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Peter C Albertsen

Publications and source records attributed to Peter C Albertsen.

At least 37 records · Page 2Linked to original sources
PubMed2005

Prostate-specific antigen: how to advise patients as the screening debate continues.

There is still no consensus on whether prostate-specific antigen (PSA) measurement should be used as a screening test for prostate cancer, but patients have the right to be informed about its risks and possible benefits. PSA testing is more likely to be beneficial in relatively young men and men at higher risk (ie, African Americans and men with a family history of prostate cancer). A possible schedule is to test at age 40, age 45, and every 2 to 3 years from age 50 until about age 75.

Diagnostic Tests, Routine↗
PubMed2004

Racial/Ethnic differences in functional outcomes in the 5 years after diagnosis of localized prostate cancer.

PURPOSE: We investigated racial/ethnic differences in functional outcomes up to 5 years after diagnosis among men with aggressively treated localized prostate cancer. PATIENTS AND METHODS: Patients were from the Prostate Cancer Outcomes Study, a population-based cohort study that surveyed patients at 6, 12, 24, and 60 months after diagnosis. Analyses were stratified by primary treatment. Racial/ethnic differences at each time point were assessed using Generalized Estimating Equations, adjusting for pretreatment function, age at diagnosis, secondary treatment, and other confounders. An adjusted summary score for each functional domain was calculated for each time period. RESULTS: Patients included 1,475 non-Hispanic white, 321 African-American, and 279 Hispanic prostate cancer patients. After 60 months, among prostatectomy patients, African-Americans had significantly higher sexual function scores than non-Hispanic whites (43.9 v 36.1; P = .02), but were more likely to have a moderate to big problem with sexual function (50.6% v 44.4%; P = .04). African-Americans also had higher urinary function scores at 5 years than non-Hispanic whites (78.5 v 72.4; P = .04) and were less likely to have problems with incontinence. Changes in sexual and bowel function after radiotherapy showed no significant racial/ethnic differences. CONCLUSION: This long-term cohort study found that, among prostatectomy patients, African-Americans had better recovery of sexual and urinary function at 60 months after diagnosis that was likely to be of mild clinical significance, despite reporting more problems with sexual function than non-Hispanic whites. More study is necessary to understand reasons for these differences. In contrast, no racial/ethnic differences in recovery from radiotherapy were found.

Black or African American↗
PubMed2004

Validation of increasing prostate specific antigen as a predictor of prostate cancer death after treatment of localized prostate cancer with surgery or radiation.

PURPOSE: Many patients who undergo surgery or radiation therapy to treat localized prostate cancer experience an increase in serum prostate specific antigen (PSA) after treatment. This study documents patterns of PSA recurrence after surgery or radiation to treat localized prostate cancer and quantifies the extent to which an increasing PSA predicts death from prostate cancer. MATERIALS AND METHODS: Posttreatment PSA levels were measured on a population based cohort of 1136 men diagnosed with localized prostate cancer in community practice in Connecticut between 1990 and 1992, and treated within 6 months of diagnosis with surgery or radiation with or without androgen withdrawal therapy. The major outcome measure was death from prostate cancer. RESULTS: PSA recurrence followed a log-linear pattern over time. Patients who died of prostate cancer had a median PSA doubling time of 0.8 years (25th and 75th percentiles 0.5 to 1.4 years). Patients who did not die of prostate cancer within 10 years of diagnosis had either no posttreatment increase in serum PSA (40%) or had a PSA doubling time longer than 1 year (44%). CONCLUSIONS: Patients whose posttreatment PSA doubling times before the initiation of androgen withdrawal therapy are less than 1 year are at high risk of dying of prostate cancer within 10 years of diagnosis. Men with PSA recurrences that are doubling at rates greater than 1 year are at low risk of death from prostate cancer within 10 years of diagnosis.

Aged↗
PubMed2004

Bicycle riding and its relationship to the development of erectile dysfunction.

PURPOSE: Researchers have suggested that cycling is a hazard to the sexual health of men. Insufficient data have left cyclists skeptical of this claim. We explore risk factors within cycling that may put riders at risk for the development of erectile dysfunction (ED). MATERIALS AND METHODS: We performed an Internet based survey of cyclists to examine factors associated with cycling that might contribute to ED as defined by the International Index of Erectile Function. A total of 688 cyclists were included in the analysis ranging in age from 18 to 77 years. RESULTS: ED prevalence was 17% (115 of 688). Although results from univariate analysis revealed a correlation between ED and several tested variables, none proved to be statistically significant after controlling for age. CONCLUSIONS: The overall prevalence of ED in the cycling community does not appear to be greater than that of historical controls. Previously suggested alterations in riding habits may not change the prevalence of ED among cyclists.

Adolescent↗
PubMed2003

Race independently predicts prostate specific antigen testing frequency following a prostate carcinoma diagnosis.

BACKGROUND: The goals of the current study were to describe patterns of prostate specific antigen (PSA) surveillance for prostate carcinoma progression in a community-based cohort of patients and to identify independent clinical and sociodemographic factors that predict the frequency of surveillance. METHODS: Patients diagnosed with localized prostate carcinoma from October 1, 1991 to December 31, 1992 in New Haven and Hartford, Connecticut, were identified. Data were collected through standardized outpatient medical record review. Multivariate statistical methods were used to determine the factors that independently predicted the frequency of surveillance. RESULTS: Six hundred fifty-eight men with localized prostate carcinoma were included in the cohort. Forty-five percent of all patients were tested at least once annually, and 69% were tested at least once every 2 years. Multivariate models indicated that African American men were half as likely as Caucasian men to receive annual testing (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.24-0.97). Men diagnosed at age 70 years or older were 38% less likely to have annual testing than men diagnosed between the ages of 65 and 69 (OR, 0.62; 95% CI, 0.41-0.94). A higher Gleason score and PSA at presentation also were associated independently with higher rates of annual PSA surveillance. CONCLUSIONS: Postdiagnosis PSA surveillance is common, although not universal. African American men were at significantly greater risk for receiving less frequent testing compared with Caucasian men. This disparity in access to care may explain, in part, previously observed racial differences in survival in prostate carcinoma. Further research is needed to identify the reasons for the racial disparity in PSA surveillance and to design interventions to lessen these differences.

Adult↗
PubMed2003

Recognition of PSA-derived peptide antigens by T cells from prostate cancer patients without any prior stimulation.

Prostate-specific antigen (PSA) is a valuable marker antigen for prostate cancer. Lately considerable interest has been generated in the prospect of developing a vaccine for prostate cancer with PSA-derived peptide epitopes to induce cytotoxic T-cell (CTL) response. We report here that T cells capable of exhibiting PSA epitope-specific effector function-in their native state, i.e, without having to be further stimulated, in vitro-are detectable in more than half of the prostate cancer patients we studied. Ex vivo cultured autologous dendritic cells (DC) were used to present four HLA-A2-binding PSA peptide epitopes to freshly isolated peripheral blood lymphocytes (PBL) from patients and healthy volunteers. Ten out of 14 patients' PBL recognized at least one of the four peptides and 6 out of 10 patients' PBL recognized more than one peptide antigen as measured by IFN-gamma secretion upon stimulation of the PBL with the peptide antigen. Intracytoplasmic cytokine analysis for IFN-gamma in purified CD8(+) cells after stimulation with peptide antigens was tested in 6 patients and this technique demonstrated a similar response. Freshly isolated and purified CD8(+) cells when tested, also recognized the epitopes, as measured by IFN assay, when presented by transporter associated with antigen-processing (TAP) deficient T2 cells in an MHC-I restricted fashion. PBL from 9 normal donors when tested in identical fashion did not show any IFN-gamma production in recognition to the peptide antigens. Interestingly, neither of these CD8(+) T cells having IFN-gamma-producing ability did show any cytolytic activity in their native state against peptide loaded target cells or tumor cells when tested in cytotoxicity assay. In long term cocultures stimulation of purified CD8(+) T cells with matured DC pulsed with PSA peptides generated a PSA-specific CTL response in 4 of 6 patients studied and in 2 of 9 normal donors. While our observations of CTL generation are consistent with the prior reports that have demonstrated that specific CD8(+) CTL could be generated which recognize PSA-derived epitopes by in vitro stimulation by one means or another, this observation that IFN-gamma-producing CD8(+) T cells are present in patients which are antigen experienced, and do not require in vitro stimulation, is novel and has major implications for prostate cancer vaccine preparation.

Adenocarcinoma↗
PubMed2003

General quality of life 2 years following treatment for prostate cancer: what influences outcomes? Results from the prostate cancer outcomes study.

PURPOSE: The goal of this study was to determine the relationship between primary treatment, urinary dysfunction, sexual dysfunction, and general health-related quality of life (HRQOL) in prostate cancer. METHODS: A sample of men with newly diagnosed prostate cancer between 1994 and 1995 was randomly selected from six population-based Surveillance, Epidemiology, and End Results registries. A baseline survey was completed by 2,306 men within 6 to 12 months of diagnosis, and these men also completed a follow-up HRQOL survey 2 years after diagnosis. Logistic regression models were used to determine whether primary treatment, urinary dysfunction, and sexual dysfunction were independently associated with general HRQOL outcomes approximately 2 years after diagnosis as measured by the Medical Outcomes Study 36-item Short Form Health Survey. The magnitude of this effect was estimated using least square means models. RESULTS: After adjustment for potential confounders, primary treatment was not associated with 2-year general HRQOL outcomes in men with prostate cancer. Urinary function and bother were independently associated with worse general HRQOL in all domains. Sexual function and bother were also independently associated with worse general HRQOL, although the relationship was not as strong as in the urinary domains. CONCLUSION: Primary treatment is not associated with 2-year general HRQOL outcomes in prostate cancer. Although both sexual and urinary function and bother are associated with quality of life, men who are more bothered by their urination or impotence are more likely to report worse quality of life. This implies that future research should be directed toward finding ways to improve treatment-related outcomes or help patients better cope with their posttreatment urinary or sexual dysfunction.

Aged↗
PubMed2003

Populations at high risk for prostate cancer.

Although prostate cancer tends to be a slow-growing neoplasm affecting older men, there is clearly a subset of patients at high risk for developing early and possibly more aggressive disease. This group of high-risk patients includes men with a family history of prostate cancer and various histologic features such as PIN and ASAP identified on an initial biopsy. Black American men have a much higher risk of developing prostate cancer when compared with white men and especially Asian men. This finding may reflect both genetic and environmental factors. Screening men at increased risk of developing prostate cancer appears to be a logical strategy, especially in light of recent reports that suggest a benefit to aggressive treatment.

Diet↗
PubMed2003

Lower urinary tract symptoms in the older male.

Lower urinary tract symptoms (LUTS) are common in older men and include urinary frequency, urgency, nocturia and slow stream. Traditionally, this symptom complex has been called benign prostatic hypertrophy or prostatism, yet such symptoms may also result from detrusor over-activity and/or excessive urine output. Clinical assessment of older men with LUTS is based on a careful history, a clinical examination and a check of the postvoid residual, with urodynamic studies reserved for select individuals. Factors such as mobility, constipation and fluid balance must also be considered. These combined with a variety of pharmacologic agents (antispasmodics, alpha-antagonists, 5 alpha reductase inhibitors) offer great potential for improving the quality of life of individuals with LUTS.

Aged↗