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)

A total of 125 patients with progressing advanced prostatic cancer were entered into a chemotherapy study comparing cyclophosphamide, 5-fluorouracil, and standard therapy. Parameters of response were studied in 110 patients who could be evaluated. Thirty-six patients (33 per cent) were considered to have an objective response, that is becoming stable (29 patients) or in partial regression (7 patients). Negative response parameters (predictors of a poor response to chemotherapy or standard theraphy leading to progress) included (1) bone marrow evidence of prostatic cancer, (2) abnormal liver scan, (3) prior radiation therapy (indirectly through increased toxicity to chemotherapy), and (4) lack of bilateral orchiectomy prior to randomization. Positive indicators (predictors of good responses) included (1) reduction of primary tumor mass, especially after administration of 5-fluorouracil or cyclophosphamide, and (2) hemoglobin values. There were more objective responders to cyclophosphamide than standard therapy whether the hemoglobin was initially normal or low. Indeterminate parameters of response included weight gain, presence of bony or soft tissue metastases, relief of pain, performance status, excretory urography, and biochemical determinations of liver and renal function.
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PMID:Chemotherapy of advanced prostatic cancer. Evaluation of response parameters. 93 81

This cooperative study was sponsored by the National Prostatic Cancer Project to determine the usefulness of serum acid phosphatase levels as a predictive indicator with regard to performance status, sites of metastases, response to treatment, and survival in patients with advanced prostatic carcinoma. The results indicate that survival was significantly shorter for those patients who had elevation of thier on-study (pretreatment) total serum acid phosphatase ler cent reduction of primary tumor mass, relief of pain, and acid phosphatase activity. No correlation could be demonstrated between serum acid phosphatase and performance status, site of metastases, and other criteria of response to therapy. It is concluded that this test as currently determined spectrophotometrically at this stage of disease and if employed alone is not sufficient to allow for total evaluation of the response of therapy. It is, however, helpful when used in correlation with the previously mentioned positive factors.
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PMID:Clinical significance of serum acid phosphatase levels in advanced prostatic carcinoma. 96 Mar 39

Prostatic acid phosphatase and alkaline phosphatase values in bone marrow were correlated with skeletal surveys and diagnoses during a six-month study. In cases of biopsy-proven adenocarcinoma of the prostate, bone marrow prostatic acid phosphatase was the most consistently abnormal value. Diagnoses other than prostatic cancer involving the bone marrow, e.g., myeloma and leukemias, were associated with elevated prostatic acid phosphatase and alkaline phosphatase values. In cases in which the bone marrow was not involved by metastasis, these values were normal. Bone marrow prostatic acid phosphatase assay was found to be a very good tool for detecting early osseous metastases from any site, including prostatic adenocarcinoma.
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PMID:New diagnostic use of bone marrow acid and alkaline phosphatase. 97 Mar 68

Lactic dehydrogenase (LDH), glutamic-oxalacetic transaminase (GOT), and acid and alkaline phosphatase activities in bone marrow and in cubital vein serum were compared. For patients without cancer, marrow serum LDH attained levels four times as high, and GOT and alkaline phosphatase, levels twice as high as those normal for cubital vein serum; levels of acid phosphatase were the same for both sources. For patients with cancer, significant increase of enzyme levels over reference levels depends on the tumor origin and on the presence and localization of metastases. Marrow enzyme levels may become elevated with or without concurrent elevation in cubital vein serum. Concurrent elevations were found with colonic carcinoma and lymphoid leukemia, and noncurrent elevations, with prostatic cancer, myeloid leukemia, and myeloma. A nonconcurrent elevation of marrow enzymes indicates that the origin of the enzyme is in the marrow, whereas with concurrent elevation, the source of the enzyme may be another organ.
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PMID:Enzymes in peripheral and bone marrow serum in patients with cancer. 98 36

Twenty-eight patients affected with disseminated prostate cancer, which proved hormone resistant (after castration and oestrogen administration), have undergone combined treatment with Testosterone (for 13 days) and 32P (for the last 7 days of the Testosterone treatment). During the initial fase of the treatment (Testosterone only), 14 patients experienced pain exacerbation and/or fever and one experienced immediate improvement. The exacerbation quickly disappeared following 32P administration, and 26 of the patients had distinct improvement at some time during or after treatment, with a mean remission duration of 3 months and mean survival rate of 7 months. No lytic or soft part deposit showed improvement; improvement was noticeable only in the mixed type or osteo-sclerotic metastases. This observation suggests that the androgen stimulates uptake of the isotope not inside the tumor cells but in the bone matrix around the tumoral deposit. The patient who showed very early improvement had a subsequent relapse on oestrogens, but later responded to the androgen alone.
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PMID:[Treatment with 32P of carcinoma of the prostate (author's transl)]. 100 7

While receiving only cursory attention compared to that of other malignant neoplasms, studies of patients with prostatic cancer have suggested that host responses, mediated in part by immunobiologic factors, may play a significant role in the pathogenesis and thus, the therapeutic management of this disease. For nearly a decade cryosurgery has gradually attained some degree of acceptance as one of the efficacious treatment modalities available in the therapeutic armamentarium for prostatic cancer. In addition to the localized destruction of the primary tumour, reports of secondary tumour cell destruction, i.e. of distant metastases, have supported the suggestion that cryosurgery, as documented in various animal species, may also be immunopotentiating in man. Although our understanding of immunopotentiation of the host's response to tumour via cryosurgery is far from complete, information derived from experimental studies demonstrating that the developement of an immunologic response following cryosurgery of the prostate may be attributed to androgenically and ontogenically dependent autoantigens may have clinical relevance. This together with knowledge that in the therapeutic management of the patient with prostatic cancer we are confronted with the treatment of an individual who, in the majority of cases, possesses waning immunocompetence, emphasizes the potential significance of evaluating what may be referred to as the 'cryosensitivity' of the prospective cryosurgical patient. At present this 'cryosensitivity' may be said to be dependent upon: (1) concentration of prostatic tissue [secretory(tumour?)]-specific or tumour-associated auto-(neo?) antigen(s); (2) physiologic state (elaboration of androgen), and (3) immunocompetence. It is hopeful that evaluation of these parameters may provide a rational approach toward determining the acceptability of cryosurgery as the treatment of choice in a given patient.
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PMID:A rational approach toward determining the candidacy of the prostatic cancer patient for cryoimmunotherapy: an interim report. 101 32

74 patients with prostatic cancer were studied annually by combined radiological and fluorine-18 scan survey over a 5-year period. The results of the long term follow-up of bone cans is reported. At the time of the initial diagnosis 71-5% of the patients had advanced disease and 56% had radiological or scan evidence of metastases. A critical evaluation of the scans resulted in the detection of early bone lesions in 25% of patients with no radiological evidence of metastases. Follow-up of these patients has shown that scan abnormalities preceded radiological changes from between 1 to 4 years and there was good correlation proven histologically by bone biopsy or autopsy in more than half of the patients. In patients with a positive bone scan and positive X-rays the scan abnormalities were more extensive than the corresponding X-ray lesions. When bone healing occurred with endocrine treatment this was more readily apparent on the X-rays. False negative scans were not seen with fluorine-18 which allows for greater accuracy in the detection of skeletal metastases. Bone scanning has enabled correct staging to be carried out. This study confirms the high incidence of cardiac and vascular complications in patients treated with oestrogens.
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PMID:Serial Fluorine-18 bone scans in the follow-up of carcinoma of the prostate. 109 3

The natural history of prostatic cancer is incompletely understood. Small cancers may have a very slow or rapid growthrate, and the majority are differentiated. Cells may leave the prostate by blood or lymph without penetrating capsule or invading the seminal vesicles. The predication of latency or of biologic activity in any givne case is impossible. Stage A cancer should be separated into A1 (focal) and A2 (diffuse). Stage A1 cancer that is low grade is best lfet alone. Stage A2 cancer and high grade cancer probably should be treated by megavoltage radiation. Stage B includes many cancers that are microscopically stage C. If this stage is separated into clinical stage B1 (tumors grossly involving less than one lobe), and B2 (tumors involving one lobe or more) the underestimation of microscopic extent in B1 will be less than in 10 per cent of the cases. In clinical stage B2 cancer, 50 per cent are microscopically stage C. Radical prostatectomy for cure should be limited to clinical B1 cases without distant spread. It is not a cure-all, but it provides the best 15-year survival rate more completely, more quickly, less expensively, and with fewer discomforts than other methods. The alternative options are no treatment, endocrine treatment, and radiation. The first is risky in many instances and may allow an ac-ive cancer to get out of control. The second rarely destroys all of the cells in the total cell population and gives one a false sense of security. The last should be reserved for cases well beyond stage B1, but without distant metastases, where its usefulness exceeds that of radical excision.
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PMID:The present status of radical prostatectomy for stages A and B prostatic cancer. 112 46

Seven surgical treatments for the management of prostatic cancer are briefly reviewed. A transurethral prostatic resection is of value, not only for the relief of bladder outlet obstruction, but also in the definitive management of Stage A lesions. The long-term survival for patients with Stage C disease treated by radical prostatectomy plus interstitial irradiation demonstrates the efficacy of this mode of therapy. Pelvic lymphadenectomy has yielded valuable information on the stage of the disease; long-term survival was related to the presence of lymph node metastases. Lymphadenectomy may have contributed to the 5-year survival rate of those with regional lymph node involvement, but there is no direct evidence to support this view. The early results in patients treated by cryosurgery indicate that this mode of therapy can be very effective in the ablation of the local lesion and may very well have a useful place in the surgical armamentarium for the management of prostatic cancer.
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PMID:Surgery of prostatic carcinoma. 115 32

During the past 10 years, some 15 publications have appeared in the English literature on the definitive radiotherapy of prostatic cancer. The long-term followup required for rational assessment of the treatment of prostatic cancer is not yet available for most of these studies. However, in the Stanford series, the direct disease-free survival at 5 years for patients with disease localized to the prostate is 70%; at 10 years, 42%. The direct disease-free survival at 5 years for patients with extracapsular extension in 36%, and at 10 years, 29%. Recently, mapping of potential lymph node metastases has been studies by several authors.Early results of extended-field irradiation required for regional treatment are presented.
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PMID:External beam radiation therapy of primary carcinoma of the prostate. 117 23


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