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

Disseminated carcinoma of the prostate (CaP) is a common manifestation of this disease. Metastatic CaP in the United States is seen in about 45,000 patients each year at diagnosis. At least the same number of patients who have had prior definitive treatment with surgery or radiotherapy develop evidence of metastatic disease. Hormonal management is the most important and well established treatment for patients with prostatic metastases. Orchiectomy remains the most efficient and most cost effective therapy in a rapid ablation of testicular androgens. Due to a well known psychological reaction to castration which is seen in many patients, diethylstilbestrol (DES) is a good alternative and cost effective therapy. The mode of action of DES is to suppress LH production and to slowly, indirectly, decrease serum testosterone level. In recent years, total androgen blockade (TAB) has become a widely accepted treatment option. This treatment has been shown in several clinical trials to be effective and well tolerated by the patients. A major problem with a routine use of TAB is a relatively high cost of this therapy. In a European prospective randomized trial, goserelin acetate-flutamide combination significantly increased time to progression when compared with orchiectomy alone. Patients with localized and symptomatic metastases are best treated with radiotherapy. Those with multiple sites of involvement are best treated with strontium-89 which results in a good palliation in a majority of patients. Nearly all hormonally treated patients, with metastatic CaP, eventually show tumor progression. Presently available chemotherapy is of a low effectiveness and should not be used for these patients outside of controlled clinical trials. Current research is directed to identify effective therapy for hormone refractory patients. Immunotherapy and gene therapy may be useful future therapeutic options.
 ...
PMID:Treatment of metastatic carcinoma of the prostate. 902 Feb 86

The p53 protein is involved in several central cellular processes, including gene transcription, DNA repair, cell cycling, genomic stability, chromosomal segregation, senescence, and apoptosis. p53 mutations frequently result in an immunocytochemically detectable accumulation of the p53 protein in tumor cells. To evaluate whether p53 gene mutations are required for the onset of hematogeneous tumor cell dissemination, we compared the p53 status of primary and micrometastatic tumor cells. Disseminated carcinoma cells could be detected in bone marrow aspirates obtained from 46 (40%) of 114 patients with various types of epithelial tumors without overt skeleton metastases. There was no correlation between the detection of p53 protein in primary lung carcinomas and the presence of tumor cells in bone marrow. Further analyses revealed that the disseminated carcinoma cells rarely accumulate mutated p53 protein and that 10 cell lines derived thereof did not harbor p53 mutations even in the presence of such mutations in the autologous primary tumors. These observations indicate that tumor cells can leave the primary tumor before mutations of the p53 gene occur and that these mutations are not essential for such early hematogeneous dissemination of cancer cells. Thus, the value of mutated p53 as a target for diagnosis and treatment of micrometastatic disease in cancer patients is questionable.
 ...
PMID:p53 gene mutations are not required for early dissemination of cancer cells. 1035 18