Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
National Cancer Institute®
Ultima Vez Modificado: 21 de noviembre del 2001
UI - 20259108
AU - Anonymous
TI - Maximum androgen blockade in advanced prostate cancer: an overview of the randomised trials. Prostate Cancer Trialists' Collaborative Group.
SO - Lancet 2000 Apr 29;355(9214):1491-8
BACKGROUND: In advanced prostate cancer, androgen suppression (AS) by surgery or drugs controls testicular hormone secretion, and the further addition of an antiandrogen such as nilutamide, flutamide, or cyproterone acetate is referred to as maximum androgen blockade (MAB). The aim of this overview was to compare the effects on the duration of survival of MAB and of AS alone. METHODS: The collaborative meta-analysis of 27 randomised trials involved central reanalysis of the data on each of 8275 men (98% of those ever randomised in trials of MAB vs AS) with metastatic (88%) or locally advanced (12%) prostate cancer. Half were over 70 years of age, and follow-up was typically for about 5 years. FINDINGS: 5932 (72%) men have died; of the deaths for which causes were provided, about 80% were attributed to prostate cancer. 5-year survival was 25.4% with MAB versus 23.6% with AS alone, a non-significant gain of 1.8% (SE 1.3; logrank 2p=0.11). There was no significant heterogeneity in the treatment effect (MAB vs AS) with respect to age or disease stage. The results for cyproterone acetate, which accounted for only a fifth of the evidence, appeared slightly unfavourable to MAB (5-year survival 15.4% MAB vs 18.1% AS alone; difference -2.8% [SE 2.4]; logrank 2p=0.04 adverse), whereas those for nilutamide and flutamide appeared slightly favourable (5-year survival 27.6% MAB vs 24.7% AS alone; difference 2.9% [SE 1.3]; logrank 2p=0.005). Non-prostate-cancer deaths (although not clearly significantly affected by treatment) accounted for some of the apparently adverse effects of cyproterone acetate. INTERPRETATION: In advanced prostate cancer, addition of an antiandrogen to AS improved the 5-year survival by about 2% or 3% (depending on whether the analysis includes or excludes the cyproterone acetate trials), but the range of uncertainty as to the true size of this benefit runs from about 0% to about 5%.
UI - 21203620
AU - Weckermann D; Wawroschek F; Hamm M; Haude K; Harzmann R
TI - Biochemical course after radical retropubic prostatectomy: preliminary results.
SO - Eur Urol 2001 Apr;39(4):418-24
AD - Department of Urology, Augsburg, Germany.
OBJECTIVE: To investigate prognostic factors in localized and lymphatically spread prostate cancer. METHODS: The biochemical course after radical retropubic prostatectomy in 306 patients was subject to a retrospective analysis. RESULTS: Prostate-specific antigen (PSA), Gleason score (prostatectomy specimen) and pathological stage proved to be prognostically relevant (p < 0.0001). PSA, Gleason score and tumor stage also were to be considered as (independent) prognostic factors by means of a multivariate analysis (p < 0.001), whereas perineural invasion (prostatectomy specimen) and preoperative bone marrow findings (CK 2) had no impact on the course of the disease. After a median follow-up of 1,307 days (3.6 years), a biochemical relapse occurred in 41.8%. CONCLUSION: High preoperative PSA values and the resulting high portion of advanced tumor stages are a possible basis for the high biochemical relapse rate in our collective. The learning curves of several surgeons and the previously more restrictive pelvic lymphadenectomy (surgical understaging) may also be considered causes.
UI - 21203621
AU - Vanuytsel L; Janssens G; Van Poppel H; Rijnders A; Baert L
TI - Radiotherapy for PSA recurrence after radical prostatectomy.
SO - Eur Urol 2001 Apr;39(4):425-9
AD - Department of Radiotherapy, University Hospitals, Leuven, Belgium. Lucien.Vanuytsel@uz.kuleuven.ac.be
OBJECTIVES: The treatment of patients presenting with an isolated PSA recurrence after radical prostatectomy (RP) remains controversial. The present study aims at assessing the results of salvage radiotherapy (RT), to define prognostic factors and to identify subgroups of patients most suitable for RT with curative intent. MATERIALS AND METHODS: A retrospective study was performed of 53 patients, diagnosed with a rising PSA after RP, and treated with RT to the prostate bed, between determinants to obtain and maintain a nondetectable PSA (< 0.02 ng/ml) were Gleason grade (< or = III vs. < or = IV), pre-RT PSA, considered as categorical or continuous variable, and pathological stage, pT (2 vs. 3). Pre-RP PSA (< or = 10 vs. >10), time interval between surgery and moment of rising PSA and pathological section margin status were not significant. On multivariate analysis, only Gleason grade and pre-RT PSA remained significant. For the patient group with a Gleason grade < or = III the PSA-free survival at 3 years was 75% (+/- 11%) compared to 27% (+/- 9%) for the patients with a Gleason grade > or = IV (p = 0.002). Pre-RT PSA significantly influenced PSA-free survival in the first group, but not in the latter. CONCLUSION: From the group of RP patients with rising PSA following a postsurgery PSA-free period, subgroups can be defined with a distinctly different probability of obtaining and maintaining nondetectable PSA levels after salvage RT.
UI - 21267671
AU - Kumi-Diaka J; Sanderson NA; Hall A
TI - The mediating role of caspase-3 protease in the intracellular mechanism of genistein-induced apoptosis in human prostatic carcinoma cell lines, DU145 and LNCaP.
SO - Biol Cell 2000;92(8-9):595-604
AD - Department of Biology, College of Liberal Arts and Sciences, Florida Atlantic University, Davie 33314, USA. email@example.com
A series of in vitro studies were carried out to investigate genistein-induced cell death, and the nature of cell death, in two human prostate cancer cell lines (LNCaP and Du145), and the possible involvement of caspase-3 protease in genistein-induced apoptosis in the target cells. The major findings of these studies are: i) genistein inhibits growth and proliferation of both LNCaP and DU145 cells via apoptosis mainly, and necrosis at higher concentrations; ii) genistein induces activation and expression of caspase-3 (CPP32) in both target cells; iii) genistein-induced apoptosis and CPP32 activation could be significantly inhibited by the caspase-3 inhibitor, z-VAD-fmk (N-benzyloxycarbonyl-Val-Asp-fluoromethyl-ketone), thus confirming a mediator role of CPP32 in the genistein-induced apoptotic pathway in the target cells. The potency of most known chemopreventive drugs for cancer is due to induction of apoptosis in solid tumors (Thompson, Science 267 (1995) 1456; Gurney et al., Science 288 (2000) 283). Inevitably, agents that increase transcription of caspase-3 protease could reinforce cell death via CPP32-mediated apoptosis. In this regard, genistein may find an application in the treatment of human prostate carcinoma, independently of hormone sensitivity.
UI - 21336417
AU - Miyake H; Hara I; Kamidono S; Gleave ME
TI - Novel therapeutic strategy for advanced prostate cancer using antisense oligodeoxynucleotides targeting anti-apoptotic genes upregulated after androgen withdrawal to delay androgen-independent progression and enhance chemosensitivity.
SO - Int J Urol 2001 Jul;8(7):337-49
AD - The Prostate Center, Vancouver General Hospital, Vancouver, Canada. firstname.lastname@example.org
Progression to androgen-independence remains the main obstacle to improving survival for patients with advanced prostate cancer. In this review, findings are summarized that have recently been demonstrated to establish novel therapeutic strategy targeting several genes playing functionally important roles after androgen withdrawal and during androgen-independent progression. The authors initially characterized changes in gene expression after androgen withdrawal in the androgen-dependent Shionogi and LNCaP tumor models using cDNA arrays. Based on these results, they focused on genes highly upregulated after androgen ablation (i.e. bcl-2, bcl-xL, TR.PM-2, IGFBP-5), which have anti-apoptotic or mitogenic activities, and thereby confer a resistance to androgen withdrawal as well as cytotoxic chemotherapy. The authors further demonstrated the efficacy of an antisense oligodeoxynucleotide (ODN) strategy for patients with advanced prostate cancer through the inhibition of target gene expression, resulting in a delay in the progression to androgen-independence by enhancing apoptotic cell death induced by androgen ablation and chemotherapy. The authors also showed the effectiveness of combined antisense ODN therapy and cytotoxic chemotherapy by achieving additive or synergistic effects. These findings provide a basic significance for the design of clinical studies using antisense ODN either alone or in combination with chemotherapeutic agents in patients with advanced prostate cancer.
UI - 21336434
AU - Arai Y
TI - Radical prostatectomy: time trends, morbidity and quality of life.
SO - Int J Urol 2001 Jul;8(7):S15-8
AD - Department of Urology, Kurashiki Central Hospital, Kurashiki, Japan. email@example.com
In recent years, increased screening for prostate cancer, primarily with prostate-specific antigen testing, has led to an apparent increase in the incidence of prostate cancer and resulted in a shift to an earlier patient age and tumor stage at diagnosis. From the early 1980s, there have been great advances in surgical technique. In the 1990s, radical prostatectomy gained popularity among Japanese urologists. Time trends and morbidity of contemporary anatomical radical prostatectomy in Japan are reported here. In addition, the quality of life in men undergoing radical prostatectomy is discussed.
UI - 21336435
AU - Naito S
TI - Androgen deprivation in combination with radical prostatectomy for localized prostate cancer.
SO - Int J Urol 2001 Jul;8(7):S19-21
AD - Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. firstname.lastname@example.org
Radical prostatectomy is the only potential modality for cure in patients with localized prostate cancer. However, the lack of reliable and accurate clinical staging frequently leads to incomplete excision of tumor, with the consequences of early local recurrence or distant metastasis. Thus, the role of neoadjuvant or adjuvant hormonal treatment has been investigated in improving disease-free or cause-specific survival. This review reports the current status and problems of such androgen deprivation in combination with radical prostatectomy for localized prostate cancer.
UI - 21336432
AU - Yoshimura I; Suzuki S; Tadakuma T; Hayakawa M
TI - Suicide gene therapy on LNCaP human prostate cancer cells.
SO - Int J Urol 2001 Jul;8(7):S5-8
AD - Department of Urology, National Defense Medical College, Tokorozawa, Japan. email@example.com
The efficacy of combination suicide gene therapy was evaluated using a Herpes simplex virus-thymidine kinase/ganciclovir (HSV-TK/GCV) system and an Escherichia coli cytosine deaminase/5-fluorocytosine (CD/5-FC) system on the LNCaP human prostate cancer cell model. Two types of plasmid vectors with the HSV-TK gene were constructed. A constitutive chicken beta-actin promoter drove one and a prostate-specific antigen (PSA) promoter drove the other. Similarly, a pair of plasmids with the CD gene under a cytomegalovirus (CMV) promoter and the PSA promoter was also constructed. LNCaP cells were transfected in vitro with either or both of those plasmids using a cationic lipid reagent. Transfected cells were treated with GCV and/or 5-FC. The percentage of viable LNCaP cells 7 days after treatment with HSV-TK/GCV or CD/5-FC under a constitutive promoter was 40% and 41% of controls, respectively. The cell viability when two suicide genes were combined was 23%. The cell viabilities after four days with PSA promoter-HSV-TK vectors, CD vectors and a combination of both were 79%, 88% and 88%, respectively. Suicide gene therapy using either HSV-TK/GCV, CD/5-FC, or both, was effective in the LNCaP model. An additive effect was observed when the two suicide genes were used together. The PSA promoter did not seem to be effective enough to elicit cytotoxicity under the experimental conditions used here.
UI - 21336433
AU - Myers RP
TI - Radical prostatectomy: making it a better operation in the new millennium.
SO - Int J Urol 2001 Jul;8(7):S9-14
AD - Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA. firstname.lastname@example.org
Radical prostatectomy provides the best hope for long-term survival, free of disease, for organ-confined adenocarcinoma of the prostate. The operation is performed successfully only by understanding the remarkable anatomic variability of the prostate apex and the cylindrical nature of the striated urethral sphincter. When surgical techniques are used that take into account variations at the apex, with preservation of (i) neurovascular structures; (ii) the sphincteric urethra; and (iii) the adjacent levator ani, patients can look forward to a cure and the rapid return of urinary control and erectile function.
UI - 21381869
AU - Rini BI; Small EJ
TI - Immunotherapy for prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):418-23
AD - University of California at San Francisco Comprehensive Cancer Center, 1600 Divisidero Street, 3rd floor, San Francisco, CA 94115, USA. email@example.com
The components of an effective immune response have been elucidated in recent years. An understanding of the dysfunction of the immune response in cancer in one or more of these components has led to a variety of immunotherapeutic approaches. These therapeutic strategies are designed to stimulate dendritic cell proliferation, promote antigen uptake and processing, stimulate an effector cell response via direct antigen presentation, or target tumor cells via antibody therapy. Many approaches in prostate cancer have demonstrated successful induction of the desired immune response. Limited clinical success has also been seen.
UI - 21381872
AU - Gingrich JR; Chauhan RD; Steiner MS
TI - Gene therapy for prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):438-47
AD - Department of Urology, University of Tennessee Medical Center, 956 Court Avenue, H216, Memphis, TN 38163, USA. Jgingrich@utmem.edu
Basic research continues to unravel the molecular complexity of normal and abnormal biologic processes. The development of means to affect the expression level of genes that promote or contribute to cellular transformation, invasion, and metastasis has spawned the concept of gene therapy. This relatively new field seeks to reverse or suspend the pathologic progression of a variety of diseases including the malignant transformation of prostatic epithelial cells. Initial clinical trials for prostate cancer have thus far shown gene therapy to be relatively safe, although definitive evidence of durable therapeutic efficacy remains to be demonstrated. In this article, recent preclinical research, current therapeutic strategies, and recent results of gene therapy clinical trials for the treatment of prostate cancer are reviewed.
UI - 21381873
AU - Jacobson JS; Chetty AP
TI - Complementary and alternative medicine in prostate cancer.
SO - Curr Oncol Rep 2001 Sep;3(5):448-52
AD - Department of Epidemiology, PH18-105, Mailman School of Public Health and Herbert Irving Cancer Center, Columbia University, 600 West 168th Street, New York, NY 10032, USA. firstname.lastname@example.org
Prostate cancer patients, like other cancer patients as well as the general population, are increasingly exploring the use of complementary and alternative medicine (CAM). This paper describes the use of CAM in this patient population and the evidence regarding some CAM treatments in the setting of prostate cancer. Some herbal agents and micronutrients have demonstrated biologic activity that may benefit patients with prostate cancer. The clinical effects of these and others and the potential interactions among CAM treatments and with conventional treatment remain an appropriate target for further investigation.
UI - 21382117
AU - Templeton HR; Coates VE
TI - Adaptation of an instrument to measure the informational needs of men with prostate cancer.
SO - J Adv Nurs 2001 Aug;35(3):357-64
AD - University of Ulster, Coleraine, UK. email@example.com
AIM OF THE STUDY: The aim of this study is to adapt an instrument suitable for assessment of the informational needs of men with prostate cancer. BACKGROUND: In recent years prostate cancer has become an important public health problem world-wide with considerable social and economic consequences. It is reported that it is the most common cancer affecting British men, with an average lifetime risk of occurrence of one in twelve. DESIGN/METHODS: Methodological research was conducted to develop an instrument to assess the informational needs of men with prostate cancer on hormonal manipulation therapy (HMT) regarding their disease and treatment. The Toronto Informational Needs Questionnaire (TINQ-BC) (Galloway et al. 1997) was modified for use with this client group and was applied to a sample of 90 men generated from three urology centres in Northern Ireland. RESULTS/FINDINGS: Construct and content validity of the instrument was established. Internal consistency reliability using Cronbach's alpha was calculated and found to be satisfactory (0.92). Using confirmatory factor analysis, factor loadings ranging from 0.37 to 0.90 were obtained and considered satisfactory. The subsections of the TINQ-BC categorized as Disease, Investigative tests, Treatment, Psychosocial and Physical needs were confirmed as individual factors. These results indicate that this instrument can be validly applied to this client group. As the instrument was initially developed in Canada and successfully used in the United Kingdom (UK), it is suggested that this instrument also has the potential for cross-cultural application. It has the potential to be used as a clinical reference instrument to assess the informational needs of this patient group. Health care professionals must be aware of the domains of information that these men perceive important so that educational interventions can be accurately and appropriately planned.
UI - 21382691
AU - Tymchuk CN; Barnard RJ; Heber D; Aronson WJ
TI - Evidence of an inhibitory effect of diet and exercise on prostate cancer cell growth.
SO - J Urol 2001 Sep;166(3):1185-9
AD - Department of Physiological Science, University of California-Los Angeles, Los Angeles, CA, USA.
PURPOSE: A high fat diet and sedentary lifestyle may predispose men to prostate cancer through effects on serum factors such as hormones. We evaluated the effects of a low fat, high fiber diet and exercise intervention on serum stimulated growth of established prostate cancer cell lines. MATERIALS AND METHODS: Fasting serum was obtained from 13 overweight men before and after undergoing an 11-day low fat, high fiber diet and exercise intervention. Serum was also obtained from 8 men who had complied with the regimen for a mean of 14.2 years. Hormone dependent LNCaP and independent PC-3 prostate cancer cell lines were grown in culture medium containing 10% of subject pre-intervention or post-intervention serum and viable cells were counted after 48 hours. Anthropometry, serum free testosterone, lipids and glucose were measured in all subjects. RESULTS: Post-intervention serum from each of the 11-day intervention subjects reduced LNCaP cell growth by a mean of 30% compared with pre-intervention serum from each (p <0.01). LNCaP cell growth in serum from long-term subjects was 15% below that of post-intervention serum (p <0.01). There was no difference in the growth of PC-3 cells when cultured with serum from either intervention group. Serum free testosterone, body weight, glucose and lipids were significantly reduced in 11-day subjects. CONCLUSIONS: A low fat, high fiber diet and exercise intervention resulted in serum changes that significantly reduced the growth of androgen responsive LNCaP prostate cancer cells in vitro.
UI - 21382608
AU - Zelefsky MJ; Fuks Z; Hunt M; Lee HJ; Lombardi D; Ling CC; Reuter VE;
TI - Venkatraman ES; Leibel SA High dose radiation delivered by intensity modulated conformal radiotherapy improves the outcome of localized prostate cancer.
SO - J Urol 2001 Sep;166(3):876-81
AD - Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA.
PURPOSE: We present the long-term outcome and tolerance of 3-dimensional (D) conformal and intensity modulated radiation therapy for localized cancer were treated with 3-D conformal or intensity modulated radiation therapy. Patients were categorized into prognostic risk groups based on pretreatment prostate specific antigen (PSA), Gleason score and clinical stage. Sextant biopsies were performed 2.5 years or greater after treatment to assess local control. PSA relapse was defined according to the consensus guidelines of the American Society for Therapeutic Radiation Oncology. Late toxicity was classified according to the Radiation Therapy Oncology Group morbidity grading scale. Median followup was 60 months. RESULTS: At 5 years the PSA relapse-free survival rate in patients at favorable, intermediate and unfavorable risk was 85% (95% confidence interval [CI] +/- 4), 58% (95% CI +/- 6) and 38% (95% CI +/- 6), respectively (p <0.001). Radiation dose was the most powerful variable impacting PSA relapse-free survival in each prognostic risk group. The 5-year actuarial PSA relapse-free survival rate for patients at favorable risk who received 64.8 to 70.2 Gy. was 77% (95% CI +/- 8) compared to 90% (95% CI +/- 8) for those treated with 75.6 to 86.4 Gy. (p = 0.05). The corresponding rates were 50% (95% CI +/- 8) versus 70% (95% CI +/- 6) in intermediate risk cases (p = 0.001), and 21% (95% CI +/- 8) versus 47% (95% CI +/- 6) in unfavorable risk cases (p = 0.002). Only 4 of 41 patients (10%) who received 81 Gy. had a positive biopsy 2.5 years or greater after treatment compared with 27 of 119 (23%) after 75.6, 23 of 68 (34%) after 70.2 and 13 of 24 (54%) after 64.8 Gy. The incidence of toxicity after 3-D conformal radiation therapy was dose dependent. The 5-year actuarial rate of grade 2 rectal toxicity in patients who received 75.6 Gy. or greater was 14% (95% CI +/- 2) compared with 5% (95% CI +/- 2) in those treated at lower dose levels (p <0.001). Treatment with intensity modulated radiation therapy significantly decreased the incidence of late grade 2 rectal toxicity since the 3-year actuarial incidence in 189 cases managed by 81 Gy. was 2% (95% CI +/- 2) compared with 14% (95% CI +/- 2) in 61 managed by the same dose of 3-D conformal radiation therapy (p = 0.005). The 5-year actuarial rate of grade 2 urinary toxicity in patients who received 75.6 Gy. or greater 3-D conformal radiation therapy was 13% compared with 4% in those treated up to lower doses (p <0.001). Intensity modulated radiation therapy did not affect the incidence of urinary toxicity. CONCLUSIONS: Sophisticated conformal radiotherapy techniques with high dose 3-D conformal and intensity modulated radiation therapy improve the biochemical outcome in patients with favorable, intermediate and unfavorable risk prostate cancer. Intensity modulated radiation therapy is associated with minimal rectal and bladder toxicity, and, hence, represents the treatment delivery approach with the most favorable risk-to-benefit ratio.
UI - 21382609
AU - Goluboff ET; Prager D; Rukstalis D; Giantonio B; Madorsky M; Barken I;
TI - Weinstein IB; Partin AW; Olsson CA; UCLA Oncology Research Network Safety and efficacy of exisulind for treatment of recurrent prostate cancer after radical prostatectomy.
SO - J Urol 2001 Sep;166(3):882-6
AD - Department of Urology, Columbia University, Columbia-Presbyterian Medical Center, Allen Pavilion, 5141 Broadway, New York, NY 10034, USA.
PURPOSE: We evaluated the safety and efficacy of exisulind for delaying disease progression in men with increasing prostate specific antigen (PSA) after radical prostatectomy. MATERIALS AND METHODS: A total of 96 men with increasing PSA after radical prostatectomy were randomized to receive placebo (49) or 250 mg. exisulind twice daily (47) for 12 months. The primary efficacy parameter was the difference in change from baseline PSA between the placebo and exisulind groups. The PSA doubling time was also evaluated before and during study. A subgroup analysis classified patients based on the risk of developing metastatic disease. RESULTS: Compared with placebo, exisulind significantly suppressed the increase in PSA in all patients (p = 0.017). The results were also statistically significant in men at high risk for metastasis (p = 0.0003) and those who could not be classified according to risk (p = 0.0009). In addition, median PSA doubling time was lengthened in high risk patients on exisulind (2.12 month increase) compared with those on placebo (3.37 month decrease, p = 0.048). Exisulind was well tolerated. CONCLUSIONS: Exisulind inhibited the increase in PSA overall and prolonged PSA doubling time in high risk patients compared with placebo. These results suggest that Exisulind has the potential to extend the time from biochemical recurrence to the need for androgen deprivation therapy. Exisulind was well tolerated in this patient population. Our results support further study of Exisulind in the treatment of patients with prostate cancer.
UI - 21382623
AU - Davis JW; Kuban DA; Lynch DF; Schellhammer PF
TI - Quality of life after treatment for localized prostate cancer: differences based on treatment modality.
SO - J Urol 2001 Sep;166(3):947-52
AD - Department of Urology, Virginia Prostate Center, Eastern Virginia Medical School, Norfolk, VA, USA.
PURPOSE: Brachytherapy with 103palladium (103Pd) is an increasingly administered treatment modality for localized prostate cancer. We compared general and disease specific health related quality of life after 103Pd treatment, radical prostatectomy and external beam radiation therapy given during the same time frame. MATERIALS AND METHODS: We performed a retrospective cross-sectional survey study of patients treated at a single community medical center between 1995 and 1999. We mailed 5 validated health related quality of life survey instruments to 269, 142 and 222 men who underwent radical prostatectomy, 103Pd treatment and external beam radiation therapy, respectively, with a response rate of greater than 80% in all groups. RESULTS: General health related quality of life assessed by the SF-36 showed the same scores in patients who underwent prostatectomy and 103Pd treatment. The University of California-Los Angeles Prostate Cancer Index was used to assess bowel, urinary and sexual function/bothersomeness. External beam radiation therapy reported was associated with worse bowel function and greater bowel bothersomeness. Prostatectomy was associated with worse urinary function compared to 103Pd and external beam radiation therapy. Prostatectomy was associated with worse sexual function than 103Pd or external beam radiation therapy, although nerve sparing surgery and erectile aids minimized the difference. American Urological Association symptom scores were initially higher for 103Pd but became equal to those in the other groups in patients treated greater than 12 months from survey time. Disease-free men who underwent prostatectomy and 103Pd brachytherapy were equally confident that cancer would not recur in the future. Satisfaction rates were equivalent and biochemical failure significantly decreased satisfaction in all groups. CONCLUSIONS: While general health related quality of life was mostly unaffected by the 3 most common treatments for prostate cancer, there were differences in bowel, urinary and sexual function. This information may aid patients in the decision making process.
UI - 21382624
AU - Han BH; Demel KC; Wallner K; Ellis W; Young L; Russell K
TI - Patient reported complications after prostate brachytherapy.
SO - J Urol 2001 Sep;166(3):953-7
AD - Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
PURPOSE: Prostate brachytherapy has gained popularity due partly to the low rates of short-term complications shown in studies from highly select clinical practices. These series rely on medical records generated by the treating physician and are prone to underreport complications. We summarize the complication reports obtained directly from patients to establish a more realistic incidence of treatment related problems. MATERIALS AND METHODS: In 1997, 160 consecutive patients treated with prostate brachytherapy at the University of Washington were studied. A questionnaire was designed to determine the rate of complications occurring within 1 year of the procedure. The questions were formulated for ease of use and conciseness, while accounting for easily recalled events associated with complications. A total of 147 (92%) patients completed the questionnaire. RESULTS: There were 8 (5%) patients who required hospital admission for an average of 2 days (range 1 to 7) as a result of the procedure. A total of 56 (38%) patients required nonroutine visits with a physician in an office setting or at an emergency room. Radiation proctitis diagnosed by endoscopy developed in 8 (5%) patients but no one needed surgical intervention. A total of 47 (32%) patients required urinary catheterization at some point after implantation. CONCLUSIONS: We demonstrated a higher rate of short-term complications than those previously reported. Fortunately, the majority of side effects were self-limited and no treatment related mortality or cardiovascular morbidity was seen. Our findings may provide a more realistic account of the complications likely to occur after implantation than might be surmised from previous reports.
UI - 21382627
AU - Lodding P; Bergdahl C; Nyberg M; Pileblad E; Stranne J; Hugosson J
TI - Inguinal hernia after radical retropubic prostatectomy for prostate cancer: a study of incidence and risk factors in comparison to no operation and lymphadenectomy.
SO - J Urol 2001 Sep;166(3):964-7
AD - Department of Urology, Sahlgrenska University Hospital, Goteborg, Sweden.
PURPOSE: The incidence, mechanisms and risk factors of inguinal hernia after radical retropubic prostatectomy are sparsely elucidated in the literature. We determined the rate of inguinal hernia after radical retropubic prostatectomy and compared it to the incidence in patients with prostate cancer who did not undergo operation or underwent only pelvic lymph node dissection. MATERIALS AND METHODS: We followed 375, 184 and 65 men who underwent radical retropubic prostatectomy plus pelvic lymph node dissection, pelvic lymph node dissection only and no surgery with respect to inguinal hernia for a mean of 39, 47 and 45 months, respectively. The prostatectomy group was also evaluated in regard to the potential risk factors of previous hernia surgery and post-prostatectomy anastomotic stricture. RESULTS: The incidence of hernia was 13.6%, 7.6% and 3.1% in the prostatectomy, lymph node dissection and unoperated group, respectively. The difference was statistically significant in the prostatectomy and unoperated groups according to the Mantel-Cox log rank test and Cox proportional hazards rate. Previous hernial surgery and post-prostatectomy anastomotic stricture were more common in patients with an inguinal hernia after prostatectomy. CONCLUSIONS: The incidence of inguinal hernia is clearly increased in men who have undergone radical retropubic prostatectomy plus pelvic lymph node dissection compared with those who undergo no surgery for prostate cancer. Inguinal hernia appears to develop more often in men with prostate cancer who undergo radical retropubic prostatectomy and pelvic lymph node dissection than in those who undergo pelvic lymph node dissection only. While surgical factors trigger hernial development, previous hernial surgery and post-prostatectomy anastomotic stricture may be important risk factors. In fact, the latter may largely explain the difference in the incidence of inguinal hernia in our lymph node dissection and prostatectomy groups. Prophylactic surgical procedures must be evaluated to address this problem.
UI - 21382641
AU - Young MD; Dahm P; Robertson CN
TI - Prostatic sarcoma with rapid tumor progression after nerve sparing radical cystoprostatectomy.
SO - J Urol 2001 Sep;166(3):994
AD - Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC, USA.
UI - 21382642
AU - Wiersinga WJ; De Reijke TM; Blank LE
TI - Local tract metastasis of prostatic adenocarcinoma 8 years after (125)iodine brachytherapy.
SO - J Urol 2001 Sep;166(3):995
AD - Department of Urology and Radiation Oncology, Academic Medical Center, Amsterdam, The Netherlands.
UI - 21385143
AU - Kasahara K; Taguchi T; Yamasaki I; Karashima T; Kamada M; Yuri K; Shuin
TI - T Fluorescence in situ hybridization to assess transitional changes of aneuploidy for chromosomes 7, 8, 10, 12, 16, X and Y in metastatic prostate cancer following anti-androgen therapy.
SO - Int J Oncol 2001 Sep;19(3):543-9
AD - Department of Urology, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.
There have been few detailed studies conducted on the cell population in relation to cytogenetic changes between the pre- and post-treatment periods in patients with prostate cancer. We investigated numerical chromosome changes associated with anti-androgen therapy, using fluorescence in situ hybridization (FISH). FISH using chromosome-specific centromeric probes was used to assess transitional changes in the frequency of aneuploidy for chromosomes 7, 8, 10, 12, 16, X, and Y in prostate cancer during the pre- and post-treatment periods. Gains of chromosomes 7, 8 and 12 were notable in the pre-treatment samples (8 out of 9 cases in chromosome 7; 8 out of 9 cases in chromosome 8; 7 out of 9 cases in chromosome 12), while a notable reduction in the number of cells with extra copies of these chromosomes was observed in post-treatment specimens. Other chromosomes did not show noticeable change in their FISH signals at each phase of clinical treatment in all 9 cases. Changes in cell number with high ploidies of chromosome 7, 8 and 12 reflect the clinical effects of anti-androgen therapy at the early phase, which might explain the androgen dependency of metastatic prostate cancer cells.
UI - 21414850
AU - Hara I; Miyake H; Hara S; Gotoh A; Eto H; Arakawa S; Kamidono S
TI - Long-term results of neoadjuvant hormonal therapy prior to radical prostatectomy in patients with clinically localized prostate cancer: biochemical and pathological effects.
SO - Hinyokika Kiyo 2001 Jul;47(7):453-8
AD - Department of Urology, Kobe University School of Medicine.
The objective of this study was to evaluate the long-term biochemical and pathological effects induced by neoadjuvant hormonal therapy (NHT) NHT for 3 to 11 months (median: 5 months) using luteinizing hormone-releasing hormone analogue prior to radical prostatectomy and pelvic lymphadenectomy. The clinical stage was T1 in 1 patient, T2 in 17 and T3 in 6, the pretreatment serum prostate-specific antigen (PSA) value was < or = 10 ng/ml in 5 patients, 10 to 20 ng/ml in 4 and > 20 ng/ml in 15 (mean: 34.7 micrograms/l), and the Gleason score was < or = 4 in 9 patients, 5 to 7 in 11 and > 8 in 3. The mean prostate specific antigen (PSA) value 3 months after NHT had reduced below 2 ng/ml in 18 of the 24 patients (67%), and finally decreased by an average of 95% (i.e., 1.9 ng/ml) prior to surgery. The pathological stage was pT0 in 2 patients, pT2 in 10 and pT3 in 12. The incidence of organ-confined disease (OCD) was significantly higher in patients with clinical stage T1 or T2a than with T2b or T3, with pretreatment PSA values < or = 10 ng/ml than with PSA values > 10 ng/ml, and with PSA values < or = 2 than with PSA values > 2 at 3 months after NHT; in contrast, the Gleason score had no significant impact on the rate of OCD. After a median follow-up of 49 months (range 34 to 85 months), 6 patients (25%) had a recurrence evidenced by rising PSA, and the 3-year recurrence-free survival rate was 79%. These results suggest that NHT appears not to be of significant additional benefit to patients who have a higher clinical T stage, higher pretreatment PSA values and/or in patients whose PSA values do not normalize early in the treatment process.
UI - 21414861
AU - Yumura Y; Hara Y; Ida T
TI - [Mucinous adenocarcinoma of the prostate: a case report]
SO - Hinyokika Kiyo 2001 Jul;47(7):505-8
AD - Department of Urology, National Atami Hospital.
A 64-year-old man presented to our department with urinary retention. Rectal examination revealed a small and soft prostate. PSA was within the normal limits. Computed tomography showed a low-density area around the prostatic urethra and urethrography revealed an irregular prostatic urethra compressed by the prostate. We performed transurethral resection of prostate (TUR-P). On resectoscopy, jelly-like round substances were seen in the bladder. Prostatic urethra and bladder neck were covered with a jelly-like substance. Pathological diagnosis was mucinous adenocarcinoma of the prostate with bladder neck involvement. One month later after TUR-P, we performed radical cystoprostatectomy. Histological findings showed the cancer, of which 70-80% was composed of extracellular mucin lakes containing floating clumps of tumor cells. Mucin lake was stained with alcian blue and PAS. Immunohistochemical study revealed the tumor cells positive for carcinoembryonic antigen (CEA) and negative for prostatic specific antigen (PSA).
UI - 21430292
AU - Matzkin H; Kaver I; Stenger A; Agai R; Esna N; Merimsky O
TI - [I125 prostate brachytherapy--short-term results of the first 150 patients in Israel]
SO - Harefuah 2001 Aug;140(8):694-8, 807
AD - Departments of Urology and Oncology, E. S
Endocrine System Cancers
Head and Neck Cancers
Urinary Tract Cancers
Bone Marrow Transplants
General Treatment Concerns
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
Cancer Resource List
Resources for Young Adults