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Latest & greatest articles for prostate cancer
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Serum testosterone changes in patients treated with radiation therapy alone for prostatecancer on NRG oncology RTOG 9408 We reviewed testosterone changes for patients who were treated with radiation therapy (RT) alone on NRG oncology RTOG 9408.Patients (T1b-T2b, prostate-specific antigen <20 ng/mL) were randomized between RT alone and RT plus 4 months of androgen ablation. Serum testosterone (ST) levels were investigated at enrollment, RT completion, and the first follow-up 3 months after RT (...) , respectively, were analyzed. For all patients, the median change in ST values at completion of RT and at 3-month follow-up were -30.0 ng/dL (p5-p95; -270.0 to 162.0; P < .001) and -34.0 ng/dL (p5-p95, -228.0 to 160.0; P < .01), respectively.RT for prostatecancer was associated with a median 9.2% decline in ST at completion of RT and a median 9.3% decline 3 months after RT. These changes were statistically significant.
Second-Line Hormonal Therapy for Men With Chemotherapy-Naive, Castration-Resistant ProstateCancer: American Society of Clinical Oncology Provisional Clinical Opinion Purpose ASCO provisional clinical opinions (PCOs) offer direction to the ASCO membership after publication or presentation of potential practice-changing data. This PCO addresses second-line hormonal therapy for chemotherapy-naïve men with castration-resistant prostatecancer (CRPC) who range from being asymptomatic with only (...) opinion inform this PCO. Provisional Clinical Opinion For men with CRPC, a castrate state should be maintained indefinitely. Second-line hormonal therapy (eg, antiandrogens, CYP17 inhibitors) may be considered in patients with nonmetastatic CRPC at high risk for metastatic disease (rapid prostate-specific antigen doubling time or velocity) but otherwise is not suggested. In patients with radiographic evidence of metastases and minimal symptoms, enzalutamide or abiraterone plus prednisone should
Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy Urothelial prostatic involvement (UPI) at the time of radical cystoprostatectomy (RCP) was found associated with worse survival outcomes by several previous reports. Our aim is to evaluate the impact of different levels of UPI on survival outcomes using a large series of male patients treated with RCP.Whole step section specimens from 995 male BCa patients were assessed for UPI defined (...) as: no involvement vs. prostatic urethral carcinoma in situ (CIS) vs. lamina propria involvement vs. ductal CIS vs. prostate stromal involvement. Primary end point of the study was predictors of prostatic involvement at RCP and its impact on overall survival after surgery.Prostatic involvement was recorded in 307 (30.9%) patients: 28% with prostatic urethral CIS, 12% with lamina propria involvement, 13% with ductal CIS and 47% with stromal involvement. Median follow-up was 70 months. Patients with stromal
Editorial Concerning â€œImpact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomyâ€ 28824944 2019 01 15 2352-3727 3 3 2017 Jul 27 Bladder cancer (Amsterdam, Netherlands) Bladder Cancer Editorial Concerning "Impact of the Level of Urothelial Carcinoma Involvement of the Prostate on Survival after Radical Cystectomy". 171-172 10.3233/BLC-179017 Shen Steven S Professor of Pathology and Laboratory Medicine, Associate Director of Surgical Pathology (...) , Department of Pathology and Genomic Medicine, Houston Methodist Hospital and Weill Medical College of Cornell University. Lerner Seth P SP Professor and Beth and Dave Swalm Chair in Urologic Oncology, Director of Urologic Oncology, Scott Department of Urology, Baylor College of Medicine. eng Editorial 2017 07 27 Netherlands Bladder Cancer 101668567 2017 8 22 6 0 2017 8 22 6 0 2017 8 22 6 1 epublish 28824944 10.3233/BLC-179017 BLC179017 PMC5545913 Eur Urol. 2008 Feb;53(2):370-5 17689003 Expert Rev
August 2014 for our primary outcome, all-cause mortality, and the main secondary outcome, prostate-cancer mortality. We describe disease progression, treatments received, and patient-reported outcomes through January 2010 (original follow-up).During 19.5 years of follow-up (median, 12.7 years), death occurred in 223 of 364 men (61.3%) assigned to surgery and in 245 of 367 (66.8%) assigned to observation (absolute difference in risk, 5.5 percentage points; 95% confidence interval [CI], -1.5 to 12.4 (...) ; hazard ratio, 0.84; 95% CI, 0.70 to 1.01; P=0.06). Death attributed to prostatecancer or treatment occurred in 27 men (7.4%) assigned to surgery and in 42 men (11.4%) assigned to observation (absolute difference in risk, 4.0 percentage points; 95% CI, -0.2 to 8.3; hazard ratio, 0.63; 95% CI, 0.39 to 1.02; P=0.06). Surgery may have been associated with lower all-cause mortality than observation among men with intermediate-risk disease (absolute difference, 14.5 percentage points; 95% CI, 2.8 to 25.6
Initiative to reduce bone scans for low-risk prostatecancer patients: A quasi-experimental before-and-after study in a Veterans Affairs hospital Bone scans (BS) are a low-value test for asymptomatic men with low-risk prostatecancer. We performed a quality improvement intervention aimed at reducing BS for these patients.The intervention was a presentation that leveraged the behavioral science concepts of social comparison and normative appeals. Participants were multidisciplinary stakeholders (...) from the Radiation Oncology and Urology services at a Veterans Affairs hospital. We determined the baseline rate of BS by retrospectively analyzing cases of asymptomatic men with newly diagnosed low-risk prostatecancer. For social comparison, we presented contemporary peer BS rates in the United States-including Veterans Affairs hospitals. For normative appeals, we reviewed guidelines from various professional groups. To analyze the effect of this intervention, we performed a quasi-experimental
Efficacy of Blended Cognitive Behavior Therapy for High Fear of Recurrence in Breast, Prostate, and Colorectal Cancer Survivors: The SWORD Study, a Randomized Controlled Trial Purpose Fear of cancer recurrence (FCR) is a common problem experienced by cancer survivors. Approximately one third of survivors report high FCR. This study aimed to evaluate whether blended cognitive behavior therapy (bCBT) can reduce the severity of FCR in cancer survivors curatively treated for breast, prostate (...) , or colorectal cancer. Patients and Methods This randomized controlled trial included 88 cancer survivors with high FCR (Cancer Worry Scale score ≥ 14) from 6 months to 5 years after cancer treatment. Participants were randomly allocated (ratio 1:1, stratified by cancer type) to receive bCBT, including five face-to face and three online sessions (n = 45) or care as usual (CAU; n = 43). Participants completed questionnaires at baseline (T0) and 3 months later (T1). The intervention group completed bCBT
Custirsen in combination with docetaxel and prednisone for patients with metastatic castration-resistant prostatecancer (SYNERGY trial): a phase 3, multicentre, open-label, randomised trial Clusterin is a chaperone protein associated with treatment resistance and upregulated by apoptotic stressors such as chemotherapy. Custirsen is a second-generation antisense oligonucleotide that inhibits clusterin production. The aim of the SYNERGY trial was to investigate the effect of custirsen (...) in combination with docetaxel and prednisone on overall survival in patients with metastatic castration-resistant prostate cancer.SYNERGY was a phase 3, multicentre, open-label, randomised trial set at 134 study centres in 12 countries. Patients were eligible for participation if they had: metastatic castration-resistant prostatecancer and had received no previous chemotherapy; prostate-specific antigen greater than 5 ng/mL; and a Karnofsky performance score of 70% or higher. Patients were randomly assigned
had more favorable-risk prostatecancer (OR, 1.35; 95% CI, 1.16 to 1.56) and a lower risk of aggressive prostatecancer (OR, 0.50; 95% CI, 0.37 to 0.67). The increase in favorable-risk prostatecancer was already observed within the first year of TRT (OR, 1.61; 95% CI, 1.10 to 2.34), whereas the lower risk of aggressive disease was observed after > 1 year of TRT (OR, 0.44; 95% CI, 0.32 to 0.61). After adjusting for previous biopsy findings as an indicator of diagnostic activity, TRT remained (...) Testosterone Replacement Therapy and Risk of Favorable and Aggressive ProstateCancer Purpose The association between exposure to testosterone replacement therapy (TRT) and prostatecancer risk is controversial. The objective was to examine this association through nationwide, population-based registry data. Methods We performed a nested case-control study in the National ProstateCancer Register of Sweden, which includes all 38,570 prostatecancer cases diagnosed from 2009 to 2012, and 192,838
The Performance of PI-RADSv2 and Quantitative Apparent Diffusion Coefficient for Predicting Confirmatory Prostate Biopsy Findings in Patients Considered for Active Surveillance of ProstateCancer To assess the performance of the updated Prostate Imaging Reporting and Data System (PI-RADSv2) and the apparent diffusion coefficient (ADC) for predicting confirmatory biopsy results in patients considered for active surveillance of prostatecancer (PCA).IRB-approved, retrospective study of 371 (...) consecutive men with clinically low-risk PCA (initial biopsy Gleason score ≤6, prostate-specific antigen <10 ng/ml, clinical stage ≤T2a) who underwent 3T-prostate MRI before confirmatory biopsy. Two independent radiologists recorded the PI-RADSv2 scores and measured the corresponding ADC values in each patient. A composite score was generated to assess the performance of combining PI-RADSv2 + ADC.PCA was upgraded on confirmatory biopsy in 107/371 (29%) patients. Inter-reader agreement was substantial (PI
+ 3 tumors. Surgery and radiation continue to be curative treatments for localized disease but have adverse effects such as urinary symptoms and sexual dysfunction that can negatively affect quality of life. For metastatic disease, chemotherapy as initial treatment now appears to extend survival compared with androgen deprivation therapy alone. New vaccines, hormonal therapeutics, and bone-targeting agents have demonstrated efficacy in men with metastatic prostatecancer resistant to traditional (...) The Diagnosis and Treatment of ProstateCancer: A Review. Prostatecancer is the most common cancer diagnosis made in men with more than 160 000 new cases each year in the United States. Although it often has an indolent course, prostatecancer remains the third-leading cause of cancer death in men.When prostatecancer is suspected, tissue biopsy remains the standard of care for diagnosis. However, the identification and characterization of the disease have become increasingly precise through
Abiraterone plus Prednisone in Metastatic, Castration-Sensitive ProstateCancer. Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostatecancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer.In this double-blind, placebo-controlled, phase 3 trial, we randomly (...) , including the time until pain progression, next subsequent therapy for prostatecancer, initiation of chemotherapy, and prostate-specific antigen progression (P<0.001 for all comparisons), along with next symptomatic skeletal events (P=0.009). These findings led to the unanimous recommendation by the independent data and safety monitoring committee that the trial be unblinded and crossover be allowed for patients in the placebo group to receive abiraterone. Rates of grade 3 hypertension and hypokalemia
primary outcome was failure-free survival (treatment failure was defined as radiologic, clinical, or PSA progression or death from prostatecancer).A total of 1917 patients underwent randomization from November 2011 through January 2014. The median age was 67 years, and the median PSA level was 53 ng per milliliter. A total of 52% of the patients had metastatic disease, 20% had node-positive or node-indeterminate nonmetastatic disease, and 28% had node-negative, nonmetastatic disease; 95% had newly (...) was 0.21 in patients with nonmetastatic disease and 0.31 in those with metastatic disease. Grade 3 to 5 adverse events occurred in 47% of the patients in the combination group (with nine grade 5 events) and in 33% of the patients in the ADT-alone group (with three grade 5 events).Among men with locally advanced or metastatic prostatecancer, ADT plus abiraterone and prednisolone was associated with significantly higher rates of overall and failure-free survival than ADT alone. (Funded by Cancer
Malakoplakia of the Prostate as a Mimicker of ProstateCancer on Prostate Health Index and Magnetic Resonance Imagingâ€“Fusion Prostate Biopsy: A Case Report Background: Isolated malakoplakia of the prostate is a rare inflammatory condition that has been clinically mistaken for prostaticmalignancies. The development of Prostate Imaging Reporting and Data System (PI-RADS) classifications, and Prostate Health Index (PHI) has led to more accurate diagnosis of clinically significant disease (...) and stratification of patients that may be at risk of prostatecancer. Case Presentation: We present a case of a 75-year-old male who was on follow-up with our hospital for elevated prostate specific antigen (PSA). He was admitted for an episode of urosepsis, which was treated with antibiotics and subsequently underwent further workup and was found to have a raised PHI, as well as a high PI-RADS classification and was later found to have malakoplakia based on histology of prostate tissue obtained during targeted
The 4Kscore blood test accurately identifies men with aggressive prostatecancer prior to prostate biopsy with or without DRE information The 4Kscore Test is a prebiopsy blood test that incorporates four prostate protein biomarkers along with patient clinical information to determine a man's risk for high-grade, aggressive (Gleason ≥7) prostatecancer. However, some men likely to benefit from the test may be seen in primary care settings where the digital rectal examination (DRE) information (...) is not always obtained. In this study, we assessed the clinical validity of the 4Kscore Test when the DRE information was not included in the algorithm.The Prospective 4Kscore Validation Study enrolled 1012 men scheduled for prostate biopsy across 26 urology practices in the United States. The 4Kscore was calculated for each patient with and without DRE information. The primary outcome was Gleason ≥7 prostatecancer on prostate biopsy. The contribution of DRE to the predictive accuracy of the test
Vasectomy and ProstateCancer Risk in the European Prospective Investigation Into Cancer and Nutrition (EPIC) Purpose Vasectomy is a commonly used form of male sterilization, and some studies have suggested that it may be associated with an increased risk of prostatecancer, including more aggressive forms of the disease. We investigated the prospective association of vasectomy with prostatecancer in a large European cohort, with a focus on high-grade and advanced-stage tumors, and death due (...) an average follow-up of 15.4 years, 4,377 men were diagnosed with prostatecancer, including 641 who had undergone a vasectomy. Vasectomy was not associated with prostatecancer risk (hazard ratio [HR], 1.05; 95% CI, 0.96 to 1.15), and no evidence for heterogeneity in the association was observed by stage of disease or years since vasectomy. There was some evidence of heterogeneity by tumor grade ( P = .02), with an increased risk for low-intermediate grade (HR, 1.14; 95% CI, 1.01 to 1.29) but not high
Moderate Hypofractionation in High-Risk, Organ-Confined ProstateCancer: Final Results of a Phase III Randomized Trial Purpose To report the final results on treatment outcomes of a randomized trial comparing conventional and hypofractionated radiotherapy in high-risk, organ-confined prostatecancer (PCa). Patients and Methods This single-institution, randomized clinical trial, conducted from January 2003 to December 2007, enrolled 168 patients with high-risk PCa who were randomly assigned (...) in a 1:1 ratio to conventional (80 Gy in 40 fractions in 8 weeks) or hypofractionated radiotherapy (62 Gy in 20 fractions in 5 weeks) to prostate and seminal vesicles. The primary outcome measure was late toxicity. Additional outcomes were freedom from biochemical failure (FFBF), prostatecancer-specific survival (PCaSS), and overall survival (OS), evaluated on an intention-to-treat basis. Results A total of 85 patients were assigned to conventional and 83 to hypofractionated radiotherapy
Development of a new rutin nanoemulsion and its application on prostatecarcinoma PC3 cell line Biological effects of rutin bioactive are limited due to its poor oral bioavailability and its degradation in aqueous environments. For the purpose of bioenhancement, different nanoemulsion systems of rutin were developed by aqueous titration method using water as dispersion media. The nanoemulsion systems were characterized for surface morphology, droplet size, polydispersity index, zeta potential (...) , in vitro release profile and the formulations were optimized. The anticancer potential of optimized nanoemulsion was evaluated by cells viability (MTT) assay, nuclear condensation, and ROS activity using human prostatecancer (PC3) cell line. On the basis of cell viability data the inhibitory concentration (IC50) value for optimized nanoemulsion formulation on PC3 cancer cells was found to be 11.8 μM. Fluorescent microscopic analysis and intracellular ROS generation demonstrated significant ROS
Limitations Limited availability (restricted to centres with onsite generation facilities) Renal excretion (which makes assessment of primary prostatecancer and local nodes difficult) Uptake is not specific to malignanttumours 1 Efflux of tracer from the tumour after approximately 30min 1 Financial considerations Regulatory issues related to manufacturing Lack of qualified personnel to facilitate preparation at local level 7 Down-regulation of PSMA expression by androgen therapy 21 (...) in detecting recurrent disease compared with radioactive labelled choline. Definitions Prostatecancer recurrence: initially demonstrated by a rise in total serum prostate specific antigen, often despite normal findings with conventional imaging. Known as a biochemical relapse or recurrence 1 . Tracer: a radioactive labeled (radiolabelled) molecule that, when used with imaging, produces images to provide information about tissue metabolism, distribution of the molecule within tissues, or passage
procedures for recurrent prostatecancer; however, questions remain about its long-term efficacy for local and distant tumor control and survival. Relevant Questions: Does salvage HIFU provide effective local tumor control, acceptable rates of remission, and longterm, disease-free survival in patients with recurrent prostatecancer following failure of EBRT or RP? Does salvage HIFU provide acceptable outcomes with regard to urinary function, prostate symptoms, and sexual function? How does salvage HIFU (...) compare with other salvage treatment options for recurrent prostatecancer? Is salvage HIFU safe, and what are the related complications? Have definitive patient selection criteria been established for salvage HIFU treatment for recurrent prostatecancer? Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Chronic Disease; Humans; Male; Neoplasm Recurrence, Local; ProstaticNeoplasms; Salvage Therapy; Ultrasound, High-Intensity Focused