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

Radical prostatectomy in patients who have had prior transurethral resection of the prostate has been reported to result in significant morbidity. From 1974 to 1982, 30 patients who had had previous transurethral resection of the prostate underwent radical perineal prostatectomy for localized prostatic cancer. Operative time and blood loss were similar to a group of patients who had not had prior transurethral resection of the prostate. Over-all, 3 patients (10 per cent) had total incontinence and 3 (10 per cent) had stress incontinence requiring a pad or device. No patient undergoing radical prostatectomy less than 4 weeks or more than 4 months after transurethral resection of the prostate had postoperative incontinence. When radical perineal prostatectomy was performed between 4 weeks and 4 months after transurethral resection of the prostate the incidence of incontinence was 50 per cent. Five patients experienced prolonged perineal urinary drainage, all but 1 of whom healed spontaneously. Of the 6 patients with incontinence 3 had prolonged drainage. No patient had a rectal injury and there was no operative mortality. Two patients died without cancer and 1 has evidence of disease recurrence. We conclude that radical prostatectomy may be performed safely with acceptable morbidity following transurethral resection of the prostate and that if 4 weeks has elapsed since resection it might be advantageous to wait 4 months before performing radical surgery to lessen the risk of incontinence.
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PMID:Morbidity of radical perineal prostatectomy following transurethral resection of the prostate. 672 61

Orgotein efficacy in minimizing the local side effects induced by radiotherapy, administered to patients suffering from bladder or prostate cancer, was studied in 3 double-blind clinical trials. Assessment parameters such as efficacy, signs and symptoms of bladder disease were chosen as follows: incontinence, pain, dysuria, cystoscopic picture, maximal voiding volume, voiding frequency (day and night), diarrhoea, amount of anti-diarrhoea preparations consumed. In the first study orgotein was administered in a dose of 4 mg, 15-30 minutes after radiotherapy. Orgotein was found to be statistically significant superior to placebo when assessed according to the above mentioned criteria. Side effects that would have compelled stopping the orgotein therapy did not develop. In the second trial 50 patients suffering from prostatic carcinoma received after each radiotherapy (5,400 rad during 6 weeks) 8 mg orgotein or placebo. The radiotherapy-induced side effects were less common in the orgotein group than in the placebo group. The third clinical trial was conducted according to the same protocol as the two previous ones. Fifty patients with either prostate or bladder cancer were given orgotein or placebo in conjunction with radio-therapy. Only data of 26 out of 50 are yet available. These data show in agreement with two previous mentioned trials a significant superiority of orgotein compared to placebo.
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PMID:Orgotein efficacy in ameliorating side effects due to radiation therapy. 704 89

PATIENTS with T1/T2 prostate cancer are well served by external beam radiation. 1. T1/T2, N0, M0 PATIENTS: The 10-year outcome of N0 patients is equal to that obtained by radical prostatectomy in similar patients without the operative mortality or incontinence that accompanies the latter procedure. Ten-year cure has been confirmed by PSA studies in irradiated patients, while this has not yet been demonstrated in surgical patients. 2. T1, NX, M0 PATIENTS: After radiation therapy these patients show no excess mortality as long as 15 years after treatment, an outcome confirming a strict criteria of cure. 3. T2, NX PATIENTS: After radiation therapy, these patients show continuing excess mortality to 15 years, but most 15-year survivors are NED, again supporting the concept of long-term cure. 4. T1/T2 N+, M0 PATIENTS: We must have clinical trials in these patients that study the roles of radiation, androgen deprivation, and surgery. 5. Conformal treatment technology is improving the technical delivery and dose administered by radiation therapy and decreasing both the acute and late side effects of treatment. It remains to be proved whether the increased dose and accuracy will improve local control and cure as hoped.
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PMID:Treatment of early stage prostate cancer: radiotherapy. 751 42

To evaluate the patterns of use of radical prostatectomy for the treatment of prostate cancer in the United States, the American College of Surgeons Commission on Cancer in association with the American Cancer Society and American Urological Association surveyed 484 institutions concerning 2,122 patients treated in 1990. The results revealed that 93% of the patients were younger than 75 years when treated. Pretreatment prostate specific antigen level was greater than 4.0 ng./ml. in 85.4% of the patients. Surgical-pathological evaluation showed that 57.5% of the patients treated had American Joint Committee on Cancer pathological stages O, I and II corresponding to American Urological Association stages A1 to B2. Positive pathological findings, for example microscopic tumor extension or invasion, were associated with elevated prostate specific antigen levels at followup. The mortality rate associated with the operation was 0.7%. Impotence following treatment was observed in 56.6% of the patients who were potent preoperatively and complete incontinence was reported in 3.6% of the patients who were previously continent. The data may provide benchmarks by which further trends in prostate cancer treatment may be compared.
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PMID:National patterns of prostate cancer treatment by radical prostatectomy: results of a survey by the American College of Surgeons Commission on Cancer. 793 40

The author presents the results of a follow-up study on 918 cases of radical prostatectomy for prostatic cancer performed by 21 urologists. The average follow-up was two years and six months, (from three months to eight years). Mortality caused by the cancer was 1.96% and from all other reasons was 3.05%. 86.82% of the patients have been operated on for clinical stage B 8.49% for stage A. 3.81% for stage C and 0.22% for stage D. Comparison between pre-operative for evaluation and for pathological features show an understaging rate of 52.03%, an overstaging rate of 4.07% and an accurate evaluation in 43.90% of the cases. Almost half on the understaged patients (208 on 422) received adjuvant therapy, but only 14 received adjuvant therapy in the group of 342 patients whose evaluation was accurate. PSA level seems to be an important component in the stadification, since 73.59% patients whose PSA level was under 50 ng/ml did receive an adjuvant therapy, while 21.24% patients whose PSA level was over 50 ng/ml remain without complementary treatment. The post-operative incontinence rate was 11.75%. The post-operative impotence rate was 83.15%.
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PMID:[Results of radical prostatectomies for cancer: a retrospective multicenter study on 918 cases]. 753 Jul 50

Radical surgical treatment of localized prostate cancer is performed to heal the patient of his malignant disease. Surgery for advanced prostate cancer, e.g. transurethral resection for obstruction or hemorrhage, is always a palliative modality and has to be seen in the context of systemic treatment. Radical prostatectomy is a major intervention which allows complete removal of the prostate gland and the seminal vesicles at the same time. Due to resection at the distal end of the prostatic urethra, the bladder sphincter system is partially destroyed. In general, to guarantee radicality, the erectile nerves and vessels are sectioned, resulting in erectile impotency. Preservation of these structures to maintain potency is indicated only exceptionally. Radical prostatectomy is today a routine operation with minimal mortality (0.5-1%) and minor complication rate. Average hospitalization is about 10 days. Long-term postoperative morbidity is characterized by urinary incontinence and erectile impotency. Incontinence takes a long time to heal. A certain number of patients will keep a generally not very bothersome stress dribbling; however, some may show complete leakage, necessitating an anti-incontinence operation. For an indication of radical prostatectomy, two essential factors have to be considered: the usually extremely slow growth of prostate cancer and the high prevalence of clinically insignificant latent carcinomas. It is for these reasons and for the consequences on live quality that radical prostatectomy should not be performed on patients with a life expectancy of less than 10 years.
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PMID:[Possibilities of surgical therapy in prostatic carcinoma]. 754 69

Prostate cancer is a common cause of cancer-related morbidity and mortality in men. Prostate-specific antigen (PSA) measurement to screen for prostate cancer has been promoted as a way to reduce morbidity and mortality from prostate cancer. This paper examines the usefulness of PSA screening for asymptomatic prostate cancer, focusing on outcomes for all patients screened. The sensitivity and specificity of PSA testing for prostate cancer are low and have not been studied properly in asymptomatic men being screened for prostate cancer. PSA screening detects localized prostate cancer undetected by digital rectal examination in fewer than 1% of men screened. The effectiveness of early treatment of prostate cancer, compared with deferral of treatment until symptoms develop, is unproven, and good survival rates have been reported among patients who defer aggressive treatment. Complications of treating prostate cancer with radical prostatectomy or radiation treatment include death, impotence, urethral stricture, incontinence, and rectal injury. At the present time, there is insufficient evidence to support a policy of PSA screening, and its use should be discouraged until randomized controlled trials demonstrate benefit from PSA screening.
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PMID:Prostate-specific antigen testing to screen for prostate cancer. 754

A new surgical procedure, cryosurgical ablation of the prostate, offers patients with organ-confined prostate cancer another treatment option. The advantages of this cryosurgical technique are complete ablation of prostatic cancers without radical prostatectomy procedures, less blood loss, decreased hospital stays, reduced health care costs, and minimal associated morbidity. Some possible complications of cryosurgical ablation of the prostate procedures include incontinence, impotence, rectal freezing from inadequate monitoring of the freezing process, urethrocutaneous and urethrorectal fistula formations, and urethral tissue sloughing. The intraoperative nurse's prime responsibility is to monitor the subfreezing temperatures of the cryoprobes. Postoperatively, patients have only a few perineal incisions covered with sterile dressings and a suprapubic catheter. Most patients have minimal discomfort that is managed easily with opiate analgesics.
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PMID:Cryosurgical ablation of the prostate. 853 51

We report a case of prostate cancer showing a complete remission after LH-RH agonist neoadjuvant therapy. A 69-year-old man was referred to our department complaining of pain on urination and urge incontinence. The serum prostate specific antigen (PSA) level was 41.6 ng/ml. Needle biopsy specimens from both lobes revealed moderately differentiated adenocarcinoma. Chest X-ray, computed tomographic (CT) scan, and bone scintigraphy demonstrated neither distant metastasis nor local invasion. LH-RH agonist was administered on a monthly basis as neoadjuvant therapy. After 4 injections, pelvic lymph node dissection and radical prostatectomy were performed on January 11, 1993. Thorough examination did not reveal any cancer cells in the removed specimen. The patient was discharged 30 days after the operation and has shown no evidence of distant metastasis or local recurrence as long as 19 months later.
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PMID:[Complete remission of prostate cancer after LH-RH agonist neoadjuvant therapy: a case report]. 764 58

A double Malecot-like 16F, polyurethane intraurethral catheter (IUC) was inserted 39 times in 25 patients between 68 and 91 years old (mean +/- SD: 77.5 +/- 5.5 years). Most of them were unfit for surgery because of severe illness or advanced age. All patients except 1 had either an indwelling catheter or a residual urine volume > 50ml at their first visit. The remaining one suffered from prostatic cancer and complained of pollakisuria and urinary incontinence. His symptoms were controlled well after ICU insertion and anticholinergic therapy. Twenty-nine insertions in 17 patients were considered successful, and the patients with successfully inserted stents voided without residual urine. Nine of 21 patients needed to take anticholinergic drugs. The mean duration of IUC use was 113 days in successful cases. In 9 out of 17 patients with an indwelling IUC for more than 112 days, the catheter became blocked by stones or clots. Therefore, we consider that the device should be changed after 110-120 days. Ten insertions failed for the following reasons: malposition, inappropriate IUC length, spontaneous migration to the bladder in patients with a short prostatic urethra, urinary retention due to underactive detrusor, and total incontinence and bleeding from prostatic cancer.
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PMID:[Experience with polyurethane intraurethral stents in aged patients]. 768 14


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