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

A case of rectal carcinoid tumor with liver metastases is reported in which a markedly elevated serum acid phosphatase level was found. Tissue assays of the patient's tumor, liver metastasis, and uninvolved liver were performed which demonstrated very high tumor levels of acid phosphatase. The patient also had elevated plasma serotonin levels and urinary 5-hydroxyindole acetic acid levels and did not exhibit the carcinoid syndrome. Autopsy showed no prostate cancer or metastatic bone lesions. Serum acid phosphatase elevation may occur with carcinoid lesions of the rectum.
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PMID:Elevated serum acid phosphatase levels with rectal carcinoid tumor. 124 71

Screening chest radiographs do not reduce mortality from lung cancer. Should an incidental noncalcified pulmonary parenchymal nodule be discovered, chest CT will demonstrate one third of such patients to, in fact, have the multiple nodules of metastatic disease. CT is very helpful to guide fine needle aspiration biopsy of lung lesions and to assist in evaluation for resectability. MR can be helpful in special circumstances, including the definition of the extent of paravertebral, superior sulcus, and diaphragmatic lesions. Endorectal ultrasound is not sensitive enough to function as a screening tool for prostate cancer but is used routinely to guide biopsies. CT and MR are rarely helpful in staging this disease. Given the highly characteristic trait of bone metastasis in prostate cancer, a bone scan is mandatory in all patients. Double contrast barium enema can be used as an adjunct or alternative to sigmoidoscopy for colorectal cancer screening, in the preoperative evaluation of patients, and in postoperative surveillance. CT and MR can detect macroscopic adenopathy and liver metastases; CT is generally the preferred study. Screening mammography can have a major impact in reducing breast cancer mortality. It is recommended that a baseline study be obtained at age 35. Annual or biannual examinations should commence at age 40. Any palpable lesion, whether or not it is demonstrated mammographically, must be subjected to biopsy. Ultrasound is the most useful initial imaging study for evaluating pelvic masses. MR will, on occasion, identify the origin of a mass not determinable from ultrasound scan. MR is particularly valuable to identify parametrial spread (inoperability) of cervical cancer, and has been underused for this purpose. Surgery remains the mainstay for the staging of ovarian and endometrial cancer, although CT can be helpful to identify macroscopic relapse, ascites, or liver metastases. Bone scan and liver CT remain the standard procedures for detecting metastases in these respective organ systems. MR can be invaluable in the imaging of epidural metastasis and spinal cord compression in patients with vertebral metastatic disease. Contrast-enhanced MR is more sensitive than contrast-enhanced CT for detecting brain metastases, but the latter remains a useful tool. Chest CT can improve the detection of pulmonary metastases when this is of crucial importance.
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PMID:Diagnostic imaging in cancer. 146 83

A new device made of piezoelectric ceramic placed in a semispherical dish and focussed at 320 mm was developed in order to generate heat and cavitation responsible for coagulative necrosis of deep tissues. The target to be treated is located with a central ultrasound probe of 3.5 MHz. In vitro studies with polyurethane phantoms showed that the ultrasound melted a surface of 2 x 12 mm within 1 s. The temperature recorded at the focus was 270 degrees C. In tissue samples (prostate cancer and benign prostate hyperplasia), the temperature rose to 85 degrees C in vitro and a hyperechoic zone appeared at the focus during shots. In vivo 8-mm plastic spheres, introduced surgically into the bladder of pigs, were melted by repeat shots without burning of crossed tissues. These studies were performed in the kidney and the liver. Autopsy performed on day 0 showed congestion, autopsy performed between day 6 and day 11 showed necrosis, whereas at 3 months the focussed area was fibrosed. This technique, which we called 'focussed extracorporeal pyrotherapy', combines phenomena of cavitation and high heat at the focus. Prostate tumors, bladder tumors, kidney tumors and liver metastases are potential indications for pyrotherapy.
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PMID:Focussed extracorporeal pyrotherapy: experimental results. 172 38

Ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia is a new technique that involves placement of a laser fiber in solid tissue under ultrasound guidance followed by irradiation from within the area to be treated. We have previously described a diffuser tip modification of the bare laser fiber, that proved to produce spherical coagulations of predictable size. In the present paper we describe the development of an ultrasonically guided technique which permits simultaneous laser irradiation and interstitial temperature measurements under real time ultrasound monitoring. The laser lesion appeared on the ultrasound image as a hyperechoic area growing in size with time as energy was applied. Macroscopically the laser lesion emerged as a sphere with a central cavity delineated by a rim of charred tissue and beyond this a larger zone of whitish coagulation. The correlation coefficient (Pearson's r) between ultrasonically and macroscopically measured diameter of the laser lesion was calculated to r = 0.89. It is concluded that ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia may have a potential as a tool in the future treatment of ultrasonically visible neoplasias like liver metastases and prostate cancer.
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PMID:Ultrasonically guided interstitial Nd-YAG laser diffuser tip hyperthermia: an in vitro study. 194 29

For patients with prostate cancer, diagnostic imaging can play three roles: screening, staging, and monitoring. Bayesian analysis dictates that if the prior probability of cancer is relatively low or if the consequences of a false-positive result are unacceptable, the test must be optimally specific. If the prior probability of cancer is high or if the consequences of missing it are unacceptable, the test must be optimally sensitive. For screening, the consequences of a miss are slight, and the consequences of labeling an insignificant cancer significant are serious. Thus, a very specific test is required. No current imaging modality fulfills this criterion. For staging, the prior probability of significant disease is relatively high, and the consequences of a miss serious, so a very sensitive test is required. Transrectal sonography, plus biopsy under sonographic control, fulfills this criterion for local disease, as does a bone scan for bone metastases. For monitoring, the prior probability is high, and the consequences of a miss serious, so a very sensitive test is needed. The bone scan is sensitive for bone metastases. Although CT is not sensitive for detecting lymph node metastases, it has practical clinical advantages over other imaging modalities for monitoring purposes in that it can detect disease in multiple structures at once. It is the only test that can monitor prostate size, the size of the lymph nodes, and whether hydronephrosis or liver metastases are present all in the scope of one examination.
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PMID:The role of imaging in prostate cancer. 202 8

The average radiologist will never compute a probability by using Bayes theorem or carry out a logistic regression, ROC, or cost-effectiveness analysis. Why, then, do we think that radiologists should be familiar with these techniques? Radiologists base many decisions on information gleaned from the published literature. In the past decade, the techniques discussed here have begun to appear in medical (including radiologic) publications. A radiologist with no comprehension of ROC analysis, for example, would be unable to critically assess a study that used this technique to compare MR imaging and CT in the detection of liver metastases and would have to accept or reject its conclusions blindly. A knowledgeable radiologist, on the other hand, could judge whether the study employed proper methodology, and could accept or reject its conclusions on that basis. The four cases presented here are specific examples of generic problems facing the radiologist: predicting the likelihood of disease on the basis of a test result, using several pieces of information provided by a single test to arrive at a diagnosis, comparing the efficacy of radiologic tests or interpretive techniques, and choosing among available tests or procedures on the basis of their relative cost-effectiveness. It is likely, therefore, that the techniques of medical decision making discussed here will appear with increasing frequency in the radiology literature. The list of potential applications is long. Some of the questions that can be addressed by the techniques presented here are: How predictive of IUGR are the various proposed Doppler criteria? How can they be used in conjunction with conventional sonographic criteria to diagnose IUGR? Which technique is best for detecting prostate cancer or for staging known cancer--sonography or MR imaging? Which MR pulse sequence is best for a variety of organ systems and clinical indications? Is routine screening obstetric sonography cost-effective? Applications of statistical decision-making techniques to these and related questions will improve the quality of health care provided by radiologists, if the statistical techniques are done properly and understood by the intended audience.
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PMID:Statistical techniques for medical decision making: applications to diagnostic radiology. 312 27

Prostate cancer with marked neuroendocrine (NE) differentiation belongs to the hormone resistant carcinomas. We report the development of TSH-secreting small cell prostate cancer (SCPC) from high grade adenocarcinoma (Gleason score 8) with an elevated number of chromogranin A positive cells located in benign structures adjacent to the cancer. Conversion to SCPC was followed-up during 4 years. The initial adenocarcinoma exerted a stronger positivity for PAP than for PSA (respective staining indexes, Sls, 2.2 and 1.8, maximum staining 3.0). In the developed SCPC, 2 cell subpopulations that were derived from epithelial cells were found (positive stain for EMA and CEA, respectively) and from one of them originated CEA-positive liver metastases. Blood CEA and NSE levels were elevated in SCPC (284 ng/ml and 24.5 ng/ml). However, blood TPS level which reflects proliferation of epithelial cells was within the normal range. The development of a << pure >> sarcomatoid prostatic tumor from adenocarcinoma with 2 areas of similar differentiation grades (Gleason score 7 and 9-10) that initially differ in staining for PSA and PAP (SIs for PSA were 1.2 and 0.02 and for PAP were 1.6 and 0.02, respectively) was followed-up during 4 years of treatment with Estracyt. Adenocarcinoma tissue specimens was slightly CEA-positive. The disappearance of lower grade adenocarcinoma during treatment was accompanied by the development of sarcomatoid areas that were 100% vimentin positive. In the last year of follow-up the primary tumor was composed only of vimentin positive sarcomatoid cells with a slight positivity for Chromogranin A, NSE and ACTH. In parallel, normal serum PSA and PAP values and elevated CEA and NSE serotests (12.6 ng/ml and 24.7 ng/ml, respectively) were found. Blood TPS level was at the upper limit of the normal range. Scintigraphy revealed extensive liver metastases. The recorded data indicate (i) extremely poor prognoses associated with high grade adenocarcinomas that demonstrate stronger immunohistochemical positivity for PAP than that for PSA (ii), chromogranin A positive cells in benign structures adjacent to the cancer as a possible paracrine promoter of SCPC from poorly differentiated adenocarcinoma, and (iii) a high degree of heterogeneity of both SCPC and sarcomatoid prostatic neoplasms with some evidence for definite links (EMA and CEA) to secretory epithelial cells.
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PMID:Immunohistochemical staining and serotest markers during development of a sarcomatoid and small cell prostate tumor. 784 May 15

The diagnostic value of a new tumor marker, c-erbB-2, was studied in the sera of 50 controls, 112 patients with benign diseases and 534 patients with malignancies. Using 15 U/ml as the cutoff, no healthy subjects, patients with benign diseases (excluding liver cirrhosis) or patients with no evidence of disease (45 patients) had serum levels higher than this limit. Abnormal c-erbB-2 levels were found in 38.5% (10 of 26) of the patients with liver cirrhosis and in 26.7% (8 of 30) of those patients with primary liver cancer. No differences were found between the c-erbB-2 serum concentrations in liver cirrhosis or primary liver cancer, suggesting the possible catabolism of this antigen in the liver. Abnormal levels of this antigen were found in 20% (56 of 278) of the patients with breast carcinoma (locoregional 7%, metastases 41.5%), in 21% (6 of 28) of ovarian carcinomas (stage I-II 0%, stage III-IV 42.8%), in 21% (3 of 14) of the colorectal tumors (locoregional 0%, metastases 30%), and in 13.3% (11 of 83) of the patients with lung cancer (locoregional 11.5%, metastases 16%). C-erbB-2 sensitivity in other patients with advanced disease was: 25% (9 of 36) in prostatic cancer, 22% (2 of 9) in gastric cancer, and 11% (1 of 9) in vesical tumors. When patients with liver metastases were excluded abnormal c-erbB-2 serum levels were only found in breast, lung, prostatic and ovarian carcinomas. C-erbB-2 sensitivity in patients with lung cancer was related to tumor histology with significantly higher value in non-small cell lung cancer (mainly adenocarcinomas) than in patients with small cell lung cancer (p < 0.013). C-erbB-2 concentrations in patients with breast cancer were significantly higher in patients with recurrence (mainly bone and liver metastases) and in patients with progesterone receptor-negative (< 15 fmol/mg) tumors (p < 0.01). In conclusion, c-erbB-2 is not a specific tumor marker and abnormal serum levels may be found in patients with liver pathologies. Its sensitivity suggests its possible application as a tumor marker in breast, ovarian, lung (mainly adenocarcinomas) and prostatic tumors.
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PMID:Serum levels of C-erbB-2 (HER-2/neu) in patients with malignant and non-malignant diseases. 914 15

Bone is among the most common sites of metastatic disease in cancers of the breast, prostate, and lung. The decision about systemic therapy depends on the histology, presence and extent of extraskeletal disease, and the performance status of the patient. For patients with estrogen-receptor-positive breast cancer or prostate cancer, hormonal treatment represents the treatment of choice. In estrogen-receptor-negative breast cancer, and for patients who have failed hormonal therapy or have liver metastases, chemotherapy should be initiated. All patients with small-cell lung cancer should receive chemotherapy. Bone metastases of differentiated thyroid cancers can be treated with radioisotopes. In non-small-cell lung cancer or renal cell cancer, systemic chemotherapy should be confined to younger patients and patients in good general condition. Radiologic assessment of responses of skeletal metastases to systemic therapy is often difficult. New approaches in measuring bone metabolites in urine might prove helpful.
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PMID:[Systematic hormone- and chemotherapy in the management of skeletal metastases]. 961 83

The purpose of this study was to determine whether the implantation of human prostate cancer cells into the prostates of nude mice and their subsequent growth there can be used to select variants with increasing metastatic potential. PC-3M and LNCaP cells were injected into the prostates of athymic mice. Tumors from the prostate or lymph nodes were harvested, and cells were reinjected into the prostate. This cycle was repeated three to five times to yield cell lines PC-3M-Pro4, PC-3M-LN4, LNCaP-Pro3-5, and LNCaP-LN3-4. Parental and variant cells were injected into the prostates of nude mice. PC-3M-LN4 cells produced enhanced regional lymph node and distant organ metastasis as compared to PC-3M-Pro4 or PC-3M cells. After i.v. or intracardiac inoculation, PC-3M-LN4 cells produced a higher incidence of lung metastasis and bone metastasis, respectively, than PC-3M or PC-3M-Pro4 cells. Subsequent to implantation into the prostate, LNCaP-LN3 cells produced a higher incidence of regional lymph node metastases than LNCaP-Pro5 or LNCaP cells. After intrasplenic implantation, LNCaP-LN3 cells also yielded experimental liver metastases. The metastatic LNCaP-LN3 cells exhibited clonal karyotypic abnormalities, were less sensitive to androgen (in vitro and in vivo), and produced high levels of prostate-specific antigen. Collectively, the data show that the orthotopic implantation of human prostate cancer cell lines in nude mice is a relevant model with which to study the biology of prostate cancer metastasis and to select variant cell lines with enhanced metastatic potential.
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PMID:Selection of highly metastatic variants of different human prostatic carcinomas using orthotopic implantation in nude mice. 981 42


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