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)

Adenocarcinoma of the prostate may occasionally present as distant metastatic disease. This tumor, if accurately identified, is amendable to effective treatment with hormonal manipulations. We have seen nine patients with prostatic cancer presenting as metastatic adenocarcinoma of undetermined origin: two presented with involvement in the lung and the mediastinum, five with left supraclavicular lymphadenopathy and two with known prostatic cancer with stable disease presented with supraclavicular lymphadenopathy. By employing an immunoperoxidase technique using prostatic acid phosphatase as the marker for the prostatic cells, we demonstrated the presence of the prostatic enzyme antigen in the paraffin embedded tissues from the metastatic tumor. This finding directed further investigation of the prostate gland leading to the discovery of the primary tumor in all nine patients. It may be beneficial to use this technique in all male patients with adenocarcinoma of undetermined primary site.
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PMID:Prostatic cancer presenting as metastatic adenocarcinoma of undetermined origin. Immunodiagnosis by prostatic acid phosphatase. 633 78

Response criteria for phase II and phase II trials of prostate carcinoma patients of the EORTC Genito Urinary-Group are described. These criteria, initially closely related to National Prostatic Cancer Project criteria, have gone through a development into the direction of more stringency. Admission of patients to phase II trials is now restricted to those showing objectively measurable lesions, excluding bone metastases. World Health Organization criteria are applied to these patients. For phase III trials, progression to Metastatic TNM system status, time to progression, and duration of survival are recommended as end points. Measurable marker lesions, as for phase II trials and subjective and nonspecific response criteria, are accepted as parameters for progression. Response usually is not evaluated in these studies. Based on recent literature and personal experiences, the author suggests that serum acid phosphatase (SPAP) and volume changes of the primary tumor can be used as indicators for response under certain conditions. There is obviously a great need for further development of objective response criteria for prostatic cancer patients.
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PMID:Treatment response criteria for prostatic cancer. 636 78

Most technical obstacles in performing biochemical androgen receptor assays on malignant prostatic tissue have been surmounted. The available data, while suggesting that nuclear androgen receptor content in malignant tissues may be a useful criterion in this regard, remain meager and contradictory. The authors suggest that the clinical nature of prostatic cancer, including the tendency for metastases to occur in osseous and deep lymphatic regions and the heterogeneous intermingling of benign and malignant elements in the primary tumor, may preclude the success of biochemical assays for androgen receptors to predict hormonal dependency of prostatic tumors.
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PMID:Androgen receptor assays in advanced prostatic cancer. 637 68

A significant number of patients with newly diagnosed prostatic cancer will be found to have metastatic disease at time of presentation. Since the work of Huggins and Hodges in the early 1940s, endocrine manipulation and androgen deprivation have become the accepted methods of treating this group of patients. Approximately 70 per cent to 80 per cent of patients demonstrate positive clinical response. Many experience a decrease in the size of the primary tumor, a decrease in the levels of serum acid phosphatase, relief of bone pain, a decrease in bladder outlet obstruction, an increase in appetite, and a generalized improvement in their overall sense of well-being. Adequate hormonal therapy usually consists of estrogen administration of bilateral orchiectomy, but other modalities include administration of antiandrogens, progestational agents, androgen-synthesis inhibitors, and, recently, gonadotropin-releasing hormone analogues. This latter group may have increasing applications, particularly if the evidence indicating reduced side effects continues to be substantiated. The probability of producing a positive clinical response is increased when hormonal therapy is introduced at the time of diagnosis, at which point the tumor is still likely to be androgen dependent.
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PMID:Hormonal therapy in prostatic carcinoma. 638 92

Twenty-one of 32 patients with locally advanced prostatic cancer (stage C) were treated with the LH-RH analogue Buserelin for 7-19 months. After an initial sequence of subcutaneous injections, treatment was continued with intranasal spray application (three daily doses of 400 micrograms each) which ensured maintenance of serum testosterone within the range seen in castrated men. To evaluate the response of the primary tumor to Buserelin, cytological regression was established for all patients by fine-needle aspiration biopsy every 3 months. The cytological results corresponded with those of DNA analyses of single-cell cytophotometry showing a statistically significant drop of the grade of aneuploidy or polyploidy when the prostatic carcinoma responded positively to Buserelin therapy. Seventeen of 21 patients treated with the potent LH-RH analogue showed good therapy response. Four patients with no cytological signs of tumor regression received secondary treatment with estramustine phosphate because of hormone resistence. One patient had to be crossed over to cyclophosphamide, the third drug, for clinical progression after 15 months. Essential side effects have not been observed. Continuous treatment of locally advanced prostatic cancer with Buserelin, combined with close control of the patient, offers not only a real alternative to surgical castration--as the patient is spared the psychical stress of orchiectomy--but also to estrogen therapy with its risk of cardiovascular side effects.
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PMID:Treatment of prostatic cancer with LH-RH analogues. 641 28

A 67-year-old patient with stage C giant prostate cancer was treated with a combination of endocrine administration and chemotherapy. After administration of diethylstilbestrol diphosphate (250 mg/D, 16 days), bilateral orchiectomy and subsequent CDDP administration (30 mg/D X 5 days, e. 3 weeks, 4 courses), the primary tumor was reduced by about 90%. Clinical response was evaluated as partial response. Serum acid phosphatase activity, prostatic acid phosphatase, prostate antigen and nuclear DNA histogram served as useful tumor markers and changed in parallel to clinical course.
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PMID:[A case of giant prostate cancer]. 654 3

The use of transrectal ultrasonography has opened new perspectives in the diagnosis and followup of patients with prostatic cancer. Our study has concentrated mainly on measurements of prostatic volume in patients treated by castration or external radiotherapy. Patients who underwent castration had stable disease or progression of the metastases from 3 to 10 months after castration. There is a statistically significant difference between the decreases of volume in the 2 groups at all intervals of the study. To date an increase in prostatic volume after an initial decrease has occurred in only 1 patient, who had no evidence of systemic progression. The initial decrease in volume of the primary tumor seems to be a critical parameter for the prediction of progression or stability in patients treated by endocrine manipulation. Transrectal ultrasonography seems not to be of great value in patients treated by external radiotherapy.
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PMID:Transrectal ultrasonography in the followup of prostatic carcinoma patients: a new prognostic parameter? 670 24

Regional lymph nodes of the rectum are not demonstrable by pedal lymphoscintigraphy. We have evaluated the technique of rectal lymphoscintigraphy, using a technique similar to that which has been used in the assessment of lymph nodes in breast and prostatic cancer. Thirty-five patients were studied: ten normal subjects and 25 patients with rectal cancer. In normal subjects, the lymph nodes accompanying the superior hemorrhoidal artery and the inferior mesenteric artery are demonstrable in succession; after three hours the aortic lymph nodes are demonstrable. The 25 patients with rectal cancer underwent resection of their primary tumor and the stage was defined according to Dukes (1932). In five patients (stage A) no alteration was demonstrable. In 11 patients (stage B) the demonstration of regional lymph nodes was delayed vs. the control group. In nine cases (stage C) the demonstration of regional lymph nodes was delayed and defective versus the control group.
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PMID:Rectal lymphoscintigraphy. 673 61

Patients with bulky prostate cancer have usually been treated by palliative measures because the likelihood of tumor control with definitive irradiation has been low and the development of distant metastases high. The addition of estrogen to irradiation has not been shown to be of value. However, we believe the method of estrogen administration may have been the cause for the apparent lack of benefit. Estrogen had been started either concurrent with irradiation or had been used for palliation and was given for long and unscheduled time periods prior to irradiation. We have used estrogen for two months prior to and concurrent with irradiation. We postulated that in those patients with estrogen responsive cancer, the reduced tumor burden prior to irradiation could enhance tumor control and survival. Between 1975 and 1980, 25 patients with bulky prostate cancer received sequential estrogen and irradiation, 12 patients irradiation alone and six patients irradiation after having become refractory to long-term estrogen use. One patient was lost to follow-up. Eighteen of 25 (72%) treated by sequential estrogen and irradiation, 14/17 (82%) with estrogen responsive cancer and 4/8 (50%) with estrogen resistant cancer had a complete tumor response. Six of 11 (55%) patients treated by irradiation alone and 2/6 (33%) treated by irradiation for estrogen refractory cancer had a complete tumor response. Disease-free survival was observed in 13/25 (52%) treated by sequential estrogen and irradiation, and 8/17 patients (47%) with irradiation. It is also possible the improved survival in the estrogen responsive group was a direct result of improved local control. Persistent local disease can act as a source for distant metastases. Distant metastases was observed in 15% of patients when the primary tumor was controlled and 30% when there was persistent or recurrent local disease. Also, progressive local disease can be an important cause of death. This was most evident in our patients with estrogen refractory cancer. Almost all patients in this group had progressive local disease that caused serious urinary bleeding and urinary infection that were considered the major cause of death. Our results suggest bulky prostate cancer should be aggressively treated when first diagnosed. The value of adjunct estrogen is unproven. Our results with the use of estrogen prior to and concurrent with irradiation is encouraging. Estrogen may shrink the cancer and allow for a more favorable geometry for external irradiation. Tumor control and survival may be thereby improved.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Improved control of bulky prostate carcinoma with sequential estrogen and radiation therapy. 674 58

The introduction of immunoperoxidase and the indirect immunoperoxidase technique made important contributions in histopathologic diagnosis of prostatic cancer. This staining can be performed on formalin-fixed paraffin-embedded tissue which is usually available. We have used this histopathologic staining technique in 56 patients. The tissues include primary and metastatic prostatic cancer tissue in addition to normal renal pelvis and bladder tissue from other patients. Our data indicate that acid phosphatase can be localized in prostatic cells but not in transitional cells. Therefore, immunohistochemical staining of prostatic acid phosphatase seems most useful to identify metastatic prostate adenocarcinoma or primary tumor and to differentiate them from intraductal prostatic transitional carcinoma or other transitional cell carcinomas.
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PMID:Immunoperoxidase staining of acid phosphatase in human prostatic tissue. 675 66


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