Prostate Cancer

Patients with metastatic prostate cancer are living longer than they used to, thanks to a wider range of therapeutic options. This means that an increasing number of men will receive long-term treatment with anti-hormonal therapy - androgen-deprivation therapy (ADT) - and the risk of side effects from this therapy is increasing. A relevant decrease in bone density is increasingly seen in patients receiving ADT, which means that a disproportionate increase in risk of fractures is seen in aging patients. Urologists are confronted with these patients in clinical practice. The question is how urologist-care for these patients is organised in the Netherlands. A survey among urologists in the Netherlands revealed that there is great diversity in how they think and act, and that there is a need for national guidelines and additional training on this subject. Nederlands tijdschrift voor geneeskunde. 2020 Feb 18*** epublish *** Donald Schweitzer, Harm H E van Melick St. Antonius ziekenhuis, ...

This is because the results can produce a false-positive result - meaning the test results can suggest cancer when it's really not there. And the PSA test can also show a false-negative result, with people who do have prostate cancer not being picked up by the test. Additionally, you may be given a digital rectal examination (when a gloved finger is inserted into your bottom) to help make a prostate cancer diagnosis. Although this may sound uncomfortable, it's vital for your health to determine if you need treatment for cancer.

When cancer recurs after prostate surgery, adding long term hormone therapy to radiation therapy may do more harm than good for men with low PSA levels, according to a University of Michigan Rogel Cancer Center led analysis published in JAMA Oncology . The U-M group performed a secondary analysis of the Radiation Therapy Oncology Group (RTOG) 9601 phase 3 randomized clinical trial . This trial originally found a survival benefit provided by long term antiandrogen therapy for men with recurrent prostate cancer when added to radiation therapy. The U-M team, however, found the benefit of hormone therapy varies depending on a patient’s prostate specific androgen level, also known as a PSA level. The level of PSA is often elevated in men with prostate cancer, and the test is used to detect prostate cancer and monitor its progression. “We showed that a patient’s PSA level can serve as both a prognostic and predictive biomarker that can help us determine who will benefit from hormone t...

To review the ongoing randomized trials of cytoreductive prostatectomy (CRP) in de novo hormone sensitive metastatic prostate cancer (HSPC) in order to identify their goals and assess their strengths and weaknesses. Pubmed, Medline and clinical trials websites searches were performed in order to identify currently ongoing trials of CRP in de novo HSPC. Nine randomized clinical trials in CRP were identified and included: SWOG 1802, SIMCAP, IP2-ATLANTA, TROMBONE, g-RAMPP, LOMP II, FUSCC-OMPCa and the Testing Radical Prostatectomy in Chinese Men with Prostate Cancer and oligoMetastases to the Bone study. Each study was different; assessing various primary outcome measures including overall survival, progression free survival and feasibility to randomize between standard therapy and CRP or between radiation therapy and CRP in the metastatic setting. In the oligometastatic setting, the trials assess OS, feasibility to randomize and time to castration. Similarly a number of secondary endpo...

To review the ongoing randomized trials of cytoreductive prostatectomy (CRP) in de novo hormone sensitive metastatic prostate cancer (HSPC) in order to identify their goals and assess their strengths and weaknesses. Pubmed, Medline and clinical trials websites searches were performed in order to identify currently ongoing trials of CRP in de novo HSPC. Nine randomized clinical trials in CRP were identified and included: SWOG 1802, SIMCAP, IP2-ATLANTA, TROMBONE, g-RAMPP, LOMP II, FUSCC-OMPCa and the Testing Radical Prostatectomy in Chinese Men with Prostate Cancer and oligoMetastases to the Bone study. Each study was different; assessing various primary outcome measures including overall survival, progression free survival and feasibility to randomize between standard therapy and CRP or between radiation therapy and CRP in the metastatic setting. In the oligometastatic setting, the trials assess OS, feasibility to randomize and time to castration. Similarly a number of secondary endpo...

Prostate cancer. Credit: Phuoc Tran, M.D., Ph.D. Highly focused, intense doses of radiation called stereotactic ablative radiation (SABR) may slow progression of disease in a subset of men with hormone-sensitive prostate cancers that have spread to a few separate sites in the body, according to results of a phase II clinical trial of the therapy. The trial, called ORIOLE (Primary outcomes of a Phase II randomized trial of observation versus stereotactic ablative radiation for oligometastatic prostate cancer), and led by Johns Hopkins Kimmel Cancer Center researchers since 2016, compared the effectiveness of SABR versus "wait and watch" observation in recurrent cases of oligometastatic prostate cancer. "It has been a longstanding question, especially important now in the era of immunotherapy, whether any type of radiation, and SABR specifically, can stimulate the immune system," Tran said. "Our trial offers the best data to date to suggest that SABR can...

NEW YORK – A team from China and the US has shared findings from a genomic, transcriptomic, and epigenomic analysis of hundreds of prostate cancer cases in China and found that they harbor recurrent mutations that differ from those seen in patients from Western countries. "Alterations of the genome and epigenome were correlated and were predictive of disease phenotype and progression," the researchers reported, noting that the broader mutations and epigenetic changes identified in the cases "converged on pathways that are important for prostate cancer, providing insights into this devastating disease." The work was led by co-senior authors Yinghao Sun and Xu Gao, urology researchers at the Second Medical University in Shanghai, and co-senior author Ting Wang at Washington University. As they reported in Nature on Wednesday, the researchers used whole-genome sequencing, RNA sequencing, microRNA sequencing, and whole-genome bisulfite sequencing to search for somat...