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)

There is compelling evidence that early hormonal therapy prolongs life in many stages of prostate cancer. Large-scale trials to answer this question have not yet been conducted in surgically treated patients or in patients with PSA-only relapse. Thus, many physicians and patients use early hormone therapy in PSA-only relapse. Many unique new agents are being tested in this population and may offer benefits. Patients and physicians are encouraged to participate in such trials, with hormone therapy reserved for subsequent use. Following failure of primary hormone therapy, a standard algorithm of care exists: antiandrogen withdrawal, use of alternative or first-line anti-androgens. ketoconazole. and chemotherapy. At each interval, clinical trials should be offered since none of these maneuvers are proven to prolong life.
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PMID:Selecting a secondary treatment. 1273 14

Prostate-specific antigen (PSA) has had a profound impact on the early diagnosis, treatment and follow-up of prostate cancer, the most common malignancy in men. However, it is not only a marker for prostate cancer but is also often expressed in benign conditions such as benign prostatic hyperplasia, prostatitis and other inflammatory disorders. For early detection of prostate cancer, limitations of the use of PSA become obvious; its widespread use has led to extensive expensive and often unnecessary diagnostic procedures associated with significant morbidity. New serum tests derived from total PSA may play a key role in enhancing the accuracy of prostate cancer diagnosis. The ratio of free to total PSA improves specificity while maintaining a high sensitivity for prostate cancer detection for men with a total PSA of 2.5-10 ng/ml who also have a normal digital rectal examination. Human glandular kallikrein 2 also has the potential to be a valuable tool in combination with both total and free PSA for the early diagnosis of prostate cancer. However, the optimal clinical use of human glandular kallikrein 2 still remains to be clarified. Complex PSA seems to be a reliable tool and equivalent alternative to total PSA to improve specificity at high sensitivity levels in men with suspected prostate cancer, mainly for PSA levels below 4 ng/ml. Several newly discovered isoforms of free PSA (bPSA, [-2]pPSA and inactive intact PSA) may also impact the early detection of prostate cancer, with encouraging preliminary results that warrant further clinical investigation. (c) 2001 Prous Science. All rights reserved.
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PMID:New serum tests for the diagnosis of prostate cancer. 1274 32

Interleukin-12 (IL-12) is an important molecule that triggers the activation of natural killer (NK) cells and T-cells, the development of T helper type 1 (Th1) cells and the expression of antiangiogenic genes. Novel methods for IL-12 delivery include cell-based ex vivo gene therapy, viral vector-based gene therapy and DNA plasmid-based nonviral gene therapy. IL-12 electroporation gene therapy may hold some promise for tumors accessible by electrode, such as head and neck cancer, breast cancer, prostate cancer and melanoma. Codelivery of other therapeutic genes with IL-12 may enhance the therapeutic effect and reduce the level of IL-12 required for efficacy. All three approaches to IL-12 gene therapy are under clinical investigation. The preliminary results indicate that IL-12 gene therapy is safe and is not associated with any major clinical toxicity. (c) 2001 Prous Science. All rights reserved.
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PMID:IL-12-Based therapy of malignancies. 1274 34

Endothelins (ET-1, ET-2 and ET-3) are 21-amino-acid peptides with two disulfide bonds that belong to the sarafotoxin family. ET-1, ET-2 and ET-3 are produced endogenously from preproendothelin to give big endothelins, which are cleaved by endothelin-converting enzyme (ECE) to yield the active protein. Endothelin has been shown to play important physiological and pathological roles by interacting with its G-protein-coupled receptors. There are two cloned ET receptors: the ET(A) receptor, which is selective for ET-1, and the ET(B) receptor, which binds ET-1, ET-2 and ET-3 with similar affinities. Since the discovery of endothelin, and especially since the availability of peptide ET antagonists such as BQ-123 and BQ-788, and nonpeptide compounds such as bosentan, considerable effort has been spent on better understanding the role of endothelin and its receptor antagonists. As a result, endothelin has been implicated in a variety of serious diseases, such as congestive heart failure, hypertension, pulmonary hypertension and prostate cancer. Research in pharmaceutical and biotechnology laboratories has generated many endothelin antagonists with either sulfonamide or triaryl carboxylic acid scaffolds, and a number of ET(A)-selective or nonselective ET(A)/ET(B) endothelin antagonists have entered clinical trials. This article will review the small-molecule ET(A)-selective and nonselective ET(A)/ET(B) antagonists that are under clinical evaluation, and highlight a member of this group of compounds, sitaxsentan. A summary of the medicinal chemistry that led to the identification of sitaxsentan will be presented, followed by selected animal and human clinical trial data. (c) 2001 Prous Science. All rights reserved.
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PMID:Nonpeptide endothelin antagonists in clinical development. 1275 Jul 62

The use of alternative medicine has increased considerably in the last 10 years. Some of the reasons for this trend include limited efficacy of existing treatments, perceived reduction in side effects with alternative treatments, patient's desire to maintain control over their treatment and a desire for a more "natural" treatment. The very high frequency of urologic diseases such as benign prostatic hyperplasia and prostate cancer makes these diseases natural targets of alternative medicine. Although a great number of therapeutic agents have been recommended for urologic diseases, this review examines the most promising for their use in benign prostatic hyperplasia and prostate cancer. (c) 2001 Prous Science. All rights reserved.
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PMID:Pharmacologic agents in complementary medicine in prostatic disease. 1276 28

Prostate cancer recurrence (after prior local treatment) that is detectable only by a rise in serum prostate specific antigen (PSA) level is a very common problem facing clinicians. Given that the majority of contemporary era men with PSA-only or biochemical recurrence are relatively young and otherwise healthy, treatment requires approaches that both improve clinical outcomes and preserve quality of life. Treatment is in one of two broad categories, additional local therapies, termed "salvage" local therapy and systemic therapies. For radical prostatectomy patients, salvage external beam radiotherapy to the prostate bed is commonly employed, being reserved for early biochemical recurrence in men with low risk at distant metastases. For primary radiation patients, salvage radical prostatectomy or cryotherapy can similarly be used for those men felt not to harbor distant metastases. Systemic therapy generally involves hormonal therapy. Traditional hormonal therapy (orchiectomy, luteinizing hormone-releasing hormone agonists, or maximum androgen blockade) is the current mainstay of systemic treatment for biochemical recurrence, although nontraditional approaches, such as antiandrogen monotherapy, are increasingly being used. Variables in predicting survival based on treating PSA relapse is problematic. The condition of biochemical failure has only been recognized in the last decade and few "PSA-era" patients with biochemical recurrence have actually died of disease. Hence, the validation of prediction variables in this setting is just emerging. Early work would suggest that timing of recurrence, Gleason grade, and PSA velocity or doubling time during relapse are important prognostic factors. New data on PSA doubling time will be presented.
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PMID:Variables in predicting survival based on treating "PSA-only" relapse. 1295

Bone scans of 64 patients with newly diagnosed prostate cancer were retrospectively analysed. Metastases were present in 29 patients (45%). In 75% of these cases, the pattern was manifeastly metastatic. The third threshold has high negative and positive predictive values. The topography of metastatic lesions is in favour of a systemic spread. There were no metastatic cases with a PSA level under 10 ng/ml. Multiple IAU and intense IAU are the most specific patterns of metastatic lesions. Also, focal lesions on sacroiliacs are also in favour of metastatic origin. The distribution of metastases is globally similar to that of the bone marrow in adult and systemic spread is the most probable. Staging bone scan must be reserved to patients with PSA level greater than 10 ng/ml, poorly degree of differentiation and advanced clinical stage.
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PMID:Bone scan in initial staging of prostate cancer. 1453 46

Magnetic resonance (MR) imaging and hydrogen 1 MR spectroscopy of the prostate gland are performed during the same examination with a conventional clinical MR unit. Prostate zonal anatomy and prostate cancer are best depicted on multiplanar T2-weighted MR images. MR imaging and 1H MR spectroscopy are not used as an initial diagnostic tool. Their use in tumor detection is reserved for patients with elevated prostate-specific antigen levels in whom previous biopsy results were negative. The use of MR imaging and 1H MR spectroscopy for the evaluation of tumor location, local extent (extracapsular extension and/or seminal vesicle invasion), volume, and aggressiveness is generating strong clinical interest. In staging and treatment planning, MR imaging has been shown to have an incremental value additive to the value of clinical nomograms. Furthermore, anatomic and metabolic mapping of the prostate gland with 1H MR spectroscopy offers the possibility of optimizing treatment planning (watchful waiting, surgery, or radiation therapy [intensity-modulated radiation therapy or brachytherapy]), thus further expanding the role of MR imaging in the achievement of patient-specific, individualized treatment.
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PMID:Pretreatment evaluation of prostate cancer: role of MR imaging and 1H MR spectroscopy. 1548 39

This report reviews the roles of conventional radiography, computerized axial tomography, and nuclear bone scanning in the diagnosis, staging, follow-up, and management of prostatic cancer. Computed tomography (CT) offers great promise for the better definition of the extent of the primary tumor of prostatic cancer. It contributes positively to the planning of radiation therapy portals in the treatment of localized disease. By means of bipedal lymphangiography and CT scanning, pelvic and periaortic lymphadenopathy may be detected more often than was previously possible without staging pelvic lymphadenectomy, which can be reserved for the discovery of microscopic disease. Soft-tissue metastases that are located deep within the body cavities can now be measured accurately by CT scanning, as can their response to therapy. Skeletal metastases, the most common variety in prostatic cancer, can be detected with a high degree of sensitivity by nuclear bone imaging. Serial bone scans are remarkably useful in following the response of osseous deposits to treatment, as well as in detecting relapsing disease. The management of malignant obstruction of the ureters has been greatly facilitated by the application of angiographic techniques to percutaneous nephrostomy performed under fluoroscopic control.
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PMID:The role of radiography, computed tomography and bone scanning in prostatic cancer. 1561 24

Endocrine therapy of prostate cancer has mostly been reserved to patients with advanced stages of the disease. The principle for endocrine treatment of prostate cancer is elimination of stimulatory effects of testicular androgens on the prostate tumour cells. This can be achieved by surgical removal of the testes, by inhibition of pituitary gonadotrohin secretion by GnRH-angonsists or antagonists, by oestrogens or by non-steroidal antiandrogens. Since non-steroidal antiandrogens have fewer side-effects than castrational therapies, there is an increased interest for using endocrine treatment as adjuvant therapy after localized treatment. At least in certain stages of the disease, early hormonal treatment may have survival benefits. The timing of endocrine therapy, the usage of combined androgen blockade and intermittent endocrine therapy will be discussed in this overview.
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PMID:Endocrine therapy for prostate cancer. 1616 20


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