Prostate Cancer

A study published in  Prostate Cancer and Prostatic Diseases  demonstrated the clinical utility of a prostate genomic classifier, created by Decipher, after radical prostatectomy in men with prostate cancer, suggesting that when treatment decisions were made and followed based on genomic test results, patient outcomes significantly improved. 1 A multidisciplinary tumor board at Thomas Jefferson University independently developed a guideline based on patient genomic risk, using Decipher as the determining factor for treatment recommendations in patients with prostate cancer following prostatectomy. Following the tumor board’s guideline, patients with adverse pathological findings after radical prostatectomy received the genomic test. Patients who received high-risk scores were recommended for immediate adjuvant radiation therapy, and those with low- and intermediate-risk scores were recommended for observation.  “Our findings show that use of Decipher Prostate (Radical...

A study published in  Prostate Cancer and Prostatic Diseases  demonstrated the clinical utility of a prostate genomic classifier, created by Decipher, after radical prostatectomy in men with prostate cancer, suggesting that when treatment decisions were made and followed based on genomic test results, patient outcomes significantly improved. 1 A multidisciplinary tumor board at Thomas Jefferson University independently developed a guideline based on patient genomic risk, using Decipher as the determining factor for treatment recommendations in patients with prostate cancer following prostatectomy. Following the tumor board’s guideline, patients with adverse pathological findings after radical prostatectomy received the genomic test. Patients who received high-risk scores were recommended for immediate adjuvant radiation therapy, and those with low- and intermediate-risk scores were recommended for observation.  “Our findings show that use of Decipher Prostate (Radical...

INTRODUCTION: To present the first case of a concomitant robotic radical prostatectomy and a left robotic partial nephrectomy performed by a single-port approach using the SP® da Vinci surgical system (Intuitive Surgical, Sunnyvale CA, EE.UU.). PATIENT AND METHODS: A 66-year-old male diagnosed with localized  prostate cancer  and a left kidney renal mass incidentally found on computed tomography (CT) scan during  prostate cancer  evaluation. Procedures were performed using a single supra-umbilical 3cm incision, plus one additional laparoscopic port, utilizing a standard Gelpoint® (Applied Medical, Rancho Santa Margarita, CA, EE.UU.) and replicating the technique previously described for single-port transperitoneal radical prostatectomy and partial nephrectomy with the use of the SP® robotic platform. RESULTS: Total operative time was 256minutes (min) with a console time of 108min for radical prostatectomy, and 101min for the partial nephrectomy respectively, i...

Many men believe they are invincible at any age. The last thing on their mind is a trip to the doctor. So what might spark at least a fleeting thought about their health among men over 50? Perhaps a push from those who love them?  How about prostate cancer?  Sixty percent of prostate cancer cases occur among men older than 65 – a figure topped only by skin cancer. And screenings are recommended for high-risk men as early as age 40 .  The American Cancer Society estimates there were 174,650 new cases of prostate cancer in 2019, an increase of 6 percent from 2018. Prostate cancer has no known cause, but in addition to age, other risk factors include family history and obesity. African American males are among certain ethnic and racial groups at greater risk. While screening and a discussion with your doctor are among the preventative tips offered by experts, what’s interesting is the emphasis they place on lifestyle. Diet, exercise and healthy behavior dominate th...

DNA mismatch repair defects (MMRd) and tumor hypermutation are rare and under-characterized in metastatic prostate cancer. Furthermore, since hypermutated MMRd prostate cancers can respond to immune checkpoint inhibitors, there is an urgent need for practical detection tools. We analyzed plasma cell-free DNA targeted sequencing data from 433 metastatic prostate cancer patients with circulating tumor DNA (ctDNA) purity ≥2%. Samples with somatic hypermutation were subjected to 185× whole exome sequencing and capture of mismatch repair gene introns. Archival tissue was analyzed with targeted sequencing and immunohistochemistry. 16 patients (3.7%) had somatic hypermutation with MMRd etiology, evidenced by deleterious alterations in MSH2, MSH6, or MLH1, microsatellite instability, and characteristic trinucleotide signatures. CtDNA was concordant with mismatch repair protein immunohistochemistry and DNA sequencing of tumor tissue. Tumor suppressors such as PTEN, RB1, and TP53 were inactiva...

To compare intraoperative and perioperative outcomes between extraperitoneal and transperitoneal radical prostatectomy performed by using a "purpose-designed" single-port robotic platform. 98 patients underwent single-port robotic prostatectomy using the da Vinci SP® robotic system with extraperitoneal (Group I (n=52)) versus transperitoneal (Group II (n=46)) approach. Demographics and perioperative data including postoperative recovery outcomes were recorded and compared between the two groups. Groups were similar regarding demographics and prostate cancer risk category. Mean operative time (201± 37.5 min vs. 248.2 ± 42.3 min; p< 0.00001) as well as median postoperative hospital stay (4.3 vs. 25.7 hours p<0.0001) was significatly shorter with extraperitoneal approach. Overall need for pain medications or narcotics as well as the required amount of narcotics per patient (if administered) were significantly lower with the extraperitoneal approach. Extraprostatic extens...

For decades, therapy to strengthen pelvic muscles has been the standard treatment for men dealing with urinary incontinence after prostate surgery. But a new study from UT Southwestern's Departments of Urology and Physical Medicine and Rehabilitation suggests that may not be the best approach. The study examined records from post-prostatectomy patients with stress urinary incontinence - meaning loss of bladder control while sneezing, bending over, etc. - who received physical therapy between 2009 and 2014. Researchers found most had some muscle "overactivity" - muscle tightness or spasms - rather than just muscle weakness, says Kelly M. Scott, M.D., an associate professor in the Department of Physical Medicine and Rehabilitation at UT Southwestern and first author of the study. Using exercise in an attempt to strengthen a tight or spasming muscle can be counterproductive, making the muscle tighter instead of stronger." Michelle H. Bradley, a physical therapist w...

Other than skin cancer, prostate cancer is the second most commonly diagnosed cancer, and it is the fifth leading cause of death in men worldwide. In developed countries, prostate cancer is diagnosed more than any other type of male cancer and is the third leading cause of cancer-related deaths among men. The majority of prostate cancer–related deaths are due to advanced disease, which arises from any combination of lymphatic, hematogenous, or contiguous local spread. The rate of death due to prostate cancer continues to rise in Europe and in countries such as Australia, Japan, and Russia. How much do you know about advanced and metastatic prostate cancer? Test your knowledge with this short quiz. Medscape © 2019 WebMD, LLC Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape. Cite this: Daniel S. Schwartz. Fast Five Quiz: Advanced and Metastatic Prostate Cancer -  Medscape  - Dec...

Current treatment options for stage D0 prostate cancer, in which a patient’s prostate specific antigen (PSA) level has become detectable again or has begun to increase after primary treatment, include watchful waiting, salvage radiation, and androgen deprivation therapy (ADT) — which often entails side effects that impact the quality of life.   But a new vaccine may one day delay the need to use ADT by harnessing patients’ immune systems, researchers reported at the 34th Annual Meeting & Preconference Programs of the Society for Immunotherapy of Cancer, or SITC 2019, which occurred in Maryland in November 2019. 1 The vaccine, which is currently being investigated at the National Institutes of Health’s National Cancer Institute, targets TARP, a 58-amino acid protein that is expressed in about 95% of prostate cancers. Initial research that looked at an earlier version of the vaccine showed that it was safe to use and that it decreased the rate of rise in PSA. 2   Relat...

Metastatic prostate cancer is incurable, but systemic therapies can improve quality of life and prolong survival. Accurate perceptions of treatment risks and benefits are vital as patients with metastatic disease make treatment decisions. We assessed treatment-related expectations for benefit among patients with metastatic prostate cancer and explored associated sociodemographic characteristics. Men with metastatic prostate cancer (N = 100) completed surveys assessing their treatment-related expectations for cancer cure, symptom relief, and prolonged life expectancy. Frequencies were used to describe the proportions of reported expectations. Fisher's exact tests were used to assess the associations of sociodemographic characteristics with treatment expectations. One third (33%) of participants believed treatment was at least a little likely to cure their metastatic cancer. Most participants believed treatment could provide symptom relief (76%) and extend life expectancy (95%...

Robot-assisted radical prostatectomy (RARP) has become the predominant surgical modality to manage localized prostate cancer in the US. However, there are very few studies focusing on the associations between hospital volume and outcomes of RARP. We identified RARPs for clinically localized (cT1-2N0M0) prostate cancer diagnosed between 2010 and 2014 in the National Cancer Database. We categorized annual average hospital RARP volume into very low, low, medium, high, and very high by most closely sorting final included patients into five equal-sized groups (quintiles). Outcomes included 30-day mortality, 90-day mortality, conversion (to open), prolonged length of stay (PLOS, >2 d), 30-day (unplanned) readmission, positive surgical margin (PSM), and lymph node dissection (LND) rates. A total of 114,957 patients were included and hospital volume was categorized into very low (3-45 cases/year), low (46-72 cases/year), medium (73-113 cases/year), high (114-218 cases/year), and very high...

Amit Kumar, PhD The Cchek Prostate Cancer Confirmation test (Cchek PCC)—which utilizes artificial intelligence (AI), flow cytometry, and liquid-biopsy technology to detect prostate cancer—has been commercially launched, according to Anixa Biosciences, Inc., developer of the test. Once it becomes available, this test will reduce the need for expensive and invasive biopsy procedures to diagnose patients with prostate cancer in certain patients. The test will be offered as a Clinical Laboratory Improvement Amendments program­–validated test through ResearchDx, a partner laboratory of Anixa Biosciences, Inc. ResearchDx independently validated the test and designed it to confirm the need for prostate biopsy. The test should minimize unnecessary and invasive procedures, as well as reduce healthcare costs that are typically associated with traditional methods for diagnosing prostate cancer, as well as associated adverse events. Over 90% of prostate biopsies performed in the United States a...

Legendary Talk host Don Imus, who passed away Dec. 27, 2019. Don Imus , a legendary Talk radio host who became famous for his morning show at the former WNBC-AM in New York and, later, at WFAN, died Friday morning from complications tied to prostate cancer. He was 79 years old. According to media reports, Imus was hospitalized Christmas Eve at Baylor Scott and White Medical Center, in College Station, Tex. An exact cause of death was not immediately known. He was diagnosed with prostate cancer 10 years ago. For years, the syndicated  Imus in the Morning  program attracted a loyal following of older men, who were magnetized by the host’s acerbic politically tinged comedy and bits that had its origins in the 1970s, when Imus was one of the most well-known — and controversial — radio stars in Cleveland and in New York. His syndicated show was brought to radio stations across the U.S. by  ABC Radio Networks  and, later, via  Cumulus Media.  It was al...

When I was diagnosed with low-risk (Gleason 3+3) prostate cancer in December 2010, I had few choices. The first was to treat the disease with a radical prostatectomy (recommended by my first urologist) or radiation. Nine years ago, maybe 94% of men like me opted for what was viewed as a "cure." Of course, what you often got in exchange were major lifestyle disruptions: incontinence and impotence, plus a risk of sepsis and even death. The urologist saw it this way on a Tuesday that December: Bad news, you have cancer. Good news, I have an opening in the OR next Tuesday. I didn't see it that way. I went for a second-opinion the next day. The University of Chicago urologist said, "Surgery?" Bad idea. Instead, he proposed active surveillance (AS). Monitor the slow-growing disease and intervene if things became aggressive. He said that I was the "poster child" for AS. He said I'd likely be in the same condition ten years hence. I drank the Kool-Ai...

Despite being a validated source of biomarkers, liquid biopsy has not yet succeeded in becoming part of the standard clinical practice in prostate cancer patients. Few biomarkers undergo adequate validation, prospective and independent, of their predictive and/or prognostic value, which results in a lack of the different available tests in the clinical practice. To carry out a pragmatic synthesis of current scientific evidence on liquid biopsy for prostate cancer patients. Non-systematic literature review, narrowing the search to papers on liquid biopsy from blood samples in prostate cancer patients. We mainly selected works evaluating clinical endpoints in prostate cancer. The most clinically advanced forms of liquid biopsy are circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). Both CTCs and ctDNA have demonstrated their prognostic value in metastatic disease. ARV7 determination is the first predictive biomarker of the disease. Its implementation into routine clinica...

This study compares the side effects of active surveillance, prostatectomy, radiation with or without adjuvant endocrine therapy, watchful waiting, and palliative therapy on patient-reported outcomes in a nationwide, population-based cohort of Danish men with prostate cancer. A total of 15,465 participants completed questionnaires over a 5 year period (2011-2016). Condition-specific quality of life, focusing on urinary function, bowel incontinence, sexual function, and hormonal symptoms were investigated using the validated EPIC-26 questionnaire at diagnosis, 1 year- and 3- year follow-up. Patients were identified from the Danish Prostate Cancer Registry with data-linked to several national healthcare registries. Longitudinal analysis with linear mixed effects models were fitted to compare changes over time on quality of life symptom scores for five treatment modalities, adjusting for age, clinical TNM stage, PSA value, Gleason score, Charlson Comorbidity score, education, disposable ...

Men can be stubborn about their health, says Sarpy County Board member Gary Mixan. But he would like to see that change, especially when it comes to preventive care. He routinely gets physicals and talks to his doctor about concerns, which led to an early diagnosis of prostate cancer this year, even though he had no physical warnings. “There are not signs,” he said. “I had no idea I had anything starting to go wrong.” Early warning signs for prostate cancer aren’t common, according to the Prostate Cancer Foundation. Tumors in the walnut-sized organ don’t press against anything to cause pain. That’s why early screening is so important. “If you catch this stuff early, you have a very good chance of just taking care of it and moving on and being cancer-free,” Mixan said. He wants more men to follow his lead. It may be convenient to ignore one’s health if nothing feels off, Mixan said, but consistent medical care and communication with doctors is important for long-term hea...