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Prostate Cancer

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NEW ORLEANS-A technique for rallying a prostate cancer patient’s antitumor response helps some patients without harming quality of life, Michael L. Salgaller, PhD, head of the immunothera-peutics division at Northwest Biother-apeutics, Seattle, reported at the 89th annual meeting of the American Association for Cancer Research (AACR).

ASCO--A Canadian study is the first to show that prostate cancer screening, using a PSA of 3.0 ng/mL as the upper limit of normal, could significantly decrease deaths from the disease. Fernand Labrie, MD, in his presentation at the ASCO plenary session, said that 27,000 lives a year could be saved in the United States alone if PSA testing were performed on all men age 50 and older.

NEW ORLEANS--High concentrations of insulin-like growth factor I (IGF-I) in the circulation identify the men most at risk of prostate cancer as well as the women at highest risk of premenopausal breast cancer, according to results presented at the 89th annual meeting of the American Association for Cancer Research (AACR).

BOSTON--Transrectal ultrasound is not a reliable method for detecting residual or recurrent tumor in prostate cancer patients after cryosurgical ablation, due to the altered appearance of the gland on ultrasound after freezing, Caryl Salomon, MD, said at the 42nd Annual American Institute of Ultrasound in Medicine (AIUM) conference.

BUFFALO, NY--Autoimmune prostatitis has been suggested as a new method for treating prostate cancer, and prostate-specific proteins are currently being sought to serve as targets for an autoimmune attack that could offer therapeutic benefits in prostate cancer.

The latest analysis of a large prevention trial conducted by the National Cancer Institute (NCI) and the National Public Health Institute of Finland showed that long-term use of a moderate-dose vitamin E supplement substantially reduced prostate cancer incidence and deaths in male smokers. The report was published in the March 18, 1998, issue of the Journal of the National Cancer Institute, and the lead author is Olli P. Heinonen, md, dsc, of the Department of Public Health, University of Helsinki, Finland.

HELSINKI, Finland--Supplemental vitamin E significantly decreased both the incidence and mortality of prostate cancer in a large randomized trial of male smokers in Finland, said Olli P. Heinonen, MD, DSc, and his colleagues from the University of Helsinki, the National Cancer Institute, and Montefiore Medical Center, New York.

WASHINGTON--Recognizing the devastating burden of prostate cancer, particularly among black men, the American Cancer Society (ACS) has released a plan of action aimed at addressing issues in research, education, patient and family support, and public policy. ACS president-elect Charles J. McDonald, MD, said that the Society will convene a conference shortly of "all key African-American national organizations" to determine how to implement the plan.

ORLANDO-Researchers at the Seattle Prostate Institute, University of Washington, and Northwest Hospital have shown excellent progression-free survival in favorable prostate cancer patients with the use of transperitoneal ultrasound-guided brachytherapy as sole treatment. Peter Grimm, DO, presented eight-year follow-up data on more than 400 patients in a poster presentation at the American Society for Therapeutic Radiology and Oncology meeting.

Drs. Forman and Velasco provide a timely and thorough review of the maturing concept of applying radiation therapy to the prostatic fossa after radical prostatectomy. The guidelines for therapy continue to evolve because of the increasing reliance on blood prostate-specific antigen (PSA) level for both detecting a recurrence of disease and evaluating response to radiotherapy.

I agree with Drs. Forman and Velasco that the optimal management of patients with an elevated prostate-specific antigen (PSA) level after prostatectomy remains to be determined. The broader issue, however, is optimizing the management of post-prostatectomy patients who are at risk for recurrence. Hence, the dilemma: Should we wait for a chemically apparent recurrence before instituting treatment? Or, should we, on the basis of available information, quantify the risk of recurrence and the possible side effects of therapy and determine whether or not adjuvant radiotherapy is warranted based on the risk/benefit ratio?

New treatments announced at the 1997 Endocrine Society Annual Meeting could help slow the rate of prostate cancer growth and improve the quality of life of those who have the disease.

The value of screening for prostate cancer, the second most common cancer in men, has been fiercely debated in recent years, but Professor Bolla from the Department of Radiotherapy, Centre Hospitalier de Grenoble, France, has no doubt that early detection is of prime importance in the treatment of prostate cancer.