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Prostate Cancer

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Pirl and Mello carefully review the current state of knowledge about the psychological complications of prostate cancer. Their discussion is worth reading, particularly by those who treat patients with the disease. To put this knowledge in context for the general reader, we should give some thought to what this review illustrates about all patients with a serious life-threatening illness.

African-American patients with advanced prostate cancer survived slightly longer than white patients, according to a multi-institutional study led by Dana-Farber Cancer Institute researchers. The findings, which were reported at the 38th annual

UPPSALA, Sweden-In a new study, radical prostatectomy reduced deaths due to prostate cancer but did not increase overall survival in men with newly diagnosed, early-stage disease. The Scandinavian Prostatic Cancer Study Group found that after a median 6.2 years of follow-up, there were no significant differences in overall survival, but patients randomized to radical prostatectomy were less likely to develop distant metastases than those randomized to watchful waiting.

ORLANDO-A new two-stage prostate cancer vaccine should be explored in a phase III study in metastatic prostate cancer patients, based on promising phase II results of an Eastern Cooperative Oncology Group trial (E7897). Howard L. Kaufman, MD, reported the results of the "prime/boost" vaccine trial at the 38th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 12).

SEATTLE-Dendreon Corporation has announced preliminary results from its analysis of its randomized, double-blind, placebo-controlled phase III study of Provenge (APC 8015) for the treatment of hormone-resistant prostate cancer. The trial of the cancer vaccine (D9901) involved 127 men with late-stage, metastatic, hormone-resistant prostate cancer, 82 of whom received Provenge, three vaccinations over a 4-week period.

The Bayer Corporation recently announced that it has teamed up with Us Too! International to offer Continuous Care, a program for advanced prostate cancer patients using the leuprolide acetate implant (Viadur). The program provides appointment reminders, education, support materials, and valuable health coupons.

ORLANDO-In clinical trials, black men with metastatic hormone-refractory prostate cancer have the same and possibly longer survival, compared with whites, according to a pooled analysis of nearly 1,000 patients in four separate randomized phase III Cancer and Leukemia Group B (CALGB) trials.

The bisphosphonate zoledronic acid (Zometa) is effective in the treatment of skeletal-related events from bone metastases in prostate cancer patients, according to data presented at the 97th annual meeting of the American Urological Association. Patients with advanced prostate cancer are at high risk for bone complications, including bone pain, pathologic fractures, need for radiation or surgery to bone, and spinal cord compression. This study marks the first time a bisphosphonate has demonstrated efficacy in the treatment of bone metastases in this patient population.

With no clearly superior treatment for localized prostate cancer, physicians and patients would like to increase patient participation in the decision-making process. Unfortunately, physicians frequently have difficulty understanding patients’ preferences, and patients often do not have sufficient knowledge to make an informed treatment decision. Shared- decision-making tools, such as decision analyses, may increase patient participation and thereby improve physicians’ understanding of their patients’ views.

Normal and hyperplastic prostate glandular epithelium does not express somatostatin receptors. Neuroendocrine prostatic cells contain bioactive secretory products such as chromogranin A, serotonin, and neuron-specific enolase. The stromal smooth muscle cells around glandular epithelium and ganglion cells of the prostatic plexus are positive for somatostatin subtype 2 receptors (sst 2).[1] In prostate cancer, however, there is nonhomogeneous distribution of sst 1. In the peritumoral veins of prostate cancer, sst 2 receptors were found by Reubi et al in 14 of 27 samples.[2]

As a tumor marker, prostate specific antigen (PSA) has revolutionized the detection and management of adenocarcinoma of the prostate. From its discovery in the early 1970s to its application in the 1980s and finally widespread use in the 1990s, PSA has profoundly affected the way in which we treat prostate cancer. Many researchers in basic science and clinical practice have helped to create the PSA story, and the authors of this manuscript have made major contributions to our understanding of PSA as a tumor marker.

ORLANDO-In patients with hormone-refractory, metastatic prostate cancer, an allogeneic vaccine delays progression of disease and prolongs survival, according to data presented at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 729).

The results of a phase III multicenter trial presented at the 38th annual meeting of the American Society of Clinical Oncology showed for the first time that chemotherapy can improve the survival of patients with advanced hormone-refractory prostate cancer. For the study, researchers compared the effects of vinblastine alone vs vinblastine combined with estramustine (Emcyt).

ATLANTA-Dynamic magnetic resonance imaging (MRI) may be able to detect recurrent prostate cancer after prostatectomy when the patient has a negative biopsy but a rising prostate-specific antigen (PSA) level.