Prostate brachytherapy: the impact of smoking on recurrence and overall survival of localized prostate cancer

Brachytherapy has been shown to be an efficacious and cost-effective treatment among patients with localized prostate cancer. In this study, we examined the effects of smoking on prostate cancer recurrence and mortality in patients undergoing brachytherapy for locally advanced prostate cancer. The study population consisted of 405 patients with an average age of 73.4 years. Smoking history included 88 (21.7%) patients with no history of smoking, 108(26.6%) patients with one to twenty pack-years, and 209 (51.7%) patients with twenty-one or more pack-years. The impact of smoking history on OS relative to nonsmokers was hazards ratio 1.39 (CI: 0.81-2.64; P<0.05). In conclusion, the era of brachytherapy dose and treatment intensification strategies to improve upon prostate cancer outcomes, our study showed that smoking increases the risk of cancer recurrence and mortality. Patients who have smoked a higher number of pack-years are at increased risk of recurrence and mortality compared to those who smoked less.

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Rapidly Shifting Concepts Regarding Androgens and Prostate Cancer

The Scientific World JOURNAL ◽

10.1100/tsw.2009.80 ◽

2009 ◽

Vol 9 ◽

pp. 685-690 ◽

Cited By ~ 8

Author(s):

Abraham Morgentaler

Keyword(s):

Prostate Cancer ◽

Cancer Recurrence ◽

Serum Testosterone ◽

High Serum ◽

Prior History ◽

Minimal Risk ◽

Increased Risk ◽

History Of ◽

Dramatic Shift ◽

Risk Of Cancer

There has been a recent dramatic shift in our understanding of the relationship between androgens and prostate cancer (PCa). Whereas for several decades it had been assumed that higher serum testosterone (T) concentrations would lead to ever-greater PCa growth, current literature indicates that PCa growth is unaffected by changes in serum T throughout most of the naturally occurring range. A Saturation Model has been proposed to explain how prostate tissue can be exquisitely sensitive to changes in serum T at the very low end of the concentration range, but appears indifferent to such changes above the near-castrate range. This has special applicability to T-deficient men, since this means that T therapy may not be nearly as risky as once assumed. Indeed, one of the more interesting changes over the last several years has been the growing acceptance of the use of T therapy in men with a prior history of PCa, with early data indicating minimal risk of cancer recurrence or progression. Provocative new evidence suggests that it is not high serum T that is problematic for PCa, butlowserum T that is associated with worrisome cancer features and outcomes, such as high Gleason score, advanced stage of presentation, and increased risk of biochemical recurrence after surgery. It will be interesting to see what changes will occur in this rapidly changing field over the next several years.

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High Expression of Somatostatin Receptors and Messenger Ribonucleic Acid for Its Receptor Subtypes in Organ-Confined and Locally Advanced Human Prostate Cancers1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.7.6698 ◽

2000 ◽

Vol 85 (7) ◽

pp. 2564-2571

Author(s):

Gabor Halmos ◽

Andrew V. Schally ◽

Baodong Sun ◽

Rodney Davis ◽

David G. Bostwick ◽

...

Keyword(s):

Prostate Cancer ◽

High Risk ◽

Radical Prostatectomy ◽

Adjuvant Treatment ◽

Binding Sites ◽

Locally Advanced ◽

Cancer Recurrence ◽

Messenger Ribonucleic Acid ◽

Prostate Cancers ◽

Risk Of Cancer

To evaluate the potential application of somatostatin (SST) analogs as an adjuvant treatment for prostate cancer, we characterized the binding sites for SST octapeptide analogs on prostate cancers in patients treated with radical prostatectomy. The affinity and density of binding sites for SST analog RC-160 on 80 surgical specimens of prostate cancers were determined by ligand competition assays. The expression of messenger ribonucleic acid (mRNA) for SST receptor subtype 1 (SSTR1), subtype 2 (SSTR2), and subtype 5 (SSTR5) was also investigated in 22 samples by RT-PCR. Fifty-two of 80 specimens (65%), showed a single class of specific binding sites for RC-160 with a mean dissociation constant (Kd) of 9.44 nmol/L and a mean maximal binding capacity of 754.8 fmol/mg membrane protein. The mRNA for SSTR1 was detected in 86% of samples, whereas the incidences of mRNA for SSTR2 and SSTR5 were 14% and 64%, respectively. The expression of SSTR2 and/or SSTR5 was 100%, consistent with the presence of RC-160 binding. In patients at high risk of cancer recurrence (stage pT3 and/or Gleason score of 8–10), the incidence of RC-160 binding (65.7%) was similar to that observed in the low risk group (64.3%). The demonstration of the high incidence of octapeptide-preferring SSTRs in organ-confined and locally advanced prostate cancers supports the merit of further investigations of the application of SST analogs and their radionuclide and cytotoxic derivatives for adjuvant treatment of patients at high risk of cancer recurrence after radical prostatectomy. Such approaches could be also considered for patients with advanced prostate cancer at the time of relapse.

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The impact of pathologic review by central pathologist on selection for treatment modality of localized prostate cancer in candidate for brachytherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.213 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 213-213

Author(s):

R. Kishimoto ◽

T. Saika ◽

K. Bekku ◽

H. Nose ◽

F. Abarzua ◽

...

Keyword(s):

Prostate Cancer ◽

Treatment Modality ◽

Local Community ◽

Treatment Decision ◽

Localized Prostate Cancer ◽

Prostate Brachytherapy ◽

Gleason Grade ◽

Final Treatment ◽

Pathological Review ◽

The Impact

213 Background: To evaluate the impact of pathological review by pathologist with genitourinary expertise (PGU) on treatment modality of localized prostate cancer, we analyzed migration of Gleason grade (GG), and final treatment decision in a cohort of patients who were candidate of permanent prostate brachytherapy (PPB). Methods: From February 2005 to July 2010, a total of 247 patients with localized prostate cancer diagnosed by local community hospital were referred to our hospital for PPB, and all pathological slides of the prostate biopsy were reviewed by single PGU. The patient finally selected their treatment modality based on our recommendation made by reference to the pathological review. Our indication of PPB, basically, is a patient classified good or intermediate risk by NCCN classification. In addition, a patient with primary GS 4 was regarded as unadapted case. Results: Six cases were reinterpreted as no cancer (2.4%), and GG change occurred in 95 cases (38.4%). GG was upgraded in 77 cases (31.2%), and downgraded in 18 cases (7.3%). As a result, a total of 86 patients changed their therapies, and 25 of 86 patients (29%) were changed their therapy based on the pathological review. Conclusions: Approximately 10% of patients were changed to proper therapies by PPB's pathological review. This study shows pathological review for biopsy specimen is mandatory for determination of treatment modality, especially in candidate for PPB. No significant financial relationships to disclose.

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Fifteen-year survival and recurrence rates after radiotherapy for localized prostate cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1997.15.10.3214 ◽

1997 ◽

Vol 15 (10) ◽

pp. 3214-3222 ◽

Cited By ~ 26

Author(s):

J A Eastham ◽

M W Kattan ◽

S Groshen ◽

P T Scardino ◽

E Rogers ◽

...

Keyword(s):

Prostate Cancer ◽

Mortality Rate ◽

Clinical Stage ◽

Localized Prostate Cancer ◽

Cancer Death ◽

Recurrence Rates ◽

External Beam Irradiation ◽

Local Progression ◽

Increased Risk ◽

Risk Of Cancer

PURPOSE To determine 15-year survival and recurrence rates after radiotherapy for localized prostate cancer. METHODS One hundred thirty-six patients with clinically localized prostate cancer treated from 1966 to 1974 with interstitial gold seed and external-beam irradiation were evaluated to determine the probability of recurrence and survival > or = 15 years after therapy. All patients were surgically staged with pelvic lymphadenectomy and none received hormonal therapy before relapse. RESULTS Overall, 60 patients (44%) have never recurred, although 57% (34 of 60) of these same patients have died of causes other than prostate cancer. Local progression developed in 39% of patients and distant metastases in 42%. At 15 years, the probability of dying of prostate cancer was 33%+/-8% (% +/- 2SE) and of all causes was 72%+/-8%. In clinical stage A2 and B, 29%+/-9% of patients died of their cancer within 15 years, compared with 57%+/-21% in stage C1, while only 18%+/-8% with clinical stage A2 and B and negative lymph nodes died of cancer within this period. In contrast, the prostate cancer mortality rate at 15 years was high for patients with positive nodes regardless of the stage of the primary tumor (73% for A2 and B; 71% for C1). Patients with nodal metastases, poorly differentiated tumors, and advanced local disease all had a significantly (P < .0001) increased risk of cancer death. CONCLUSION The cancer-specific mortality rate for patients with stage A2 and B tumors and negative nodes compares favorably with other series of patients treated with radiation therapy and > or = 15 years' follow-up evaluation. While local progression rates are high and associated with a substantial risk of prostate cancer death, many patients live with the disease and ultimately die of causes other than prostate cancer.

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A randomized trial of a clinic-based weight loss intervention in cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.167 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 167-167

Author(s):

Rachel Lynn Yung ◽

Anita Giobbie-Hurder ◽

Laura Shockro ◽

Keelin O'Connor ◽

Nancy Campbell ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Cancer Survivors ◽

Physical Functioning ◽

Intervention Group ◽

Cancer Recurrence ◽

Weight Loss Intervention ◽

Increased Risk ◽

Risk Of Cancer ◽

The Impact

167 Background: Evidence increasingly links obesity to increased risk of cancer recurrence and mortality in breast and other cancers, but few studies have evaluated weight loss interventions in cancer patients. We evaluated the impact of a group-based weight loss intervention implemented through an oncology clinic on weight and other outcomes in a mixed population of cancer survivors. Methods: Overweight and obese cancer survivors were randomized 1:1 to immediate or delayed participation in a 15-week group-based weight loss program focused on calorie restriction and increased physical activity. Weight, body composition, physical activity, fitness and quality of life were assessed at baseline and 15 weeks. Changes in measurements between baseline and 15 weeks were compared using Wilcoxon rank sum tests. The primary outcome was change in weight between baseline and 15 weeks between groups. Results: 60 participants were randomized; 30 to intervention and 30 to control. Median age was 52, average BMI was 31.8 kg/m2, 97% of participants were women, and 80% had breast cancer. Intervention participants lost 5.3% of baseline weight at 15 weeks vs 0.2% weight gain in controls (P < 0.001) (Table). Improvements in fitness (6-minute walk test) and physical functioning (EORTC QLQ C30) were also observed in the intervention group vs. controls. Conclusions: We found thatparticipation in a 15-week group-based intervention resulted in weight loss and improvements in fitness and physical functioning in overweight and obese cancer survivors. More work is needed to evaluate the feasibility and sustainability of weight loss programs implemented through oncology practices. Clinical trial information: NCT01978899. [Table: see text]

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The role of genetic polymorphisms in endolysosomal ion channels TPC2 and P2RX4 in cancer pathogenesis, prognosis, and diagnosis: a genetic association in the UK Biobank

npj Genomic Medicine ◽

10.1038/s41525-021-00221-9 ◽

2021 ◽

Vol 6 (1) ◽

Author(s):

Abeer F. Alharbi ◽

John Parrington

Keyword(s):

Prostate Cancer ◽

Ion Channels ◽

Genetic Variants ◽

Cancer Recurrence ◽

Malignant Neoplasms ◽

Uk Biobank ◽

Cancer Subtypes ◽

Increased Risk ◽

The Uk ◽

Risk Of Cancer

AbstractRecent studies have implicated important roles for endolysosomal ion channels in cancer biology. We used UK Biobank data to characterise the relationships between genetic variants in two genes coding for endolysosomal ion channels—i.e. TPCN2 and P2RX4—and cancer in terms of the definition of tumour types, susceptibility, and prognosis. We investigated these relationships at both global and local levels with regard to specific types of cancer, including malignant neoplasms of the brain, breast, bronchus, lung, colon, lymphoid and haematopoietic systems, skin, ovary, prostate, rectum, thyroid gland, lip, oral cavity, pharynx, and urinary tract. Apart from rs3829241 (p value < 0.05), all the genetic variants were in Hardy–Weinberg equilibrium. We included 468,436 subjects in the analysis and stratified them into two major cohorts: cancer-free controls (385,253) and cancer cases (83,183). For the first time, we report novel associations between genetic variants of TPCN2 and P2RX4 and cancer/cancer subtypes in the UK Biobank’s population. Genotype GG in TPCN2 rs3750965 was significantly associated with a decreased risk of cancer and an increased risk of lip, oral cavity, and pharynx cancer and cancer recurrence in patients with prostate cancer, and genotypes GA/GG were associated with a significantly lower risk of developing various malignant neoplasms (involving melanoma, prostate, mesothelial, and soft tissues). rs35264875:TA was associated with a high risk of cancer at the global level, with subtypes of cancer at the local level (including breast, colon, prostate, and stated or presumed primary cancer of lymphoid, haematopoietic, and related tissue), and with a significantly low risk of cancer metastasis. rs72932540:GA was associated with a higher incidence of cancer/cancer subtypes (including breast, melanoma, and rectal cancer), and genotypes GA/GG were associated with an increased risk of prostate cancer. The P2RX4 rs25644 allele GG was associated with a high risk of prostate cancer, whereas it was associated with a low risk of cancer recurrence in patients with prostate cancer. Genotypes GA/GG in rs28360472 were associated with an increased risk of breast, mesothelial, and soft tissue cancers but with a decreased risk of colon cancer. We also provide insights into the pathophysiological contributions made by these significant polymorphisms to cancer/cancer subtypes and their effects on expression or channel activity. Further investigations of these genetic variants could help identify novel cancer biomarkers and facilitate the development of new diagnostic and therapeutic strategies. This would constitute a further step towards personalised cancer care.

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