[Purification and enzyme immunoassay of tumor markers for prostate cancer: prostatic acid phosphatase, prostate-specific antigen and creatine kinase BB].
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Acid Phosphatase↗
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Results for “Prostate Cancer”
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[Familial prostate cancer and prostate cancer susceptibility locus on chromosome-1 (hereditary prostate cancer-1, HPC-1)].
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Adult↗
Urinary and sexual function after radical prostatectomy for clinically localized prostate cancer: the Prostate Cancer Outcomes Study.
CONTEXT: Patients with prostate cancer and their physicians need knowledge of treatment options and their potential complications, but limited data on complications are available in unselected population-based cohorts of patients. OBJECTIVE: To measure changes in urinary and sexual function in men who have undergone radical prostatectomy for clinically localized prostate cancer. DESIGN: The Prostate Cancer Outcomes Study, a population-based longitudinal cohort study with up to 24 months of follow-up. SETTING: Population-based cancer registries in 6 geographic regions of the United States. PARTICIPANTS: A total of 1291 black, white, and Hispanic men aged 39 to 79 years who were diagnosed as having primary prostate cancer between October 1, 1994, and October 31, 1995, and who underwent radical prostatectomy within 6 months of diagnosis for clinically localized disease. MAIN OUTCOME MEASURES: Distribution of and change in urinary and sexual function measures reported by patients at baseline and 6, 12, and 24 months after diagnosis. RESULTS: At 18 or more months following radical prostatectomy, 8.4% of men were incontinent and 59.9% were impotent. Among men who were potent before surgery, the proportion of men reporting impotence at 18 or more months after surgery varied according to whether the procedure was nerve sparing (65.6% of non-nerve-sparing, 58.6% of unilateral, and 56.0% of bilateral nerve-sparing). At 18 or more months after surgery, 41.9% reported that their sexual performance was a moderate-to-large problem. Both sexual and urinary function varied by age (39.0% of men aged <60 years vs 15.3 %-21.7% of older men were potent at > or =18 months [P<.001]; 13.8% of men aged 75-79 years vs 0.7%-3.6% of younger men experienced the highest level of incontinence at > or =18 months [P = .03]), and sexual function also varied by race (38.4% of black men reported firm erections at > or =18 months vs 25.9% of Hispanic and 21.3% of white men; P = .001). CONCLUSIONS: Our study suggests that radical prostatectomy is associated with significant erectile dysfunction and some decline in urinary function. These results may be particularly helpful to community-based physicians and their patients with prostate cancer who face difficult treatment decisions.
Adult↗
Early intervention or expectant management for prostate cancer. The Prostate Cancer Intervention Versus Observation Trial (PIVOT): a randomized trial comparing radical prostatectomy with expectant management for the treatment of clinically localized prostate cancer.
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Aged↗
Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study.
BACKGROUND: African-Americans have twice the risk of non-Hispanic whites for presenting with advanced-stage prostate cancer. To investigate the reasons for this difference, we evaluated the association between race/ethnicity and advanced-stage prostate cancer, adjusting for demographic, socioeconomic, clinical, and pathologic factors. METHODS: A population-based cohort of 3173 men diagnosed with prostate cancer between October 1, 1994, and October 31, 1995, was analyzed. Medical record abstracts and self-administered survey questionnaires were used to obtain information regarding race/ethnicity, age, marital status, insurance status, educational level, household income, employment status, comorbidity, urinary function, prostate-specific antigen level, tumor grade, and clinical stage. The odds ratio (OR) for advanced-stage prostate cancer was estimated with weighted logistic regression analysis. All P: values were two-sided. RESULTS: Clinically advanced-stage prostate cancers were detected more frequently in African-Americans (12.3%) and Hispanics (10.5%) than in non-Hispanic whites (6.3%). Socioeconomic, clinical, and pathologic factors each accounted for about 15% of the increased relative risk. After adjusting for all covariates, the risk remained statistically significantly increased for African-Americans (OR = 2.26; 95% confidence interval [CI] = 1.43 to 3.58) but not for Hispanics (OR = 1.23; 95% CI = 0.73 to 2.08). CONCLUSION: Traditional socioeconomic, clinical, and pathologic factors accounted for the increased relative risk for presenting with advanced-stage prostate cancer in Hispanic but not in African-American men.
Black or African American↗
Chemoprevention of prostate cancer: the Prostate Cancer Prevention Trial.
BACKGROUND: A variety of innovative approaches to the prevention of prostate cancer are now available, including selenium, alpha tocopherol, dietary interventions, and vitamin D. Perhaps the most promising opportunity is based upon considerable evidence that cumulative androgen exposure of the prostate contributes to the age-related risk of prostate cancer. METHODS: The Prostate Cancer Prevention Trial has completed randomization of over 18,000 healthy men to either finasteride or placebo. CONCLUSIONS: While the primary objective of this study is to determine whether finasteride can reduce the period prevalence of prostate cancer over a 7-year period, the biologic and data resources of this study will provide multiple opportunities to better understand this most common cancer in U.S. men.
Aged↗
Monograph series on aging-related diseases: X. Prostate cancer.
Prostate cancer is the most commonly diagnosed cancer among Canadian men, excluding non-melanoma skin cancer. Prostate cancer incidence increases almost exponentially with age; most cases are diagnosed in men aged 65 years or older. With the possible exception of animal fat consumption, no known widespread modifiable risk factors have been identified. Although the prognosis is good if appropriate treatment occurs in the early stages of disease, the ability of existing early detection techniques to decrease mortality has not yet been demonstrated. The considerable economic and societal burden of prostate cancer and its treatment, coupled with the projected large increase in the number of new prostate cancer cases as the population ages, make this disease a very important public health issue.
Aged↗
Quality of life and psychosocial status in stage D prostate cancer. Zoladex Prostate Cancer Study Group.
Inasmuch as treatments for advanced prostate cancer may have identical clinical outcomes but very different meanings to patients, we sought to compare the impact of surgical and medical castration (orchiectomy versus injected goserelin acetate Zoladex) on quality of life and psychosocial status. A total of 147 men with Stage D prostate cancer participated in the study: 115 selected treatment with goserelin acetate, and 32 chose orchiectomy. Quality of life, as measured by the Functional Living Index: Cancer (FLIC), improved at both the 3 and the 6 month follow-up in the goserelin acetate group (p = 0.0001), but did not change from baseline at 6 months in the orchiectomy group (p = 0.54). These findings were paralleled by improvement from baseline in psychosocial status, as measured by the Profile of Mood States (POMS), at 6 month follow-up (p = 0.01 in the goserelin acetate group versus p = 0.60 in the orchiectomy group). This investigation, which is among the first to evaluate patients' appraisals of their lives following treatment choices for advanced prostatic cancer, argues compellingly for including quality of life in assessments of therapy.
Activities of Daily Living↗
Parenteral estrogen versus combined androgen deprivation in the treatment of metastatic prostatic cancer -- Scandinavian Prostatic Cancer Group (SPCG) Study No. 5.
OBJECTIVE: In the mid-1980s, interest in parenteral estrogen therapy for prostate cancer was renewed when it was found that it influenced liver metabolism only marginally and had very few cardiovascular side-effects. In this study high-dose polyestradiol phosphate (PEP; Estradurin) was compared to combined androgen deprivation (CAD) for the treatment of patients with metastatic prostate cancer. The aim of the study was to compare anticancer efficacy and adverse events, especially cardiovascular side-effects. MATERIAL AND METHODS: A total of 917 patients with T0-4, NX, M1, G1-3 prostate cancer and an Eastern Cooperative Oncology Group performance status of 0-2 were randomized to treatment with either PEP 240 mg i.m. twice a month for 2 months and thereafter once a month or flutamide (Eulexin) 250 mg t.i.d. per os in combination with either triptorelin (Decapeptyl) 3.75 mg per month i.m. or, on an optional basis, bilateral orchidectomy. A total of 556 patients had died at the time of this analysis. RESULTS: There was no difference between the treatment arms in terms of time to biochemical or clinical progression and overall or disease-specific survival. There was no increase in cardiovascular mortality in the PEP arm. The PEP group had a higher prevalence of cardiovascular disease prior to the study and a significantly higher incidence of non-fatal ischemic heart events and heart decompensation during the study. CONCLUSIONS: PEP has an equal anticancer efficacy to CAD and does not increase cardiovascular mortality. Final evaluation of cardiovascular morbidity is awaiting further analysis and follow-up. PEP is considerably cheaper than CAD.
Aged↗
Derivation of MPR and TRAMP models of prostate cancer and prostate cancer metastasis for evaluation of therapeutic strategies.
Pre-clinical models of primary and metastatic prostate cancer are increasingly needed to evaluate efficacy of the new therapeutic strategies currently under investigation. The androgen-independent RM1 and androgen-dependent TR cell lines derived from transgenic mouse models of prostate cancer were examined in this regard. Following implantation in immune competent mice, the RM1 cell line was able to generate extremely fast growing s.c. and iprost tumors and metastatic lung lesions providing a time period of approximately 14-17 days from the time of tumor establishment to animal sacrifice to assess therapies. Implantation of TR cell lines resulted in more slowly growing s.c. and iprost tumors and metastatic lung lesions that exhibited highly variable incidence and growth. These models represent the best available means to evaluate therapeutics in primary and metastatic prostate cancer variants in an intact immune system.
Animals↗
Preclinical models of prostate cancer.
Prostate cancer is the most common non-skin malignancy, yet the biological and molecular characteristics of the disease remain only poorly understood. One of the many reasons for this is that there are so few animal or human laboratory models of prostate cancer. Prostate cancer rarely arises spontaneously in animals, and the human cancer is unusually hard to grow in culture or as xenografts even short-term. The prostate cancer models that do exist are basically rodent models, human cell lines, human xenografts, and gene transfer and transgenic models. Many laboratories have put great effort into developing prostate cancer models, without much success. These efforts recently have been forced to be curtailed, primarily due to a lack of funding. There is good reason to believe, however, that propagation of metastatic tissue will be much more successful. At the University of Washington, the Prostate Cancer Donor Program, organized in a manner similar to existing methods for cadaver organ harvest, has been instituted to help recruit patients for these approaches. Prospects for success of model development also have been improved because of advances in techniques for the maintenance of severe combined immunodeficiency disease mice or nude mice.
Animals↗
The polycomb group protein EZH2 is involved in progression of prostate cancer.
Prostate cancer is a leading cause of cancer-related death in males and is second only to lung cancer. Although effective surgical and radiation treatments exist for clinically localized prostate cancer, metastatic prostate cancer remains essentially incurable. Here we show, through gene expression profiling, that the polycomb group protein enhancer of zeste homolog 2 (EZH2) is overexpressed in hormone-refractory, metastatic prostate cancer. Small interfering RNA (siRNA) duplexes targeted against EZH2 reduce the amounts of EZH2 protein present in prostate cells and also inhibit cell proliferation in vitro. Ectopic expression of EZH2 in prostate cells induces transcriptional repression of a specific cohort of genes. Gene silencing mediated by EZH2 requires the SET domain and is attenuated by inhibiting histone deacetylase activity. Amounts of both EZH2 messenger RNA and EZH2 protein are increased in metastatic prostate cancer; in addition, clinically localized prostate cancers that express higher concentrations of EZH2 show a poorer prognosis. Thus, dysregulated expression of EZH2 may be involved in the progression of prostate cancer, as well as being a marker that distinguishes indolent prostate cancer from those at risk of lethal progression.
Biomarkers, Tumor↗
Prostate cancer risk in U.S. blacks and whites with a family history of cancer.
Prostate cancer occurs more frequently in U.S. blacks than whites. A population-based case-control study which investigated the association with family history of cancer was carried out among 981 men (479 black, 502 white) with pathologically confirmed prostate cancer, diagnosed between August 1, 1986, and April 30, 1989, and 1,315 controls (594 black, 721 white). Study subjects, aged 40-79, resided in Atlanta, Detroit, and 10 counties in New Jersey, geographic areas covered by population-based cancer registries. Prostate cancer risk was significantly elevated among those who reported a history of prostate cancer in first-degree relatives (O.R. = 3.2; 95% C.I.: 2.0-5.0), with blacks and whites having similarly elevated risks. These risks were unchanged by statistical adjustment for job-related socio-economic status, education, income, and marital status. Overall, the ORs associated with history of prostate cancer in fathers and brothers were 2.5 (95% C.I.: 1.5-4.2) and 5.3 (95% C.I.: 2.3-12.5), respectively. Risks associated with a family history of prostate cancer were consistently elevated among younger and older subjects. Only small non-significant excesses of prostate cancer risk were associated with a family history of breast, colorectal, or other cancers. While familial occurrence is a key risk factor for prostate cancer and likely to be genetically based, the similar familial risks among blacks and whites suggest that the ethnic disparity in incidence is influenced by environmental factors.
Adult↗
[Usefulness of prostate specific antigen/gamma-seminoprotein ratio for diagnosis of prostate cancer].
Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) are used as tumor markers of the prostate cancer. However, the serum concentrations of PSA and gamma-Sm are frequently increased in patients with benign prostatic hypertrophy (BPH). We measured the ratio of serum PSA to gamma-Sm concentration (P/S ratio), and evaluated its usefulness for diagnosis of prostate cancers. Between April 1988 and July 1992, 162 men underwent prostatic biopsy and/or TUR-P, and were diagnosed pathologically. Of 162 patients, 112 were diagnosed as BPH and 50 were diagnosed as prostate cancer. Of 24 patients with serum PSA level of > 20 ng/ml, 23 (95.8%) were prostate cancer, while, of 79 patients with serum PSA level of 3.0-20 ng/ml, 23 (29.1%) were prostate cancer. The sensitivity and the specificity for PSA were 92.0% and 49.1%, respectively. Of 85 patients with serum gamma-Sm level of > 4.0 ng/ml, 30 (35.3%) were prostate cancer. The sensitivity and the specificity for gamma-Sm were 60.0% and 50.9%, respectively. A mean +/- SD of P/S ratio in 112 patients with BPH was 0.954 +/- 0.591. While, the mean +/- SD of P/S ratio was 16.295 +/- 58.584 in all prostate cancer patients, and 2.031 +/- 0.654 in 27 prostate cancer patients with serum PSA level of < or = 20 ng/ml. P/S Ratio in prostate cancer patients with serum PSA of < or = 20 ng/ml as well as in all prostate cancer patients were significantly higher than P/S Ratio of BPH patients (p < 0.0001). Of 55 patients with P/S Ratio of > or = 1.50, 45 (81.8%) were prostate cancer and 10 (18.2%) were BPH. While, of 107 patients with P/S Ratio of < 1.50, 102 (95.3%) were BPH and 5 (4.7%) were prostate cancer. The sensitivity and the specificity for P/S Ratio were 90.0% and 91.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
Adenocarcinoma↗
Therapeutic targets for metastatic prostate cancer.
Prostate cancer is the most commonly diagnosed non-cutaneous cancer in adult males. Although prostate cancer that is confined to the gland can be cured in many patients using surgery or radiation, these treatments are only effective for localized tumors and the long-term failure rates for these treatments suggests that prostate cancer can metastasize relatively early in the course of the disease. Once prostate cancer has metastasized there are no curative therapies. The greatest challenge in the treatment of advanced prostate cancer is to access and eliminate metastatic cells. Therefore, effective prostate cancer therapy will require novel strategies to target cancer cells both at the site of the primary tumor and at distant metastatic sites. In this article we review several therapeutic targets and approaches that may provide new treatments for metastatic prostate cancer. We discuss the use of small molecules to target specific molecular events associated with metastatic prostate cancer, the use of specific antibodies that target unique metastasis associated molecules and the use of various gene therapy strategies to achieve anti-metastatic activities.
Animals↗
Prostate-specific antigen testing to screen for prostate cancer.
Prostate cancer is a common cause of cancer-related morbidity and mortality in men. Prostate-specific antigen (PSA) measurement to screen for prostate cancer has been promoted as a way to reduce morbidity and mortality from prostate cancer. This paper examines the usefulness of PSA screening for asymptomatic prostate cancer, focusing on outcomes for all patients screened. The sensitivity and specificity of PSA testing for prostate cancer are low and have not been studied properly in asymptomatic men being screened for prostate cancer. PSA screening detects localized prostate cancer undetected by digital rectal examination in fewer than 1% of men screened. The effectiveness of early treatment of prostate cancer, compared with deferral of treatment until symptoms develop, is unproven, and good survival rates have been reported among patients who defer aggressive treatment. Complications of treating prostate cancer with radical prostatectomy or radiation treatment include death, impotence, urethral stricture, incontinence, and rectal injury. At the present time, there is insufficient evidence to support a policy of PSA screening, and its use should be discouraged until randomized controlled trials demonstrate benefit from PSA screening.
Humans↗
Prostatic intraepithelial neoplasia in dogs with spontaneous prostate cancer.
Prostatic intraepithelial neoplasia (PIN) is the most likely precursor of human prostate cancer. The prevalence and immunophenotype of PIN in dogs with spontaneous prostate cancer has not been previously described. To investigate the association between PIN and prostate cancer, we evaluated the prostates of dogs with spontaneous prostate carcinoma. The prevalence of PIN was determined in formalin-fixed prostates from 29 dogs with spontaneous prostate cancer. Using immunoperoxidase techniques, we compared basal cell layer integrity (high molecular weight keratin 34 beta-E12), proliferative index (MIB-1), and microvessel density (Factor VIII-related antigen) in 14 prostates which contained benign epithelium, PIN, and carcinoma. PIN was present in 19 of 29 (66%) prostates from dogs with spontaneous prostate cancer. The basal cell layer was intact in benign epithelium, disrupted in 72% of acini with PIN, and absent in carcinoma. The mean proliferative index was 17%, 25%, and 40% for benign epithelium, PIN, and carcinoma, respectively, and these differences were significant. The mean microvessel density in foci of PIN and carcinoma (32 and 39 vessels per mm2, respectively) was greater than in benign epithelium (23 vessels per mm2). High-grade PIN is common in the prostates of dogs with spontaneous carcinoma. The basal cell layer is partially disrupted in PIN, whereas it is absent in prostate cancer. The proliferative index and microvessel density of PIN are intermediate between benign epithelium and cancer. These results are similar to those reported for human PIN and prostate cancer, and indicate that PIN is part of a morphologic continuum in the progression of prostate cancer. To our knowledge, this is the first description of high-grade PIN spontaneously occurring in animals. The canine prostate may serve as a useful model for examining factors that modulate PIN and prostate cancer progression.
Animals↗
Early detection of prostate cancer.
Prostate cancer is the second most common malignancy in American males and the third leading cause of cancer deaths in this population. There are no symptoms that are unique to early prostate cancer, and nearly one-half of patients will have metastatic disease at diagnosis. Because of its tremendous impact upon the health and well-being of the American male population, and the importance of early diagnosis in curability, there is keen interest in the development of effective screening procedures that are highly sensitive, specific, and cost-effective. Rectal examination serves as the historical control. The serum tumor markers of prostate cancer, prostatic acid phosphatase (PAP), and prostate-specific antigen (PSA), are sensitive but relatively nonspecific in the diagnosis of prostate cancer. The use of transrectal ultrasound as a screening tool is highly controversial but suffers from a similar lack of specificity. As yet, no diagnostic tests, alone or in combination, have proven to be of practical value in screening for prostate cancer. Fundamental but unanswered questions about the natural history and the high incidence of "latent" disease also obscure the issue of early diagnosis of prostate cancer and its impact on survival.
Biomarkers, Tumor↗