1743: Risk Count Assessment: A New Concept for Detection of Life Threatening Prostate Cancer During a Window of Curability

2007 ◽  
Vol 177 (4S) ◽  
pp. 579-580 ◽  
Author(s):  
H. Ballentine Carter ◽  
Anna E. Kettermann ◽  
Luigi Ferrucci ◽  
Patricia Landis ◽  
E. Jeffrey Metter
Keyword(s):  
Prostate Cancer ◽  
Life Threatening

scholarly journals WOMEN IN CANCER THEMATIC REVIEW: New roles for nuclear receptors in prostate cancer

2016 ◽  
Vol 23 (11) ◽  
pp. T85-T108 ◽  
Author(s):  
Damien A Leach ◽  
Sue M Powell ◽  
Charlotte L Bevan
Keyword(s):  
Prostate Cancer ◽  
Nuclear Receptors ◽  
Nuclear Receptor ◽  
Current Knowledge ◽  
Transcriptional Responses ◽  
Number Variation ◽  
Genomic Studies ◽  
Life Threatening ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant

Prostate cancer has, for decades, been treated by inhibiting androgen signalling. This is effective in the majority of patients, but inevitably resistance develops and patients progress to life-threatening metastatic disease – hence the quest for new effective therapies for ‘castrate-resistant’ prostate cancer (CRPC). Studies into what pathways can drive tumour recurrence under these conditions has identified several other nuclear receptor signalling pathways as potential drivers or modulators of CRPC.The nuclear receptors constitute a large (48 members) superfamily of transcription factors sharing a common modular functional structure. Many of them are activated by the binding of small lipophilic molecules, making them potentially druggable. Even those for which no ligand exists or has yet been identified may be tractable to activity modulation by small molecules. Moreover, genomic studies have shown that in models of CRPC, other nuclear receptors can potentially drive similar transcriptional responses to the androgen receptor, while analysis of expression and sequencing databases shows disproportionately high mutation and copy number variation rates among the superfamily. Hence, the nuclear receptor superfamily is of intense interest in the drive to understand how prostate cancer recurs and how we may best treat such recurrent disease. This review aims to provide a snapshot of the current knowledge of the roles of different nuclear receptors in prostate cancer – a rapidly evolving field of research.

scholarly journals An unusual cause of delayed hematoma after carotid endarterectomy: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Zhao ◽  
Zhichao Lai ◽  
Xiaojun Song ◽  
Rong Zeng ◽  
Changwei Liu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Carotid Endarterectomy ◽  
Early Stage ◽  
Prostatic Hyperplasia ◽  
Surgical Patients ◽  
Blood Products ◽  
Case Presentation ◽  
Life Threatening ◽  
History Of

Abstract Background Neck hematoma is a complication of carotid endarterectomy, usually occurring in the comparatively early stage postoperatively. Case presentation We described a patient developing life-threatening hemorrhage and non-clotting hematoma at a comparatively later stage after CEA. DIC was diagnosed according to the lab results, and the patient underwent re-operation and was supported with blood products until the coagulopathy was corrected. The patient had a history of prostatic hyperplasia and experienced malaise during the hospitalization. Prostate cancer with bone metastases was diagnosed. Conclusions This case report describes a rare underlying cause of hematoma after CEA, which reminds us to pay attention to prostate symptoms or related medical history, especially malignancy, in surgical patients, which may result in severe complications.

Low-dose docetaxel, estramustine and thalidomide followed by maintenance thalidomide in androgen-independent prostate cancer (AIPC): Final results of a phase II community based study in elderly men

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15609-15609
Author(s):  
R. C. Frank ◽  
L. Versea ◽  
N. Cohen ◽  
J. Long ◽  
K. Nair
Keyword(s):  
Prostate Cancer ◽  
Low Dose ◽  
Metronomic Chemotherapy ◽  
Elderly Men ◽  
Community Based ◽  
Measurable Disease ◽  
Potential Synergy ◽  
Life Threatening ◽  
Dose Reductions ◽  
Androgen Independent

15609 Background: The TET regimen was developed to test the potential synergy and tolerability of low dose, metronomic chemotherapy plus an anti-angiogenesis agent in the treatment of AIPC in elderly men. Preliminary results were presented in 2004 (ASCO Proceedings #4681); we now present the final results 5 years from protocol initiation. Methods: Eligible patients had progressive AIPC, an adequate PS (0–2) and were chemotherapy naïve. All patients received the TET regimen: Docetaxel (Taxotere [T]) 25 mg/m2 weekly for three weeks per month, Estramustine 140 mg po tid x 3 days per week (with T) and Thalidomide (Thal) 100–200 mg as tolerated. After six monthly cycles of TET, patients with responding or stable disease received maintenance Thal until progression. Coumadin 2 mg daily was given for thromboprophylaxis. A total of 19 patients out of an intended 25 were accrued from 6/01 to 9/05. Results: The median age was 79 (59–86); 70% of patients were ≥ 75 years of age. The median PSA was 83 (20–2266), median Gleason score 7, bone metastases were present in 14/19 patients and measurable disease in 12/19 patients. 17 patients completed at least one cycle of TET and were eligible for analysis. The PSA declined >50% in 10/17 (59%); there was 1 PR and 7 SD by RECIST criteria. Of six patients that received maintenance Thal, only one had PSA stabilization for more than three months. The median survival was 17 months. The major grade ¾ toxicities included non-life threatening DVT (3 patients), asthenia (6 patients), edema and dyspnea (one patient each). Thal 200 mg was especially poorly tolerated, requiring dose reductions in over half of the patients. Conclusions: In this trial of elderly men with AIPC, low-dose TET did not seem to improve upon the results previously reported for docetaxel or docetaxel/estramustine. The observed toxicities make it doubtful that a higher dose TET regimen could be tolerated by this population. Thalidomide maintenance was ineffective in maintaining responses. No significant financial relationships to disclose.

Prevention of docetaxel-associated febrile neutropenia with primary granulocyte colony-stimulating factors (GCSF) in Chinese metastatic hormonal-sensitive (mHSPC) and castration-resistant prostate cancer (mCRPC).

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 72-72
Author(s):  
Darren M.C. Poon ◽  
Kuen Chan ◽  
T.W. Chan ◽  
Bryan Ng ◽  
S Wai-kwan Siu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Febrile Neutropenia ◽  
Performance Status ◽  
Poor Performance ◽  
Chinese Patients ◽  
Poor Performance Status ◽  
Castration Resistant Prostate Cancer ◽  
Increased Risk ◽  
Docetaxel Treatment ◽  
Life Threatening

72 Background: Plenty reports suggest Asian prostate cancer patients are more susceptible to docetaxel-related febrile neutropenia (FN). However, primary GCSF prophylaxis is currently not recommended by international guidelines for patients with mCRPC or mHSPC when docetaxel is administered. Therefore, we aim to evaluate the potential benefit of primary GCSF in preventing the potentially life-threatening FN for Chinese mHSPC and mCRPC treated with docetaxel. Methods: Two cohorts (2003-2012 & 2015-2018) that consisted of Chinese patients with mHSPC and mCRPC who had docetaxel at six public oncology centres in Hong Kong were grouped and analysed. Primary GCSF was defined as its administration within 5 days of beginning docetaxel, and its use was at the discretion of oncologists. The primary outcome was FN within 21 days of first cycle of docetaxel (1st FN). Multivariable regression analysis was used. Results: A total of 377 metastatic prostate cancer (mHSPC, n=100 (26%); mCRPC, n=277 (73%)) patients with docetaxel treatment was identified. Primary GCSF was given in 71 (18%) patients. The baseline characteristics were balanced between groups with and without primary GCSF. FN was happened in 61 patients (16%), with 37 (9%) of them at 1st cycle. Primary GCSF were administered in 2 and 69 patients with and without 1st FN, respectively (5.4% vs 20.3%, p=0.03). Primary GCSF was associated with reduced risk of 1st FN (odds ratio (OR), 0.22; 95% CI 0.05 - 0.96; p=0.04) in overall, and a similar trend was observed in both mHSPC (OR, 0.36; p=0.35) and mCRPC (OR, 0.16, p=0.08) subgroups. Besides, among various clinical parameters, poor performance status (ECOG 2-3) was associated with increased risk of 1st FN (OR, 3.90, 95% CI 1.66 – 9.13, p=0.002). Conclusions: Primary GCSF prophylaxis is suggested for Asian mCRPC and mHSPC patients, particularly those with poor performance status, to alleviate the risk of docetaxel-related febrile neutropenia.

1189: Identifying Potentially Life Threatening Prostate Cancer at Diagnosis

2004 ◽  
Vol 171 (4S) ◽  
pp. 314-314
Author(s):  
Anthony V. D'Amico ◽  
Ming-Hui Chen ◽  
Kimberly A. Roehl ◽  
William J. Catalona
Keyword(s):  
Prostate Cancer ◽  
Life Threatening

Novel methodology for cost evaluation of anticancer drugs in castrate-resistant prostate cancer.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 200-200 ◽  
Author(s):  
Helmy M. Guirgis
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Anticancer Drugs ◽  
Reference Value ◽  
Cost Evaluation ◽  
Life Threatening ◽  
Castrate Resistant Prostate Cancer ◽  
Castrate Resistant ◽  
Fatal Adverse Events

200 Background: There is a need for a screening methodology to evaluate cost effectiveness of anticancer drugs. High costs raise concerns on approval, affordability and utilization. Objectives: Develop simplified methodology to screen and score cost versus value survival of docetaxel, cabazitaxel, abiraterone and sipuleucel-T in castrate- resistant prostate cancer (CRPC) Methods: Estimated costs in US $ of the entire course of an evaluated drug were added to downstream ancillary costs. The total was divided by the reported median survival gain over control in days. A reference value scale between 0- 100% was constructed with 0% assigned to cost/overall survival (OS) > $750, life threatening/ fatal adverse events (AEs) and worsened quality of life (QoL). A plan was designed to correct for AEs and QoL. Results were expressed as cost/OS and value and corrected scores. Results: Abiraterone at $5,000 per month x 6 months demonstrated cost/OS of $256 with 66% value and 61% corrected scores. Abiraterone x 9-12 months raised cost/OS and decreased scores. Generic docetaxel x 8 cycles demonstrated $63 cost/OS and 92% value score. Ancillary treatment increased cost/OS to $136 and decreased score to 82%. Cost/OS of cabazitaxel x 6 cycles ranged from $477- $596 with 21-36% scores. Corrections for AEs and QoL reduced scores to 6-21%. Sipuleucel-T demonstrated relatively higher cost/OS and lower scores. Conclusions: Preliminary findings would support utilization of docetaxel and abiraterone more than cabazitaxel and sipuleucel-T. The proposed methodology of cost versus value-survival could facilitate cost evaluation and budgetary planning of anticancer drugs.

Psychometric evaluation of the German version of the Life Attitude Profile–Revised (LAP-R) in prostate cancer patients

2008 ◽  
Vol 6 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Anja Mehnert ◽  
Uwe Koch
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Psychometric Evaluation ◽  
German Version ◽  
Life Threatening Illness ◽  
Confirmatory Factor ◽  
Related Quality ◽  
Health Related ◽  
Valid Instrument ◽  
Life Threatening

ABSTRACTObjective:There has been an increasing interest in the measurement of patients efforts to find meaning during the experience of a life-threatening illness. The aim of this study was to validate the German version of the Life Attitude Profile–Revised (LAP-R), a multidimensional measure of meaning and purpose.Methods:A total of 511 prostate cancer patients with an average age of 64 years filled in the questionnaire during outpatient follow up care (response rate 70%).Results:Five of the original six dimensions were replicated by exploratory and confirmatory factor analysis: Coherence, Existential Vacuum, Choice/Responsibleness, Death Acceptance, and Goal Seeking. The Purpose dimension was not replicated. Most LAP-R subscales showed good internal consistencies with Cronbach's α between .80 and .82, whereas the reliability for Existential Vacuum (α = .69) and Goal Seeking (α = .74) was less sufficient, but still acceptable. Results show significant concurrent associations between all LAP-R dimensions and measures of emotional distress, coping, and health-related quality of life; however, moderate correlations were found only for Existential Vacuum and depression, and inversely for depressive coping and the mental health subscale.Significance of research:The German LAP-R is a reliable and valid instrument that can be recommended for further use in research and clinical cancer care.

Just caring: screening needs limits

2019 ◽  
Vol 46 (4) ◽  
pp. 253-254
Author(s):  
Leonard Michael Fleck
Keyword(s):  
Prostate Cancer ◽  
Public Funding ◽  
Personal Narratives ◽  
Specific Antigen ◽  
Screening Tests ◽  
Health Care Needs ◽  
Care Needs ◽  
Democratic Deliberation ◽  
Medical Disorders ◽  
Life Threatening

This personal narrative tugs at the heart strings. However, personal narratives are not sufficient to justify public funding for any screening policy. We have to take seriously the ‘just caring’ problem. We have only limited resources to meet virtually unlimited health care needs. No doubt, screening tests often save lives. The author wants public funding for prostate-specific antigen screening for prostate cancer. However, why only prostate cancer? Numerous cancers at various stages can be screened for. Are all of them equally deserving of public funding? What about screening for a very long list of other life-threatening medical disorders? There is nothing ethically special about cancer. Where does the money come from to pay for all these screening tests? Do we reduce expensive life-prolonging care for patients in late-stage diseases? Ultimately, a balance must be struck between saving statistical lives through screening and saving identifiable lives in the intensive care unit. Achieving a just balance requires rational democratic deliberation as justification for these choices, not personal narratives.

Docetaxel-induced cardiac-respiratory arrest in a patient with chronic atrial fibrillation

2017 ◽  
Vol 24 (7) ◽  
pp. 531-536 ◽  
Author(s):  
Mostaqul Huq ◽  
Tracie M Balvanz ◽  
Scott Mambourg
Keyword(s):  
Prostate Cancer ◽  
Atrial Fibrillation ◽  
Drug Administration ◽  
Case Reports ◽  
Food And Drug Administration ◽  
Chronic Atrial Fibrillation ◽  
Respiratory Arrest ◽  
Life Threatening ◽  
Cancer Types ◽  
Hispanic Male

Docetaxel has been approved by the Food and Drug Administration for the treatment of many cancer types, including breast cancer, head and neck cancer, lung cancer, and prostate cancer. Many severe to life-threatening side effects (Grades 3–5) of docetaxel have been reported in clinical trials, case reports, and Food and Drug Administration Adverse Events Reporting System. These include anaphylactic reactions, febrile neutropenia, fluid retention, acute respiratory distress, pleural effusion, pneumonia, and peripheral neuropathy. There were fewer cardiac toxicities reported for docetaxel as compared to paclitaxel, which were less severe. In this report, we present a clinical case of docetaxel-induced cardiac-respiratory arrest in a 62-year-old Hispanic male patient with stable chronic atrial fibrillation, who has been recently diagnosed with metastatic prostate cancer. The cardiac event developed within 15 min of docetaxel infusion during the second cycle of chemotherapy despite using recommended premedication with corticosteroids.

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