Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The records of 132 patients participating in clinical trials using fast neutron (n = 94), mixed neutron and photon (n = 16), or conventional photon (n = 22) irradiation for primary management of prostatic cancer were retrospectively reviewed to assess treatment-related neurological complications. With a median follow-up of 14 months (range 1 to 101 months), 31/132 patients (26 neutron, 3 mixed beam, 2 photon) have experienced either sciatica beginning during or shortly after treatment, or diminished bladder or bowel continence that developed at a median time of 6.5 months following treatment. Sciatica responded to oral steroids and was usually self-limited, whereas sphincter dysfunction appears to be permanent. Pre-treatment risk factors for complications included a history of hypertension, diabetes, cigarette smoking or peripheral vascular disease, with 81% of affected patients having one or more risk factors compared with 55% of unaffected patients (p = 0.01). Seven patients have moderate (5) or severe (2) residual problems, all in the cohorts receiving neutrons (6/7) or mixed beam therapy (1/7).
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PMID:Transient and chronic neurological complications of fast neutron radiation for adenocarcinoma of the prostate. 212 Jul 42

Common urologic complaints in the midlife man include bladder outlet obstruction, bladder hyperactivity, and large urinary output. Obstruction can result from benign prostate hypertrophy or some other problem distal to the bladder neck, such as urethral stricture. Hyperactivity can be induced by stress and caffeine or can suggest neurologic disease or bladder neoplasia. Large urinary output suggests excessive fluid intake, diabetes insipidus or mellitus, or mobilization of fluid from the use of diuretics or reclining at night. Sexual dysfunction may be caused by stress, but it is more often linked to peripheral vascular disease. Screening for prostate cancer is controversial; the benefit of PSA testing is most clear in patients at elevated risk (eg, due to race or family history).
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PMID:Urologic 'nuisances': how to work up and relieve men's symptoms. 905 86

The degree to which comorbidities affect the diagnosis of prostate cancer is not clear. The purpose of this study was to determine how comorbidities affect the stage at which prostate cancer is diagnosed in elderly white and black men. We obtained data from the Surveillance, Epidemiology, and End Results program of the National Cancer Institute merged with Medicare claims data. For each patient, we estimated associations between stage of disease at diagnosis and each of the 27 comorbidities. The sample included 2,489 black and 2,587 white men with staged prostate cancer. Coronary artery disease, benign hypertension, and dyslipidemia reduced the odds of late-stage prostate cancer. A prior diagnosis of peripheral vascular disease, severe renal disease, or substance abuse increased the odds of being diagnosed with late-stage disease. The study shows some effect modification by race, particularly among white men with substance abuse, cardiac conduction disorders, and other neurologic conditions. The strongest predictors of late-stage prostate cancer diagnosis for both white and black men were age at diagnosis of at least 80 years and lack of PSA screening. Comorbidities do affect stage at diagnosis, although in different ways. Four hypotheses are discussed to explain these findings.
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PMID:Comorbidities and the risk of late-stage prostate cancer. 1761 18

Arsenic has been well documented as the major risk factor for blackfoot disease (BFD), a unique peripheral vascular disease that was endemic to the southwestern coast of Taiwan, where residents consumed artesian well water containing high levels of arsenic for more than 50 yr. Chronic arsenic exposure was also reported to be associated with mortality attributed to prostate cancer in a dose-response relationship. A tap-water supply system was implemented in the early 1960s in the BFD-endemic areas in Taiwan. Artesian well water was no longer used for drinking and cooking after the mid-1970s. The objective of this study was to determine whether prostate cancer mortality decreased after the improvement of drinking-water supply system through elimination of arsenic ingestion from artesian well water. Standardized mortality ratios (SMRs) for prostate cancer were calculated for the BFD-endemic area for the years 1971-2006. Results showed that mortality attributed to prostate cancer declined gradually after the improvement of drinking-water supply system. Based on the reversibility criterion, the association between arsenic exposure and development of prostate cancer is likely to be causal.
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PMID:Does arsenic exposure increase the risk for prostate cancer? 1892 98

Well leg compartment syndrome is rare after laparoscopic radical prostatectomy. We report a 68-year-old man that developed compartment syndrome after laparoscopic radical prostatectomy for prostate cancer. There are several circumstantial risk factors associated with LRP that, when combined, may potentially predispose to the development of compartment syndrome, including: obesity, evidence of peripheral vascular disease (advanced age, hypertension, hyperlipidemia, and diabetes mellitus), thromboembolism prophylaxis with compressive leg wraps together with intermittent pneumatic devices, combined general-spinal anesthesia, prolonged operative time in Trendelenburg position, and systemic hypotension due to intraoperative bleeding. The pathogenesis of this serious complication is discussed and preventive measures are highlighted.
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PMID:[Combined risk factors leading to well-leg compartment syndrome after laparoscopic radical prostatectomy]. 1990 Mar 89

As men grow older, testosterone (T) levels decline and the significance of this change is debated. The evidence supporting a causal role for lower circulating T, or its metabolites dihydrotestosterone (DHT) and estradiol, in the genesis of atherosclerosis and cardiovascular disease (CVD) in men is limited. Observational studies associate low baseline T levels with carotid atherosclerosis, aortic and peripheral vascular disease, and with the incidence of cardiovascular events and mortality. Studies using mass spectrometry suggest that when total T is assayed optimally, calculation of free T might not necessarily improve risk stratification. There is limited evidence to support an association of estradiol with CVD. Interventional studies of T therapy in men with coronary artery disease have shown beneficial effects on exercise-induced myocardial ischemia. However, placebo-controlled, randomized clinical trials (RCTs) of T therapy in men with the prespecified outcomes of cardiovascular events or deaths are lacking. Meta-analyses of randomized controlled trials of T published up to 2010 found no increase in cardiovascular events, mortality, or prostate cancer with therapy. Recently, in a trial of older men with mobility limitations, men randomized to receive a substantial dose of T reported cardiovascular adverse effects. This phenomenon was not reported from a comparable trial where men received a more conservative dose of T, suggesting a prudent approach should be adopted when considering therapy in frail older men with existing CVD. Adequately powered RCTs of T in middle-aged and older men are needed to clarify whether or not hormonal intervention would reduce the incidence of CVD.
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PMID:Sex steroids and cardiovascular disease. 2440 88

Estimating the risk of competing mortality is of importance in tailoring optimal individual management strategies in patients with early prostate cancer. Using proportional hazard models for competing risks, we determined which parameters predict competing mortality in patients selected for radical prostatectomy aged 70 yr or older and compared the prognostic impact of individual parameters with that of their younger counterparts. Three common diseases (diabetes mellitus, chronic lung disease, and other cancer) that predicted competing mortality in younger men were not predictors of competing mortality in men selected for radical prostatectomy aged 70 yr or older (hazard ratio [HR]:<1). Besides age (HR/yr: 1.08, p=0.0255), peripheral vascular disease (HR: 2.33, p=0.0195), cerebrovascular disease (HR: 2.23, p=0.0242), American Society of Anesthesiologists physical status class 3 (HR: 2.19, p<0.0001), current smoking (HR: 2.18, p=0.0098), and lower or unknown level of education (HR: 2.07, p=0.0002) were independent predictors of competing mortality in patients aged 70 yr or older. Combining these five conditions in a score might provide a superior comorbidity measure in this particular population.
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PMID:Predicting Competing Mortality in Patients Undergoing Radical Prostatectomy Aged 70 yr or Older. 2978 50