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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 1966 to 1979, 360 patients with clinical stages A2, B and C1 prostate cancer underwent staging pelvic lymphadenectomy, and completed a course of combined interstitial radioactive gold seeds and external beam radiotherapy. All patients had a normal serum prostatic acid phosphatase level and a bone scan negative for metastases. All patients were followed until death or for a mean of 7.3 years (range 1.2 to 18.25 years) for those alive at analysis. To determine the risk of dying of prostate cancer we reviewed the records of the 142 patients (39%) who died. At analysis 21% of the patients had died of prostate cancer and 17% of other known causes. The cause of death could not be determined in 4 patients (1%). Cardiovascular disease accounted for a fifth of all deaths. The actuarial risk of death of prostate cancer for all patients was 8 +/- 3% (+/- 2 standard errors) at 5 years and 30 +/- 7% at 10 years. The risk of death of all causes was 16 +/- 4% at 5 years and 46 +/- 7% at 10 years. An increased risk of cancer death was associated with established risk factors, including advanced local disease, poorly differentiated histology, pelvic nodal metastases and distant recurrence. We also noted a substantial risk of cancer death in patients who had local tumor recurrence. While previous studies have reported a relatively low incidence of cancer deaths (4 to 17%) in patients initially diagnosed with localized disease, our data suggest that prostate cancer is the major cause of mortality in such patients. Aggressive curative therapy, regardless of treatment modality, should be considered for localized prostate cancer in men with a life expectancy of 10 or more years.
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PMID:The risk of dying of prostate cancer in patients with clinically localized disease. 189 20

A study was conducted to compare results of transrectal ultrasound with pathologic findings on 116 patients who underwent radical prostatectomy for treatment of prostate cancer. In 96% (111 of 116), transrectal ultrasound guided biopsies of a hypoechoic lesion proved cancer; seven patients had known Stage A cancer; one patient had cancer detected by palpation and not detected by ultrasound. Cancers in the outer gland (peripheral and central zones) were compared with cancers in the inner gland (transition zone) by both ultrasound and pathology. Forty-eight percent (52 of 108) of cancers originating in the outer gland showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the outer gland were the prostatic capsule (38%), anterior fibromuscular stroma (5%), seminal vesicle (18%), the base of the gland at the neurovascular bundle (21%), and the apex (31%). Twenty-two percent (17 of 54) of cancers originating in the inner gland (transition zone) showed extraprostatic extension (Stage C disease). The primary sites of tumor escape from the inner gland were the anterior fibromuscular stroma (6%) and apex (11%). Both histologic and biologic differences between outer and inner gland cancers were found when tumor size was controlled. Gleason scores were significantly different for inner and outer gland cancers, with mean scores of 6.2 +/- 1.6 and 7.4 +/- 0.9, respectively. An odds ratio of 8.6 confirmed the increased risk of extraprostatic extension for outer gland cancer. Outer gland cancers showed increased aggressive behavior of both histologic and biologic nature. The difference in biologic aggressiveness of outer and inner gland cancers has definite implications for treatment options. Use of other diagnostic parameters, such as DNA ploidy, may help to determine which cancers to treat and when to treat them; this may have more relevance for cancers originating in the inner gland. Strategic transrectal ultrasound guided biopsy affords accurate tumor mapping and staging when modes of internal spread and escape of cancer from both outer and inner gland are known. Thus, transrectal ultrasound may be our "window of observation" through which additional research may explain the histologic and biologic discrepancies between outer and inner gland cancers.
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PMID:Prostate cancer: transrectal ultrasound and pathology comparison. A preliminary study of outer gland (peripheral and central zones) and inner gland (transition zone) cancer. 199 Dec 71

Analysis of the different rate of prostatic cancer in Israel among Jews from various countries of origin reveals some very interesting and marked varieties in incidence, which are studied more closely now. Aggressive, combined treatment for the invasive cases of prostatic cancer has been used since 1975. This was based on orchiectomy, DES, and chemotherapy for the stage D2 disease, and on radiotherapy and hormonal therapy for the stage C, and possibly also the stage D1 disease. Results so far have been very encouraging indeed, and with considerably better results than obtained with the individual, more conventional forms of therapy. Five-year survival in the stage D2 disease has been 63.5%, and 87.6% in the stage C (+D1?) disease. It appears that this approach is more justified, certainly in the advanced stages of this disease.
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PMID:Carcinoma of the prostate in Israel: some epidemiological and therapeutic considerations. 673 72

Specific red cell adherence testing has established itself as a valuable means of predicting the behavior of non-invasive bladder carcinoma. In an attempt to determine whether specific red cell adherence testing could have a similar role in low grade, low stage prostatic carcinoma we first attempted to detect its presence in benign prostatic diseases. We tested 36 consecutive prostatectomy specimens of benign disease for the presence of specific red cell adherence in the prostatic acini. We were able to detect the presence of specific red cell adherence in only 36 per cent of the cases with benign prostatic hyperplasia. Thus, we believe that specific red cell adherence testing is not present in a sufficient percentage of patients with benign disease to allow its usefulness in determining the aggressive behavior of prostatic cancer.
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PMID:Specific red cell adherence testing and benign prostatic hyperplasia. 701 69

Prostate cancer is an important and increasing source of male morbidity and mortality. In the absence of any primary preventative strategy, medical approaches to control it will concentrate on attempts at cure in localized disease and effective palliation otherwise. Observational epidemiological studies suggest that, in practice, differences in the effectiveness of aggressive and conservative approaches will be small, but may yet be worthwhile in selected groups of men. However, the confounding and biases inherent in all observational epidemiology mean that the data available from this source is insufficiently certain or precise either to make treatment recommendations for individuals, or to quantify relative benefits to inform health policy. Randomized trial data has not suggested any overwhelming benefit for any one treatment modality, but the five published trials have been small and lacked the statistical power to demonstrate potentially important differences. Aggressive management aimed at cure should be evaluated in adequately designed randomized trials in comparison with expectant medical management ('watchful waiting'). The trials currently planned or under way should be supported enthusiastically by all centres with an interest in management of prostate cancer.
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PMID:Management of localized prostate cancer: an epidemiological perspective. 754 16

Incidentally discovered prostatic cancer can pursue a benign clinical course or it can rapidly progress. For the purpose of this study, we summarized pathological and clinical results of 107 (5.3%) stage A prostatic cancer patients in 2008 transurethral resection of the prostate for clinically diagnosed benign prostatic hyperplasia. For each patient, 3.9 slides, 13.6 tissue chips per slide and 52.5 tissue chips per patient (from 16 to 140 chips) were examined microscopically. The survival rates of patient with well, moderately and poorly differentiated groups were 62, 37 and 12% at 10 years, and those with Gleason score 2 to 4, 5 to 7 and 8 to 10 group were 63, 42 and 0% respectively. The survival rates in stage A1 (well differentiated or Gleason score 4 or less in less than 5% of the tissue removed during transurethral resection of the prostate) and stage A2 (anything other than stage A1) were 63 and 41% at 10 years, respectively. And cancer specific survival rates in stage A1 and stage A2 were 96% and 64% at 10 years, respectively. The number of cancer specific death were 1 in 30 (3.3%) in stage A1 group and 14 in 77 (18.2%) in stage A2 group. Our results indicated that tumors with low potential for aggressive behavior had a volume extent of less than 5% and a well differentiated group. Aggressive treatments should be recommended to all patients who were diagnosed stage A2 prostatic cancer.
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PMID:[Prognosis of incidental (stage A) prostatic cancer]. 768 24

Various studies indicate that men with prostate cancer began sexual activity at a younger age; have a higher sexual, particularly at younger ages; a lower frequency of coitus, particularly at older ages; or a higher frequency until around 50 years old, at which time it falls. These findings add weight to the hypothesis that prostate cancer is linked to high testosterone levels. Aggression, criminal violence, impatience and irritability, hostility, reduced tactile sensitivity, and sensation seeking are all associated with high testosterone levels. Variety of sexual experiences is a sensation-seeking behavior. In fact, amount of heterosexual experience, number of heterosexual partners, and interest in erotica are significantly associated with high testosterone levels. Coital frequency of men with high testosterone levels are high early in marriage while low later in marriage, indicating a high degree of variance. Prostate cancer is also associated with divorce, sexually transmitted diseases, and patronage of prostitutes, which factors are secondary to a causal association with high testosterone levels. Some research suggests a link between prostate cancer and vasectomy. If indeed this is true, this association may be secondary to the link of both prostate cancer and vasectomy to high testosterone levels. Men choose to undergo vasectomy, and sensation seekers generally volunteer for unusual experiments. This gives more credence to the hypothesis that the association between prostate cancer and vasectomy is secondary to high testosterone levels. Some reproductive specialists suggest that the ductus deferens transports high levels of androgens from the prostate. Thus, if followed to its logical conclusion, vasectomy should protect against prostate cancer. So the argument that both vasectomy and prostate cancer are associated with high testosterone levels may account for the link between vasectomy and prostate cancer.
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PMID:Prostatic cancer, coital rates, vasectomy and testosterone. 801 82

Prostate cancer is rare in young adults and when clinically detected it has been invariably locally or distantly advanced, undifferentiated and exhibiting aggressive behavior. To our knowledge no previous report documents clinically detected and localized disease amenable to curative surgery in a young adult. We report on a 29-year-old man with clinically detected, moderately differentiated adenocarcinoma of the prostate who was treated by nerve sparing radical retropubic prostatectomy. The patient was disease-free and morbidity-free 30 months after treatment.
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PMID:Clinically detected carcinoma of the prostate treated by radical prostatectomy in a 29-year-old man. 805 69

The purpose of this study was to identify attitudes associated with the willingness of African Americans to participate in prostate cancer screening. Subjects > or = 40 years were recruited from South Central Los Angeles. Fifty-six respondents were divided into low or middle socioeconomic groups based on education and occupation. Focus group discussions were conducted to assess knowledge, attitudes, and beliefs about prostate cancer screening and treatment, willingness to participate in screening, incentives and barriers toward participating in screening, and source of medical care. The middle socioeconomic respondents expressed a greater willingness to participate in prostate screening. This difference was attributed to their greater knowledge about the disease and screening procedures, enhanced access to health promotion activities, being less fearful of discovering abnormal results, exposure to more aggressive behavior on the part of the provider with respect to screening, and receiving medical care in an environment that is more respectful toward the consumer. Efforts to increase minority participation in prostate cancer screening or prevention studies must take these findings into consideration.
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PMID:Attitudes of African Americans regarding screening for prostate cancer. 864 60

It is controversial whether neuroendocrine (NE) differentiation in adenocarcinoma of the prostate is associated with more aggressive behavior. Most studies included patients with tumors of a wide range of grades and stages and an end point of disease-specific survival, a relatively insensitive marker of progression. The authors studied completely embedded radical prostatectomy specimens from 104 patients with clinically organ-confined carcinoma and no history of adjuvant or neoadjuvant therapy. Progression was marked by a serum prostate-specific antigen (PSA) concentration greater than or equal to 0.2 ng/mL. Seventy-six men did not progress, with a mean follow-up period of 8.0 years (range = 7 to 10 years). Forty-eight men progressed at a mean time after surgery of 3.6 years (range = 1 to 8 years). Twenty-one percent of the tumors were organ confined: 79% had capsular penetration. Seminal vesicles and lymph nodes were negative in all cases. A representative section through the main tumor mass was stained for chromogranin A. Reactive neoplastic cells were counted subjectively as well as individually enumerated. Gleason grade, pathological stage, and degree of NE differentiation all correlated with progression. Only grade and extent of NE differentiation predicted progression in a multivariate analysis. NE differentiation did not correlate with stage or grade. Extent of NE differentiation separated patients (59 cases) with tumors of Gleason sum less than or equal to 6 into groups with high and low risks for progression (P < .008) independent of Gleason sum. Extent of NE differentiation provides prognostic information in addition to that provided by grade in cases of early prostate cancer treated by radical prostatectomy.
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PMID:Neuroendocrine differentiation in prostate cancer: enhanced prediction of progression after radical prostatectomy. 869 12


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