Independent prognostic factors in patients with metastatic (stage D2) prostate cancer

Article Abstract:

For 40 years hormone therapy has been used to treat men with cancer that has spread beyond the prostate (metastatic prostate cancer), the gland that surrounds the base of the urethra. Little progress has been made during these four decades. Although most patients improve with therapy, about 20 percent do not respond at all. In a study of 283 patients, over 522 days so far, 78 patients had died. Four factors were identified that predicted the progression of the disease when four groups of similar patients were compared. The goal is to find the best timing for hormone therapy to begin, and to identify the patients who will most likely benefit from hormone treatment. The four predictors were levels of testosterone (a male hormone) and alkaline phosphatase (an enzyme), bone pain, and performance status. Patients with a high testosterone level were much more likely to be alive two years later, especially if they had a high performance status. If no bone pain was evident, the survival rate at two years reached 82 percent. A favorable alkaline phosphatase level produced a marginal improvement to 84 percent. The problem with serum testosterone level is that the circadian (24-hour) variation is great, therefore the prognosis will vary according to when the sample was taken. The level is low in the afternoon. The authors suggest that patients with a poor prognosis be eliminated from clinical trials, and that they be given experimental treatment in the event that it proves beneficial. The side effects of conventional or experimental hormone treatment are not mentioned, nor is a comparison made with survival rates of those who decide to forego treatment. The results of improved prognosis may provide improved counseling for those patients who elect to undergo hormone therapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Testosterone, Circadian rhythms, Alkaline phosphatase

---

The next era for prostate cancer: controlled clinical trials

Article Abstract:

Prostate cancer is a frequent cause of cancer death in men. Screening elderly men using a digital rectal examination (DRE) was promoted to improve survival by detecting cancer early. However, mortality from prostate cancer has not changed. It appears that assays of prostate-specific antigen (PSA) may provide prognostic information about prostate cancer. PSA is a protein produced only by the prostate gland, and is often present in larger amounts in men with prostate cancer. A 1992 study found that men with newly-diagnosed prostate cancer and PSA levels of 10 micrograms per liter or less were unlikely to have a positive bone scan, indicating that the disease had not spread to the bones. Another study found that annual DREs were not necessarily effective in reducing mortality or disease progression. Controlled studies are needed to determine whether PSA assays and regular DREs can reduce mortality from prostate cancer.

Editorial, Medical examination, Tumor antigens, Rectum, Rectal examination

---

Androgen deprivation therapy for prostate cancer

Article Abstract:

The evidence on the risks and benefits of androgen deprivation therapy (ADT) for prostate cancer as well as clinical management of its adverse effects is reviewed. The results revealed that androgen deprivation therapy has clear roles in the management of advanced prostate cancer and high-risk localized disease.

United States, Analysis, Risk factors, Androgens

Similar abstracts:

• Abstracts: Prognostic factors in patients with stage I epithelial ovarian cancer
• Abstracts: Clinical prognostic factors in patients with posterior uveal malignant melanoma
• Abstracts: Measurement of serum granulocyte colony-stimulating factor in a patient with congenital agranulocytosis (Kostmann's syndrome)
• Abstracts: Gastric lavage in patients with gastrointestinal hemorrhage: yea or nay? Gastrointestinal tract hemorrhage: the value of a nasogastric aspirate
• Abstracts: CT evaluation for pulmonary metastases in patients with extrathoracic malignancy

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.