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

The unspecific granulomatous prostatitis (GP) is a rare prostate disease. Its relevance lies on the common confusion with prostate carcinoma. Review of 21 cases of unspecific GP, two of which had previously undergone transurethral resection of the prostate. Forty-eight percent of patients developed urinary tract infection prior to GP diagnosis. In 13 patients (62%), prostate carcinoma was suspected after rectal examination of the prostate and transrectal ultrasound. Diagnosis was achieved by histopathology after prostate biopsy and transurethral resection (100%). Prostate Specific Antigen (PSA) was within the normal ranges in all cases that it was performed (six), with the exception of one patient who developed prostate cancer. During follow-up, four patients developed prostate cancer (19%) with an average presentation time of 5.5 years after GP diagnosis.
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PMID:[Non-specific granulomatous prostatitis. Relationship and differential diagnosis with prostatic cancer]. 797 15

The purpose of this study was to evaluate the role of CT in patients with and without prostatic disease. CT and MR findings were reviewed in 25 patients without known prostatic disease, 11 patients with benign prostatic hyperplasia and 11 patients with prostatic cancer. Differential attenuation allowed for distinction of the peripheral zone and inner gland of the prostate by CT in 72% of normal patients. The distinction rate of prostatic zonal anatomy by CT decreased to 30% in the diseased group. When zonal anatomy of the prostate is not visualized on pelvic enhanced CT, the presence of prostatic disease might be considered.
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PMID:[Role of CT in patients with prostatic disease: usefulness of depiction of prostatic zonal anatomy]. 802 53

Androgens are needed in male fertility control methods to impede gonadotropin secretion. Large and frequent doses of testosterone esters are used to induce this effect, but these large and frequent doses are linked to wide fluctuations of plasma testosterone levels. Thus, men need a contraceptive that supplies effective, appropriate, continuous replacement doses over long periods. The synthetic androgen 7alpha-methyl-19-nortestosterone (MENT) can likely address this problem. Studies in primates, rats, and adult men show that it is much more potent than testosterone and can be administered via subdermal implants in effective amounts, which mimic physiologic doses and effects of testosterone, for 12 months. There will most likely be 2 subdermal implants, 1 releasing MENT and the other releasing a luteinizing hormone releasing hormone. Unlike testosterone, MENT is not reduced (5alpha-reduction) to a 5alpha-dihydrosteroid in the prostate. If MENT is administered in a dose sufficient to not disturb normal muscle mass and gonadotropin secretion, it will not hyperstimulate the prostate. Thus, it is less apt to cause benign prostatic hypertrophy and, possibly, prostate cancer than is testosterone. MENT is the first androgen to promote health (i.e., reduction of the incidence of prostate disease). Clinicians may also be able to use MENT to treat hypogonadism, prostatic hyperplasia, and muscle wasting.
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PMID:7 alpha-methyl-nortestosterone (MENT): the optimal androgen for male contraception. 848 61

Evolution of the roles proposed for antiandrogenic agents in prostatic disease has been rapid. Since the early suggestions by Labrie and his colleagues that the nonsteroidal antiandrogen flutamide could be used in combination with medical or surgical castration to provide superior care for patients with metastatic prostate cancer, and subsequent substantiation of the theory in a number of clinical trials, we have observed an increasing tendency to test the use of antiandrogens (alone or in combination with other interventions) earlier in the disease process. At least in part, this tendency is a consequence of our increased ability to detect prostate cancer earlier in the disease process. At the present time, flutamide is the only nonsteroidal antiandrogen available for the treatment of prostate cancer in general clinical practice in the United States. However, two other nonsteroidal antiandrogens currently await decisions on their efficacy and safety by the Food and Drug Administration: nilutamide and bicalutamide. Will either of these agents offer clinical benefits beyond those offered by flutamide? Will the safety, activity, and dosing profiles of the nonsteroidal antiandrogens allow us to use them to treat even earlier stages of prostate cancer and perhaps even prostatic intraepithelial dysplasia in patients at high risk of prostate cancer? What are the potential future roles for bicalutamide and other nonsteroidal antiandrogens in the management of prostatic disorders? This article will attempt to lay out the key questions that await definitive answers as we expand our understanding of the possible future roles for antiandrogens in the management of prostate cancer and related conditions.
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PMID:Hormone therapy for prostate cancer: a topical perspective. 856 Jun 75

Five randomized pilot studies of screening for prostate cancer (PC) have been conducted in the area of Rotterdam from 1991 to 1994. The purpose of these studies was to establish the feasibility of a randomized screening protocol with PC mortality as the major end point in The Netherlands and at a European level. All procedures related to recruitment of participants, to application of the screening tests and to data collection were evaluated. Men (7,200) aged 55-74 years were invited through the Rotterdam Population Registry. The recruitment rate over the 5 pilot studies averaged 38.2% (2,747 men). Recruitment procedures proved to be relevant for establishing higher participation rates (invitation and consent by mail). The screening tests were well accepted and tolerated. The general population-based character of the sample was confirmed by studying symptoms of prostatic disease in participants and in men who refused participation. Data based on one PSA serum determination, rectal examination and transrectal ultrasonography are presented; 204/1,403 men (14.5%) had a positive screening result by either test combination and underwent biopsy. Forty-nine cancers were found in 1,403 men (3.5%); 65% of prostate cancers (17/26) identified in men who eventually underwent radical prostatectomy proved to be locally confined. From the pilot studies, we conclude that a large contribution to a European Randomized Study of Screening for Prostate Cancer (ERSPC) can be made by recruiting about 40,000 men in the area of Rotterdam. The preliminary data suggest that after confirmation of the present data during the first years in the European study, DRE and TRUS can be withheld depending on the PSA result in a large proportion of the screening population.
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PMID:European randomized study of screening for prostate cancer--the Rotterdam pilot studies. 856 9

Growth of the prostate is controlled by androgen. However, there is information indicating that androgen may not act directly, but may act indirectly through polypeptide growth factors, to control prostate growth. This review will focus on the involvement of members of the fibroblast growth factor (FGF) family in this process. The properties of FGFs and FGF-receptors are described that implicate these molecules in growth control. Information is provided that prostate stromal cells synthesize FGF2 and FGF7. FGF2 is a potent mitogen for stromal cells; whereas, FGF7 is exclusively a mitogen for epithelial cells. Transforming growth factor beta (TGF beta), also produced by prostate cells, inhibit cell growth. This suggests that prostate growth is controlled by autocrine and paracrine mechanisms. Evidence is presented that altered FGF expression accompanies benign prostatic hyperplasia and prostate cancer. A model is proposed whereby androgen regulates TGF beta, influencing FGF2 and FGF7 expression, and in turn regulating growth of the prostatic stroma and epithelium. An imbalance in the influence of these growth factors may contribute to prostate disease.
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PMID:Regulation of prostate growth by fibroblast growth factors. 858 Oct 1

Androgens play a key role in prostate structure and function, leading to the hypothesis that effects of the hormone are an important component in the development of prostatic disease. Differences in serum testosterone levels and 5alpha-reductase activities between ethnic and racial groups have been implicated in the variable incidence of prostate cancer among certain populations. Androgen receptors transduce the steroid signal within cells, but attempts to correlate differences in receptor levels with prostatic disease have been unsuccessful. However, molecular studies of androgen receptor gene structure have recently provided new insights toward defining a genetic basis for the pathology associated with three diseases--spinal bulbar muscular atrophy, breast carcinoma, and prostate cancer--affecting middle-aged and older men. In summary, epidemiologic data on androgen biosynthesis, metabolism, and action of androgens and molecular genetic analysis of gene structure have led to a new understanding of the interrelationships between environmental and genetic factors that may impact on the incidence of certain pathologic conditions in men.
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PMID:Provocative aspects of androgen genetics. 863 Feb 38

Differences in endogenous androgen levels have been hypothesized to explain ethnic differences in prostate cancer risk. To examine this hypothesis, we gathered data on serum concentrations of androgens and sex hormone-binding globulin (SHBG) in healthy older men from four ethnic groups at different levels of prostate cancer risk. As part of a population-based case-control study of prostate cancer we conducted in California, Hawaii, and Vancouver, Canada, 1127 African-American, white, Chinese-American, and Japanese-American control men, mostly ages 60 years or older (mean age, 69.9 years) provided information on various lifestyle factors and donated an early morning fasting blood sample between March 1990 and March 1992. We used these data to examine the distributions of serum androgens [testosterone (total, free, and bioavailable), dihydrotestosterone (DHT)], the ratio of DHT to total testosterone (DHT:testosterone ratio), and SHBG in these four ethnic groups. We also assessed correlations between concentrations of these measures with age, body size, physical activity, and other personal characteristics, and we evaluated ethnic differences in concentrations of androgens and SHBG after adjusting for these characteristics. In each of the four ethnic groups, concentrations of free and bioavailable testosterone declined with age, whereas SHBG concentrations increased with age. Age-adjusted concentrations of all androgen measures and SHBG decreased with increasing levels of Quetelet's index. After adjustment for age and Quetelet's index, androgens and SHBG showed no clear and consistent relationships to physical activity, alcohol consumption, or tobacco use. DHT:testosterone ratio was higher in men reporting a history of benign prostate disease than in men without such a history, and higher in vasectomized men than in nonvasectomized men. SHBG concentrations were higher in men reporting one or more first-degree relatives with prostate cancer than in men without such a family history. After adjustment for age and Quetelet's index, the levels of total and bioavailable testosterone were highest in Asian-Americans, intermediate in African-Americans, and lowest in whites. However, the DHT:testosterone ratio was highest in African-Americans, intermediate in whites, and lowest in Asian-Americans, corresponding to the respective incidence rates in these groups and providing indirect evidence for ethnic differences in 5alpha-reductase enzyme activity.
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PMID:Serum androgens and sex hormone-binding globulins in relation to lifestyle factors in older African-American, white, and Asian men in the United States and Canada. 867 90

The role of free (F) and complexed serum PSA is now under investigation. In the present study, we evaluated the clinical significance of F-PSA and F/Total (T) PSA ratio in a preliminary series of samples from 88 patients with prostate cancer (PC), 113 with benign prostatic disease (BPD), and 98 with non-prostatic disease (NP). We used the F-PSA and third generation T-PSA (DPC, Los Angeles, USA) chemiluminescent enzyme immunometric assays with the IMMULITE automated system. At the 10 ng/ml cutoff for T-PSA levels, we obtained a sensitivity of 83% with a specificity of 100% in NP and 80% in BPD. The addition of the F/T ratio--rather than F-PSA levels--was useful to better discriminate PC and BPD in the cases erroneously classified by T-PSA alone: 44/68 samples (65%) were correctly diagnosed. Moreover, the F/T ratio was particularly effective in the critical T-PSA range between 4.1-9.9 ng/ml; 26/40 cases (65%) were correctly evaluated. In conclusion, the F/T ratio seems to be an interesting auxiliary test to T-PSA, to be reserved for selected cases where additional diagnostic information is necessary.
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PMID:Preliminary clinical evaluation of free/total PSA ratio by the IMMULITE system. 874 Jun 38

The Prostate-Specific Antigen (PSA) and the Cancer-Associated Serum Antigen (CASA) assay for the MUC1 mucin were compared in the serum of 303 patients with malignant or benign prostatic disease. Using cutpoints of 4, 10, and 20 micrograms/l, PSA was elevated in 93%, 81%, and 64% of patients with prostate cancer (n = 113), with corresponding specificities of 55%, 84%, and 96% in benign prostate disease (prostatic hyperplasia or prostatitis, n = 190). Using the recommended cutpoint of 4 Units/ml, CASA was elevated in 38% of patients with prostate cancer, with a specificity of 91% in benign disease. PSA and CASA showed a poor correlation in prostate cancer (r = 0.367) and benign disease (r = 0.158), and CASA was elevated in some PSA negative samples. Used together, PSA > or = 20 micrograms/l and CASA > or = 4 kU/l gave perfect specificity in benign disease, with a corresponding sensitivity of 29% (positive and negative predictive values of 100% and 70%, respectively). However, this combination gave no improvement over the use of PSA alone, with sensitivity 47% when the cutpoint was raised to give perfect specificity. These data suggest that CASA is of little use as an adjunct to PSA in the differentiation of benign and malignant prostate disease.
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PMID:Prostate-specific antigen (PSA) and cancer-associated serum antigen (CASA) in distinguishing benign and malignant prostate disease. 875 Jun 49


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