Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prostate, after the age of 45 years, may undergo benign hyperplasia (BPH). Its etiology has not yet been completely explained, but different factors play a major role in its occurrence, among them, the sexual hormones (with a fundamental role of 5 alpha reductase). The 5-alpha reductase activity and inflammatory aspects in the prostate tissue can be effectively controlled with the use of highly standardized plant extracts (Pygeum africanum, Serenoa repens, etc.), which yield excellent results in the prophylaxis and treatment of the symptoms linked to prostate hypertrophy. The prostate tissue is not affected only by benign diseases but may also be subject to neoplastic transformation. From an epidemiological point of view, a vegetable derivative, lycopene, was linked with a lower occurrence of prostate carcinoma. A recent clinical study demonstrated that lycopene might not only prevent prostate cancer but also have therapeutic effects.
 ...
PMID:Botanical derivatives for the prostate. 1093 Jul 9

Over the past 15 years, the number of US males diagnosed with prostate cancer has increased 350% because of the aging of the population and improved detection with the prostate specific antigen (PSA) blood test. A new strategy to case management is chemoprevention, or early intervention with a well-tolerated drug. It is believed that prostate cancer is initiated when a cell undergoes genetic changes with malignant potential. Next, the cancer grows, or is promoted, until it is prominent, detectable, and has acquired a propensity to spread. Primary chemoprevention intervenes in the initiation and promotion process. Secondary chemoprevention involves early detection, treatment, and cure. Chemoprevention research, therefore, is focusing on identification of active agents that will be well tolerated in the general population, such as micronutrients as vitamins and minerals. For example, research indicates that intake of lycopene or other components in tomatoes may reduce prostate cancer risk. Other researchers are testing a drug to block the activity of the enzyme 5-alpha reductase, because men deficient in this enzyme fail to develop prostate cancer. Other agents under investigation are selenium, vitamin E, nonsteroidal anti-inflammatory drugs, retinoids, and a compound known as DFMO, which stabilizes cellular DNA. Efforts are also being made to reverse cases of prostatic intraepithelial neoplasia, which is thought to be a precursor of cancer. Eventually, predictions of degree of risk will be used to include men in chemoprevention trials.
 ...
PMID:Chemoprevention and prostate cancer. 1232 68

Cancer of the prostate is the most commonly diagnosed solid malignancy and the second leading cause of cancer-related death in men living in developed countries. With an ageing population, the number of men living with early stages of prostate cancer is expected to increase. There is an increasing need to prevent the onset of cancer or delay the progression of carcinogenesis in this organ. Chemoprevention is the administration of pharmacological agents to prevent, delay or reverse carcinogenesis. An example is the reversal of high grade intraepithelial neoplasia by hormonal manipulation using anti-oestrogens in breast carcinogenesis or anti-androgens in prostate carcinogenesis. Epidemiological data showing ethnic and geographic variations in the incidence of, and mortality from, prostate cancer have suggested that the consumption of certain dietary factors, particularly anti-oxidants, may be protective. These factors include the vitamins D and E, soy, lycopene and selenium. The administration of 5-alpha reductase inhibitors to patients with benign prostatic hyperplasia may also constitute a potentially chemopreventive intervention. The efficacy of chemopreventive agents needs to be investigated in randomised, placebo-controlled trials in suitable cohorts of high-risk individuals. In parallel, reliable assays of potential biomarkers of the efficacy of intervention need to be developed and validated rigorously.
 ...
PMID:Chemoprevention of prostate cancer by diet-derived antioxidant agents and hormonal manipulation (Review). 1246 79

There are no established risk factors for prostate cancer other than age, ethnic group, and family history. For dietary factors, the WCRF/AICR reported that diets high in vegetables were possibly protective, and that regular consumption of red meat, fat, saturated/animal fat, and milk and any products possibly increased risk. Among nutritional factors, a protective effect of lycopene, vitamin E, selenium, and perhaps fish oil and phytoestrogens appear particularly promising, although no definite answers have yet emerged. Although hormonal influences are biologically plausible, observational studies of androgen have not produced consistent results. While, insulin-like growth factor 1 could be a risk factor. Based on these evidences, several chemoprevention trials were launched using 5-alpha reductase inhibitor, selenium, vitamin E and so on.
 ...
PMID:[Risk factors and current chemoprevention studies in prostate cancer]. 1571 86

Ever since Huggins and Hodges won a Nobel Prize in 1966 for their work describing the relationship between testosterone and prostate cancer, androgen deprivation has continued to be an important component in the treatment of prostate cancer. Refinements in the therapy have occurred in the past 50 years, yet controversies still exist. This review details the controversies and advances in androgen deprivation for prostate cancer including: neoadjuvant androgen deprivation, combined androgen blockade, early versus late androgen deprivation treatment, intermittent versus continuous androgen deprivation monotherapy, anti-androgen monotherapy, anti-androgen and 5-alpha reductase inhibitor combinations, androgen deprivation with periodic intravenous bisphosphonate infusions, and androgen deprivation in conjunction with chemotherapy.
 ...
PMID:Controversies of androgen ablation therapy for metastatic prostate cancer. 1651 96

Prostate cancer is an important public health problem. Chemoprevention offers an attractive solution because it may lead to decreased disease-specific mortality. Furthermore, because many men are treated radically for prostate cancers that pose little or no threat to life, chemoprevention may also provide an excellent strategy for diminishing treatment-related costs and adverse effects such as erectile and urinary dysfunction. The Prostate Cancer Prevention Trial was a 7-year randomized study of finasteride versus placebo among men aged older than 55 years. All men were intended to have a prostate biopsy at study conclusion. At trial's end, there was a 25% reduction in period prevalence in all prostate cancers (24.4% for placebo vs 18.4% for finasteride). This represents a 6% absolute risk reduction. A larger number of higher-grade cancers were noted among men randomized to finasteride, which post hoc analyses and studies suggest are almost certainly related to previously unrecognized biases in trial design. There continues to be great debate as to the clinical significance of the cancers prevented. It is our opinion that among men who warrant 5-alpha reductase inhibitors (5ARIs) as part of their benign prostatic hyperplasia regimen, cancer prevention should be recognized as an additional benefit of treatment. Furthermore, men with high risk of clinically significant prostate cancer, such as significant family history, abnormal prostate biopsy histologies, and African descent, should be made aware of these findings. Men with significant anxiety or concern about prostate cancer should also be made aware of the risks and benefits of this therapy. Additional trials of antiestrogens, micronutrients, and other 5ARIs, which will mature over the next 2 to 5 years, will better define the role of 5ARIs in prostate cancer chemoprevention.
 ...
PMID:Should finasteride be used to prevent prostate cancer? 1690 51

Prostate cancer is the most common male malignancy and the second or third leading cause of cancer death among men in the West. The descriptive epidemiology of prostate cancer suggests that it is a preventable disease. Prevention has the theoretical advantage of not only saving lives, but also reduce the morbidity of radical prostate cancer therapy. This article reviews the past, present, and future of prostate cancer prevention. In particular, the evidence and scientific data of a variety of prevention strategies are reviewed. Strategies reviewed include dietary fat reduction and supplementation with vitamins D and E, and selenium. Dietary intake of soy, green tea, and tomato-rich products (lycopene) are also reviewed. Data regarding pharmacological intervention with cyclo-oxygenease inhibitors, antiestrogens, and in particular 5-alpha reductase inhibitors are reviewed. The results of the Prostate Cancer Prevention Trial including the controversy surrounding higher-grade cancers among men randomized to finasteride are also summarized. Finally, a variety of trial designs as well as a roster of current phase 2 trials are presented. Probably no cancer is being investigated more thoroughly in the context of prevention as prostate cancer in 2007. Definitive answers to pivotal phase 3 trials will be available in the coming 2 to 7 years.
 ...
PMID:Prostate cancer prevention: past, present, and future. 1789 70

The PCPT trial is the first phase III trial with the principal objective of examining the hypothesis that the use of chemoprevention could prevent the development of prostate cancer. This is a large scale randomised clinical trial comparing finasteride (5-alpha reductase inhibitor) to placebo. A total of 18,882 men aged 55 years old or above with unremarkable rectal examination and serum PSA below 3 ng/ml were randomised between daily treatment with 5 mg of finasteride or placebo for 7 years. The incidence of prostate cancer diagnosed by biopsy was 24.4% in the placebo group compared to 18.4% in the finasteride group. The incidence of high Gleason grade cancers (7-10) in the finasteride group (6.4%) appeared to be higher than in the placebo group (5.1%) although it was subsequently shown that these results were not significant. Sexual adverse effects were more common in the finasteride group and urinary symptoms were more common in the placebo group than in the finasteride group. The volumes of prostates treated with finasteride were reduced by 24% compared to the placebo arm. It does not therefore appear at present appropriate to give finasteride to prevent the development of prostate cancer until more detailed results are available about the nature of the cancers which may possibly have been detected or avoided.
 ...
PMID:[The PCPT trial]. 1845 82

Benign prostatic hyperplasia is a common condition affecting older men. Typical presenting symptoms include urinary hesitancy, weak stream, nocturia, incontinence, and recurrent urinary tract infections. Acute urinary retention, which requires urgent bladder catheterization, is relatively uncommon. Irreversible renal damage is rare. The initial evaluation should assess the frequency and severity of symptoms and the impact of symptoms on the patient's quality of life. The American Urological Association Symptom Index is a validated instrument for the objective assessment of symptom severity. The initial evaluation should also include a digital rectal examination and urinalysis. Men with hematuria should be evaluated for bladder cancer. A palpable nodule or induration of the prostate requires referral for assessment to rule out prostate cancer. For men with mild symptoms, watchful waiting with annual reassessment is appropriate. Over the past decade, numerous medical and surgical interventions have been shown to be effective in relieving symptoms of benign prostatic hyperplasia. Alpha blockers improve symptoms relatively quickly. Although 5-alpha reductase inhibitors have a slower onset of action, they may decrease prostate size and alter the disease course. Limited evidence shows that the herbal agents saw palmetto extract, rye grass pollen extract, and pygeum relieve symptoms. Transurethral resection of the prostate often provides permanent relief. Newer laser-based surgical techniques have comparable effectiveness to transurethral resection up to two years after surgery with lower perioperative morbidity. Various outpatient surgical techniques are associated with reduced morbidity, but symptom relief may be less durable.
 ...
PMID:Diagnosis and management of benign prostatic hyperplasia. 1853 71

Dutasterid is a novel effective inhibitor of 5-alpha reductase of both types which can be used in patients with large (more than 80 cm3) prostatic adenoma to prevent intra- and postoperative hemorrhagic complications before transurethral resection of the prostate (TUR). The trial included 70 males aged 67-82 years (mean age 74 years) with large size prostatic adenoma (more than 80 cm3) having indications for prostatic TUR. Patients with coagulopathy, suspected prostatic cancer, previous treatment with 5-alpha reductase inhibitors were not included. Group 1 (n=35) received dutasterid in a dose 0.5 mg/day for 38 days, on the average, before operation, and alpha-adrenoblocker tamsulosin in a dose 0.4 mg to prevent acute urine retention. Group 2 (n=35) received only alpha-adrenoblocker tamsulosin. Comparison of intraoperative indices showed that group 1 demonstrated shorter duration of the operation (62 vs. 79 min), more amount of the removed tissue (92 vs. 85 g), less volume of the irrigation liquid (16.7 vs. 19.3), shorter duration of urethral catheter tension (10.4 vs. 19.3), less volume of intraoperative blood loss (93.6 ml vs. 138.6 ml, p < 0.05). As a result, hospitalization time, time of urinary bladder drainage were also reduced in group 1. Postoperative hemorrhagic complications were not registered. We recommend to begin dutasterid administration in a dose 0.5 mg for 1 month before TUR not only for patients with larger prostate (greater than 80 cm3) but with smaller prostates (30-80 cm3) for prevention of hemorrhagic complications and better conditions for surgery.
 ...
PMID:[The experience in dutasteride use before transurethral prostatic resection for large adenoma]. 1905 96


1 2 3 Next >>