Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patient presenting with severe bone pain after primary hormonal therapy, with vertebral collapse, or with uremia resulting from ureteric obstruction should be considered for intravenous stilbestrol diphosphate therapy. The urologist can expect early marked improvement in the patients' mobility and pain, with a reduction in analgesic requirements, from a single 7-day course of treatment. In addition, the drug is inexpensive and free of the side effects commonly associated with cytotoxic therapy. Accurate monitoring of the response is possible with serum prostate-specific antigen measurements, which also enable further therapy to be planned efficiently.
 ...
PMID:Use of intravenous stilbestrol diphosphate in patients with prostatic carcinoma refractory to conventional hormonal manipulation. 199 67

During the years 1988-1991 sequential serum prostate-specific antigen (PSA) determinations were performed during systemic treatment of hormone-resistant prostate cancer. The following drugs were used: prednisone (5 mg 4 times per os daily, 8 patients); flutamide (250 mg 3 times per os daily, 13 patients); estramustine phosphate (280 mg 2-3 times per os daily, 12 patients), and epirubicin (100 mg/m2 i.v. every 3rd week, 18 patients). In 3, 3, 4 and 6 patients, respectively, a PSA reduction of > or = 50% was observed during treatment, which in 12 patients was combined with pain relief and improvement in the performance status. Though the exact mechanism of PSA reduction and its clinical significance are not completely understood, the findings suggest that hormone-resistant prostate cancer still contains hormone-sensitive tumor cells. The 4 drugs used in this study seem to be equally effective in achieving a PSA reduction of > or = 50%.
 ...
PMID:Reduction of serum prostate-specific antigen during endocrine or cytotoxic treatment of hormone-resistant cancer of the prostate. A preliminary report. 752 31

A total of 20 patients with hormone-refractory prostate carcinoma entered a pilot study of combination chemotherapy based on the EAP (etoposide, Adriamycin and cisplatin) regimen, in which Adriamycin was replaced by pirarubicin, a less cardiotoxic derivative of Adriamycin. The response was assessed by criteria modified from those of the National Prostatic Cancer Project: prostate-specific antigen was employed instead of acid phosphatase. Of 18 evaluable patients, 6 achieved a partial response, 5 had stable disease, and in 7 the disease had progressed during therapy; thus, the overall response rate was 33.3% [95% confidence interval (CI) 11.5-55.1%]. Significant pain alleviation and performance status improvement were obtained in 5 of 12 patients (41.7%; CI 13.8-69.6%) and 3 of 13 patients (23.1%; CI 0.2-46.0%), respectively. Although myelosuppression was moderate to severe, no chemotherapy-related deaths or bacteriologically documented sepsis occurred; nor was there any clinical cardiotoxicity. All the responding patients received maintenance chemotherapy with etoposide thereafter. At present, the median duration of response is 33 weeks (range: 23-91 weeks) and the median survival period for all patients is 42 weeks (range: 27(+)-136 weeks), with 12 deaths. In spite of the small number of patients treated, these results suggest that this chemotherapy regimen is active in advanced hormone-refractory prostate carcinoma.
 ...
PMID:Treatment of advanced hormone-refractory prostate carcinoma with a combination of etoposide, pirarubicin and cisplatin. 780 81

57 patients with advanced prostate cancer and a failure of prior hormonal treatment were selected for a double-blind placebo-controlled trial, in which they were randomly allocated to receive either clodronate (C) or placebo concomitantly with the basic cancer treatment, estramustine phosphate (E) (560 mg daily). The treatment was started intravenously with 300 mg of C or placebo in 5 consecutive days, and thereafter maintained orally with 1600 mg of C or identical placebo daily for 3 months. Bone biopsies were taken at admission and at 3 months. Measurements of serum calcium, phosphate, alkaline phosphatase, prostate-specific antigen and creatinine were made at the time of both bone biopsies and at 1 month. Serum intact parathyroid hormone and vitamin D metabolites were measured at admission and at 3 months. Because of several discontinuations, the study groups at final analysis comprised 20 patients taking E + C and 19 patients taking E and placebo. Bone resorption, as judged by eroded surface and osteoclast number, was markedly increased especially in biopsies taken from tumour-involved bone. Treatments with E + C or E both induced a significant decrease in bone resorption, but were associated with the development of hypocalcaemia, secondary hypoparathyroidism, hypophosphataemia and severe impairment of mineralisation of newly formed bone, i.e. osteomalacia. Since the patients were not vitamin D deficient, we conclude that osteomalacia resulted from a relative deficiency of calcium and phosphate. The transiency of pain relief achieved with anti-resorptive agents in the treatment of bone metastases from prostate cancer may be due to the development of osteomalacia.
 ...
PMID:The effect of clodronate on bone in metastatic prostate cancer. Histomorphometric report of a double-blind randomised placebo-controlled study. 791 32

This European Organization for Research and Treatment of Cancer (EORTC) trial 30853 is the fifth EORTC--Genitourinary Group randomized phase III trial of endocrine treatment for patients with newly diagnosed metastatic prostate cancer. Special attention was given to the assessment of response and/or progression. Each of the following factors was assessed separately as nonspecific and subjective criteria of response or progression: performance status, pain, alkaline and acid phosphatase, hemoglobin, urinary symptoms, and prostate-specific antigen (PSA). Objective progression was based on measurable disease. The observed sequence of progression was: (1) protein-specific antigen; (2) bone; (3) pain; and (4) performance status. Protein-specific antigen, an optional parameter, was the first sign of progression in more than 50% of patients whose disease had progressed.
 ...
PMID:Orchiectomy versus goserelin and flutamide in the treatment of newly diagnosed metastatic prostate cancer. Analysis of the criteria of evaluation used in the European Organization for Research and Treatment of Cancer--Genitourinary Group Study 30853. 825 92

So far, no curative treatment is available for hormone-refractory prostate carcinoma. Therapy is thus focused on alleviating symptomatic tumor progression with the aim of improving quality of life. Therefore, anthracyclin-derived mitoxantrone was administered to 25 patients with hormone-refractory prostate carcinoma and symptomatic progressive disease. After a median treatment of 13 weeks, a median of 4 cycles and a follow-up of 14 months, 48% of the patients (12/25) reported improvement in tumor-related pain; in 60% (15/25) there was improvement of the self-assessment symptom score and 32% of the patients (8/25) gained weight. Additionally, partial tumor response with regression of lymph-node metastases occurred in 3/25 patients (12%). In 10/25 patients the serum level of prostate-specific antigen (PSA) decreased as well as the alkaline phosphatase (AP) in 7/25 patients. Side effects subsequent to chemotherapy were leucopenia WHO grade III in 25% of the patients and thrombocytopenia WHO grade III in 3/25 and grade V (treatment-related death) in 1/25 patients. Non-hematological toxicity occurred in 2 patients (cardiotoxicity n = 1, nephrotoxicity n = 1, WHO grade II each).
 ...
PMID:[Therapy of hormone refractory prostate carcinoma with mitoxantrone. A clinical phase II study]. 865 Aug 48

The authors consider fundamentals of hormone therapy in prostate cancer, mechanism of long-term androgenic stimulation, detail mechanism of action of antiandrogen (ciproteron acetate-androcur) on the basis of discovered key role of cellular receptor in endocrine regulation of physiological functions in metabolism. Monotherapy with androcur-depo (300 mg once a week) was given to 24 patients with prostatic cancer stage T2-T4. Eight patients had metastases to the bones. The age of the patients ranged from 58 to 80 years. Alleviation of pain, reduction of the prostate size and density, positive uroflowmetric changes (maximal urination rate increased from 2-5 to 10-15 ml/s), residual urine fall occurred as early as treatment week 5-7. There was also a decrease in the activity of acid phosphotase from 5-10 to 0.3-0.8 units according to Bodansky. Serum level of prostate-specific antigen (PSA) dropped from 388-23 to 116-4 ng/ml. Androcur-depo monotherapy demonstrated high efficacy in the treatment of local prostatic cancer.
 ...
PMID:[Cyproterone acetate (Androcur-depo) in the treatment of inoperable prostatic cancer]. 868 22

Combined androgen blockade (CAB) is becoming standard treatment for patients with newly diagnosed advanced prostate cancer. This statement is based on the outcome and long-term evaluation of patients treated in prospective randomised trials. Particularly, patients with 'good' prognostic signs at the time of diagnosis benefit most from this approach. Patients with metastatic prostate cancer treated with CAB can be stratified on the basis of clinical prognostic parameters such as performance status, the presence or absence of pain, the levels of alkaline phosphatase, and the levels of prostate-specific antigen (PSA) during the first months of CAB: for combined androgen deprivation, if they fall in the good prognostic category (+/- 30-35% of the patients); for surgical castration and palliative treatment or (experimental) cytotoxic therapy if they belong to the poor prognostic category (+/- 20% of the patients), and, for initial CAB during the first 3-6 months of therapy, followed by an evaluation of the regression of PSA under therapy. If PSA normalises (rapidly) during this period, patients could be considered as good prognostic candidates and continue CAB. If PSA does not decrease or normalise sufficiently, patients might be classified as belonging to the poor prognostic category and should be treated with palliative measures and/or experimental cytotoxic therapy after (surgical) castration.
 ...
PMID:Combined androgen blockade is the treatment of choice for patients with advanced prostate cancer: the argument for. 871 60

Non-bacterial prostatitis is a common problem in young men. It is a disease which is often recurrent and each episode lasts for several months. Different causative mechanisms of the disease have been discussed including identified and non-identified microorganisms, stone formation and psychological factors. It was shown in an earlier study that urinary reflux (as shown by a high creatinine concentration in prostatic fluid) took place to a varying extent in the prostatic ducts and this reflux was related to prostatic pain and urate concentration in expressed prostatic secretion (EPS). Allopurinol treatment lowered the urate concentration in EPS and relieved the subjective discomfort. This study reports serum (S) levels of prostate-specific antigen (PSA) in patients with non-bacterial prostatitis and the way in which S-PSA was affected by allopurinol treatment. It is also shown that the S-PSA level is age dependent. A correlation existed between the S-PSA concentration and EPS content of white blood cells. Patients with high EPS urate concentrations corresponded to low S-PSA levels and allopurinol treatment resulted in elevated S-PSA levels. PSA in EPS was also increased by allopurinol treatment. Hence, an increased release of PSA from the prostate gland was noted upon allopurinol treatment. The mechanism of the allopurinol-induced release is obscure. It might be explained by an induction of PSA synthesis via an allopurinol effect on the genome but an increased leakage of the prostatic cells elicited by allopurinol could no be ruled out.
 ...
PMID:Allopurinol treatment results in elevated prostate-specific antigen levels in prostatic fluid and serum of patients with non-bacterial prostatitis. 882 1

Two open-label, multicenter studies were conducted to evaluate the efficacy and safety of a long-acting depot formulation of leuprolide acetate (22.5 mg) administered intramuscularly every 12 weeks to patients with stage D2 prostate cancer. Clinical evaluations were performed every 12 weeks, and serum testosterone levels were monitored biweekly or weekly for 24 weeks. Onset of castrate levels (< or = 50 ng/dL) of testosterone was achieved within 30 days of the initial depot injection in 87 (95%) of the 92 assessable patients enrolled in the two studies. Mean testosterone levels remained well within the castrate range throughout each dosing interval. Two patients experienced a transient escape (testosterone levels > 50 ng/dL on two consecutive determinations). Delay of an injection of up to 2 weeks did not have an effect on testosterone suppression: in 16 patients in whom the depot injection was delayed by 3 to 14 days, testosterone values remained within the castrate range. A favorable objective tumor response (no progression) to treatment occurred in 85% of the patients. Prostate-specific antigen and prostatic acid phosphatase decreased by 50% or more in 96% and 84% of patients, respectively, with elevated pretreatment values and at least one treatment value. Assessment of local disease status and overall performance status showed improvement or stability in most patients. The most common adverse events were hot flashes (59%), pain (27%), and testicular atrophy (21%). The 22.5-mg depot formulation of leuprolide, which acts in a manner similar to the monthly 7.5-mg depot formulation, was shown to be effective and safe in treating patients with advanced prostate cancer.
 ...
PMID:Leuprolide acetate 22.5 mg 12-week depot formulation in the treatment of patients with advanced prostate cancer. 887 93


1 2 3 4 5 6 7 8 9 10 Next >>