Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0007112 (prostatic adenocarcinoma)
 2,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Radical prostatectomy was performed in 14 patients following local failure of radiation therapy for adenocarcinoma of the prostate. Ten patients were treated with external beam and 4 with interstitial radiation. The interval from beginning radiation therapy to biopsy-proved residual or recurrent disease was twenty-four to one hundred fourteen months (mean 61 months). Ten patients had significant anterior and lateral fibrosis. Five patients had loss of tissue planes between the prostate and rectum, however, no rectal injuries occurred. Estimated blood loss was 300-8,000 cc (median 1,000 cc). Operative time was one hundred ten to three hundred seventy-five minutes (median 185 minutes). Significant late complications are impotence (100%) and incontinence (55%). Tumor volume was 1.1-27.2 cc (mean 11.1 cc). Seven patients had seminal vesicle involvement, 9 had level III capsule penetration, and 6 had positive surgical margins. Follow-up ranges from one to fifty-two months (median 18 months). Currently, 6 patients are clinically without disease and have serum prostate-specific antigen (PSA) of 0.0 ng/mL. Four patients have no clinical evidence of disease but do have detectable serum PSA, and 4 patients have evidence of metastatic bone disease on bone scan with elevated serum PSA levels. Radical prostatectomy following radiation therapy has no greater immediate morbidity or mortality compared with radical prostatectomy without prior irradiation and takes only slightly longer to perform. However, there is a marked increased risk of impotence and incontinence. More patients followed for a longer time are needed to assess the benefit of radical prostatectomy on survival of patients who fail radiation therapy.
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PMID:Radical prostatectomy after definitive radiation therapy for prostate cancer. 200 Jun 72

Twenty-seven patients with adenocarcinoma of the prostate, and available partners, were interviewed to qualitatively and quantitatively assess their level of sexual function prior to and 12 months after radiotherapy. Assessments were made using the Derogatis Interview for Sexual Functioning (DISF). Five domains of sexual functioning are measured: sexual fantasy, arousal, experience, orgasm, and drive. Prior to therapy 17 of 27 patients (62.9%) were considered impotent. There were eight patients with a DISF score of less than 20 who were impotent. Six patients had a DISF score of greater than 47 and were considered potent. Of the patients with DISF scores between 20-47 four were potent, and nine were impotent. Post radiation therapy three of the patients considered potent (with a score greater than 47) maintained their potent status. Four patients considered impotent prior to therapy became potent after therapy. All patients with a score less than 20 prior to radiation therapy remained impotent after therapy. Results indicate that an objective evaluation of sexual function pre treatment is necessary to determine the effect of radiotherapy. Our method of qualitative assessment of sexual function was easy to implement, was reproducible and could be used to evaluate long-term effects of radiotherapy on sexual function. Of the patients presenting for radiotherapy, 62.9% were impotent. Twelve months after radiation therapy 19 of 27 (70.3%) were impotent.
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PMID:Pre and posttreatment evaluation of sexual function in patients with adenocarcinoma of the prostate. 221 Dec 22

Forty-three patients with adenocarcinoma of the prostate and available partners were interviewed to assess qualitatively and quantitatively their levels of sexual functioning prior to radiotherapy. The mean age was 67.7 years (58-80 years). The Derogatis Interview for Sexual Functioning (DISF) was the evaluation used. The Derogatis Interview for Sexual Functioning measures five domains of sexual functioning: sexual fantasy, arousal, experience, orgasm, and drive. Twenty-seven of the 43 (62.7%) patients evaluated were considered impotent. Fifteen of the 27 patients scored low in all five domains of sexual functioning even though they could achieve erection but they were unable to maintain erection throughout the phases of the sexual response cycle. Twelve of the 27 patients had scored 0 on sexual arousal and orgasm, thus had no ability for erection. Sixteen of the 43 (37.2%) patients were considered potent. This group of patients had achieved erection throughout the phases of sexual cycle and scored adequately in all five domains of sexual functioning. Patients with DISF score less than 20 were impotent. Those with a Derogatis Interview for Sexual Functioning score of greater than 45 were potent. Only 6 of 19 patients with scores between 20 and 45 were potent. The Derogatis Interview for Sexual Functioning score was highly prognostic for impotence, (p = .002) was easy to use and could be used for follow-up of the effect of therapy on sexual function in patients with adenocarcinoma of the prostate. Patients who present for radiation therapy are older, 50% are on cardiac or antihypertensive medication, and the majority (62.7%) are already impotent prior to therapy.
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PMID:Pretreatment evaluation of sexual function in patients with adenocarcinoma of the prostate. 221 Dec 38

The best treatment for adenocarcinoma of the prostate depends on the patient's age, general medical condition, life expectancy, and willingness to accept such side effects as impotence. Radical prostatectomy or full-dose radiation therapy are usually curative when cancer is confined to the gland. The technique of prostatectomy has been improved and potency often can be preserved. Once the tumor extends beyond the gland, treatment alternatives are radiation or endocrine therapy. If lymph nodes are negative, radiation therapy may result in a long period without progression. If lymph nodes are positive, the expense and morbidity of radiation therapy may not be worthwhile because the likelihood of cure is low. Androgen deprivation, or endocrine manipulation, is preferred for metastatic disease. Response is varied and may depend on the patient's testosterone level when therapy is initiated. Survival is shorter in those with levels below normal.
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PMID:Adenocarcinoma of the prostate. Stage-by-stage treatment alternatives. 305 50

The safety and efficacy of buserelin, a luteinizing hormone-releasing hormone (LH-RH) agonist, was tested in 33 evaluable patients with Stages C or D adenocarcinoma of the prostate. With a minimum follow-up duration of 10 months, there was one complete response and 22 partial responses (69%) by National Prostatic Cancer Project criteria, with a median duration greater than 18 months. Six patients (18%) had stable disease, median duration greater than 25 months, and only 12 patients have progressed. Performance status improved in 67%, patient-scored pain improved in 75%, and quality of life improved in 58%. Symptoms occurring during treatment consisted of hot flashes, loss of libido, and impotence. Buserelin produces a high frequency of durable objective and subjective responses in patients with advanced prostatic carcinoma.
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PMID:Buserelin treatment of advanced prostatic carcinoma. Long-term follow-up of antitumor responses and improved quality of life. 310 4

In 16 patients who underwent radical retropubic prostatectomy because of adenocarcinoma of the prostate after previous transurethral resection, the difficulty of the operation, the morbidity rate, and the survival time were evaluated. Eleven patients had tumours staged A2, 5 patients tumours staged B1. Duration of the operation and blood loss were almost similar to the group of patients who had not had prior transurethral resection of the prostate. The impotence rate was 100% due to difficulties preparing and preserving the neurovascular bundle. Only 1 patient had stress incontinence. One patient died after 2 years with rapid tumour progression, 1 patient shows local recurrence. Radical prostatectomy may be performed safely with an acceptable morbidity rate following transurethral resection of the prostate.
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PMID:Radical retropubic prostatectomy after transurethral prostatic resection. 321 50

The effectiveness of buserelin, a luteinizing hormone-releasing hormone agonist, was tested in 28 patients with Stages C or D adenocarcinoma of the prostate. Of 24 evaluable patients, there were 13 partial responses (54%) by National Prostatic Cancer Project criteria, median duration greater than 6 months. Nine patients had stable disease (38%), median duration greater than 5 months, and only two patients progressed. Performance status improved in 38%, patient-scored pain improved in 46%, and quality of life improved in 57%. Symptoms occurring during treatment consisted of hot flashes, loss of libido, and impotence. A flare of symptoms was observed in only one patient, despite a transient 25% increase in testosterone in 36% of patients. Buserelin is an effective treatment for inducing frequent and meaningful remissions in advanced prostatic cancer.
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PMID:Buserelin as primary therapy in advanced prostatic carcinoma. 393 64

Sixty-five patients with prostatic adenocarcinoma Stages B and C were treated with intraoperative Iodine-125 prostatic implantation following bilateral pelvic lymphadenectomy. Pelvic nodal metastases were found in 31% of the patients: 23% (7/31) in clinical Stage B1 disease, 29% (8/28) in clinical Stage B2, and 83% (5/6) in clinical Stage C. All the patients have been followed for a period of 1 1/2 to 6 years. Serial digital rectal examination revealed complete regression of the palpable disease in 15% of the patients at 6 months, 47% at 1 year, and 87% at 2 years. Post-operative complications were also evaluated: 13% of the patients became sexually impotent, 11% had impaired potency after the procedure, and 16% of patients complained of dry ejaculation; and 17% developed scrotal and/or penile swelling, which persisted up to 14 months, but usually subsided within 5 months. Two patients developed local recurrence. Both patients responded to subsequent external radiation therapy of 7000 rad in 11 to 14 weeks with clinical regression of palpable disease.
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PMID:Intra-operative iodine-125 prostatic implant following bilateral pelvic lymphadenectomy. 673 55

Twenty-five consecutive patients with localized adenocarcinoma of the prostate treated with 1,050 rad preoperative radiation therapy and Iodine-125 seed brachytherapy arreviewed. Significant long-term postoperative complications included radiation cystitis (12%), radiation proctitis (4%), genital and leg edema (12%), stress incontinence (8%), total incontinence (4%), and impotence (26%). Complications occurred in 75 per cent of patients who received additional postoperative radiation. Improved staging with CT scan, lymphangiography, and Chiba needle biopsy of any possibly abnormal lymph nodes provided excellent preoperative staging with only 1 patient (6%) upstaged at surgery to Stage D1.
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PMID:Complications associated with preoperative radiation therapy and Iodine-125 brachytherapy for localized prostatic carcinoma. 687 81

In an effort to help physicians offer their patients unbiased advice on the best alternatives for treatment of localized prostate cancer, we present a retrospective comparison of the effectiveness of brachytherapy and radical retropubic prostatectomy in 1305 men with stage T1 and T2 adenocarcinoma of the prostate. Data from 1305 patients treated in our community-based private practice urology group from 1993 to 2002 were reviewed, and patients were classified by initial prostate-specific antigen (PSA) level and risk grouping. Risk grouping was defined by preoperative PSA levels and Gleason scores. We used time to PSA-indicated recurrence as the measure of efficacy. Brachytherapy and radical prostatectomy provided similar responses to treatment (no significant differences given the sample size, length of follow-up, and numerical differences observed) for localized prostate cancers. A prospective study is presently underway to evaluate the respective outcome of these procedures (including incidence of incontinence and impotence), and assess their impact on patient quality of life. The results presented here fail to show any superiority of prostatectomy over brachytherapy with palladium-103 (TheraSeed; Theregenics Corp., Buford, GA) with respect to time until relapse indicated by PSA level increase (> 0.2 ng/mL for prostatectomy and >1.5 ng/mL and rising for brachytherapy). In fact, any differences between treatments favor brachytherapy, particularly for intermediate- and high-risk groups. We conclude that both brachytherapy and prostatectomy should be offered, equally and without bias, to men with stage T1 or T2 organ-confined prostate cancer.
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PMID:Brachytherapy versus radical prostatectomy in patients with clinically localized prostate cancer. 1208 97


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