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Genitourinary Cancers

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ASCO-Docetaxel (Taxotere) plus estramustine phosphate (Emcyt) and low-dose hydrocortisone proved effective and well tolerated in a phase II study of men with hormone-refractory prostate cancer. The study was conducted by the Cancer and Leukemia Group B (CALGB) and presented at the ASCO annual meeting.

NEW YORK--The National Comprehensive Cancer Network (NCCN) and the American Cancer Society (ACS) have collaborated to translate the NCCN prostate cancer guidelines into a patient-friendly resource for appropriate treatment, the two organizations announced at a press briefing.

DALLAS-An analysis of SEER data shows small but steady decreases in prostate cancer mortality since 1991, Robert A. Stephenson, MD, said at the American Urological Association annual meeting. He attributed the decline to a combination of factors, including earlier detection and better treatment of advanced disease. Yet overall, he said, the data show that prostate cancer remains a major cause of death in men and may be undertreated in the elderly.

New research shows that a low-calorie diet slows the progress of prostate cancer in animals. Tumor progression was inhibited irrespective of how the calories were reduced; ie, by cutting fat or carbohydrates or by changing the overall diet. The research

The VA Cancer of the Prostate Outcomes Study (VA CaPOS) is collecting quality-of-life (QOL) information from prostate cancer patients, spouses, and physicians at six VA medical centers. Currently, 601 men with prostate

New Orleans-The advisability of neoadjuvant hormonal therapy in the management of prostate cancer is a hotly debated issue. At the American Society of Therapeutic Radiology and Oncology (ASTRO) spring refresher course, two opinion leaders in radiation oncology squared off on opposite sides of this issue.

BETHESDA, Md-The National Cancer Institute is funding a wide range of prostate cancer research, including genetic epidemiology, molecular diagnostics, diet and nutrition, animal models, surveillance, diagnostic imaging, clinical trials, prevention and early detection, and the Cancer Genome Anatomy Project .

WASHINGTON-The Health Care Financing Administration (HCFA) has announced a national decision that Medicare will cover cryosurgery for patients with localized prostate cancer. The decision rescinds an October 1996 ruling against such coverage, which HCFA said reflected a lack of conclusive scientific evidence at that time in favor of the procedure. Additional evidence supporting its effectiveness led HCFA to reverse itself and grant coverage.

BUFFALO, NY-Roswell Park Cancer Institute is offering a new blood test to detect early prostate cancer. The complexed prostate-specific antigen (cPSA) test appears to be more accurate than standard PSA at differentiating between prostate cancer and benign conditions, and thus may eliminate the need for unnecessary biopsies when PSA tests are ambiguous

ROCKVILLE, Md-Patients with advanced prostate cancer treated with luteinizing hormone-releasing hormone (LHRH) agonists have essentially the same survival rate and experience roughly the same side effects regardless of which drug they receive, according to a technology assessment report prepared for the Department of Health and Human Services’ Agency for Health Care Policy and Research (AHCPR).

CHICAGO-A Canadian study has shown that men with hormone-resistant prostate cancer have improved global and social function, fewer symptoms, and a greater improvement in quality of life (QOL) measures over time when mitoxantrone (Novantrone) is added to prednisone. A subset of patients who crossed over to mitoxantrone after prednisone therapy had failed also experienced significantly greater improvement in quality of life measures.

Prostate cancer is the most common form of cancer (except skin cancer) in men. Several factors have been associated with an increased risk for prostate cancer, including age, ethnicity, family history, lifestyle, and

The promise of using reverse transcriptase–polymerase chain reaction (RT-PCR) technology for the detection of circulating prostate cancer cells in peripheral blood, although technically feasible at the molecular level, has proven clinically impractical for routine implementation in patient management. Reverse transcriptase–polymerase chain reaction has been successfully applied to detect and quantify (relatively speaking) genes that are differentially expressed in cells and tissues obtained from patients during various stages of malignant growth. In addition, the method has been applied to the detection of circulating cancer cells in peripheral blood using highly specific primer sets for specific molecular targets. These include epithelial cell cytokeratins for breast cancer, as well as enzymes, such as tyrosinase for melanoma and prostate-specific antigen (PSA) and prostate-specific membrane antigen (PSMA) for prostate cancer, using either nonnested or nested methodologies.

The article by Drs. de la Taille, Olson, and Katz is an accurate and concise review of clinical studies for the detection of circulating prostate cancer cells using reverse transcriptase–polymerase chain reaction (RT-PCR) technology. These investigators from the Department of Urology at Columbia-Presbyterian Medical Center have as much experience as any group in the use of RT-PCR for this purpose. Initially very strong proponents of the efficacy of RT-PCR as a staging tool, they have become slightly more reserved in the current article. In this well-written review, the authors allude to a number of issues affecting RT-PCR results from prostate cancer patients that deserve further comment.

Dr. de la Taille and colleagues from Columbia University provide an overview of the concept of molecular staging” of prostate cancer using reverse transcriptase–polymerase chain reaction (RT-PCR). They do an admirable job of summarizing all of the currently available data on the results of this assay in the clinical staging of prostate cancer. As they note, only their group and one other have been able to demonstrate that a positive assay correlates with final pathologic stage. A limited number of other studies have suggested that the RT-PCR assay can predict prostate-specific antigen (PSA) recurrence.