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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Prostate Cancer - September 2002
National Cancer Institute®
Last Modified: September 1, 2002
- Nomograms for clinically localized prostate cancer. Part I: radical prostatectomy.
- Nomograms for clinically localized prostate cancer. Part II: radiation therapy.
- Nomograms for clinically localized disease. Part III: watchful waiting.
- Outcome predictions for patients with metastatic prostate cancer.
- New tactics shorten hospital stays for prostate patients.
- [Competitive morbidity ant its impact on life expectancy: evaluation and inclusion in the therapeutic decision regarding localized prostatic
- [Brain metastasis of prostatic cancer: regression under hormonal treatment]
- Long-term effects of androgen deprivation therapy in prostate cancer patients.
- Prostate cancer and selenium.
- Gene therapy of prostate cancer: current and future directions.
- Vitamin A and apoptosis in prostate cancer.
- Comparing contemporary surgery to external-beam radiotherapy for clinically localized prostate cancer.
- Randomized study of three different doses of suramin administered with a fixed dosing schedule in patients with advanced prostate cancer: results
- Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution
- [Standards, options and recommendations for the management of prostate cancer: therapeutic decision criteria]
- Predicting prostate-specific antigen recurrence established: now, who will survive?
- Radical radiation for localized prostate cancer: local persistence of disease results in a late wave of metastases.
- International validation of a preoperative nomogram for prostate cancer recurrence after radical prostatectomy.
- Introduction. Recent scientific and technological advances have challenged the traditional treatment options for patients with localized
- Quality of life and sexuality of men with prostate cancer 3 years after cryosurgery.
- Prostate cryoablation: a scientific rationale for future modifications.
- Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer.
- Cryosurgery as primary treatment for localized prostate cancer: a community hospital experience.
- Conformal photon-beam radiotherapy of prostate carcinoma.
- Can diet affect prostate cancer?
- Urodynamic findings 3 months after radiotherapy in patients treated with conformal external beam radiotherapy for prostate carcinoma.
- Single-therapy androgen suppression in men with advanced prostate cancer: a systematic review and meta-analysis.
- Hormonal therapy for advanced prostate cancer.
- Analysis of biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer using dose-distribution variables and tumor
- The development of erectile dysfunction in men treated for prostate cancer.
- Neoadjuvant hormonal ablative therapy before radical prostatectomy: a review. Is it indicated?
- Medical versus surgical androgen suppression therapy for prostate cancer: a 10-year longitudinal cost study.
- Intravesical pressure and the TUR syndrome.
- Larry Clark's legacy: randomized controlled, selenium-based prostate cancer chemoprevention trials.
- Laparoscopic radical prostatectomy: initial cases at Okayama University Hospital.
- Ribozyme-targeting of a secreted FGF-binding protein (FGF-BP) inhibits proliferation of prostate cancer cells in vitro and in vivo.
- System for robotically assisted prostate biopsy and therapy with intraoperative CT guidance.
- Phase I trial of oral estramustine and 3-hr infusional paclitaxel for the treatment of hormone refractory prostate cancer.
- Estramustine plus a taxane for advanced prostate cancer: the new standard therapy?
- Cancer flourishes.
- Prostate cancer screening.
- Use of prostate-specific antigen for prostate cancer screening in primary care practice.
- A preliminary report on a patient-preference study to compare treatment options in early prostate cancer.
- Is 'watchful waiting' a real choice for men with prostate cancer? A qualitative study.
- Modulation of heat-induced cell death in PC-3 prostate cancer cells by the antioxidant inhibitor diethyldithiocarbamate.
- [Second cancer after starting treatment for prostate cancer]
- Radiosensitivity with Par-4 expression in prostate cancer.
- Incidence, etiology, and therapy for erectile dysfunction after external beam radiotherapy for prostate cancer.
- Permanent prostate brachytherapy-induced morbidity in patients with grade II and III obesity.
- Focal "nerve-sparing" cryosurgery for treatment of primary prostate cancer: a new approach to preserving potency.
- Can combined androgen blockade provide long-term control or possible cure of localized prostate cancer?
- Clinical predictors of androgen-independent prostate cancer and survival in the prostate-specific antigen era.
- Smiley incision: a direct surgical approach for retropubic radical prostatectomy.
- Interstitial thermal therapy in patients with localized prostate cancer: histologic analysis.
- Biochemical outcome for hormone-naive patients with Gleason score 3+4 versus 4+3 prostate cancer undergoing permanent prostate brachytherapy.
- Leuprorelin acetate in prostate cancer: a European update.
- An investigation into the use of palliative care services by patients with prostate cancer.
- Alpha1-adrenoceptor antagonists radiosensitize prostate cancer cells via apoptosis induction.
- Medical or surgical orchidectomy.
- Technology evaluation: APC-8015, Dendreon.
- Primary malignant lymphoma of the prostate--a report of three cases.
- Doxorubicin enhances TRAIL-induced apoptosis in prostate cancer.
- Early surgical results with intent to treat by radical retropubic prostatectomy for clinically localized prostate cancer.
- SWOG-9510: evaluation of topotecan in hormone refractory prostate cancer: a Southwest Oncology Group study.
- Inhibition of NF-kappaB, clonogenicity, and radiosensitivity of human cancer cells.
- Tumor necrosis factor-alpha-induced apoptosis in prostate cancer cells through inhibition of nuclear factor-kappaB by an IkappaBalpha
- COX-2 specific inhibitor, NS-398, increases macrophage migration inhibitory factor expression and induces neuroendocrine differentiation
- Silibinin inhibits constitutive and TNFalpha-induced activation of NF-kappaB and sensitizes human prostate carcinoma DU145 cells to
- Par-4, a pro-apoptotic gene, inhibits radiation-induced NF kappa B activity and Bcl-2 expression leading to induction of radiosensitivity
- Serum testosterone suppression and potential for agonistic stimulation during chronic treatment with monthly and 3-month depot formulations of
- Impact of previous local treatment for prostate cancer on subsequent metastatic disease.
- Prostate brachytherapy seed migration to a coronary artery found during angiography.
- A clinical study of 22.5 mg. La-2550: A new subcutaneous depot delivery system for leuprolide acetate for the treatment of prostate cancer.
- Prognostic significance of the nadir prostate specific antigen level after hormone therapy for prostate cancer.
- Diet and trend in prostate-specific antigen: inferences for prostate cancer risk.
- Lack of effect of a low-fat, high-fruit, -vegetable, and -fiber diet on serum prostate-specific antigen of men without prostate cancer: results
- Redbook and PSA testing.
- Prostate cancer update.
- A randomized trial comparing radical prostatectomy with watchful waiting in early prostate cancer.
- Quality of life after radical prostatectomy or watchful waiting.
- Surgery and the reduction of mortality from prostate cancer.
- Prostate cancer update.
- Improved prostate cancer treatment.
- [Nadir PSA and kinetics of PSA decline between the 3rd and 6th month after external beam radiotherapy for T1 T2 Nx M0 localized prostate
- [Prognostic factors of prostate cancer treated with first-line hormone therapy]
- [Study of intermittent endocrine therapy in patients presenting with biologic recurrence after radical prostatectomy or radiotherapy]
- [A rare entity: cystadenoma of the prostate]
- Survival of docetaxel-resistant prostate cancer cells in vitro depends on phenotype alterations and continuity of drug exposure.
- Lung embolization of prostate cancer brachiotherapy seeds: incidental finding during left heart catheterization.
- Post-nerve-sparing prostatectomy, dose-escalated intensity-modulated radiotherapy: effect on erectile function.
- Pathologic evidence of dose-response and dose-volume relationships for prostate cancer treated with combined external beam radiotherapy and
- Phase III study of ibuprofen versus placebo for radiation-induced genitourinary side effects.
- Early clinical experience with anatomy-based inverse planning dose optimization for high-dose-rate boost of the prostate.
- Prostate cancer: management and controversies.
- Overview consensus statement. Newer approaches to androgen deprivation therapy in prostate cancer.
- Endpoints in prostate cancer clinical trials.
- Novel trial designs: which agents and how do we test them?
- Receptor tyrosine kinases as rational targets for prostate cancer treatment: platelet-derived growth factor receptor and imatinib
- Emerging role of adjuvant hormonal therapy.
- Androgen receptor as a target in androgen-independent prostate cancer.
- Impact of androgen deprivation therapy on survival in men treated with radiation for prostate cancer.
- Radiation and hormonal therapy for locally advanced and clinically localized prostate cancer.
- The role of androgen deprivation therapy combined with prostate brachytherapy.
- Patterns of failure after primary local therapy for prostate cancer and rationale for secondary therapy.
- Antiandrogen monotherapy: indications and results.
- Contemporary patterns of androgen deprivation therapy use for newly diagnosed prostate cancer.
- A review of measurement of patient preferences for treatment outcomes after prostate cancer.
- Osteoporosis during androgen deprivation therapy for prostate cancer.
- Secondary hormonal therapies in the treatment of prostate cancer.
- Chemotherapy for prostate cancer.
- Screening for carcinoma of the prostate in a randomly selected population using duplicate digital rectal examination.
- Automatic MR volume registration and its evaluation for the pelvis and prostate.
- Clinical and biochemical outcome of conventional dose radiotherapy for localized prostate cancer.
- [Prostatic brachytherapy indications and technique]
- MR imaging for prostate cancer staging: beauty or beast?
- Relationship between prostate volume, prostate-specific antigen nadir, and biochemical control.
- Erectile function after permanent prostate brachytherapy.
- The role of endorectal coil MRI in patient selection and treatment planning for prostate seed implants.
- Vinorelbine in androgen-independent metastatic prostatic carcinoma--a phase II study.
- A novel approach for the adsorption of iodine-125 on silver wire as matrix for brachytherapy source for the treatment of eye and prostate
- Phase I study of replication-competent adenovirus-mediated double suicide gene therapy for the treatment of locally recurrent prostate
- Cancer prevention clinical trials.
Table of Contents
1
UI - 12012298
AU - Han M; Partin AW
TI -
Nomograms for clinically localized prostate cancer. Part I: radical
prostatectomy.
SO - Semin Urol Oncol 2002 May;20(2):123-30
AD - James Buchanan Brady Urological Institute, the Department of Urology,
The Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Many nomograms are currently available for patients' and physicians' use
for prediction of pathologic stage based on preoperative parameters,
such as prostate-specific antigen (PSA) level, clinical stage (tumor,
node, metastasis), and Gleason score from prostate biopsy specimen.
Based on the probability of final pathologic stage as well as patient
comorbidity and life expectancy, patients and physicians can decide
whether definitive local therapy, systemic therapy, or palliative
therapy would be most appropriate. Nomograms have also been developed
based on preoperative parameters for prediction of biochemical
recurrence-free survival outcome following surgery. These nomograms can
help patients understand the long-term cancer cure rates after radical
prostatectomy. Copyright 2002, Elsevier Science (USA). All rights
reserved.
2
UI - 12012299
AU - Potters L
TI -
Nomograms for clinically localized prostate cancer. Part II: radiation
therapy.
SO - Semin Urol Oncol 2002 May;20(2):131-9
AD - Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center
at Mercy Medical Center, Rockville Center, NY 11570, USA.
Prostate cancer can be effectively treated with either external beam
radiation techniques or with brachytherapy. This study was designed to
address the methodology that is used to assess outcome data in the
current radiation literature and to evaluate available nomograms that
can be used to predict outcomes. A literature search was performed and
12 articles reviewed. Risk stratification was the most frequently used
methodology to analyze data. This method encompasses disease-specific
variables: the pretreatment prostate-specific antigen (PSA) value and
the Gleason score are classified by using cut points into low,
intermediate, and high-risk groups. Another methodology uses nomograms
to predict outcome. The nomogram uses continuous values of each variable
so that the outcome probability for a specific set of parameters is
quite specific. The advantage of nomogram analysis over risk
stratification analysis is presented. In conclusion, only 3 reports were
identified in the radiation literature that used a nomogram to predict
outcome. One of the nomograms is proprietary and difficult to interpret.
The other 2 nomograms, 1 for 3-dimensional radiation and the other for
brachytherapy, have been incorporated into hand-held devices that can be
used at consultation with the patient to discuss outcome probabilities
to assist in treatment decisions. Copyright 2002, Elsevier Science
(USA). All rights reserved.
3
UI - 12012300
AU - Schwartz E; Albertsen P
TI -
Nomograms for clinically localized disease. Part III: watchful waiting.
SO - Semin Urol Oncol 2002 May;20(2):140-5
AD - Division of Urology, University of Connecticut Health Center,
Farmington, CT 06030-3955, USA.
Patients with newly diagnosed, clinically localized prostate cancer need
information concerning long-term outcomes to make informed decisions
regarding treatment options. Several nomograms have been developed that
can help in this decision process. By using a nomogram originally
published in 1998, patients and clinicians can predict the 15-year
clinical outcomes in the absence of aggressive treatment based on age
and Gleason score at diagnosis. These predictions are based on patients
diagnosed and treated before the routine use of PSA that has accelerated
the diagnosis of prostate cancer by at least 5 years. Longer follow-up
of contemporary patients will determine whether this nomogram remains
accurate in the prostate-specific antigen (PSA) era. In view of the
lead-time bias resulting from PSA testing, the outcomes of contemporary
patients are likely to be better rather than worse than the results
shown. Copyright 2002, Elsevier Science (USA). All rights reserved.
4
UI - 12012302
AU - Smaletz O; Scher HI
TI -
Outcome predictions for patients with metastatic prostate cancer.
SO - Semin Urol Oncol 2002 May;20(2):155-63
AD - Genitourinary Oncology Service, Department of Medicine, Memorial
Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Estimating prognosis with patients with metastatic disease is important
for patient counseling, guiding treatment selection, and assessing
treatment outcomes. For patients with noncastrate metastatic disease,
androgen ablation is considered first-line therapy, with upward of 80%
of patients showing clinical benefit. For these patients, information
about duration of response to hormones and overall survival is
important. Most patients eventually relapse, at which point the
mortality from cancer greatly exceeds that from other causes. This
article focuses on prognostic models for patients with progressive
noncastrate and castrate metastatic prostate cancer. Copyright 2002,
Elsevier Science (USA). All rights reserved.
5
UI - 12182171
AU - Levenson D
TI -
New tactics shorten hospital stays for prostate patients.
SO - Rep Med Guidel Outcomes Res 2001 Jun 28;12(13):5-7
6
UI - 11859652
AU - Soulie M; Villers A; Richaud P; Prapotnich D; Ruffion A; Grosclaude P
TI -
[Competitive morbidity ant its impact on life expectancy: evaluation and
inclusion in the therapeutic decision regarding localized prostatic
cancer]
SO - Prog Urol 2001 Dec;11(6):1195-204
AD - Service de Chirurgie Urologique et d'Andrologie, CHU Rangueil, 31403
Toulouse. SOULIE.M@chu-toulouse.fr
OBJECTIVES: The treatment decision taken by a multidisciplinary meeting
for patients with localized prostate cancer must take into account the
clinical stage of the cancer and its histological characteristics, but
also the patient's age, general state and any concomitant diseases, as
treatment is only beneficial when it induces a reduction of morbidity
and specific mortality. The specific survival with or without recurrence
after treatment for localized prostate cancer is long, at least more
than 10 years. Curative treatment is generally not proposed to men with
localized prostate cancer when his probability of survival related to a
competitive morbidity (intercurrent medical disease) is estimated to be
less than 10 years. The objective of this study was to measure the
increase or reduction of the survival probability of a patient with
localized prostate cancer according to his competitive morbidity, based
on the mean life expectancy of the general population. METHODS: Review
of the literature. RESULTS: Studies describing the natural history of
prostate cancer show that the impact of treatment on morbidity of the
cancer (local and/or metastatic) requires a life expectancy of about 8
to 10 years. The impact of a treatment on specific survival requires a
life expectancy of about 13 to 15 years. The exact prevalence of
diseases coexisting with prostate cancer is unknown. In the USA, The
Index of Coexisting Disease (ICD), which takes into account 14 diseases,
appears to be the most reliable tool to measure the competitive
morbidity in patients with localized prostate cancer. Each disease is
classified into 4 levels of severity (score 0 to 3). A table indicates
estimated life expectancies by age-group and by ICD score. All men with
a high score (2 to 3) die within 10 years after diagnosis, men with a
score of 0 have a better estimated life expectancy according to age than
that of the general population. CONCLUSION: The upper age limit,
theoretically set at 70 years, in order to propose curative treatment
for localized prostate cancer needs to be reviewed (the mean life
expectancy for a 70-year-old man is 12.9 years in France). According to
the ICD, the life expectancy at 70 years is 14.8 years in the case of a
score of 0 and 8.4 years in the case of a score of 2. In the case of a
score of 2, the impact of curative treatment on localized prostate
cancer would be real on morbidity, but not on specific mortality.
7
UI - 11859670
AU - Ameur A; Touiti D; el Mostarchid B; el Alami M; Jira H; Abbar M
TI -
[Brain metastasis of prostatic cancer: regression under hormonal
treatment]
SO - Prog Urol 2001 Dec;11(6):1298-301
AD - Service d'Urologie, Hopital Militaire d'Instruction Mohammed V, BP 1018,
Rabat, Maroc. ahmed ameur.1@caramail.com
Central nervous system metastases from prostate cancer are exceptional
secondary sites, reported in less than 4% of postmortem cases. The
authors describe an unusual case of cerebral metastasis from prostate
cancer in a 44-year-old man that temporarily regressed during endocrine
therapy.
8
UI - 12072048
AU - Basaria S; Lieb J 2nd; Tang AM; DeWeese T; Carducci M; Eisenberger M;
TI -
Dobs AS
Long-term effects of androgen deprivation therapy in prostate cancer
patients.
SO - Clin Endocrinol (Oxf) 2002 Jun;56(6):779-86
AD - Division of Endocrinolgy and Metabolism, Johns Hopkins University School
of Medicine, Baltimore, MD 21287, USA.
BACKGROUND: Prostate cancer (PCa) is one of the most common cancers in
men and has an increasing incidence. In 1999, 37 000 men died from PCa
in the USA. Androgen deprivation therapy (ADT) with GnRH agonists is
frequently employed in the treatment of recurrent and metastatic PCa by
inducing medical castration, rendering these men hypogonadal. Because
hypogonadism in men is associated with a wide range of complications, we
attempted to determine the effects of long-term ADT in men with PCa.
METHODS: We conducted a cross-sectional study at a tertiary care centre
to determine the effect of ADT on lean body mass (LBM), muscle strength,
bone mineral density (BMD), sexual function, and quality of life (QOL)
in men with PCa. Three groups of men were enrolled: (1) 20 men with PCa
who were undergoing medical castration with GnRH agonists for at least
12 months prior to the onset of the study (ADT group); (2) 18
age-matched men with nonmetastatic PCa who were post prostatectomy
and/or radiotherapy but had not yet undergone ADT (non-ADT group); and
(3) 20 age-matched normal men who were healthy and ambulatory (control
group). RESULTS: Men on ADT had castrate levels of serum total
testosterone (P < 0.0001), free testosterone (P < 0.0001) and oestradiol
(P < 0.0001), which were significantly lower than in the other groups.
Total body (P = 0.03) and lumbar spine (P < 0.0001) BMD was
significantly lower in patients on ADT compared to other groups and was
associated with higher levels of urinary N-telopeptide (P = 0.02). The
ADT group had higher fat mass compared to the other groups (P = 0.0001)
and significantly reduced upper body strength (P = 0.001) when compared
to non-ADT patients. The ADT group had lower overall scores on Watt's
Sexual Function Questionnaire compared to other groups (P = 0.0001), in
particular a decrease in desire, arousal and frequency of spontaneous
early morning erections. The ADT group also had lower overall QOL
scores, resulting in significant limitation of physical function (P =
0.001), role limitation (P = 0.02) and perception of physical health (P
= 0.004). CONCLUSIONS: This study suggests that osteoporosis,
unfavourable body composition, sexual dysfunction and reduced quality of
life are seen in patients receiving androgen deprivation therapy for at
least 12 months. Longitudinal studies in this patient population will
shed further light on the timing of the development and the extent of
these complications. Meanwhile, this information will assist both
physicians and patients with prostate cancer to make informed decisions
regarding androgen deprivation therapy.
9
UI - 12109357
AU - Nelson MA; Reid M; Duffield-Lillico AJ; Marshall JR
TI -
Prostate cancer and selenium.
SO - Urol Clin North Am 2002 Feb;29(1):67-70
AD - Arizona Cancer Center, University of Arizona, 1515 North Campbell
Avenue, Tucson, AZ 85724, USA. mnelson@azcc.arizona.edu
The important progress achieved in the treatment of prostate cancer
comes by exacting significant costs [11, 16-18, 20, 23, 25]. Currently,
there is incomplete evidence that the radical interventions at hand
significantly reduce the human costs of the disease. Surgery and
radiotherapy induce substantial risks of incontinence and impotence. The
PSA test has probably decreased the stage at which prostate cancer is
diagnosed [15]. Nonetheless, the PSA is a means of earlier detection; it
does not elucidate quantitatively distinct modes of treatment. The PSA
test is not a means of prostate cancer prevention. The continuing
incidence, morbidity, and mortality imposed by this disease strongly
indicate that preventive strategies for its control are necessary.
Chemoprevention with selenium and other agents offers a promising
approach that is undergoing intensive investigation. Randomized trials
underway at the authors' center are building on the important clinical
trial results reported by Dr. Larry C. Clark. These studies will
evaluate the activity of selenium at several points along a continuum
ranging from cancerous prostatic tissue in men with diagnosed cancer to
premalignant tissue in men with high-grade PIN to healthy tissue in
high-risk men with negative biopsy to long-term effects on cancerous
tissue in men with frank cancer. These trials will also offer an
opportunity for preliminary evaluation of the mechanisms by which
selenium treatment could result in the slower development or progression
of prostate cancer.
10
UI - 12121835
AU - Mabjeesh NJ; Zhong H; Simons JW
TI -
Gene therapy of prostate cancer: current and future directions.
SO - Endocr Relat Cancer 2002 Jun;9(2):115-39
AD - Winship Cancer Institute, Department of Hematology and Oncology, Emory
University School of Medicine, 1365 Clifton Road, Suite B4100, Atlanta,
Georgia 30322, USA.
Prostate cancer (PCA) is the second most common cause of death from
malignancy in American men. Developing new approaches for gene therapy
for PCA is critical as there is no effective treatment for patients in
the advanced stages of this disease. Current PCA gene therapy research
strategies include cytoreductive approaches (immunotherapy and
cytolytic/pro-apoptotic) and corrective approaches (replacing deleted or
mutated genes). The prostate is ideal for gene therapy. It is an
accessory organ, offers unique antigens (prostate-specific antigen,
prostate-specific membrane antigen, human glandular kallikrein 2 etc.)
and is stereotactically accessible for in situ treatments. Viral and
non-viral means are being used to transfer the genetic material into
tumor cells. The number of clinical trials utilizing gene therapy
methods for PCA is increasing. We review the multiple issues involved in
developing effective gene therapy strategies for human PCA and early
clinical results.
11
UI - 12121833
AU - Zhang XK
TI -
Vitamin A and apoptosis in prostate cancer.
SO - Endocr Relat Cancer 2002 Jun;9(2):87-102
AD - The Burnham Institute, Cancer Center, 10901 North Torrey Pines Road, La
Jolla, California 92037, USA. xzhang@burnham-inst.org
Apoptosis represents an effective way to eliminate cancer cells.
Unfortunately, advanced prostate tumors eventually progress to
androgen-independent tumors, which are resistant to current therapeutic
approaches that act by triggering apoptosis. Vitamin A and its natural
and synthetic analogs (retinoids) induce apoptosis in prostate cancer
cells in vitro and in animal models, mainly through induction of
retinoic acid receptor-beta (RARbeta). Expression levels of RARbeta,
however, are significantly reduced in hormone-independent prostate
cancer cells. Recently, a new class of synthetic retinoids related to
6-[3-(1-adamantyl)-4-hydroxyphenyl]-2-naphthalene carboxylic acid (AHPN)
(also called CD437) that effectively induces apoptosis of both
hormone-dependent and -independent prostate cancer cells in a retinoid
receptor-independent manner was identified and has drawn a lot of
attention in the field. The apoptotic effect of AHPN requires expression
of orphan receptor TR3 (also called nur77 or NGFI-B). Paradoxically, TR3
expression is also induced by androgen and other mitogenic agents in
prostate cancer cells to confer their proliferation. The recent finding
that TR3 migrates from the nucleus to mitochondria to trigger apoptosis
in response to AHPN suggests that the opposing biological activities of
TR3 are regulated by its subcellular localization. Thus, agents that
induce translocalization of TR3 from the nucleus to mitochondria will
have improved efficacy against prostate cancer. TR3, therefore,
represents an unexplored molecule that may be an ideal target for
developing new agents for prostate cancer therapy.
12
UI - 12177094
AU - Zelefsky MJ; Leibel SA
TI -
Comparing contemporary surgery to external-beam radiotherapy for
clinically localized prostate cancer.
SO - J Clin Oncol 2002 Aug 15;20(16):3363-4
13
UI - 12177096
AU - Small EJ; Halabi S; Ratain MJ; Rosner G; Stadler W; Palchak D; Marshall
TI -
E; Rago R; Hars V; Wilding G; Petrylak D; Vogelzang NJ
Randomized study of three different doses of suramin administered with a
fixed dosing schedule in patients with advanced prostate cancer: results
of intergroup 0159, cancer and leukemia group B 9480.
SO - J Clin Oncol 2002 Aug 15;20(16):3369-75
AD - Comprehensive Cancer Center, University of California-San Francisco,
1600 Devisadero Street, Third Floor, San Francisco, CA 94115, USA.
smalle@medicine.ucsf.edu
PURPOSE: To test the hypothesis that the efficacy and toxicity of
suramin in the treatment of patients with hormone-refractory prostate
cancer was dose dependent. PATIENTS AND METHODS: Patients were
randomized with equal probability to receive low-, intermediate-, or
high-dose suramin (total doses 3.192, 5.320, and 7.661 g/m(2),
respectively). Overall survival, time to progression, and response rate
(prostate-specific antigen [PSA] and objective) for each treatment arm
were compared. Relationships between plasma suramin concentrations and
response, toxicity, and survival were also evaluated. RESULTS: Three
hundred ninety patients were randomized. For the low-, intermediate-,
and high-dose arms, the median survival time was 16, 14, and 13 months,
respectively (P =.49). The objective response rate was 9%, 7%, and 15%,
respectively (P =.10). PSA response rates were 24%, 28%, and 34%,
respectively (P =.082). Landmark analyses of a 50% decline in PSA at 20
weeks showed a significant correlation with survival. There was a
dose-response relationship between dose and toxicity. After adjusting
for treatment arm, the measured suramin concentration was not associated
with clinical response, PSA response, survival, or toxicity. CONCLUSION:
Although high-dose suramin was associated with higher objective and PSA
response rates, these were not statistically significant. Overall, no
dose-response relationship was observed for survival or progression-free
survival, but toxicity was increased with the higher dose. Patients
treated with the low-dose level experienced modest toxicity, making it
the preferred arm on this study. The lack of a dose-response
relationship and the toxicity profile observed raise questions regarding
the utility of suramin, particularly high-dose suramin, as administered
on this schedule.
14
UI - 12177097
AU - Kupelian PA; Elshaikh M; Reddy CA; Zippe C; Klein EA
TI -
Comparison of the efficacy of local therapies for localized prostate
cancer in the prostate-specific antigen era: a large single-institution
experience with radical prostatectomy and external-beam radiotherapy.
SO - J Clin Oncol 2002 Aug 15;20(16):3376-85
AD - Department of Radiation Oncology, Desk 728, Cleveland Clinic Foundation,
9500 Euclid Avenue, Cleveland, OH 44195, USA. kupelip@ccf.org
PURPOSE: To review biochemical relapse-free survival (bRFS) rates after
either external-beam radiotherapy (RT) or radical prostatectomy (RP) for
localized prostate cancer. PATIENTS AND METHODS: All 1,682 patients had
pretreatment prostate-specific antigen (PSA) levels and biopsy Gleason
scores (bGS) assigned. No adjuvant therapy was administered after local
treatment. RP was the treatment in 1,054 patients (63%) and RT in 628
patients (37%). Median follow-up was 51 months (range, 1 to 134). The
median follow-up for RP versus RT patients was 50.5 v 51.0 months.
Biochemical relapse was considered detectable PSA levels (> 0.2 ng/mL)
in RP patients and three consecutive rising PSA levels in RT patients.
The analysis was repeated with a more stringent definition of
biochemical control after either RP or RT-namely, reaching and
maintaining a PSA level < or = 0.5 ng/mL-and excluding patients
receiving any androgen deprivation (AD). RESULTS: Eight-year bRFS rates
for RP versus RT were 72% and 70%, respectively (P =.010). Multivariate
analysis indicated T stage (P <.001), pretreatment PSA (P <.001), bGS (P
<.001), year of therapy (P <.001), and neoadjuvant AD (P =.019) to be
the only independent predictors of relapse. Age (P =.78), race (P =.29),
prior transurethral resection of prostate (P =.81), and treatment
modality (P =.96) were not independent predictors of treatment failure.
Fifty-one percent of RP patients had favorable tumors (T1 to T2A,
pretreatment PSA < or = 10 ng/mL, bGS < or = 7), compared with only 34%
of RT patients (P <.001). Repeat analysis with a stringent definition of
biochemical failure and excluding patients receiving AD indicated no
impact of treatment modality on outcome. CONCLUSION: Eight-year
biochemical failure rates were identical between RT and RP in any
subgroup. Outcome is determined mainly by pretreatment PSA levels, bGS,
clinical T stage, and, for RT patients, radiation dose.
15
UI - 12135863
AU - Chatelard PP; Groupe De Travail Du
TI -
[Standards, options and recommendations for the management of prostate
cancer: therapeutic decision criteria]
SO - Bull Cancer 2002 Jun;89(6):619-34
AD - 101, rue de Tolbiac, 75654 Paris Cedex 13.
CONTEXT: The "Standards, Options and Recommendations" (SOR)
collaborative project was initiated in 1993 by the Federation of the
French Cancer Centres (FNCLCC), with the 20 French Regional Cancer
Centres, several French public university and general hospitals, as well
as private clinics and medical specialty societies. Its main objective
is the development of serviceable clinical practice guidelines in order
to improve the quality of health care and the outcome of cancer
patients. The methodology is based on a literature review, followed by
critical appraisal by a multidisciplinary group of experts. Draft
guidelines are produced, then validated by specialists in cancer care
delivery. OBJECTIVES: Produce clinical practice guidelines for prostate
cancer patients related to therapeutic main decision criteria, using the
methodology developed by the Standards, Options and Recommendations
project. METHODS: The FNCLCC and the French Urology Society (AFU) set-up
a multidisciplinary group of experts which reviewed the available
evidence. Following the selection of pertinent articles, synthesis of
the results, and production of the draft SOR, the document was validated
by independent reviewers. RESULTS: The main recommendations are: 1)
Specific survival with a minimum of 15 years follow-up, is required to
assess the impact of a treatment for localised prostate cancer. 2)
Ten-year metastatic-free survival is a good endpoint for assessing
treatment efficacy for local cancer. 3) Complete remission is defined as
undetectable PSA concentration (< 0.1 mug.L- 1). 4) Progression after
radical prostactectomy, external-beam radiotherapy or brachytherapy is
defined as an increase PSA concentration, measured in three successive
determinations, at monthly intervals. 5) Clinical stage, Gleason score
and pretherapeutic PSA concentration are the prognostic factors for
locoregional involvement and therefore treatment response, which should
be used as an aid for therapeutic decision-making.
16
UI - 12149288
AU - D'Amico AV
TI -
Predicting prostate-specific antigen recurrence established: now, who
will survive?
SO - J Clin Oncol 2002 Aug 1;20(15):3188-90
17
UI - 12149291
AU - Coen JJ; Zietman AL; Thakral H; Shipley WU
TI -
Radical radiation for localized prostate cancer: local persistence of
disease results in a late wave of metastases.
SO - J Clin Oncol 2002 Aug 1;20(15):3199-205
AD - Department of Radiation Oncology, Massachusetts General Hospital, 100
Blossom Street, Cox 3, Boston, MA 02114, USA. jcoen@partners.org
PURPOSE: To assess whether failure to maintain local control (LC) of
prostate cancer after radiation therapy results in a higher incidence of
distant metastasis (DM). PATIENTS AND METHODS: From 1972 to 1999, 1,469
patients with clinically localized prostate cancer were treated with
radical radiation therapy. Disease outcome was retrospectively reviewed
for all patients with more than 2 years of follow-up. RESULTS: The
actuarial 10-year LC rate was 79%. Gleason score > or = 7,
prostate-specific antigen (PSA) more than 15, and T3 to T4 tumors
predicted a higher incidence of local failure (LF) (palpable recurrence
or positive rebiopsy). The 10-year distant metastasis-free survival
(DMFS) was 74%. Gleason score > or = 7, PSA more than 15, and T3 to T4
tumors predicted a higher incidence of distant failure. LF was the
strongest predictor for DM in a multivariate model. The 10-year DMFS for
LC and LF patients was 77% and 61%, respectively. Median time to distant
failure was prolonged in patients with LF compared with patients with
locally controlled disease (54 v 34 months). Hazard rate analysis of the
time to DM revealed that patients who maintain LC have a lower rate of
DM, which remains constant over time. Patients who ultimately develop LF
have a higher initial rate of DM, which increases with time. CONCLUSION:
Patients with locally persistent prostate cancer are at greater risk of
DM. The higher initial hazard of DM is consistent either with an
increased likelihood of subclinical micrometastases before treatment or
with posttreatment tumor embolization. The prolonged time to appearance
of DM in locally failing patients and the increasing hazard of DM over
time is most consistent with a late wave of metastases from a locally
persistent tumor.
18
UI - 12149292
AU - Graefen M; Karakiewicz PI; Cagiannos I; Quinn DI; Henshall SM; Grygiel
TI -
JJ; Sutherland RL; Stricker PD; Klein E; Kupelian P; Skinner DG;
Lieskovsky G; Bochner B; Huland H; Hammerer PG; Haese A; Erbersdobler A;
Eastham JA; de Kernion J; Cangiano T; Schroder FH; Wildhagen MF; van der
Kwast TH; Scardino PT; Kattan MW
International validation of a preoperative nomogram for prostate cancer
recurrence after radical prostatectomy.
SO - J Clin Oncol 2002 Aug 1;20(15):3206-12
AD - Department of Urology, Division of Solid Tumor Oncology, Memorial
Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021,
USA.
PURPOSE: We evaluated the predictive accuracy of a recently published
preoperative nomogram for prostate cancer that predicts 5-year freedom
from recurrence. We applied this nomogram to patients from seven
different institutions spanning three continents. METHODS: Clinical data
of 6,754 patients were supplied for validation, and 6,232 complete
records were used. Nomogram-predicted probabilities of 60-month freedom
from recurrence were compared with actual follow-up in two ways. First,
areas under the receiver operating characteristic curves (AUCs) were
determined for the entire data set according to several variables,
including the institution where treatment was delivered. Second,
nomogram classification-based risk quadrants were compared with actual
Kaplan-Meier plots. RESULTS: The AUC for all institutions combined was
0.75, with individual institution AUCs ranging from 0.67 to 0.83.
Nomogram predictions for each risk quadrant were similar to actual
freedom from recurrence rates: predicted probabilities of 87% (low-risk
group), 64% (intermediate-low-risk group), 39% (intermediate-high-risk
group), and 14% (high-risk group) corresponded to actual rates of 86%,
64%, 42%, and 17%, respectively. The use of neoadjuvant therapy,
variation in the prostate-specific antigen recurrence definitions
between institutions, and minor differences in the way the Gleason grade
was reported did not substantially affect the predictive accuracy of the
nomogram. CONCLUSION: The nomogram is accurate when applied at
international treatment institutions with similar patient selection and
management strategies. Despite the potential for heterogeneity in
patient selection and management, most predictions demonstrated high
concordance with actual observations. Our results demonstrate that
accurate predictions may be expected across different patient
populations.
19
UI - 12206841
AU - Katz AE; Rukstalis DB
TI -
Introduction. Recent scientific and technological advances have
challenged the traditional treatment options for patients with localized
prostate cancer.
SO - Urology 2002 Aug;60(2 Suppl 1):1-2
AD - Department of Urology, Columbia-Presbyterian Medical Center, New York,
New York 10032, USA.
20
UI - 12206843
AU - Robinson JW; Donnelly BJ; Saliken JC; Weber BA; Ernst S; Rewcastle JC
TI -
Quality of life and sexuality of men with prostate cancer 3 years after
cryosurgery.
SO - Urology 2002 Aug;60(2 Suppl 1):12-8
AD - Department of Oncology and Program in Clinical Psychology, University of
Calgary, Calgary, Alberta, Canada.
The current study was designed to describe the long-term life quality
and sexuality of men enrolled in a phase 2 clinical trial of cryosurgery
for the treatment of localized prostate cancer. A total of 75 men were
administered the Functional Assessment of Cancer Treatment-Prostate
(FACT-P) before treatment and after treatment at 6 weeks, and at 3, 6,
12, 24, and 36 months. Additionally, these men completed a Sexuality
Follow-Up Questionnaire (SFQ) 3 years after cryosurgery. By 12 months
after cryosurgery, most FACT-P subscales had returned to pretreatment
levels. Quality of life remained stable over the subsequent 2 years. The
only exception to this general trend was persistent impairment in
measures of social/family well-being. At 36 months, 13% (5 of 38) of
patients had regained erectile functioning, and an additional 34% (13 of
38) of patients were sexually active with the help of aids. The 3-year
quality-of-life outcomes support the renewed interest in cryosurgery. No
late complications were observed. Whereas improvements in erectile
function were observed between years 1 and 3 for some patients, most
continue to experience erectile dysfunction. For these patients, aids
are an important adjunct to the treatment of their erectile dysfunction.
21
UI - 12206844
AU - Rukstalis DB; Goldknopf JL; Crowley EM; Garcia FU
TI -
Prostate cryoablation: a scientific rationale for future modifications.
SO - Urology 2002 Aug;60(2 Suppl 1):19-25
AD - Department of Surgery, Division of Urology, MCP Hahnemann University
School of Medicine, Philadelphia, Pennsylvania 19129, USA.
daniel.rukstalis@drexel.edu
This investigation was designed to identify potential directions for
future modification of the percutaneous prostate cryoablation procedure.
An analysis of prostate cancer location and volume in radical
prostatectomy specimens was performed to evaluate the potential clinical
consequences of these proposed modifications. A list of recommendations
for improvements in the prostate cryoablation procedure was compiled
from informal discussions held with participants in 9 training courses
and conferences on prostate cryoablation over 18 months. Subsequently, a
population of 112 consecutive, sagittally sectioned whole-mount radical
prostatectomy samples was evaluated for prostate cancer volume, number
of individual foci, and location to examine the disease-specific
outcomes of these proposed modifications. The most common areas for
potential alterations in the current cryoablation technique include
modifications that would further simplify the procedure, continue to
reduce real and perceived toxicity, and augment efficacy. Importantly,
modifications designed to reduce treatment side effects could conflict
with efforts designed to improve eradication of prostate cancer.
Pathologic analysis revealed multifocal cancer in 79.5% of the samples,
with 66% of cases exhibiting cancer within 5 mm of the urethra. The
median volume of the index cancer was 1.6 cm3, whereas the median volume
of the smaller ancillary lesions was 0.3 cm3. Prostate
parenchymal-sparing alterations, proposed to reduce incontinence and
erectile dysfunction by targeting the index cancer, would likely
eradicate clinically significant cancer in 79% of men. The recent
enthusiasm for prostate cryoablation as a reasonable minimally invasive
treatment option for men with clinically localized cancer is likely to
result in modifications of the established surgical technique. Knowledge
of the anatomic location and cancer volume within the prostate gland is
an important adjunct to planning such alterations. It is possible that
parenchymal-sparing modifications to total gland prostate cryoablation
can eradicate clinically significant cancer in most men, with a
reduction in toxicity and cost.
22
UI - 12206842
AU - Bahn DK; Lee F; Badalament R; Kumar A; Greski J; Chernick M
TI -
Targeted cryoablation of the prostate: 7-year outcomes in the primary
treatment of prostate cancer.
SO - Urology 2002 Aug;60(2 Suppl 1):3-11
AD - Prostate Institute of America, Community Memorial Hospital, Ventura,
California 93003, USA. dkbahn@cmhhospital.org
The efficacy and safety of the long-term experience with targeted
cryoablation of prostate cancer (TCAP) at a community hospital is
retrospectively reviewed. A series of 590 consecutive patients who
underwent TCAP as primary therapy with curative intent for localized or
identified. Patients were stratified into 3 risk groups according to
clinical characteristics. Biochemical disease-free survival (bDFS),
post-TCAP biopsy results, and post-TCAP morbidity were calculated and
presented. The mean follow-up time for all patients was 5.43 years. The
percentages of patients in the low-, medium-, and high-risk groups were
15.9%, 30.3%, and 53.7%, respectively. Using a prostate-specific antigen
(PSA)-based definition of biochemical failure of 0.5 ng/mL, results were
as follows: (1) the 7-year actuarial bDFS for low-, medium-, and
high-risk patients were 61%, 68%, and 61%, respectively; (2) the bDFS
probabilities for a PSA cutoff of 1.0 ng/mL for low-, medium-, and
high-risk patients were 87%, 79%, and 71%, respectively; and (3) the
bDFS probabilities for low-, medium-, and high-risk patients using the
American Society for Therapeutic Radiology and Oncology (ASTRO)
definition of biochemical failure (3 successive increases of PSA level)
were 92%, 89%, and 89%, respectively. The rate of positive biopsy was
13%. After a positive biopsy, 32 patients underwent repeat cryoablation.
For those patients who underwent repeat cryoablation, 68%, 72%, and 91%
remain bDFS using definitions of 0.5 ng/mL, 1.0 ng/mL, and the ASTRO
criteria, respectively, after a mean follow-up time since repeat
cryoablation of 63 months. The rates of morbidity were modest, and no
serious complications were observed. TCAP was shown to equal or surpass
the outcome data of external-beam radiation, 3-dimensional conformal
radiation, and brachytherapy. These 7-year outcome data provide
compelling validation of TCAP as an efficacious treatment modality for
locally confined and locally advanced prostatic carcinoma.
23
UI - 12206846
AU - Ellis DS
TI -
Cryosurgery as primary treatment for localized prostate cancer: a
community hospital experience.
SO - Urology 2002 Aug;60(2 Suppl 1):34-9
AD - Urology Associates of North Texas, and United States Medical
Development, Arlington, Texas 76012, USA. dellis@uant.com
The technique and recent experience incorporating cryosurgery into our
community practice for primary treatment of localized prostate cancer is
patients underwent targeted cryoablation for localized prostate cancer.
Of the 93 patients, 18 had failed radiotherapy, and cryotherapy was used
as salvage therapy. The remaining 75 patients underwent targeted
cryoablation of the prostate as primary therapy. A single urologist
using an argon-based cryoablation system performed the procedure.
Cryoprobes and thermosensors were placed under transrectal ultrasound
guidance via a transperineal route. A double freeze-thaw cycle was used
with anterior-to- posterior probe operation. Strategically placed
thermosensors were used to monitor and control the freezing, and a
warming catheter was used to protect the urethra. We achieved a nadir
prostate-specific antigen level of < or =0.4 ng/mL in 84% of the entire
population we studied (63 of 75 patients). Postsurgery complications
were minimal. Incontinence developed in 4 patients, as did
postsuprapubic catheter removal urinary retention. Erectile dysfunction
developed in 28 of 34 patients who were potent preoperatively, with 6 of
the 34 patients regaining potency after surgery. No rectourethral
fistula formation occurred. Urethral sloughing was observed in 5
patients, 1 of whom developed a scrotal abscess during treatment of the
sloughing. The use of cryoablation of the prostate for the treatment of
localized adenocarcinoma of the prostate is feasible and can easily be
transferred from the pioneering centers to the community hospitals
without sacrificing safety or efficacy.
24
UI - 12074793
AU - Bogers JA; van der Maazen RW; Visser AG
TI -
Conformal photon-beam radiotherapy of prostate carcinoma.
SO - Eur Urol 2002 May;41(5):515-22
AD - Department of Radiation Oncology, University Medical Center, P.O. Box
9101, 6500 HB Nijmegen, The Netherlands. j.bogers@rhter.azn.nl
Three-dimensional conformal radiotherapy is the recommended radiation
technique for localized or locally advanced prostate cancer. In the past
decades, external beam irradiation procedures have evolved in the
context of technical developments of radiation and imaging equipment.
The article summarizes these developments and gives a definition of new
techniques and their potential advantages over conventional irradiation.
It is meant to provide urologists and medical and radiation oncologists
with a better comprehension of modern radiation treatment of prostate
cancer and its possible improvements in the future.
25
UI - 12081790
AU - Barber NJ; Zhu G; Muir GH
TI -
Can diet affect prostate cancer?
SO - BJU Int 2002 Jul;90(1):141; discussion 142
26
UI - 12081772
AU - Do V; Choo R; Deboer G; Herschorn S; Danjoux C; Chen CH; Barak I
TI -
Urodynamic findings 3 months after radiotherapy in patients treated with
conformal external beam radiotherapy for
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