefit most.

On the bright side, artificial intelligence techniques that can effectively leverage vast amounts of highly detailed medical data are likely to prove critical in developing improved 3D-printed medical products. Specifically, AI algorithms can analyze patient-specific data to optimize the design and fabrication of 3D-printed implants and prosthetics. For instance, implant makers can use AI-driven image analysis to create highly accurate 3D models from CT scans and MRIs that they can use to design customized implants.

Furthermore, machine learning algorithms can predict the long-term performance and potential failure points of 3D-printed prosthetics, allowing prosthetics designers to optimize for improved durability and patient safety.

Three-dimensional printing continues to break boundaries, including the boundary of the body itself. Researchers at the California Institute of Technology have developed a technique that uses ultrasound to turn a liquid injected into the body into a gel in 3D shapes. The method could be used one day for delivering drugs or replacing tissue.

Overall, the field is moving quickly toward personalized treatment plans that are closely adapted to each patient’s unique needs and preferences, made possible by the precision and flexibility of 3D printing.

Anne Schmitz, Associate Professor of Engineering, University of Wisconsin-Stout and Daniel Freedman, Dean of the College of Science, Technology, Engineering, Mathematics & Management, University of Wisconsin-Stout

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Zhenbo Wang, University of Tennessee

Half a century after the Apollo astronauts left the last bootprints in lunar dust, the Moon has once again become a destination of fierce ambition and delicate engineering.

This time, it’s not just superpowers racing to plant flags, but also private companies, multinational partnerships and robotic scouts aiming to unlock the Moon’s secrets and lay the groundwork for future human return.

So far in 2025, lunar exploration has surged forward. Several notable missions have launched toward or landed on the Moon. Each has navigated the long journey through space and the even trickier descent to the Moon’s surface or into orbit with varying degrees of success. Together, these missions reflect both the promise and difficulty of returning to the Moon in this new space race defined by innovation, competition and collaboration.

As an aerospace engineer specializing in guidance, navigation and control technologies, I’m deeply interested in how each mission – whether successful or not – adds to scientists’ collective understanding. These missions can help engineers learn to navigate the complexities of space, operate in hostile lunar environments and steadily advance toward a sustainable human presence on the Moon.

Why is landing on the Moon so hard?

Lunar exploration remains one of the most technically demanding frontiers in modern spaceflight. Choosing a landing site involves complex trade-offs between scientific interest, terrain safety and Sun exposure.

The lunar south pole is an especially attractive area, as it could contain water in the form of ice in shadowed craters, a critical resource for future missions. Other sites may hold clues about volcanic activity on the Moon or the solar system’s early history.

Each mission trajectory must be calculated with precision to make sure the craft arrives and descends at the right time and place. Engineers must account for the Moon’s constantly changing position in its orbit around Earth, the timing of launch windows and the gravitational forces acting on the spacecraft throughout its journey.

They also need to carefully plan the spacecraft’s path so that it arrives at the right angle and speed for a safe approach. Even small miscalculations early on can lead to major errors in landing location – or a missed opportunity entirely.

Once on the surface, the landers need to survive extreme swings in temperature – from highs over 250 degrees Fahrenheit (121 degrees Celsius) in daylight down to lows of -208 F (-133 C) at night – as well as dust, radiation and delayed communication with Earth. The spacecraft’s power systems, heat control, landing legs and communication links must all function perfectly. Meanwhile, these landers must avoid hazardous terrain and rely on sunlight to power their instruments and recharge their batteries.

These challenges help explain why many landers have crashed or experienced partial failures, even though the technology has come a long way since the Apollo era.

Commercial companies face the same technical hurdles as government agencies but often with tighter budgets, smaller teams and less heritage hardware. Unlike government missions, which can draw on decades of institutional experience and infrastructure, many commercial lunar efforts are navigating these challenges for the first time.

Successful landings and hard lessons for CLPS

Several lunar missions launched this year belong to NASA’s Commercial Lunar Payload Services program. CLPS is an initiative that contracts private companies to deliver science and technology payloads to the Moon. Its aim is to accelerate exploration while lowering costs and encouraging commercial innovation.

The first Moon mission of 2025, Firefly Aerospace’s Blue Ghost Mission 1, launched in January and successfully landed in early March.

The lander survived the harsh lunar day and transmitted data for nearly two weeks before losing power during the freezing lunar night – a typical operational limit for most unheated lunar landers.

Blue Ghost demonstrated how commercial landers can shoulder critical parts of NASA’s Artemis program, which aims to return astronauts to the Moon later this decade.

The second CLPS launch of the year, Intuitive Machines’ IM-2 mission, launched in late February. It targeted a scientifically intriguing site near the Moon’s south pole region.

The Nova-C lander, named Athena, touched down on March 6 close to the south pole. However, during the landing process, Athena tipped over. Since it landed on its side in a crater with uneven terrain, it couldn’t deploy its solar panels to generate power, which ended the mission early.

While Athena’s tipped-over landing meant it couldn’t do all the scientific explorations it had planned, the data it returned is still valuable for understanding how future landers can avoid similar fates on the rugged polar terrain.

Not all lunar missions need to land. NASA’s Lunar Trailblazer, a small lunar orbiter launched in February alongside IM-2, was intended to orbit the Moon and map the form, abundance and distribution of water in the form of ice, especially in shadowed craters near the poles.

Shortly after launch, however, NASA lost contact with the spacecraft. Engineers suspect the spacecraft may have experienced a power issue, potentially leaving its batteries depleted.

NASA is continuing recovery efforts, hoping that the spacecraft’s solar panels may recharge in May and June.

Ongoing and future missions

Launched on the same day as the Blue Ghost mission in January, Japanese company ispace’s Hakuto-R Mission 2 (Resilience) is on its way to the Moon and has successfully entered lunar orbit.

The lander carried out a successful flyby of the Moon on Feb. 15, with an expected landing in early June. Although launched at the same time, Resilience took a longer trajectory than Blue Ghost to save energy. This maneuver also allowed the spacecraft to collect bonus science observations while looping around the Moon.

The mission, if successful, will advance Japan’s commercial space sector and prove an important comeback for ispace after its first lunar lander crashed during its final descent in 2023.

The rest of 2025 promises a busy lunar calendar. Intuitive Machines plans to launch IM-3 in late 2025 to test more advanced instruments and potentially deliver NASA scientific experiments to the Moon.

The European Space Agency’s Lunar Pathfinder will establish a dedicated lunar communications satellite, making it easier for future missions, especially those operating on the far side or poles, to stay in touch with Earth.

Meanwhile, Astrobotic’s Griffin Mission-1 is scheduled to deliver NASA’s VIPER rover to the Moon’s south pole, where it will directly search for ice beneath the surface.

Together, these missions represent an increasingly international and commercial approach to lunar science and exploration.

As the world turns its attention to the Moon, every mission – whether triumph or setback – brings humanity closer to a permanent return to our closest celestial neighbor.

Zhenbo Wang, Associate Professor of Mechanical and Aerospace Engineering, University of Tennessee

This article is republished from The Conversation under a Creative Commons license. Read the original article.