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Genitourinary Cancers

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The report by Hanks and colleagues examines two controversial issues that are related to the treatment of prostate cancer with external-beam radiotherapy: (1) the outcome of younger vs older men, and (2) the relative risk of relapse with follow-up beyond 5 years. The findings of their study are important not only in addressing these points, but also because they shed light on another concern often raised by urologists.

A study was undertaken to evaluate the question of cure in "young" men with prostate cancer treated by external-beam radiation. Results in young men (£ 65 years) were compared to older men. Biochemical freedom from failure was examined to 10 years’ follow-up, and hazard functions for failure vs time were reported. Results show that prostate cancer patients are cured by external-beam radiation and that there is no difference in results for young or older men. Few failures occur after 5 years’ follow-up and the percentage cured is similar to that with prostatectomy, with much less morbidity. Appropriate dose is necessary to optimize outcome. [ONCOLOGY 15(5):563-574, 2001]

BETHESDA, Md-Prostate cancer researchers at the University of California, San Francisco (UCSF) are focusing on GM-CSF, dendritic cells, and anti-VEGF antibodies, Eric Small, MD, said at a conference sponsored by the National Cancer Institute and the Society of Urologic Oncology. Dr. Small is associate professor of medicine and of urology and co-director of the UCSF/Mt. Zion Urologic Oncology Program.

A new bill called the Men’s Health Act of 2001 aims to focus more attention on diagnosing and treating men with prostate cancer. Rep. Randy Cunningham’s (R-Calif) Men’s Health

BOSTON-Men are far more likely to be diagnosed with prostate cancer today than 2 decades ago, and they have more aggressive treatment options. Is their chance of dying of the disease dropping as a result? It is too early in the era of prostate-specific antigen (PSA) testing to tell, keynote speaker Michael J. Barry, MD, said at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology .

BOSTON-A combination of transurethral resection (TUR) and radiochemotherapy with cisplatin (Platinol) and fluorouracil (5-FU) produced the most promising results in a German study of bladder-sparing protocols for patients with invasive bladder cancer.

BOSTON-Investigators at Johns Hopkins University School of Medicine are testing a common cold virus as a vector for gene therapy against prostate cancer, Theodore L. DeWeese, MD, reported at the 42nd annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO). The therapy was found to be safe, and the technique showed signs of antitumor activity in a phase I trial.

Prostate cancer is now the most commonly diagnosed noncutaneous neoplasm in men.[1] While there are many questions of profound clinical significance related to the management of this neoplasm, few are as critical as those regarding the limitations of current imaging modalities for clinicians involved in the management of these patients. As such, the thorough, if somewhat depressing, overview of the current status of imaging in prostate cancer by El-Gabry et al provides timely insight into both where we are and where we need to go.

Various treatment options are available for adenocarcinoma of the prostate-the most common malignant neoplasm among men in the United States. To select an optimum management strategy, we must be able to identify an organ-confined disease (in which local therapy such as surgery or radiation may be beneficial) vs prostate cancer beyond the confines of the gland (for which other treatment approaches may be more appropriate). At present, no standard imaging modality can by itself reliably diagnose and/or stage adenocarcinoma of the prostate. Standard transrectal ultrasound, magnetic resonance imaging (MRI), computed tomography, bone scans, and plain x-ray are not sufficiently reliable when used alone. Fortunately, advances in imaging technology have led to the development of several promising modalities. These modalities include color and power Doppler ultrasonography, ultrasound contrast agents, intermittent and harmonic ultrasound imaging, MR contrast imaging, MRI with fat suppression, MRI spectroscopy, three-dimensional MRI spectroscopy, elastography, and radioimmunoscintigraphy. These newer imaging techniques appear to improve the yield of prostate cancer detection and staging, but are limited in availability and thus require further validation. This article reviews the status of current imaging modalities for prostate cancer and identifies emerging imaging technologies that may improve the diagnosis and staging of this disease. [ONCOLOGY 15(3):325-342, 2001]

BOSTON-One year after prostate cancer treatment, men who had radiation therapy were more likely to be able to maintain an erection than those who had radical prostatectomy, according to a study presented at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

NEW YORK-Among prostate cancer patients with biochemical evidence of relapse after radical surgery, exisulind, a selective apoptotic antineoplastic drug, had a significant impact on rising PSA levels in a double-blind, placebo-controlled study, according to a report at the Chemotherapy Foundation Symposium XVIII.

BOSTON-Raising 3D conformal radiation therapy doses for localized prostate cancer produced far less toxicity than expected in a nine-center cooperative study reported at the annual meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

CARPINTERIA, Calif-A newly available fluorescent-based immunocytologic test to detect superficial bladder cancer, ImmunoCyt, used in conjunction with urinary cytology, will likely reduce the need for periodic cystoscopies in patients with transitional cell bladder cancer and enhance the early detection of recurrent disease.

BETHESDA, Md-Grants totaling $12.7 million have been awarded to five institutions for new research initiatives in breast and prostate cancer. The National Cancer Institute under its SPORE program (Specialized Program of Research Excellence) will fund the projects. The money will pay for the first year of the 5-year projects. Awards went to:

BOSTON-Short-term hormone therapy may benefit patients with localized intermediate- and high-risk prostate cancer, according to three retrospective studies presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting.

BOSTON-Combining long-term hormone therapy with radiation therapy for locally advanced prostate cancer significantly improves local progression, disease-free survival, freedom from distant metastasis, and biochemical control, according to results of a phase III clinical trial presented at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting.

Prostate Cancer Research

A second omnibus health-care bill-this one called the Public Health Improvement Act (H.R. 2498)-was passed quietly at the end of the 2000 session, with a prostate cancer section included. That section was originally a free-standing bill called