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)

Eighty patients with prostatic cancer, who first visited Kyorin University School of Medicine from January 1976 through December 1986, were analyzed. Incidence of prostatic cancer was 3.9% among male inpatients. Age distribution was between 55 and 88, with an average of 72 years old. The most common symptoms were dysuria followed by pollakisuria, hematuria, lumbago and lower extremity pain. Duration from onset of symptom to examination ranged from 6 to 84 months, with an average of 22 months. Clinical stage was A in 7.5%, B in 10%, C in 11.3% and D in 71.3%. According to histological grade, well, moderately, and poorly differentiated adenocarcinomas were observed in 29.9, 29.9 and 40.2%, respectively. According to the General Rules for Clinical and Pathological Studies on Prostatic Cancer, clinical T classification were T0 in 8.7%, T1 in 3.8%, T2 in 47.5%, T3 in 27.5% and T4 in 12.5%. In the correlation between stage and grade, the largest number of poorly differentiated adenocarcinoma cases was in stage D. There was no correlation between stage and T classification. Of the 80 patients, 71.25% were treated with antiandrogen therapy, 16.25% with radiation therapy chiefly, 7.5% by surgery chiefly, and 5% with chemotherapy. Survival rate was calculated by the Kaplan-Meier method. Overall survival rate of the 80 patients was 54.4% at 5 years. Survival rate by stage were 100% in stage A at 4 years, and 100% in B, 87.5% in C and 40.5% in D at 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical study of prostatic cancer]. 281 99

Chemotherapeutic effects of CDDP used as the main drug were studied in 20 patients with progressive prostatic cancer in stage C or D. On the average 208 mg of CDDP was given to the patients receiving chemotherapy without antiandrogen therapy (13 patients who showed resistance to hormone and an untreated new patient) and both ADM and IFM were also given to 3 of them. According to the criterion proposed by Shida and his coworkers, the chemotherapy without antiandrogen therapy was effective in 2 cases, relatively effective in 7 cases, and ineffective in 5 cases. The chemotherapy was effective for metastatic tumors of the lung in 2 out of 2 cases, but had no effect on tumors of the lymph node (1 case) and primary lesion of the tumors (14 cases). The chemotherapy improved acid phosphatase values in 5 out of 10 cases, alkaline phosphatase values in 3 out of 10 cases, dysuria in 4 out of 8 cases, nocturia in 1 out of 12 cases, residual urine in 5 out of 6 cases, lumbago in 6 out of 8 cases, and constitutional symptom in 6 out of 12 cases. The effect of the chemotherapy in combination with antiandrogen therapy was excellent in 4 and good in 2 of the 6 patients treated with castration + diethylstilbestrol diphosphate + CDDP + ADM +/- IFM. The chemotherapy with antiandrogen therapy had no effect on metastatic tumors of the bone (2 cases), but decreased the hardness and size of primary lesion in 6 out of 6 cases. Urethrography showed better changes in 6 out of 6 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of advanced prostatic carcinoma with cis-diamminedichloroplatinum]. 654 17

Seventy-seven cases of prostate cancer were treated for 5 years at our department and all cases were followed by bone scintigraphy and tumor markers. Of these cases on case of flare response on bone scintigraphy was recognized. A 51-year-old man was hospitalized with chief complaint of lumbago. Serum PAP and gamma-Sm levels were 320 ng/ml and 15 ng/ml, respectively. Prostate biopsy revealed moderately differentiated adenocarcinoma. Bone scintigraphy and CT scan demonstrated multiple bone metastases and lymph nodes involvements. Treatment was started with diethylstilbestrol diphosphate (DES). At one month after the initiation of treatment tumor markers fell down to the normal level and lumbago was diminished, but only serum alkaline phosphatase was elevated and bone scintigraphy showed apparent progression of individual lesions (flare response). The treatment was not altered. At the times after 2, 8, 12 and 36 months successful treatment the bone imaging improved with reduced tracer uptake and no new lesions. The flare response is a healing reaction and is followed apparent improvement. In general, serial bone scintigrams accurately depict the activity of bone metastases in the patients of prostate cancer, but between 1 and 3 months after starting treatment the paradoxical "flare phenomenon" should be taken care.
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PMID:[Flare response on bone scintigraphy in metastatic prostate cancer]. 802 46

An 81-year-old man, admitted with lumbago and pollakisuria, was diagnosed to have stage D2 prostate cancer (T3N2M1). Although the serum level of prostate specific antigen (PSA) was 3,560 ng/ml, serum testosterone (55.6 ng/dl) and luteinizing hormone (LH, 0.8 mIU/ml) levels were very low. Detailed inquiry of the patient revealed a daily intake of patent medicine containing 6-9 mg methyltestosterone for the past 30 years. He was treated by surgical castration and oral chlormadinone acetate. We advised him not to take such androgenic drugs. The disease has been well controlled for 7 months. We stress the importance of checking medication habits of patients with prostate cancer, especially androgen-containing drugs which can be purchased without a physician's prescription. A low serum LH level may be an important finding indicating the intake of androgenic drugs.
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PMID:[Prostate cancer associated with long-term intake of patent medicine containing methyltestosterone: a case report]. 943 23

For many large physician groups, about 75% of all revenues come from capitation contracts. These groups may reduce the variable expenses of patient care by conducting medical outcome studies. Physician groups will obtain the most benefit for their limited research dollars by focusing outcomes research on prevalent medical conditions. The purpose of this study is to provide a comprehensive analysis of the content of physicians' medical practices. We found that 21 diagnostic clusters defined 70% or more of the episodes treated by primary care physicians. For specialists, no more than eight diagnostic clusters were needed to define the majority of their practices. Outcomes research should initially focus on abdominal pain, acute lower respiratory infections, cataracts, cholelithiasis, congestive heart failure, diabetes mellitus, external abdominal hernias, ischemic heart disease, low back pain, maternity care, menstrual disorders, otitis media, peptic diseases, prostate cancer, psychotic episodes, renal calculi, seizure disorders, and thyroid diseases.
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PMID:Analyzing the content of physicians' medical practices. 1013 99

A 57-year-old male with prostatic cancer was scheduled for a radical prostatectomy under general anesthesia combined with epidural anesthesia. An epidural catheter was introduced at the L 1-2 interspace without problem. The patient was placed in a hyperlordotic supine position with a bolster under his lower back for the seven and a half hour operation. Upon emergence from anesthesia, he complained of severe low back pain in addition to incisional pain. On the second postoperative day, the epidural catheter was removed. After residural analgesic effects had fully disappeared, he experienced muscular weakness in the left thigh and could not walk. Regional sensory loss and edema were also observed where pressure had been applied by the bolster, although spinal cord magnetic resonance imaging studies were almost normal. It took him seven weeks to walk without the support of a brace after surgery. Hyperextension of the lumbar spine could increase the pressure on the inferior vena cava which is transmitted to the intraspinal vein, and could lead to the disci intervertebrales compression and the stress on the facet joint. We believe that the primary cause of the presented symptoms was related to this position. Prolonged and/or excessive hyperlordosis during surgery should be avoided.
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PMID:[Severe low back pain and muscular weakness in the thigh following urological surgery in the hyperlordotic position]. 1184 Jun 67

Neurologic complications continue to pose problems in patients with metastatic prostate cancer. From 15 to 30 percent of metastases are the result of prostate cancer cells traveling through Batson's plexus to the lumbar spine. Metastatic disease in the lumbar area can cause spinal cord compression. Metastasis to the dura and adjacent parenchyma occurs in 1 to 2 percent of patients with metastatic prostate cancer and is more common in those with tumors that do not respond to hormone-deprivation therapy. Leptomeningeal carcinomatosis, the most frequent form of brain metastasis in prostate cancer, has a grim prognosis. Because neurologic complications of metastatic prostate cancer require prompt treatment, early recognition is important. Physicians should consider metastasis in the differential diagnosis of new-onset low back pain or headache in men more than 50 years of age. Spinal cord compression requires immediate treatment with intravenously administered corticosteroids and pain relievers, as well as prompt referral to an oncologist for further treatment.
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PMID:Neurologic complications of prostate cancer. 1201 6

A case of osteosarcoma in pelvic bone following radiation therapy for prostate cancer is reported. A 74-year-old patient was diagnosed with prostate cancer 10 years ago and started on the endocrine therapy with LH-RH agonist. He had no apparent distant metastasis, and received radiation therapy 8 years ago. He has complained of low back pain since several months ago. A high uptake on bone scintigram and osteolytic and osteoblastic damages on CT were noted in pubic bone and sacrum. The PSA level was less than 0.2 ng/ml. Pathohistological diagnosis by biopsy of the pubic bone was chondroblastic type osteosarcoma, showing an atypical cell proliferation with osteoid. Immunostaining for nonepithelial marker vimentin was positive. He underwent heavy ion radiation therapy for osteosarcoma at the National Institute of Radiological Sciences. Osteosarcoma is one of the rare delayed complications after radiation therapy and requires biopsy for correct diagnosis.
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PMID:[A case of osteosarcoma in pelvic bone following radiation therapy for prostate cancer]. 1497 43

Prostate-specific antigen (PSA) decline after discontinuation of estramustine phosphate (EMP) is extremely rare. We report a case with dramatic PSA decline after withdrawal of EMP. A patient with prostate cancer had been treated with luteinizing hormone-releasing hormone and EMP. After refractory, EMP was withdrawn. After withdrawal of EMP, PSA dramatically decreased from 214 ng/mL to 3.71 ng/mL (98.5% decline) and remained low for more than 17 months. In association with PSA decline, lumbago and metastatic lesions improved. We should be aware of this phenomenon and the discontinuation of EMP is recommended in patients with rising PSA after an initial response to EMP.
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PMID:Dramatic decline in prostate-specific antigen by withdrawal of estramustine phosphate in hormone refractory prostate cancer. 1688 80

A 69-year-old man (163 cm, 72 kg) with hypertension and lumbar spondylosis deformans was diagnosed as having prostate cancer and subsequently underwent perineal prostatectomy under sevoflurane anesthesia combined with epidural anesthesia using mepivacaine in the exaggerated lithotomy position. Supplemental intravenous fentanyl was also given. The patient's systolic blood pressure ranged between 80 and 120 mmHg throughout the 255-minute procedure. On emergence from the anesthesia, the patient was free from pain and epidural infusion with 0.2% ropivacaine, fentanyl 2 microg x ml(-1) and droperidol 12.5 microg x ml(-1) at a rate of 5 ml x hr(-1) was started. Shortly thereafter, the patient began to complain of severe low back pain, which required intramuscular pentazocine injection as a rescue analgesic for 5 days postoperatively. On the 6th postoperative day, creatine kinase, which had apparently passed its peak, was 4,795 IU x l(-1). MRI on the 8th day demonstrated the presence of hemorrhage in the bilateral erector spinae muscles. On day 16, CT scan also confirmed partial necrotizing changes in the bilateral gluteal and erector spinae muscles. We believe that the low back pain was due to rhabdomyolysis secondary to ischemia of the lumbar and pelvic muscles resulting from lengthy compression during surgery. The recognition and early diagnosis of rhabdomyolysis following prolonged time in the exaggerated lithotomy position are the key to prevent potentially fatal sequelae.
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PMID:[Rhabdomyolysis accompanying low back pain following prolonged urological surgery in the exaggerated lithotomy position: a case report]. 1705 83


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