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Prostate Cancer

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ORLANDO--Today, after more than 10 years of research, PSA-related testing can daunt even the most experienced urologists, said a panel of experts at the American Urological Association meeting. Three panelists advised urologists on how to interpret a rising PSA after prostate cancer treatment and what further actions to take when this occurs.

ASCO--In an EORTC study, the combination of radiotherapy and adjuvant hormonal therapy with an LHRH analog has been shown to significantly increase survival in patients with locally advanced prostate cancer, compared with radiotherapy alone.

ASCO--Many men diagnosed with prostate cancer will not die of their disease if left untreated, but clinicians have no way of telling which early cancers require more aggressive treatment and which are likely to be indolent. A new genetic test, developed by researchers at Dana-Farber Cancer Institute, may shed some light on this important dilemma.

FORT LAUDERDALE, Fla--The duration of anticipated survival after a prostate cancer diagnosis, and therefore the period of time at risk in the disease, is unique to prostate cancer in the influence it exerts on selection of therapy.

ABBOTT PARK, Ill--Abbott Laboratories and the Finnish-based company Wallac Oy, a subsidiary of EG&G Inc. (Wellesley, Mass), have received a US patent for two methods of assaying free PSA (prostate-specific antigen).

MARINA DEL REY, Calif--Preliminary studies show that cryosurgical ablation of the prostate can be used to treat localized prostate cancer, resulting in negative post-treatment biopsies and undetectable serum PSA levels, reported Peter R. Carroll, MD, associate professor of urology and director, Urologic Oncology Program, University of California, San Francisco (UCSF).

Adenocarcinoma of the prostate is now the most common tumor in males. The use of the digital rectal examination, prostate-specific antigen (PSA), and transrectal ultrasound of the prostate with biopsies has improved the detection of prostate cancer and has increased the percentage of patients with organ-confined disease who are treated with radical prostatectomy. It is critical for the practicing urologic and medical oncologist to have accurate and precise pathologic information in order to counsel patients for appropriate therapy. Ideal biopsy and clinical predictive criteria for tumor volume in prostates are not readily available in the literature.

Dr. Epstein provides a comprehensive review of the pathology of prostatic carcinoma and its importance in guiding the clinical management of treatment for our patients with abnormal prostates and prostate cancer. Prostate cancer, its evaluation, screening, and treatment, remain in many aspects the most controversial for the urologic oncologist. Clearly, our decisions on how we treat patients with elevated PSA's, abnormal prostate exams, and a diagnosis of prostate cancer is influenced greatly by the interpretation of the pathologist of biopsies and radical prostatectomy specimens. In short, the oncologist and urologist are unable to make intelligent and accurate recommendations without accurate pathologic review.

The pathologist plays an integral role in the evaluation and treatment of many urologic cancers. Prostate cancer may be the best example of the importance of the pathologist in providing accurate clinical staging. Dr. Epstein has written an excellent review of the critical pathologic information available from prostate needle biopsy and radical prostatectomy specimens. The article highlights how to utilize this information in day-to-day clinical practice. Although the article is complete, some areas deserve special attention.

PALM SPRINGS, Calif--Early diagnosis of prostate cancer can be a mixed blessing, bringing with it not only the chance of cure but also the psychological distress of choosing between watchful waiting and treatment, and if treatment is chosen, which treatment, Andrew Roth, MD, said at the Academy of Psychosomatic Medicine meeting.

WILMINGTON, Del--Zeneca Pharmaceuticals has received clearance from the FDA to market a new formulation of Zoladex (goserelin acetate implant) for the palliative treatment of advanced prostate cancer.

MIAMI BEACH--Potency status in prostate cancer patients before radiation therapy, not the radiation dose, is the main determinant of potency status afterwards, Adam P. Dicker, MD, said at the 37th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

MIAMI BEACH--Cancer patients treated with strontium-89 (Metastron) for palliation of their metastatic bone pain may also benefit therapeutically, said Michael J. Katin, MD, a radiation oncologist in Fort Myers, Florida, whose practice includes a significant number of patients with painful bone metastases resulting primarily from prostate cancer.

WASHINGTON--In 1990, General H. Norman Schwarzkopf commanded the imagination of the American people during his service as Commander of Operations Desert Shield and Desert Storm. At the First National Congress on Cancer Survivorship, he stormed the stage of the Washington Court Hotel to describe his role as a prostate cancer survivor and patient advocate. The message was simple and personal. "I am here," the general said, "because I won a battle."

JERUSALEM--Tumor cells that are not eradicated by chemotherapy or radiotherapy can enter a prolonged dormant state and thus pose a continuous threat of tumor relapse in patients who are seemingly "cured," Eitan Yefenof, PhD, said in an interview with Oncology News International.

WILMINGTON, Del--Zeneca Pharmaceutical's Casodex (bicaluta-mide), a new nonsteroidal antiandrogen, has received FDA approval for the hormonal treatment of advanced prostate cancer in combination with a luteinizing-hormone-releasing hormone analog (LHRH-A). The agent acts by binding to cytosol androgen receptors.

NEW YORK-Citing the dispro-portionally high incidence and mortality of prostate cancer among African-American men, Marc B. Garnick, MD, associate clinical professor of medicine, Harvard Medical School, singled out this segment of the population as the target for intensive efforts to raise awareness.

NEW YORK-A new study by Louis Harris and Associates points to serious gaps between what doctors treating prostate cancer say they tell their patients and what prostate cancer patients report they have heard. A panel of experts at a press conference called to present the findings agreed that these communication gaps must be repaired if further progress is to be made in fighting what they called this "male epidemic."

SEATTLE-Current screening techniques allow the early detection of prostate cancer in large numbers of men every year. The problem is that prostate cancer appears to be an almost ubiquitous malignancy in men over the age of 50. The question, then, is which patients require intervention to prevent their cancer from becoming life threatening?