Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C1519176 (PSA)
 5,490 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Adenocarcinoma of the prostate is the most prevalent neoplastic disease in men and continues to be a major cause of morbidity and mortality. Death from prostate cancer is associated with objective and biochemical progression following hormonal manipulations often described as hormone refractory prostate cancer (HRPCA). Therapy for HRPCA is primarily palliative and therapeutic efficacy has to be balanced against potential treatment-related side effects. Therapeutic efficacy may be assessed by evaluating the percentage of patients obtaining a PSA decline of > 50%, evaluating the response of bidimensionally measurable disease or by improvements in quality of life assessments. The most effective cytotoxic therapies at the present time seem to be combinations of estramustine phosphate with taxanes and etoposide. Regimes employing ketoconazole with estramustine, vinblastine or bisphosphonates seem to be worthy of further evaluation. Mitoxantrone has an impressive palliative effect in patients, particularly when combined with hydrocortisone. Oral chemotherapeutic regimens with a combination of estramustine phosphate, cyclophosphamide and prednisone appear to offer a less toxic alternative. For the future we need prospective randomized clinical phase-III studies, prognosticators identifying patients as being at high or low risk who might benefit from different therapeutic approaches and generally binding eligibility and response guidelines in order to be able to compare trials of different therapeutic approaches.
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PMID:Current status of cytotoxic chemotherapy in hormone refractory prostate cancer. 1122 70

As no treatment has been demonstrated to prolong survival in hormone-refractory prostate cancer, it was interesting to define the current management of these patients. This survey was designed to identify the criteria used to define hormonal escape, to more clearly define the treatment modalities at this stage of the disease and to evaluate the various therapeutic approaches used. A self-administered questionnaire accompanied by 3 clinical cases was sent by mail to all French urologists registered with the AFU. Three hundred and one (31%) questionnaires were returned. The diagnosis of hormone-refractory cancer was based on the presence of clinical signs or elevated PSA levels in 61% of cases. 65% of urologists reported that they changed treatment as soon as symptoms appeared. The objectives of treatment were improvement of quality of life in 95% of cases and relief of symptoms in 90% of cases. The first-line treatment after hormonal escape is very predominantly (at least 90% of cases) multiple hormonal manipulations. Chemotherapy or referral of patients to an oncologist is performed by more than one third of doctors as second-line treatment (35% of cases) and in almost all cases as third-line treatment (87% of cases). Mitoxantrone-prednisone is the combination chemotherapy most frequently reported in this survey (2 out of 3 doctors). These data illustrate the application by French urologists of the current CCAFU guidelines (Oncology Committee of the French Urology Association) for hormone-refractory prostate cancer.
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PMID:[Diagnosis and management of advanced hormone-refractory prostate cancer: results of a practice survey on 301 French urologists]. 1521 32