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

In a comparative analysis of 29 studies, maximal androgen deprivation (MAD) was not found to be superior to partial androgen deprivation. Thus, MAD cannot be regarded as the new gold standard. Most trials focus on quality of life which--given the palliative aim of the treatment--deserves special attention. This aspect has not yet been evaluated, however, in the largest multicenter study, intergroup study 0105. In patients with advanced bone metastasis or severe pain, MAD treatment should be begun because of the flare phenomenon. The synergistic effects of LHRH agonists on the prostate are currently being investigated. Since no clear prognostic factors exist and reduction of serum-PSA levels under MAD does not delay progression, the patient must help to make the decision of whether or not MAD should be begun.
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PMID:[Complete androgen blockade versus monotherapy]. 956 24

There is almost a complete failure of the urological profession to study chronic prostate gland pain, which is its most common and difficult condition to manage. Variations in nomenclature for the disease include pelvic floor myalgia syndrome, chronic anxiety syndrome, prostatodynia, interstitial cystitis and abacterial prostatitis, so comparison of treatment populations is difficult. Over 50% of negative prostate biopsies being performed for PSA elevation show prostatitis lesions. Transperineal aminoglycoside injection for 'hard-core' prostatitis reported a 77% cure rate. A 5 year study of 75 patients with recalcitrant benign painful prostate syndrome treated with transrectal ultrasound guided intraprostatic injection of gentamycin and xylocaine produced a 90% cure rate. Of the patients, 74% required only a single injection of 160 mg of gentamycin in 4 cc with 2 cc of 1% xylocaine to achieve a cure. Minimal injection pain was encountered. Some patients required 5 injections over the 5 year period. Multiple injection patients were considered therapeutic failures. Fourteen tumor-negative prostate needle biopsies showed prostatitis lesions. One elevated PSA patient had 3 biopsies. Current medical therapy of prolonged one month antibiotics, anti-inflammatory agents and alpha adrenergic blocking agents had failed in all injection treated patients. Of the patients, 60% had prostatic calculi. Cystic seminal vesicle abnormalities were frequent. Complications were only minor, with hematospermia, gross hematuria and mild pain. The 90% cure rate was defined by the absence of symptoms.
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PMID:Transrectal ultrasonography directed intraprostatic injection of gentamycin-xylocaine in the management of the benign painful prostate syndrome. A report of a 5 year clinical study of 75 patients. 1009 59

Fourteen cancer patients with bone metastases from various primary malignancies were submitted to repeated dual X-ray absorptiometry (DEXA) scan before and after systemic antineoplastic treatments. In the nine patients with lytic lesions the Bone Mineral Density (BMD) increased after chemotherapy + pamidronate in four (by +11.2%, +7.5%, +5.0% and +6.6%, respectively), decreased in four (by -19.9%, -8.1%, -7.5%, and -7.0%, respectively) and remained unchanged in one. BMD changes paralleled variations in painful symptomatology and biochemical markers. In patients with blastic metastases the BMD on target metastatic lesions did not change after hormone therapy or chemotherapy in one case but showed a significant increase in four. BMD increase was associated to bone pain improvement and PSA decrease in two cases, and with a worsening in skeletal pain and/or serum PSA in the remaining two. Our data suggest that BMD evaluation by DEXA instrument may be a reliable tool in assessing the response of bone metastases to treatment.
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PMID:Evaluation by dual energy X-ray absorptiometry of changed bone density in metastatic bone sites as a consequence of systemic treatment. 1085 43

93 patients with hormone refractory metastatic prostate cancer were entered on a prospective study to measure reduction in pain and changes in quality of life (QoL) after the administration of 150 MegaBequerel (MBq) Strontium-89 (Sr-89). QoL was assessed using a validated instrument, the Functional Living Index - Cancer (FLIC) questionnaire. Pain response was measured using the Radiation Therapy Oncology Group scoring system. Overall there was limited QoL improvement over 3 months following Sr-89. However, in the 53 patients (63%) achieving pain responses, QoL did significantly improve within 6 weeks of receiving Sr-89 compared to patients with stable or worsening bone pain, and this was independent of other parameters that might influence QoL outcomes, such as performance status, baseline PSA and extent of skeletal disease (P = 0.004). PSA 'response' occurred in 30 patients (37%) over 4 months after Sr-89. This did not appear to correlate with clinical improvement. This study supports the presumption that improvement in pain following Sr-89 is accompanied by better QoL. The lack of correlation of PSA response and clinical parameters indicates that in the palliative setting, PSA may not provide a useful surrogate for treatment outcome.
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PMID:Less pain does equal better quality of life following strontium-89 therapy for metastatic prostate cancer. 1116 91

A 64-year-old man having backbone pain was referred to our institute, and laboratory examinations revealed that he was suffering from severe renal failure. Abdomino-pelvic CT revealed bilateral hydronephrosis, a giant prostate over 500 g in weight, and multiple para-aortic lymph node metastasis. Histological diagnosis of the prostate was small cell neuroendocrine carcinoma. Serum neuron-specific enolase (NSE) level was slightly high reflecting the positive immunohistochemical staining, but serum PSA remained within normal limits. The patient was treated with hormone-chemotherapy after successful treatment of the renal failure, but he died on the 74th hospital day. Small cell carcinoma is known to have a high rate of malignancy and metastasis from an early stage. Several giant prostatic tumors have been reported previously, but this case is considered to be the second gigantic small cell carcinoma in the Japanese literature.
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PMID:[A case of giant small cell carcinoma of the prostate]. 1123 25

A 68-year-old man consulted our department for sudden onset of dysuria and perineal pain. On digital rectal examination, soft and a hen-egg-sized mass was palpated. Serum PSA value was elevated to 11.4 ng/ml. Pelvic magnetic resonance imaging (MRI) suggested a large hemorrhagic cyst associated with prostate cancer. In addition to a pathological diagnosis as poorly differentiated adenocarcinoma (Gleason grade 5/4), which was established by transurethral biopsy, aspirated cyst contents revealed an elevated PSA value (3,090 ng/ml). Clinical staging was determined as T4N0M0. Following administration of androgen-deprivation therapy for 3 months, radiation therapy (64 Gy) was administered to the prostate. Twelve months after the diagnosis, the serum PSA value has remained within normal limits, and no local recurrence of the disease was detected.
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PMID:[Prostate cancer associated with hemorrhagic cyst: a case report]. 1132 64

The proto-oncogene HER2 presents a novel therapeutic target. We report results in 25 patients with HER2+ advanced prostate cancer treated with the bispecific antibody MDX-H210 15 microg m(-2)by intravenous infusion plus GM-CSF 5 microg kg(-1)day(-1)by subcutaneous injection for 4 days repeated weekly for 6 weeks. Patients with stable disease or better received further cycles of treatment until disease progression or study withdrawal. 1 patient received no treatment and 4 received less than 1 cycle and are included in the toxicity analysis only. Median duration of follow up was 105+ (range 21-188) days. Toxicity was generally NCI-CTG 0-2. There were 2 grade 4 adverse events (heart failure and dyspnoea) and 1 grade 3 event (allergic reaction) resulting in discontinuation of the study medication. There were 9 further grade 3 events not resulting in trial withdrawal. There were no treatment-related deaths. 7/20 (35%) evaluable patients had a >50% PSA response of median duration 128 (range 71-184+) days. 7/12 (58%) patients with evaluable pain had improvements in pain scores. The PSA relative velocity on therapy decreased in 15/18 (83%) assessable patients compared to pre-study. GM-CSF and MDX-H210 is active in hormone refractory prostate carcinoma with acceptable toxicity; further studies are warranted.
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PMID:A phase II study of the bispecific antibody MDX-H210 (anti-HER2 x CD64) with GM-CSF in HER2+ advanced prostate cancer. 1146 Oct 69

Sexual function was evaluated in 34 patients with low-risk prostate cancer (PSA < or = 10, Gleason score < or = 6, clinical stage T1/T2) undergoing brachytherapy in a phase III prospective randomized trial comparing iodine-125 ((125)I) to palladium-103 ((103)Pd). The mean and median International Index of Erectile Function (IIEF) scores for the entire group were 14.2 and 16.5, respectively, and there was no difference between these scores when stratified by isotope. IIEF scores < 6, 6 to 11, and > or = 12 were recorded in 35% (12/34), 6% (2/34), and 59% (20/34) of patients, respectively. Hematospermia, orgasmalgia (pain at the time of orgasm), and alteration in intensity of orgasm were documented in 26% (9/34), 15% (5/34), and 38% (13/34) of patients, respectively, but these side effects were of limited duration for most patients. There was no relationship between radiation dose to the neurovascular bundles (NVB), which averaged 209% of the prescribed prostate dose, and the development of postbrachytherapy impotence. All four impotent patients who used sildenafil responded favorably. With a median follow-up of 13 months, 65% of patients undergoing prostate brachytherapy maintained sexual function without pharmacologic support. Including sildenafil responses, 76.5% of patients sustained erections sufficient for sexual intercourse.
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PMID:Short-term sexual function after prostate brachytherapy. 1158 84

BACKGROUND: A study for pain relief therapy with 188Re-HEDP was done in patients with bone metastases secondary to breast and prostate cancer. MATERIALS AND METHODS: Patients received 1.3 or 2.2 GBq, in single or multiple doses. Platelets, white and red cells were evaluated during 11 weeks. Pharmacokinetic characterization was done from blood and urine samples for 5 patients along 24 hours. Urinary excretion was evaluated in other 16 patients during 6 hours. Bone uptake was estimated as remaining activity in whole body. Scintigraphic images were acquired at 2 and 24 hs post-administration. Absorbed dose in bone marrow was estimated with Mirdose3. Analgesics intake and pain score were daily recorded. Tumour markers (PSA, and Tn-structure) were monitored in 9 patients during 4 to 6 months. Single doses of low activity (1.3 GBq) were given to twelve patients. Nine patients received multiple doses. RESULTS: All except one patient had normal levels of platelets, white and red cells. Remaining dose in blood at 2 hours was 9%. Urinary elimination was 58%. Bone uptake at 24 hours was 43% (mean value; n = 5). No changes of the haematological parameters were detected along follow-up period. Pain relief was evidenced by decrease or supression of opioid analgesic and by subjective index. PSA showed a decrease in prostate cancer patients (n = 4). Tn-structure showed a significant increase after 4 to 8 months. CONCLUSION: Single or multiple dose scheme could be safely used, with administered activity of 188Re-HEDP up to 60 mCi, with low bone marrow absorbed doses.
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PMID:Re-HEDP : pharmacokinetic characterization, clinical and dosimetric evaluation in osseous metastatic patients with two levels of radiopharmaceutical dose. 1173 69

An 82-year old man received total androgen blockade therapy (bilateral orchiectomy and 375 mg/day flutamide) for the treatment of stage C prostate cancer. Serum PSA levels were undetectable for 13 months and thereafter increased gradually. We administered estramustine phosphate sodium (EPS) instead of flutamide under the diagnosis of hormone refractory prostate cancer. EPS therapy was discontinued after 9 months because serum PSA levels increased again. Then, the patient complained of bilateral breast nodules and pain. Bilateral mammectomies were performed due to bilateral breast cancers which had been diagnosed by aspiration biopsies and radiographic examinations, but he died four months after the operations. Final pathological diagnosis was ductal adenocarcinoma of the breasts. Immunohistochemical study revealed expressions of PSA in the breast cancers. We diagnosed double cancers of the prostate and the breast because of the different expression patterns of progesterone receptor between them. We review the literatures and discuss the differential diagnosis of prostate cancer and PSA-producing breast cancer.
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PMID:[A male case of primary bilateral breast cancers during estrogen therapy for prostate cancer]. 1176 69


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