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Prostate Cancer

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Patients who experience fatigue during radiotherapy for breast or prostate cancer may be reacting to activation of the proinflammatory cytokine network, a known inflammatory pathway, according to researchers from the University of California, Los Angeles.

Men with prostate cancer who consumed the active compounds in green tea demonstrated a significant reduction in serum markers predictive of prostate cancer progression, according to a study in Cancer Prevention Research (online June 19, 2009).

Ferring Pharmaceuticals announced that the US Food and Drug Administration (FDA) has approved the trade name Firmagon (degarelix for injection) for its prostate cancer treatment previously marketed under the generic name degarelix.

The optimal treatment for clinically localized prostate cancer is an ongoing subject of controversy.[1] As pointed out by Drs. Mirhadi and Sandler, no randomized trial has compared radical prostatectomy (RP) to radiation therapy (RT), and no study has definitively “proven” the superiority of one technique over the other. Therefore, we disagree with the author’s conclusion that RT “is the ‘only way to go’ when managing early-stage prostate cancer.”

Prostate cancer patients who undergo androgen deprivation therapy have an increased chance of developing bone- and heart-related side effects compared to patients who do not undergo ADT, according to an analysis in Cancer online (April 29, 2009).

A new technique, ultrasonic tissue-type imaging, could revolutionize the detection and treatment of prostate cancer, according to Ernest J. Feleppa, PhD, research director of the Frederic L. Lizzi Center for Biomedical Engineering at the Riverside Research Institute in New York. “The method seems to be capable of distinguishing cancerous from noncancerous tissue in the prostate,” Dr. Feleppa said

Crawford and Hou[1] review the data on luteinizing hormone-releasing hormone (LHRH) antagonists in prostate cancer. They describe the results of a phase III trial comparing monthly degarelix to monthly leuprolide in men with advanced prostate cancer. Degarelix treatment was associated with a more rapid decline of serum testosterone, and was not associated with an initial surge of serum testosterone seen during the first few days of treatment with leuprolide. They discuss the role of this new form of medical gonadal suppression for the treatment of prostate cancer.

The recent US Food and Drug Administration (FDA) approval of degarelix, a luteinizing hormone-releasing hormone (LHRH) antagonist, has renewed interest in this class of drugs as a prostate cancer therapy. Approval was based on a prospective phase III trial of 610 patients randomized to one of two dosing schedules of degarelix, or standard-of-care monthly leuprolide acetate monotherapy, with initial antiandrogen therapy allowed at the treating physician’s discretion for prevention of clinical flare.[1]

Physicians have known since 1941 that testosterone suppression benefits patients with symptomatic metastatic prostate cancer.[1] The pioneering study in this regard showed that estrogen therapy achieved comparable efficacy to castration by improving acid and alkaline phosphatase levels associated with relief of cancer-related symptoms. More than 6 decades later, however, many of the therapies subsequently developed for achieving androgen deprivation still suffer from serious limitations.

Ferring Pharmaceuticals announced the launch of a phase IIIB clinical trial of degarelix for injection, a new injectable gonadotropin-releasing hormone (GnRH) receptor antagonist approved by the US Food and Drug Administration (FDA) for the treatment of hormone-sensitive advanced prostate cancer.

Is the era of PSA screening coming to an end? Proponents say the test saves lives, but a growing number of critics contend that widespread screening does more harm than good. The ongoing controversy over the clinical value of PSA screening has long been perpetuated by a lack of persuasive data, leaving doctors and their patients with difficult conversations and a host of perplexing decisions.

PSA is the most important biomarker in a common malignancy. I will continue to test men starting at age 35 if there is a family history of prostate or breast cancer. Depending on the vitality of the individual, I will continue with PSA testing for the duration of the man’s health.

Although significant questions remain, the recently released IMPACT study is a major victory for Dendreon's prostate cancer vaccine, Provenge. Two years ago, Provenge was denied FDA approval causing a wave of public outcry. Now, all eyes are on FDA as Dendreon gears up to once again tackle the approval process.