Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Carcinoma of the male urethra is an uncommon tumor. Four patients are reported in this investigation. All the patients belonged to the middle age group under the age of 45 years. None of them suffered from preivous urethral structure. The most unusual presentation was impotence due to the involvement of the corpus spongiosum of the penis. Urethrogram and urethroscopy with biopsy are the most useful aids in the diagnosis. All of them had epidermoid carcinoma nad were treated with external radiation therapy. Two patients with distal urethral lesions without metastases responded well with a 4 and 5 years survival and disappearence of the tumor. Two patients with extensive bulbomembranous lesions had palliation with relief of pain and partial regression of the tumor. Radiation therapy in a properly selected patient with an early lesion gives gratifying result.
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PMID:Radiotherapy in the treatment of carcinoma of the male urethra. 63 95

Treatment of carcinoma of the prostate with hormones can be carried out as partial or complete androgen deprivation. As primary therapy it may be administered palliatively in advanced carcinomas (almost always metastatic), as adjuvant treatment following radical prostatectomy, as "salvage" treatment in post-irradiation recurrent disease, or secondarily after unsuccessful primary treatment. In the case of primary treatment, androgen deprivation is more effective than chemotherapy (NPCP Protocol 1300). LHRH analogues (of the gosereline acetate type) are equally as effective as orchiectomy (standard therapy), but cause a flare-up of the patient's symptoms within the first two weeks, and are therefore given in combination with an antiandrogen. The use of a pure antiandrogen (of the flutamide type) is equally as effective as the standard therapy, but in contrast to the latter, impotence does not occur. Complete androgen deprivation (LHRH analogues plus pure antiandrogens) is more effective in the case of low-volume metastases--in terms of time-to-progression--than standard therapy.
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PMID:[Conservative therapy of prostate cancer]. 172 88

From 1983 to 1986 183 patients with transitiocellular carcinoma of the urinary bladder, category T2-T4a, entered a randomized study. The patients were allocated to receive either preoperative irradiation (40 Gy) followed by cystectomy or radical irradiation (60 Gy) followed by salvage cystectomy in cases of residual tumor. The two randomization groups were comparable in regard to sex, age, T-categories, tumor size, histological grade and concomitant dysplasia. The two randomization groups included 88 and 95 patients respectively. The treatment plan was followed by 66 patients (75%) in the planned cystectomy group and by 88 (92%) in the radical radiotherapy group of which 27 (28%) were treated with salvage cystectomy. The results showed a trend to a higher survival rate following the combined treatment with preoperative irradiation and cystectomy compared to radical irradiation followed by salvage cystectomy in case of residual tumor, but a statistical significant difference could not be demonstrated. The lack of difference also applied according to the actually given treatment. There was no difference in surgical complications between planned and salvage cystectomy and there were no postoperative deaths among the cystectomized patients. The type of late complications was different in the two treatment groups, but there were no major differences in the number of complications except for the fact that all male patients experienced erective impotence after cystectomy. The T-category, response to radiotherapy and frequency of lymph node metastases were found to be of prognostic importance.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of advanced bladder cancer category T2 T3 and T4a. A randomized multicenter study of preoperative irradiation and cystectomy versus radical irradiation and early salvage cystectomy for residual tumor. DAVECA protocol 8201. Danish Vesical Cancer Group. 178 4

From February 1981 until August 1984 20 patients (group A) with localized prostate cancer were treated by radical pelvic lymphadenectomy and direct 125-Iodine seed implantation. From September 1984 until January 1988 51 patients (group B) underwent a modified diagnostic pelvic lymphadenectomy: four weeks later the transperineal seed implantation, guided by rectal ultrasound, followed. The follow-up period in group A is 90 months (range 72 to 114), in group B 48 months (range 30 to 70). Nine patients of group A presented with a progression of disease, four died with/of disease. Ten patients of group B developed distant metastases, three of them presented with both, distant disease and local recurrence: one patient died of disease. The Kaplan-Meier five-year survival probability is 82.3% in group A, and 96.5% in group B: the disease-free survival 62.3% and 75.2% respectively. The probability of local control is 78% in group A and 93.5% in group B. In group A there is a higher incidence of complications compared to group B, in particular concerning edemas of the legs and the genital region. The rate of impotence after seed implantation is very low (2/57 = 3.5%).
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PMID:[Iodine-125 seed implantation in the treatment of prostatic carcinoma]. 200 May 49

Twenty patients with advanced prostate cancer have been treated with an intermittent endocrine therapy schedule. Hormone therapy (diethylstilbestrol in 19 patients and flutamide in 1 patient) was administered until a clinical response was clearly demonstrated and then it was withheld until symptoms recurred. Prior to treatment 17 of 20 patients had bone pain and positive radionuclide scans, two had asymptomatic pulmonary metastases, and one had symptomatic localized disease. Duration of endocrine therapy prior to withdrawal of all treatment ranged 2 to 70 months (median, 10 months). Disease progression occurred 1 to 24 months (median, 8 months) after interruption of therapy. All patients who relapsed had a rapid clinical response following resumption of endocrine therapy. Nine of ten patients rendered impotent by endocrine therapy resumed sexual activity within 3 months of stopping treatment. This data indicates that satisfactory palliation of advanced prostatic cancer can be achieved in selected patients using intermittent endocrine therapy.
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PMID:Intermittent endocrine therapy for advanced prostate cancer. 2823 8

Prostate cancer is the most common malignancy in men over 70. Chronic course of the disease and multiple therapeutic options allow a customized management of the patient's individual problems. Prognostic factors are stage, size of primary tumors, serum acid phosphatase levels, number of metastases, ureteral obstruction and patient's age. In localized disease, surgery and radiation therapy are equally effective for patients with a life expectancy less than or equal to 10 years. Surgery may be superior to radiation if longer survival is expected. In locally advanced disease radiation therapy is preferred to surgery, due to a lower rate of complications. Management of metastatic disease requires offsetting androgen effects by castration or by antiandrogens. Orchiectomy, the safest way to produce castration, is unacceptable to 50% of patients. LHRH analogs are safer than estrogens, but more expensive; the risk of tumor flare up controindicates these compounds in life-threatening situations. The use of ketoconazole is limited by long-term toxicity, but may be life-saving in life-threatening situations, due to a rapid onset of action. Antiandrogens are as effective as castration, but are not commercially available in the USA. Alternative treatments include Estracyt, intermittent estrogentherapy, progesterone derivative and aminogluthetimide. Radical prostatectomy and radiation therapy to the prostate cause erectile impotence with persistence of orgasmic sensations. These patients are ideal candidates for erection-restoring interventions, such as intrapenile injections or penile implants.
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PMID:Prostate cancer: a model of cancer in the elderly. 266 Jul 61

From April 1984 to May 1986, 129 patients with prostate cancer entered a prospective trial with a new LH-RH agonist, Zoladex. Mean age was 72 years (range of 45-94 years) and, in most cases, patients had metastatic disease, not previously treated by chemotherapy or hormone therapy. Patients received a monthly injection of 3.6 mg. Serum testosterone was lowered into the range of castrate levels after 4 weeks of treatment. In 105 evaluable patients at 3 months, a 65% partial response (PR) rate was observed, with 11% stable and 24% progressive disease. Median time to progression was 37 weeks. Analysis of objective criteria revealed 30% PR for prostate volume and 51% CR-PR for prostatic acid phosphatases. Seventeen percent of lytic metastases had recalcified. One hundred twenty-nine patients were evaluable for toxicity. Endocrinological side effects were common: decrease in libido, 92%; impotence, 86%; hot flushes, 48%; and breast swelling or tenderness, 9%. Nonendocrinologic side effects were rare. The treatment is generally well accepted by patients owing to the convenient depot formulation and to the minor side effects.
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PMID:Zoladex as primary therapy in advanced prostatic cancer. A French cooperative trial. 297 63

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 treatment of early stage prostatic cancer with retropubic radical prostatectomy, pelvic lymphadenectomy and antiandrogenic therapy is reported. Out of 22 patients operated in the past 9 years, none died because of the tumor and metastases appeared in 1 patient only. The latter showed a microscopic seminal vesicle invasion and was considered as a P3 stage. Excluding impotence which is generally the rule, urinary incontinence was the most common complication: it was complete in 1 case but successfully treated surgically and mild in 6 cases without, however, requiring surgical intervention or collection device.
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PMID:Radical economic surgery and antiandrogenic therapy in management of prostatic cancer. 644 70

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


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