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)

With the rapidly spreading enthusiasm for early detection of prostate cancer and the increasing use of serum PSA to evaluate the gland, more cancers that are not palpable on digital rectal examination are being identified. These tumors have pathologic characteristics that are very similar to those of clinically localized, palpable prostate cancers identified on digital rectal examination. Thus, the tumors detected on the basis of an elevated serum PSA value should not be disregarded as insignificant. In fact, these tumors should be given the same therapeutic consideration as the clinically localized, palpable cancers. In the TNM staging system, "PSA-detected" cancers can be classified as stage T1c, and in the Whitmore-Jewett staging system, they can be referred to as stage B0. Long-term follow-up of these prostate cancers will be necessary to establish the prognosis.
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PMID:PSA-detected (clinical stage T1c or B0) prostate cancer. Pathologically significant tumors. 750 77

The findings of these two large-scale clinical studies indicate that serum PSA is an accurate and reliable predictor of the bone scan findings for 40% of the patients presenting with newly diagnosed, untreated prostate cancer. For these patients with no skeletal symptoms and a serum PSA value of 10 ng/mL or less by either the Tandem-R or the IMx assay, a staging radionuclide bone scan is not necessary, as it provides no additional useful information over what is learned from the serum PSA value. If these bone scans were eliminated for these selected patients, approximately $38 million could be saved annually in the United States. As the incidence of newly diagnosed prostate cancer continues to increase, so will the economic savings associated with using the serum PSA concentration to predict the bone scan findings in appropriate patients.
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PMID:Using PSA to eliminate the staging radionuclide bone scan. Significant economic implications. 750 79

1. With an average follow-up of 53 months (range 12-120 months), 19.4% (185/955) of men have had a cancer recurrence after radical prostatectomy for clinically localized prostate cancer. A detectable serum PSA was the only evidence of recurrence in 11.2%, whereas 2.2% have had a recurrence locally and 6% with distant metastases. 2. The actuarial status at 10 years was 70% for undetectable serum PSA; 23% for isolated serum PSA elevation only; 7% for distant metastases; and 4% for local recurrence. 3. In our study, no patient demonstrated disease progression (local or distant) without detectable serum PSA. 4. The actuarial likelihood of an elevated serum PSA increased with increasing clinical stage, Gleason score, preoperative serum PSA concentration, and pathologic stage. 5. The actuarial recurrence rate for tumors with a Gleason score of 7 was not statistically different from the recurrence rate for lesions of Gleason score 8-10. 6. There exist marked differences in actuarial recurrence-free probabilities for men with tumors of low Gleason score (< 7) compared with those with tumors of high Gleason score (> or = 7) when there is pathologically established capsular penetration. 7. Patients with preoperative serum PSA concentrations greater than 10.0 ng/mL are at a statistically increased risk of recurrence. 8. Men who have detectable serum PSA within the first year after surgery are at a significantly higher risk of disease progression than those men who have measurable serum PSA in postoperative years two and three. 9. Men with an isolated elevation of serum PSA after radical prostatectomy have a 25% likelihood of harboring an occult local recurrence. However, radiation therapy produces a sustained suppression of PSA to undetectable levels for 2 years or more in only 10% of men. This suggests that radiation therapy is not effective in sterilizing occult local residual tumor in many men. 10. Valuable information concerning disease recurrence and progression can be obtained through early postoperative measurement of serum PSA. This article demonstrates the long-term value of serum PSA as a measure of progression after anatomic radical prostatectomy.
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PMID:Serum PSA after anatomic radical prostatectomy. The Johns Hopkins experience after 10 years. 750 80

A rising PSA level for clinically localized prostate cancer after definitive radiotherapy is an ominous finding that correlates with positive postirradiation biopsy and traditional clinical progression. The study detailed in this article found that the proportion of patients treated with radiotherapy who achieved stable PSA levels and were clinically free of disease was disappointingly low.
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PMID:PSA after definitive radiotherapy for clinically localized prostate cancer. 750 81

Patients who present with advanced prostate cancer and who are treated with primary endocrine therapy have a significantly longer time to progression and a clear survival advantage if their serum PSA concentration normalizes. The prognostic significance of normalization of PSA is independent of other prognostic measures. Normalization of serum PSA at month 3 is the earliest and most highly correlated predictor of response. Most patients (80%-85%) who have disease progression while on hormonal therapy will show a rising PSA 6 to 12 months before other clinical findings become abnormal. A rising PSA in the hormonally treated patient, even if the values are within the "normal" range, signals impending clinical progression. These patients should be considered for second-line hormonal therapies or alternative salvage protocols, as a theoretically favorable window of opportunity may exist when the PSA begins to rise. Patients treated with second-line therapies should also undergo serial PSA measurements; those responding with an 80% to 90% decrease in serum PSA are statistically more likely to enjoy a prolonged response.
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PMID:Serum PSA after antiandrogen therapy. 750 83

The sensitivity and specificity of prostate-specific antigen density (PSAD), a quotient of serum PSA and prostate volume, in the detection of localized prostate cancer was analysed in a prospective study. A total of 235 patients were examined, 145 without prostate cancer and 90 patients before radical prostatectomy for localized prostate cancer. PSAD was determined by dividing the serum level of PSA by the volume of the entire prostate (estimated by transrectal ultrasound) and multiplying by 100. Using a PSAD of 15, the specificity achieved in our collective was the same as with an absolute PSA value of 4 ng/ml (88.9-90%). On the other hand, with the PSAD of 15 we also found the same sensitivity as with an ab-solute PSA of 10 ng/ml (75.2-76.5%).
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PMID:[PSA volume quotient: an additional parameter in diagnosis of locally confined prostate cancer]. 750 50

Thirty patients with small and medium-sized obstructive prostates were operated by transurethral incision of the prostate (TUIP) under local anesthesia as an outpatient procedure. All patients except one tolerated this manoeuvre without any complications or discomfort. The obstructive symptoms were relieved in all patients; however, 6 patients had lasting irritative symptoms, 2 of whom were cured after TURP. The costs of TUIP was calculated to be one sixth of that of TURP. During one year follow-up 5 patients were found to have prostate cancer despite careful rectal examination and PSA measurement preoperatively. In conclusion, TUIP may be carried out as safely and cost-effectively as an outpatient procedure and is beneficial in patients with predominantly obstructive symptoms. However, careful investigations concerning possible prostate cancer must be undertaken in this group of patients with small but symptomatic prostates.
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PMID:Outpatient transurethral incision of the prostate under local anesthesia: operative results, patient security and cost effectiveness. 750 61

There is no effective therapy available for stage D2 prostate cancer once patients become refractory to hormonal therapy. In a pilot study, we treated 17 patients with hormone-refractory stage D2 prostate cancer using autolymphocyte therapy, an outpatient form of adoptive immunotherapy in which patients are treated with autologous T cells that have been activated ex vivo. Feasibility and safety were documented. Transient PSA reductions up to 66% were noted, suggesting biological activity. Further studies to test the safety and efficacy of autolymphocyte therapy in the treatment of prostate cancer are warranted.
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PMID:Adoptive immunotherapy of hormone-refractory, stage D2 prostate cancer using ex vivo activated autologous T cells (autolymphocyte therapy): results from a pilot study. 750 87

Sixty five 50 to 60 year old patients have been treated for prostatic cancer over a 21 year period. Twenty four had a local prostatic cancer (A1, A2, B1, B2) and 41 (63.2%) a locally advanced or metastatic (D1, D2 disease at diagnosis. The mean age was 56 years old. As being as retrospective study, miscellaneous treatments were done. The 5 and 10 years survival, analysed with the Kaplan-Meier method, was 61% and 31% respectively. According to the stage of cancer, the 10 year survival was 72% and 5% for (A-B) and (C-D) respectively. For well differentiated tumors, 5 years survival was 67% instead of 36% for undifferentiated ones. The 10 year survival was 36% for well differentiated tumors with 6 on 8 patients who survived with a mean of 11.6 ears. The authors discussed the benefit of an early diagnosis of prostatic in the 50-60 year old men group which is 4% of the total prostatic cancer diagnosed within the same period. They analysed the influence of PSA and transrectal sonography interest at this age.
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PMID:[Prostatic cancer between 50 and 60. A more than 20-year-long retrospective study. Apropos of 65 case reports]. 750 34

Six kinds of assay kits based on different detecting principle for PSA were evaluated. Polyclonal antibody was used in 2 kits (Eiken, Markit-F) and monoclonal antibody in 4 kits (Ball Elsa, Delfia, Markit-M, Tandem-R). To evaluate their characteristics, sera of 12 female patients, 5 prostatectomized patients and 2 high stage prostate cancer patients were measured by these kits. On the female sera the polyclonal assay kits yielded values higher than the defined minimal sensitive value, but the kits of monoclonal antibody detected nothing. Dilution test of sera with high PSA level showed satisfactory results in every kit but the values of 6 assays were different to each other. For monitoring the recurrence or recrudescence of the prostatic cancer, the monoclonal antibody kits may be preferable to the polyclonal antibody kits. These results showed that we must understand the characteristics of every assay kit which is used clinically.
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PMID:[Comparative assessment of the characteristics in various assay kits for prostate specific antigen]. 750 30


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