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)

Soybean isoflavones possess hormonal and nonhormonal properties that may reduce the risk of coronary heart disease, osteoporosis, and certain cancers, and alleviate hot flashes in menopausal women. Among the various cancers whose risk may be reduced by isoflavones, there is particular interest in prostate cancer. Eleven trials have examined the effects of isoflavones on serum prostate-specific antigen (PSA) levels. The dose of isoflavones in these trials from supplements or soy protein ranged from 60 to 900 mg/day (typical Japanese intake is 30-50 mg/day), subject number/group ranged from 8 to 62, and study duration from 20 days to 1 year. Isoflavones did not affect serum PSA in healthy subjects. In contrast, in 4 of 8 trials involving prostate cancer patients, isoflavones significantly favorably affected PSA although in no studies was there an absolute decrease in PSA concentrations. The mechanism by which isoflavones affect PSA could not be determined from the existing research, although hormonal changes do not seem to be a factor. The clinical evidence is sufficiently encouraging to justify considering additional Phase II and III clinical trials investigating the efficacy of soy isoflavones in different populations of prostate cancer patients alone and in combination with other treatments.
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PMID:An overview of the health effects of isoflavones with an emphasis on prostate cancer risk and prostate-specific antigen levels. 1691 55

A 52-year-old male with elevated serum prostate-specific antigen (PSA) level, moderate lower urinary tract symptoms (LUTS), and negative family history of prostate cancer is found to have adenocarcinoma of the prostate with negative bone scan. Following radical retropubic prostatectomy and satisfactory postoperative recovery, heretofore undetectable serum PSA level rose 35 months later. Digital rectal examination (DRE) and bone scan were negative. Adjuvant external beam radiation preceded by a 3-month injection of goserelin was initiated. Radiation was well tolerated, although the patient reported significant loss of libido, hot flashes, and depression warranting antidepressant medication. Failure to respond to this intervention led to initiation of supplemental testosterone; 1 month later, the patient reported significant relief of symptoms. The patient is currently successfully tapering use of supplemental testosterone in order to decrease andropause symptoms and to permit restoration of intrinsic testosterone.
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PMID:Testosterone replacement therapy for a man with prostate cancer. 1698 11

Complementary medicine has become an increasing area of interest for patients and researchers around the world. The utilization of some of these therapies by many individuals makes it imperative to understand if they have a role in cancer or other disease treatment. Soy products have generated a large interest because a variety of laboratory and epidemiologic research suggests these items may play a role in the prevention of prostate cancer. Clinical trials are addressing this issue and whether or not these products could also improve prognosis of prostate cancer. Additionally, other soy-based capsules (ipriflavone) have received some research, but the largest clinical study to date does not support the use of these supplements to reduce hot flashes and/or osteoporosis risk. Dietary fat reduction to prevent prostate cancer is supported by numerous case-control studies over the past 25 years. However, recent prospective studies suggest that fat reduction may not play a strong role in prevention of prostate carcinoma. Soy products and fat reduction may have a symbiotic relationship. Any healthy lifestyle or dietary change should be encouraged, because it may reduce the risk of cardiovascular disease, which is still the number one cause of mortality.
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PMID:Complementary medicine for prostate cancer: effects of soy and fat consumption. 1698 97

Androgen deprivation therapy (ADT) is commonly used for the treatment of prostate cancer. For many undergoing ADT, hot flashes can affect and significantly reduce quality of life. Traditional medications for hot flashes are limited by both clinical effectiveness and side effects. In two case reports, ADT-induced hot flashes quickly resolved after a short course of a specific intravenous combination of vitamins and minerals. This therapeutic approach may have potential for the treatment of ADT-induced hot flashes.
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PMID:Intravenous nutrient therapy eliminated androgen deprivation therapy-induced hot flashes in two men with prostate cancer. 1702 23

Prostate cancer is one of the most common cancers in men. Androgen-deprivation therapy (ADT) is often employed in the treatment of recurrent and metastatic prostate cancer. Although its use as an adjuvant therapy has resulted in improved survival in a subset of patients, ADT also results in a multitude of endocrine complications. These complications affect quality of life and sense of well-being in these men. Some of the endocrine complications of ADT such as osteoporosis, sexual dysfunction, hot flashes, gynecomastia, and adverse body composition are well-known. Recently, insulin resistance, hyperglycemia, and metabolic syndrome have emerged as metabolic complications of castration and may be responsible for increased cardiovascular mortality in this population. In this article, we provide a detailed review of the endocrine complications of ADT, touching upon management strategies where applicable.
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PMID:Endocrine complications of androgen-deprivation therapy in men with prostate cancer. 1709 26

While both short- and long-term androgen deprivation therapy (ADT) are effective for treating prostate cancer, with the clinical benefits patients can often have significant side-effects. It is important that these complications are recognized and managed appropriately so that adverse effects on the patient's quality of life (QoL) are minimized. The incidence of deaths from prostate cancer has decreased over the last decade, probably as a result of various factors including improved screening and diagnosis, improved treatments, and better risk assessment to help guide therapy. A meta-analysis of prostate cancer trials comparing the use of early vs late hormonal therapy found that 10-year overall survival increased by up to 20% between 1990 and 2000, and this was attributed to the earlier use of hormone therapy (HT) in these patients. Data from the USA Cancer of the Prostate Strategic Urological Research Endeavor database also suggest a significant decrease in risk in the last two decades in the USA, with more patients being identified with low-risk disease at diagnosis. In addition, there has been an increase in recent years in the use of HT at all stages of prostate cancer. The extensive use of ADT has raised concerns about potential adverse effects. ADT might be associated with a range of adverse effects that vary in their degree of morbidity and effect on the patient's QoL. They include hot flashes, osteoporosis, loss of libido or impotence, and psychological effects, e.g. depression, memory difficulties or emotional lability. Effective strategies are available for managing the major side-effects of HT, but to many patients these unwanted effects are often less important than the benefits of treatment. An investigation of health-related QoL found that men with prostate cancer receiving ADT had a poorer QoL than those not receiving ADT, but the difference was less pronounced after controlling for comorbidities. Many new therapies are currently under investigation which aim to maximize the clinical effects of ADT while reducing the adverse effects.
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PMID:Contemporary use of hormonal therapy in prostate cancer: managing complications and addressing quality-of-life issues. 1722 66

The gold standard for objectively measuring hot flashes in women is an increased sternal skin conductance level (SCL), but validation studies in prostate cancer patients are lacking. In the laboratory, an SCL increase of > or = 1.78 micro-mho in 45 s had a sensitivity of 68% and a positive predictive value of 100% in detecting self-reported hot flashes among prostate cancer patients. Outside the laboratory, 71% of the objective markers of hot flashes were accompanied by a subjective report of a hot flash, and 65% of subjective reports occurred in the absence of an objective criterion. This study demonstrates that sternal skin conductance can be used to detect hot flashes in men in a manner analogous to its utilization among women. Such use would improve outcome analysis of treatment studies.
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PMID:Validation of sternal skin conductance for detection of hot flashes in prostate cancer survivors. 1734 2

This article reviews the issues and controversies relevant to the treatment of advanced prostate cancer with androgen deprivation therapy. Initially, diethylstilbestrol was used for achieving androgen deprivation, but was replaced by luteinizing hormone-releasing hormone (LHRH). Adverse events associated with LHRH agonists include the flare phenomenon, hot flashes, loss of libido, erectile dysfunction, depression, muscle wasting, anemia, and osteoporosis. Intermittent therapy has been advocated to reduce morbidity of treatment. The addition of an antiandrogen provides maximum androgen blockade. There remains controversy regarding the timing of the addition of an antiandrogen. Secondary hormonal therapies include antiandrogens, adrenal androgen inhibitors, and estrogens.
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PMID:Androgen deprivation therapy in the treatment of advanced prostate cancer. 1738 71

Prostate cancer is the most common malignancy in men. Treatment with hormonal ablation is often accompanied by disabling hot flashes. This article reviews the pathophysiology of hot flashes and treatment options for this common side effect of treatment.
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PMID:Managing hot flashes in men being treated for prostate cancer. 1799 66

Androgen deprivation therapy (ADT) is part of standard therapy for locally advanced or metastatic prostate cancer and is frequently used in men with a rising prostate-specific antigen following radical prostatectomy or radiation therapy. In some men, ADT may be administered for years or even decades. The intended therapeutic effect of ADT is testosterone deficiency. Because estrogen is a normal metabolite of testosterone, ADT also results in estrogen deficiency. ADT has a variety of adverse effects, many of which are primarily related to estrogen deficiency. Bone mineral density may decrease by 4% to 13% per year in men receiving ADT. The fracture rate for patients on ADT averages 5% to 8% per year of therapy. Hot flashes, gynecomastia, and breast tenderness are common side effects associated with ADT. In the clinic, minimum baseline testing should include weight measurement, blood pressure reading, and fasting lipid panel and serum glucose tests. Currently, there are no large outcome trials in men on ADT testing the available therapies for adverse effects. No therapies are specifically approved for treatment of adverse effects in men on ADT. Although some therapies can be used for a single indication (based upon small studies), there is currently no agent to treat the multiple estrogenic side effects of ADT.
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PMID:Estrogenic side effects of androgen deprivation therapy. 1823 13


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