National Cancer Institute®
Last Modified: June 1, 2002
UI - 11887984
AU - Schroder FH
TI - Prostate cancer: natural history and surgical treatment of localised disease.
SO - Eur J Cancer 2001 Oct;37 Suppl 7():S127-36
AD - Department of Urology, Erasmus University and Academic Hospital, Rotterdam, The Netherlands.
In summary, there is increasing and convincing evidence that radical prostatectomy is effective in locally confined, poorly differentiated prostate cancer. Diagnostic efforts, therefore, should be targeted toward this disease and probably also, based on the natural history evidence, toward moderately differentiated disease, mainly Gleason score 7. It is unclear, at present, how this can be achieved. Further improvement of our diagnostic capabilities is urgently needed. Hopefully ongoing randomised studies comparing radical prostatectomy to surveillance and studies comparing radical prostatectomy to radiotherapy are urgently desired. The randomised screening studies, which are ongoing, will provide important information with respect to the effect of treatment. If prostate cancer mortality in those men who are randomised to screening turns out to be better than in those randomised to control, this will also be an indication of the effectiveness of treatment. Also, the screening studies and associated natural history studies based on serum repositories and follow-up in non-screened patients will provide important information with respect to the natural history of prostate cancer in relation to PSA and changes of PSA over time. Finally, quality of life with and without treatment will have to be evaluated, in a prospective manner, in multicentre settings according to validated criteria such as those presented by Litwin. The outcomes of such studies will have to be added as utilities to data relating to traditional endpoints such as cancer-specific and overall survival. In the meantime, clinical practice will be determined by the fact that the only way to cure prostate cancer is early diagnosis and aggressive management. Encouragement comes from the increasing volume of evidence showing that poorly differentiated disease can be eradicated as long as it is locally confined.
UI - 11887985
AU - Dearnaley DP
TI - Radiotherapy and combined modality approaches in localised prostate cancer.
SO - Eur J Cancer 2001 Oct;37 Suppl 7():S137-45
AD - The Institute of Cancer Research and The Royal Marsden NHS Trust, Academic Unit of Radiotherapy, Sutton, Surrey, UK.
UI - 11887986
AU - Sternberg CN
TI - Systemic treatment and new developments in advanced prostate cancer.
SO - Eur J Cancer 2001 Oct;37 Suppl 7():S147-57
AD - Vincenzo Pansadoro Foundation, Clinic Pio XI, Rome, Italy.
UI - 11528175
AU - Hoznek A; Salomon L; Olsson LE; Antiphon P; Saint F; Cicco A; Chopin D;
TI - Abbou CC Laparoscopic radical prostatectomy. The Creteil experience.
SO - Eur Urol 2001 Jul;40(1):38-45
AD - Service d'Urologie, CHU Henri-Mondor, 51 Av. de Ml. de Lattre de Tassigny, F-94010 Creteil, France. email@example.com
OBJECTIVES: In an effort to reduce the morbidity associated to radical prostatectomy, we implemented laparoscopic surgery to this advanced ablative and reconstructive procedure. In our study, we describe our operative technique and assess our results in terms of oncologic cure, continence and potency. METHODS: 200 patients with clinically localized prostate cancer underwent laparoscopic radical prostatectomy. 66 of these patients were either referred, or operated during surgical demonstrations. Thus, complete evaluation is based on a homogeneous personal series of 134 patients and was performed by an independent clinical analyst. There were 91 T1 and 43 T2. We did not perform pelvic lymph node excision in 78 patients whose PSA was less than 10 ng/ml and the Gleason score of endorectal biopsies was below 7. The surgical procedure recapitulated the steps of traditional retropubic prostatectomy with one basic difference however: the first step of the technique consisted in a rectoprostatic cleavage, which was done transperitoneally. Except for the first 10 patients, the vesicourethral reconstruction was performed either with two hemi-circumferential or a single circumferential running suture. RESULTS: All interventions were performed as planned, no conversions were necessary, and only 4 patients required blood transfusion. Operating time decreased with growing experience; after the first 20 patients the usual operating time was 3.5 h without and 4 h with lymphadenectomy. The surgical complication rate was 22.5% in the first 40 patients, and 3.2% in the remaining 94 patients. Except for the first 10 patients, the mean hospital stay was 6.1 days and bladder catheterization 4.8 days. Median catheterization time was 4 days. Histological study of the specimen showed pT2 disease in 101 patients and pT3 in 33 patients, the rate of positive margins was 16.8 and 48.8%, respectively. At 1 year, overall erection rate (with or without sexual intercourse) was 56%, the rate of patients without pad was 86.2% during the day and 100% during the night. CONCLUSIONS: Laparoscopic environment seems to comply with the oncologic goals of radical prostatectomy. Improved intraoperative visualization and magnification may provide benefits for the preservation of continence and potency by allowing a more precise dissection and vesicourethral reconstruction. Despite longer operative times and the steep learning curve this new technique is currently proliferating due to expectations of decreased postoperative morbidity and better quality of life.
UI - 11528176
AU - Turk I; Deger S; Winkelmann B; Schonberger B; Loening SA
TI - Laparoscopic radical prostatectomy. Technical aspects and experience with 125 cases.
SO - Eur Urol 2001 Jul;40(1):46-52; discussion 53
AD - Department of Urology, Charite Hospital, Medical School of the Humboldt University, Schumannstrasse 20/21, D-10177 Berlin, Germany. firstname.lastname@example.org
PURPOSE: The laparoscopic access for radical prostatectomy offers an alternative to the open surgical procedure with less morbidity. We report on our experience with 125 laparoscopic prostatectomies, especially with respect to making the laparoscopic approach a routine procedure and with a view to the oncological and functional results. laparoscopic prostatectomies. These included only patients with cancer stages T1 or T2. The mean PSA concentration was 10.5 ng/ml. Forty-four percent of the patients had undergone previous abdominal and 19% previous transurethral surgery. For our laparoscopic prostatectomies we used the descending technique. Free-hand laparoscopic suturing and in situ knot-tying technique were used for the urethrovesical anastomosis. The mobilized specimens were removed in an endobag via a muscle splitting incision. RESULTS: All 125 procedures could be completed successfully. No case required conversion to open surgery. The average operating time was 255 min, the last 40 procedures taking 200 min only. Mean blood loss was 185 ml. Two patients (2%) required postoperative blood transfusion. After an initial learning curve, catheter remained in place for an average of 5.5 days, and the average postoperative stay in hospital was 8 days. Intraoperative complications were seen in 5 patients (4%). In 13 patients (10.4%) postoperative complications were observed. 86% of the patients are continent 6 months postoperatively. Preservation of the neurovascular bundle and sexual potency is possible. CONCLUSION: Laparoscopic radical prostatectomy is an ambitious procedure with a steep learning curve, especially for the laparoscopic dissecting and suturing technique. The excellent sight for dissection results in a reduced blood loss and faster convalescence with an overall lower morbidity. Also with regard to oncological and functional (continence) results the minimally invasive access is at least equivalent to the open procedure. In our opinion, laparoscopic prostatectomy will be the future method of choice for radical prostatectomy.
UI - 11528177
AU - Rassweiler J; Sentker L; Seemann O; Hatzinger M; Stock C; Frede T
TI - Heilbronn laparoscopic radical prostatectomy. Technique and results after 100 cases.
SO - Eur Urol 2001 Jul;40(1):54-64
AD - Department of Urology, Klinikum Heilbronn, University of Heidelberg, Am Gesundbrennen 20, D-47074 Heilbronn, Germany. email@example.com
INTRODUCTION: In 1999, Guillonneau and Vallancien presented a refined approach of a descending laparoscopic radical prostatectomy which based mainly on the primary access to the seminal vesicles and an improved suturing and knotting technique. Based on our own experience reconstructive laparoscopy as well as with open retropubic radical prostatectomy we have used a combined ascending/descending technique similar to open surgery. In this paper we want to describe our approach and to present the initial results with the Heilbronn technique. MATERIALS AND METHODS: A transperitoneal approach is used with a W-shaped arrangement of the trocars (13-mm umbilical port, 2 x 10 mm medial, 2 x 5 mm lateral ports). After the exposure of the Retzius' space and control of the dorsal vein complex the urethra is incised and the distal pedicles of the prostate (+/- the neurovascular bundle) are transsected. We now pull the apex ventrally and start with the incision at the bladder neck followed by a transvesical access to both vasa deferentia and seminal vesicles. The gland is entrapped in the Extraction Bag. After accomplishing the posterior wall of the urethrovesical anastomosis with five interrupted sutures, the foley catheter is placed into the bladder and the bladder neck is closed. Now tumors). The mean preoperative PSA was 26.8 (1.4-75.5) ng/ml. Two tumors were grade 1, 72 grade 2 and 26 grade 3. Median Gleason score was 6 (3-9). All specimen were inked and examined according to the Stanford protocol. Postoperative continence was evaluated using a questionnaire monitored by a colleague who was involved in surgery. RESULTS: We had 5 conversions (rectal injury, difficult dissection, adhesion, 2x bleeding at the dorsal vein complex). The mean operating time was 278 (180-500) min., the transfusion rate 31%. One patient required reintervention due to bleeding from the right obturator fossa. 95% of the patients did not require any analgesia on the second postoperative day. Positive margins were found in 17% of the patients, of which 12 had a PSA nadir to a value of less than 0.1 ng/ml within 3 weeks after surgery. In 82 patients, the anastomosis was tight after removal of the catheter, median catheter time was 8 (6-30) days. 4% developed a stricture at the anastomotic site which could be treated by laser incision. On discharge 33% were continent, after 6 months 81%, whereas only 2 patients still suffer from grade II stress incontinence at 9 months. CONCLUSIONS: Laparoscopic radical prostatectomy is feasible but requires laparoscopic expertise. Its learning curve is still ongoing. Morbidity is low, oncological control is similar to results of open surgery, functional results are promising.
UI - 11528178
AU - Bollens R; Vanden Bossche M; Roumeguere T; Damoun A; Ekane S; Hoffmann
TI - P; Zlotta AR; Schulman CC Extraperitoneal laparoscopic radical prostatectomy. Results after 50 cases.
SO - Eur Urol 2001 Jul;40(1):65-9
AD - Department of Urology, Erasme Hospital, University Clinics of Brussels, Route de Lennik, 808, B-1070 Brussels, Belgium.
INTRODUCTION: After an initial experience using transperitoneal laparoscopic radical prostatectomy as described by Vallancien and Guillonneau, we developed a pure extraperitoneal approach. This approach seems more comparable to the open technique and avoid potential risks of specific complications due to the transperitoneal approach. We evaluated the perioperative parameters (blood loss, operating time, transfusion rate) and postoperative results (oncological results, continence and potency) after our first 50 cases. MATERIAL AND METHOD: Between prostatectomy. On average, patients were 63.3 years old (range 47-71), had preoperative mean PSA values of 9.14 ng/ml (1.1-23). Median Gleason score was 6 (4-10) with 2.5 (1-6) positive biopsies for a mean prostate volume of 40 cm(3) (17.5-95.0). Clinical stage was T1, T2a, T2b and T3 in 46.3, 41.5, 9.8 and 2.4% of the cases, respectively. We used a pure extraperitoneal approach and we performed a descending technique starting with the dissection at the bladder neck. The seminal vesicles dissection is comparable to the open approach. RESULTS: 42 extraperitoneal and 8 transperitoneal procedures were performed (2 in the initial experience, 3 because of previous abdominal surgery and 3 because of incidental peritoneal opening). Mean operative time was 317 min, mean blood loss 680 cm(3), transfusion rate of 13%. 1 patient/50 was converted to an open procedure. Pathological stage was pT1a, pT2a, pT2b, pT2c, pT3a and pT3b in 2.2, 8.5, 42.5, 2.2, 34 and 10.6% of cases, respectively. Positive surgical margins were observed in 22% of cases. The potency rate after neurovascular bilateral bundle preservation was 43% at 3 months (n = 7) and 67% at 6 months and (n = 6) without any further treatment. The continence rate (no pad) was 39% at 3 months and 85% at 6 months. Detectable postoperative PSA at 3 month was observed in 2 patients only. Two major complications occurred: one acute transient renal failure one uretrorectal fistula at day 20. CONCLUSIONS: The extraperitoneal laparoscopic radical prostatectomy results seem comparable to transperitoneal laparoscopic radical prostatectomy or open surgery. This approach is reproducible and seems to avoid the potential risks of intraperitoneal injury. Long-term follow up and comparative series are however necessary to further evaluate these new techniques.
UI - 11528179
AU - Pasticier G; Rietbergen JB; Guillonneau B; Fromont G; Menon M;
TI - Vallancien G Robotically assisted laparoscopic radical prostatectomy: feasibility study in men.
SO - Eur Urol 2001 Jul;40(1):70-4
AD - Department of Urology, Institut Mutualiste Montsouris, University Pierre and Marie Curie, 42 Boulevard Jourdan, F-75014 Paris, France.
PURPOSE: We report our early experience of robotically assisted laparoscopic radical prostatectomy. MATERIAL AND METHODS: Five consecutive patients, with an average age of 58 years, PSA 12, 1.6 positive biopsies, Gleason score 6, were operated in our institution over a period of 1 week by the same surgeon. A robotically assisted laparoscopic nerve sparing radical prostatectomy was performed according to the Montsouris technique with the Da Vinci robot (Intuitive Inc., Mountain View, Calif., USA). RESULTS: The mean installation time was 93 min (range 76-149). The mean operating time (starting at the dissection of the seminal vesicles until the final stitch of the anastomosis) was 222 min (range 150-381 min). The average blood loss was 800 cm(3) (range 700-1,600 cm(3)). No postoperative complications were seen. Bladder catheter time: 6.5 days, hospital stay 5.5 days, urine leak 1/5, continence 4/5, positive margin 1/5. CONCLUSION: After this short experience, we conclude that: The use of a tele manipulation system accompanied by a three-dimensional view of the operating field provides a real benefit for the surgeon, and the urethro-anastomosis is easier to perform. The benefit for the patient is presently not very clear in terms of operating time, postoperative course and functional results, our initial results show that the robotically assisted procedure is at least as safe and effective as the conventional laparoscopic procedure.
UI - 11528180
AU - Rassweiler J; Frede T; Seemann O; Stock C; Sentker L
TI - Telesurgical laparoscopic radical prostatectomy. Initial experience.
SO - Eur Urol 2001 Jul;40(1):75-83
AD - Department of Urology, Klinikum Heilbronn, Am Gesundbrennen 20, D-74074 Heilbronn, Germany. firstname.lastname@example.org
INTRODUCTION: Telepresence surgery offers theoretically to overcome two main problems of laparoscopic surgery, i.e. the limitation to only four degrees of freedom and the lack of stereovision. Since 1998, telesurgical minimally invasive procedures have been performed with the da Vinci system mainly for cardiac bypass surgery. Clinical experience in urology is still very limited. We want to present our initial experience using the device for robot-assisted laparoscopic radical prostatectomy. MATERIAL AND METHODS: The Intuitive surgical system consists of two main components: the surgeon's viewing and control console with 3D imaging and the surgical arm unit that positions and maneuvers detachable surgical instruments. These instruments introduced via two 8-mm trocars allow movements in all 6 degrees of freedom due to the EndoWrist technology. The surgeon performs the procedure seated at the console holding specially designed instruments. Highly specialized computer software and mechanics transfer the surgeon's hand movements exactly to the microsurgical movements of the manipulators at the operative site. We have used a semilunar-shaped 5-trocar arrangement with the robot's arms at the lateral trocars and two assistant trocars medially. A sixth trocar was used in the right suprapubic area for retraction of the gland. The left assistant used different instruments such as bipolar forceps, Ultracision, Endoclip, whereas the right assistant mainly used the suction-irrigation device. Except the first case, the Intuitive System was attached after exposure of Retzius' space. RESULTS: We have treated 6 patients (2 pT2, 4 pT3, median Gleason score 6). The OR time averaged 315 (242-480) min including pelvic lymph node dissection. No intraoperative complications occurred, 1 patient required transfusions. There were no positive margins, median catheter time was 5 days. 3 patients were completely continent after 1 month. CONCLUSION: Telerobotic laparoscopic surgery offers several advantages over all presently available techniques, such as all six degrees of freedom, dexterity enhancement, tremor filtering, and stereovision. There is a learning curve with the device, mainly because of the magnification, the 3D image and the lack of tactile feedback. However, only after a short period of time, the experienced surgeon is able to get familiar with the device. However, there are still concerns with respect to the high investment and running costs of the device as well as regarding the necessity of further developments of instruments for urological procedures.
UI - 11998038
AU - Grumet SC; Bruner DW
TI - The identification and screening of men at high risk for developing prostate cancer.
SO - Urol Nurs 2000 Feb;20(1):15-8, 23-4, 46
AD - Englewood-Mount Sinai Cancer Risk Assessment and Counselling Program, Mount Sinai School of Medicine/Englewood Hospital and Medical Center, Englewood, NJ, USA.
It is estimated that the lifetime risk of being diagnosed with prostate cancer is 1 in 5. The identification of risk factors, including age, African-American ancestry, family history, and possibly diet and environmental factors, has allowed health care professionals the opportunity to identify, screen, and study men at the greatest risk of developing prostate cancer. The risk factors, current screening tools, and the informed consent process for men participating in a prostate cancer screening program are outlined.
UI - 11998041
AU - Amerine E; Nagle GM; Bollinger JR
TI - Sowing seeds: transperineal implantation.
SO - Urol Nurs 2000 Feb;20(1):47-53
Prostate cancer, the second leading cause of male deaths in the United States, has increased by 126% since 1987 (Stephenson, 1998). Early diagnosis is attributed to public awareness and technologic advances. Multiple options for definitive treatment with equally positive outcomes dramatically influence the patient's decision-making process. One popular option for these patients is transperineal implantation of radioactive seeds into the prostate.
UI - 12018929
AU - Hellerstedt BA; Pienta KJ
TI - The current state of hormonal therapy for prostate cancer.
SO - CA Cancer J Clin 2002 May-Jun;52(3):154-79
AD - Division of Hematology and Oncology, University of Michigan Medical Center, Ann Arbor, USA.
Androgen deprivation therapy remains a mainstay of treatment for men with prostate cancer. New uses for hormonal therapy, including use in the adjuvant and neoadjuvant setting, are being evaluated. Prevention of the side effects of therapy has led to the development of alternative schedules and therapeutics.
UI - 12018801
AU - Foxhall LE; Von Eschenbach AC
TI - Counseling patients about prostate cancer screening.
SO - Am Fam Physician 2002 May 1;65(9):1752, 1754, 1757
UI - 11077903
AU - Nijs HG; Essink-Bot ML; DeKoning HJ; Kirkels WJ; Schroder FH
TI - Why do men refuse or attend population-based screening for prostate cancer?
SO - J Public Health Med 2000 Sep;22(3):312-6
AD - Department of Health Promotion, Municipal Health Services Rotterdam Area, The Netherlands. email@example.com
BACKGROUND: The aims of this study were to investigate the motives for refusing or attending population-based screening for prostate cancer, in relation to various background characteristics. METHODS: The present study is part of the European Randomized Study of Screening for Prostate Cancer (ERSPC), and took place in 1995-1996. Men aged 55-75 years were invited using the Rotterdam population registry (100 per cent coverage), of whom 42 per cent gave written informed consent. These men were randomized to receive either determination of prostate specific antigen (PSA), digital rectal examination (DRE), transrectal ultrasound (TRUS) and biopsy on indication (screening group), or no screening (control group). To 626 consecutive men of the screening group a questionnaire was sent before the screening. To 500 randomly selected refusers (no written informed consent) a similar questionnaire was sent, followed by two reminders. In both refusers and attenders we addressed motives, knowledge of prostate cancer, attitudes towards screening, background characteristics and urological complaints (American Urological Association symptom index, AUA7). RESULTS: Response rates for questionnaires were 48 per cent in refusers and 99 per cent in attenders. Main reported motives for refusing were absence of urological complaints (57 per cent) and anticipated pain or discomfort (18 per cent). Main reported motives for attending were personal benefit (82 per cent), contribution to science (49 per cent) and presence of urological complaints (25 per cent). Compared with attenders, refusers were slightly and significantly older, less often married and had a lower level of education; they had less knowledge about prostate cancer and a less positive attitude towards screening; they had worse general health but fewer urological complaints (AUA7 median 2 versus 4, p < 0.001). CONCLUSION: In refusing or attending population-based prostate cancer screening, urological complaints but also knowledge, attitudes and sociodemographic factors seem to play a role. Therefore, the approach of the general population should be carefully considered.
UI - 12031385
AU - Walsh PC; Marschke PL
TI - Intussusception of the reconstructed bladder neck leads to earlier continence after radical prostatectomy.
SO - Urology 2002 Jun;59(6):934-8
AD - James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-2101, USA.
INTRODUCTION: Although there is no evidence that the reconstructed bladder neck actively contributes to post-radical prostatectomy continence, we set out to determine whether buttressing sutures, which prevent the bladder neck from pulling open as the bladder fills, would result in the earlier return of urinary control.TECHNICAL CONSIDERATIONS: Forty-five men (mean age 57 years, range 37 to 67) with clinical localized prostate cancer underwent anatomic radical retropubic prostatectomy with standard tennis racket bladder neck reconstruction. The bladder neck was then intussuscepted using two 2-0 Maxon Lembert sutures placed lateral and posterior to the reconstructed bladder neck. Filling of the bladder with saline at this point revealed little leakage. Patient-reported continence at 3 months was compared with the published outcome of 64 men using the same quality-of-life instrument (the UCLA Prostate Cancer Index). At 3 months, 82% of men who underwent intussusception of the bladder neck were continent (no pad/dry pad) compared with 54% in our prior report (P = 0.0035). The occurrence of bladder neck contracture was similar: 7% versus 5%. CONCLUSIONS: Intussusception of the bladder neck led to a significant improvement in urinary control at 3 months postoperatively. Longer follow-up will be necessary to determine whether this approach may eliminate the 2% probability of long-term significant problems with urinary control.
UI - 11967955
AU - Hour TC; Chen J; Huang CY; Guan JY; Lu SH; Pu YS
TI - Curcumin enhances cytotoxicity of chemotherapeutic agents in prostate cancer cells by inducing p21(WAF1/CIP1) and C/EBPbeta expressions and suppressing NF-kappaB activation.
SO - Prostate 2002 May 15;51(3):211-8
AD - Department of Urology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan, Republic of China.
BACKGROUND: The modulatory effects and molecular mechanisms of curcumin (CCM) on the cytotoxicity of chemotherapeutic agents to prostate cancer cells were explored. METHODS: The combined effects of CCM and chemotherapeutic agents were examined by three different administration schedules (one concurrent and two sequential treatments) in two androgen-independent prostate cancer (AIPC) cells (PC-3 and DU145). Alteration of cell cycle progression, protein levels, and transcriptional activation in PC-3 cells were assayed by flow cytometry, Western blotting, and gel shift assay, respectively. RESULTS: The combined effects of CCM --> chemotherapeutic agent schedule showed the greatest synergistic cytotoxicity when compared to the other two schedules in both cells. CCM induced a significant G1 arrest in PC-3, which may be mediated by the induction of p21(WAF1/CIP1) and C/EBPbeta. Moreover, CCM was able to inhibit both the constitutional and TNF-alpha-induced NF-kappaB activation in a time-dependent manner. CONCLUSIONS: The incorporation of CCM into cytotoxic therapies may be a promising strategy for the treatment of AIPC. Copyright 2002 Wiley-Liss, Inc.
UI - 11967956
AU - Suzuki H; Akakura K; Komiya A; Ueda T; Imamoto T; Furuya Y; Ichikawa T;
TI - Watanabe M; Shiraishi T; Ito H CAG polymorphic repeat lengths in androgen receptor gene among Japanese prostate cancer patients: potential predictor of prognosis after endocrine therapy.
SO - Prostate 2002 May 15;51(3):219-24
AD - Department of Urology, Graduate School of Medicine, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan. firstname.lastname@example.org
BACKGROUND: Several investigators have examined the clinical significance of the length of the CAG repeat at the N-terminal region of the androgen receptor in the pathogenesis of prostate cancer. Because the clinical significance of CAG repeat length during the course of prostate cancer in Japanese patients is unknown, the present study analyzed CAG repeat length in relation to several potential clinical factors. MATERIALS AND METHODS: A total of 88 Japanese patients with prostate cancer and a control group of 53 patients with benign prostatic disease were enrolled in this study. The length of the CAG repeat was determined by PCR sequencing and analyzed in relation to several clinical factors. RESULTS: The length of the CAG repeat did not significantly differ between prostate cancer and benign prostatic disease. Although not statistically different with regard to clinical stage and serum PSA level, the CAG repeat length was associated with histological grade and age at diagnosis. In addition, the CAG repeat length in CR and in non CR patients significantly differed at 22.1 +/- 2.4 and 24.4 +/- 3.0, respectively (P = 0.0264), suggesting that the CAG repeat length can act as a molecular marker with which to predict response to endocrine therapy in stage D prostate cancer patients. CONCLUSIONS: A shorter CAG repeat length appears to predict a response to endocrine therapy, showing a positive prognostic value and indicating good prognosis in the metastatic stage of prostate cancer patients. Copyright 2002 Wiley-Liss, Inc.
UI - 11814468
AU - Usui S; Suzuki K; Yamanaka H; Nakano T; Nakajima K; Hara Y; Okazaki M
TI - Estrogen treatment of prostate cancer increases triglycerides in lipoproteins as demonstrated by HPLC and immunoseparation techniques.
SO - Clin Chim Acta 2002 Mar;317(1-2):133-43
AD - Department of Biochemistry and Biophysics, Graduate School of Allied Health Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Tokyo 113-8519, Bunkyo, Japan.
BACKGROUND: Estrogen administration is known to increase serum triglyceride concentrations. This study measured changes in lipoproteins of patients with prostate cancer treated with estrogen to determine whether the increased triglyceride concentrations are associated with atherogenic lipoprotein patterns. METHODS: Fifteen patients (52-87 years) with histologically diagnosed prostate cancer received diethylstilbestrol diphosphate (250 mg/day). Serum samples were collected before and after 1 and 2 weeks of treatment. Cholesterol and triglyceride profiles of major lipoproteins were determined by HPLC, remnant-like particle cholesterol and triglyceride concentrations by an immunoseparation technique, and apolipoproteins by immunologic methods. RESULTS: Estrogen treatment induced a 63.3% increase in total triglyceride concentrations, which occurred in all major lipoprotein classes with significant increases in HDL-triglycerides (130.4%), LDL-triglycerides (60.7%) and VLDL-triglycerides (56.2%). HDL-cholesterol increased significantly by 26.8%, while LDL-cholesterol decreased (15.6%). Remnant-like particle triglyceride concentrations also increased significantly by 77%, whereas remnant-like particle cholesterol concentrations remained unchanged. Apolipoproteins A-I and A-II increased; apolipoprotein E and Lp(a) decreased. CONCLUSIONS: The techniques used here conveniently demonstrated that short-term estrogen treatment in prostate cancer patients resulted in triglyceride enrichment of all major lipoprotein classes but did not induce changes in the lipoprotein profiles generally recognized as increasing risk for cardiovascular disease, except for the elevation of plasma triglyceride and remnant-like particle triglyceride.
UI - 11889683
AU - Gholz RC; Conde F; Rutledge DN
TI - Osteoporosis in men treated with androgen suppression therapy for prostate cancer.
SO - Clin J Oncol Nurs 2002 Mar-Apr;6(2):88-93
Men with advanced or metastatic prostate cancer commonly receive long-term treatment with luteinizing hormone-releasing hormone (LHRH) agonist therapy. This prolonged treatment causes a hypogonadal state of chronic testosterone deficiency. Similar to estrogen deficiency in postmenopausal women, testosterone deficiency among these men negatively affects bone metabolism through a complex self-regulating, negative feedback system and subsequent reduction in bone formation. If left undetected or untreated, the risk for osteoporosis rises. Osteoporosis increases the likelihood of fracture, especially of the hips. Researchers are studying the effects of LHRH agonist therapy on osteoporosis and other related conditions to determine whether interventions, such as pharmacologic agents (e.g., bisphosphonates), dietary supplements (e.g., calcium, vitamin D), and exercise, can slow or prevent the process and assist healthcare providers in knowing how to counsel patients. Current recommendations are found in the literature on glucocorticoid-induced and menopausal osteoporosis. Nurses need to stay abreast of current knowledge in this area, as it is expanding rapidly.
UI - 11905682
AU - Neal DE; Donovan JL
TI - Prostate cancer: to screen or not to screen?
SO - Lancet Oncol 2000 Sep;1(1):17-24
AD - School of Surgical Sciences, Medical School, University of Newcastle upon Tyne, UK. email@example.com
The aim of screening is to identify cancers that are potentially curable; before a programme can be introduced, it must satisfy the requirement that it does more good than harm, particularly in terms of survival and quality of life. Prostate cancer is a common disease in older men and presents a significant burden to health services. Prostatic tumours range from small slow-growing lesions to aggressive tumours that metastasise rapidly, but because the natural history of prostate cancer is poorly understood, there is controversy about which screen-detected lesions will become clinically significant. Current methods of screening involve measurement of serum prostate specific antigen, followed by transrectal ultrasound scanning and biopsy, but these lack adequate specificity and sensitivity. There are three major treatment options for localised disease: radical prostatectomy, radical radiotherapy, and monitoring with treatment if required. There is no randomised controlled trial evidence to suggest a survival advantage of any of these treatments, and each has risks. There is intense speculation about future developments in diagnostic testing, molecular markers of progression, and early chemoprevention, but the central question that remains is whether radical treatments can improve survival and quality of life.
UI - 10344219
AU - Simmons SJ; Tjoa BA; Rogers M; Elgamal A; Kenny GM; Ragde H; Troychak
TI - MJ; Boynton AL; Murphy GP GM-CSF as a systemic adjuvant in a phase II prostate cancer vaccine trial.
SO - Prostate 1999 Jun 1;39(4):291-7
AD - Cancer Research Division, Pacific Northwest Cancer Foundation, Northwest Hospital, Seattle, Washington 98125, USA.
BACKGROUND: Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF; Leukine [sargramostim], Immunex Corp., Seattle, WA) was administered to a subgroup of 44 patients in a phase II clinical trial for prostate cancer using DC pulsed with HLA-A2-specific prostate-specific membrane antigen (PSMA) peptides. Our purpose was to determine if GM-CSF caused any enhancement of patients' immune responses, including enhancement of clinical response to the DC-peptide treatment. This report compares the clinical responses to DC-peptide infusions with and without systemic GM-CSF treatment. METHODS: GM-CSF was administered by subcutaneous injection at a dose of 75 microg/m2/day for 7 days with each of six infusion cycles. Prefilled syringes were supplied to the patients for self-administration. RESULTS: One complete and 8 partial responders were identified among 44 patients who received GM-CSF, as compared to 2 complete and 17 partial responders among 51 patients who did not receive GM-CSF. For patients who received GM-CSF and were tested by delayed-type hypersensitivity (DTH) skin test, 3 cases of improved immune response were identified, compared to 5 cases of improvement in patients who did not receive GM-CSF. The main GM-CSF side effects reported were local reactions at the site of injection, fatigue, pain, and fever. Most reported side effects were of mild severity, with some cases of moderate severity leading to discontinuation of GM-CSF. CONCLUSIONS: Our results suggest GM-CSF as employed in this trial did not detectably enhance clinical response to DC-peptide infusions, or significantly enhance the measured immune response.
UI - 10996633
AU - Tjoa BA; Murphy GP
TI - Development of dendritic-cell based prostate cancer vaccine.
SO - Immunol Lett 2000 Sep 15;74(1):87-93
AD - Pacific Northwest Cancer Foundation, 13758 Lake City Way NE, Suite 200, Seattle, WA 98125, USA. firstname.lastname@example.org
Available treatments for metastatic prostate cancer have failed to demonstrate significant curative potential. Current efforts are now directed towards developments of novel strategies for the treatment of metastatic prostate cancer. Cancer immunotherapeutic strategies utilize patient immune system components to kill cancer cells. This review discusses progress in active specific immunotherapeutic approaches as potential alternative methods in the treatment of metastatic prostate cancer. One of the newest advances in cancer immunotherapy is the use of dendritic cells as the vehicle to deliver cancer antigens for an effective in vivo T cell activation. The development of dendritic cell-based prostate cancer vaccine, as well as results of several clinical trials in prostate cancer involving the administration of peptide-pulsed autologous dendritic cell pulsed are discussed.
UI - 11905798
AU - Duchesne GM
TI - Radiation for prostate cancer.
SO - Lancet Oncol 2001 Feb;2(2):73-81
AD - Monash University, Melbourne, Australia. email@example.com
The balance between tumour control and normal tissue damage with conventional radiotherapy is critical to outcome and morbidity in the treatment of localised prostate cancer. Recent technological advances have allowed a reduction in the amount of normal tissue included in target treatment volumes. This reduces morbidity and allows dose escalation, theoretically increasing the likelihood of tumour control. The methods used to achieve dose escalation are discussed and the available evidence for their safety and efficacy, relative to conventional treatment, is reviewed. Although there are no randomised studies to provide evidence of increased survival, the available evidence supports the hypothesis that dose escalation produces survival rates equivalent to surgical series and provides a realistic choice for patients.
UI - 11958585
AU - Feleppa EJ; Ennis RD; Schiff PB; Wuu CS; Kalisz A; Ketterling J; Urban
TI - S; Liu T; Fair WR; Porter CR; Gillespie JR Spectrum-analysis and neural networks for imaging to detect and treat prostate cancer.
SO - Ultrason Imaging 2001 Jul;23(3):135-46
AD - Biomedical Engineering Laboratories, Riverside Research Institute, New York, NY 10038, USA. firstname.lastname@example.org
Conventional B-mode ultrasound currently is the standard means of imaging the prostate for guiding prostate biopsies and planning brachytherapy to treat prostate cancer. Yet B-mode images do not adequately display cancerous lesions of the prostate. Ultrasonic tissue-type imaging based on spectrum analysis of radiofrequency (rf) echo signals has shown promise for overcoming the limitations of B-mode imaging for visualizing prostate tumors. This method of tissue-type imaging utilizes nonlinear classifiers, such as neural networks, to classify tissue based on values of spectral parameter and clinical variables. Two- and three-dimensional images based on these methods demonstrate potential for guiding prostate biopsies and targeting radiotherapy of prostate cancer. Two-dimensional images are being generated in real time in ultrasound scanners used for real-time biopsy guidance and have been incorporated into commercial dosimetry software used for brachytherapy planning. Three-dimensional renderings show promise for depicting locations and volumes of cancer foci for disease evaluation to assist staging and treatment planning, and potentially for registration or fusion with CT images for targeting external-beam radiotherapy.
UI - 12001138
AU - Koot RW; Maarouf M; Hulshof MC; Voges J; Treuer H; Koedooder C; Sturm V;
TI - Bosch AD Analysis of the recurrence in relation to the plannings target volume (PTV) for brachytherapy or external beam radiation therapy (EBRT).
SO - Cancer 2002 Apr 15;94(8):2316-7
UI - 11911282
AU - Lin X; Switzer BR; Demark-Wahnefried W
TI - Effect of mammalian lignans on the growth of prostate cancer cell lines.
SO - Anticancer Res 2001 Nov-Dec;21(6A):3995-9
AD - Division of Urologic Surgery, Duke University Medical Center, Durham, NC 27710, USA. email@example.com
BACKGROUND: Mammalian lignans, enterolactone (EL) and enterodiol (ED), have been shown to inhibit breast and colon carcinoma. To date, there have been no reports of the effect of lignans on prostatic carcinoma. We investigated the effects of ED and EL on three human prostate cancer cell lines (PC-3, DU-145 and LNCaP). MATERIALS AND METHODS: Cells were treated with either 0.1% (v/v) DMSO (vehicle) or 10-100 microM of EL, ED or genistein (positive control) for 72 hours. Cell viability was measured by the propidium iodide nuclei staining fluorometric assay with each assay performed in triplicate. RESULTS: At 10-100 microM, EL significantly inhibited the growth of all cell lines, whereas ED only inhibited PC-3 and LNCaP cells. While EL was a more potent growth inhibitor than ED, both were less potent than genistein. The dose for 50% growth inhibition of LNCaP cells (IC50) by EL was 57 microM, whereas IC50 was 100 microM for ED, (the observed IC50 for genistein was 25 microM). CONCLUSION: ED and EL suppress the growth of prostate cancer cells, and may do so via hormonally-dependent and independent mechanisms.
UI - 12023128
AU - Huang E; Dong L; Chandra A; Kuban DA; Rosen II; Evans A; Pollack A
TI - Intrafraction prostate motion during IMRT for prostate cancer.
SO - Int J Radiat Oncol Biol Phys 2002 Jun 1;53(2):261-8
AD - Division of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA.
PURPOSE: Although the interfraction motion of the prostate has been previously studied through the use of fiducial markers, CT scans, and ultrasound-based systems, intrafraction motion is not well documented. In this report, the B-mode, Acquisition, and Targeting (BAT) ultrasound system w