Prostate Cancer

2011 ◽  
Author(s):  
Jonathan E. Rosenberg ◽  
Philip W Kantoff
Keyword(s):  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The United States ◽  
Incidence Rates ◽  
Clinical Staging ◽  
Specific Cancer ◽  
History Of ◽  
Cancer Of The Prostate

Prostate cancer is the most commonly diagnosed noncutaneous malignancy in men in the United States. This chapter discusses the epidemiology, pathogenesis, and diagnosis of prostate cancer, as well as risk factors, the use of digital rectal examination and prostate-specific antigen measurement for screening, and staging for the disease. Also reviewed are the natural history of untreated prostate cancer; the treatment of localized and advanced prostate cancer, including prostatectomy, radiation therapy, and androgen deprivation therapy; and the prevention of prostate cancer. Figures illustrate the incidence rates of prostate cancer by race, age-adjusted and/or age-specific cancer of the prostate, the risk of a diagnosis in 20 years (based on being cancer free at certain ages), the 5-year survival rate, and the overall survival in patients with early prostate cancer treated with observation or radical prostatectomy. Tables in this chapter review the clinical staging definitions and the combined-modality staging approach to prostate cancer. This chapter contains 116 references.

Prostate Cancer

2011 ◽  
Author(s):  
Jonathan E. Rosenberg ◽  
Philip W Kantoff
Keyword(s):  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The United States ◽  
Incidence Rates ◽  
Clinical Staging ◽  
Specific Cancer ◽  
History Of ◽  
Cancer Of The Prostate

Prostate cancer is the most commonly diagnosed noncutaneous malignancy in men in the United States. This chapter discusses the epidemiology, pathogenesis, and diagnosis of prostate cancer, as well as risk factors, the use of digital rectal examination and prostate-specific antigen measurement for screening, and staging for the disease. Also reviewed are the natural history of untreated prostate cancer; the treatment of localized and advanced prostate cancer, including prostatectomy, radiation therapy, and androgen deprivation therapy; and the prevention of prostate cancer. Figures illustrate the incidence rates of prostate cancer by race, age-adjusted and/or age-specific cancer of the prostate, the risk of a diagnosis in 20 years (based on being cancer free at certain ages), the 5-year survival rate, and the overall survival in patients with early prostate cancer treated with observation or radical prostatectomy. Tables in this chapter review the clinical staging definitions and the combined-modality staging approach to prostate cancer. This chapter contains 116 references.

scholarly journals Apalutamide: a better option for the treatment of non-metastatic castration resistant prostatic carcinoma

2018 ◽  
Vol 7 (9) ◽  
pp. 1853 ◽  
Author(s):  
Raushan Kumar Ranjan ◽  
Akash Chandra
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The Body ◽  
Blood Levels ◽  
Gnrh Analogue ◽  
Castration Resistant Prostate Cancer ◽  
Reductase Inhibitors ◽  
Castration Resistant ◽  
Cancer Of The Prostate

Prostate cancer is cancer of the prostate, a gland in the male reproductive system. Most prostate cancers are slow growing; however, some grow relatively quickly. The cancer cells may spread from the prostate to other area of the body, particularly the bones and lymph nodes. Factors that increase the risk of prostate cancer include older age, a family history of the disease, and race. About 99% of cases occur in males over the age of 50. Clinical features include hematuria, dysuria (painful urination),nocturia(urination at night). Lower blood levels of vitami D may increase the risk of developing prostate cancer. Infection with the sexually transmitted diseases, chlamydia, gonorrhea, syphilis and prostatitis seem to increase risk of prostate cancer. Diagnosis can be confirmed by digital rectal examination (DRE) with prostate-specific antigen (PSA) blood test, cystoscopy, transrectal ultrasonography and biopsy (The removal of small pieces of the prostate for microscopic examination). Medicines like 5-alpha-reductase inhibitors (finasteride and dutasteride) reduce the overall risk of prostate cancer. Apalutamide, sold under the brand name Erleada, is a nonsteroidal antiandrogen (NSAA) medication which is used in the treatment of prostate cancer. It is specifically indicated for use in conjunction with castration in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC). It is taken by mouth. Apalutamide was first described in 2007 and was approved for the treatment of prostate cancer in February 2018. Apalutamide is used in conjunction with castration, either via bilateral orchiectomy or gonadotropin-releasing hormone analogue (GnRH analogue) therapy, as a method of androgen deprivation therapy in the treatment of non-metastatic castration-resistant prostate cancer (NM-CRPC).

scholarly journals Screening digital rectal examination and prostate cancer mortality: a case-control study

1998 ◽  
Vol 5 (2) ◽  
pp. 99-103 ◽  
Author(s):  
K E Richert-Boe ◽  
L L Humphrey ◽  
A G Glass ◽  
N S Weiss
Keyword(s):  
Prostate Cancer ◽  
Case Control Study ◽  
Digital Rectal Examination ◽  
The United States ◽  
Case Control ◽  
Similar Proportion ◽  
Health Maintenance ◽  
Rectal Examination ◽  
History Of ◽  
Control Study

Background Prostate cancer is the second most common cause of death from cancer in men in the United States. Digital rectal examination is the oldest and most commonly used screening test for prostate cancer, but as yet there are no studies which demonstrate its effectiveness. Methods A case-control study was conducted among members of a large health maintenance organisation to estimate the effect of screening digital rectal examination on mortality from prostate cancer. 150 men, aged 40–84 when cancer was diagnosed, who developed fatal prostate cancer, and 299 male controls matched for age who did not die from prostate cancer were studied. A history of screening digital rectal examination during the 10 years before the date on which cancer was diagnosed was determined from medical records. Results A similar proportion of men who died from prostate cancer and controls had undergone at least one screening digital rectal examination during the 10 year interval (odds ratio = 0.84, 95% confidence interval 0.48 to 1.46). Similar results were obtained when a shorter interval (such as five years before diagnosis) during which screening histories were evaluated was considered, or in analyses in which men with a history of benign prostatic hypertrophy were excluded. Conclusions The data suggest that screening digital rectal examination does not reduce mortality from prostate cancer to any appreciable degree.

The change in prostate cancer presentation and diagnosis coinciding with screening recommendations.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 95-95 ◽  
Author(s):  
Franklin Gaylis ◽  
Jae Choi ◽  
Paul Dato ◽  
Edward Cohen ◽  
Renee Calabrese ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Task Force ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The United States ◽  
Volume Number ◽  
Post Hoc Analysis ◽  
Gleason Grading ◽  
Bonferroni Adjustment ◽  
Post Hoc

95 Background: The controversy surrounding prostate cancer (PCa) screening resulted in the United States Preventative Services Task Force (USPSTF) and several primary care societies to recommend against this practice. We examined the characteristics of men evaluated in a large urology practice for an elevated prostate specific antigen (PSA) and the subsequent PCa diagnoses since the USPTF recommendation. Methods: Characteristics of all men presenting for an elevated PSA from August 2011 to August 2014 were prospectively collected in a database. Age at the time of biopsy, self-declared race, insurance status, family history, digital rectal examination findings, PSA within 6 months of biopsy, biopsy history, prostate volume, number of cores sampled, pathologic read (number and percent cores positive, Gleason grading) were all recorded. Kruskall-Wallis rank sum tests were used to compare across all years with post-hoc Dunn’s tests for pairwise multiple comparisons using Bonferroni adjustment. Results: The number of men referred for elevated PSA dropped from 933 in year 1 to 754 by year 3 (19%) with a concomitant drop in the number of biopsies performed in newly referred men from 461 to 370 (20%). The group’s prostate biopsy volume decreased by 15% (1,133 biopsies in year 1 compared to 958 in year 3). Median pre-biopsy PSA increased across all years from 7.0 ng/ml to 8.1 ng/ml (p = 0.0006) with a rise in the proportion of men having PSAs > 10 from 28% to 38%. In the post-hoc analysis, median pre-biopsy PSA was significantly different between years 1 and 3 (p = 0.0002) and years 2 and 3 (p = 0.017) but not years 1 and 2 (p = 0.33). The biopsy positivity rate increased slightly from 46% to 50% across all years with a rise in the proportion of men having Gleason scores (GS) ≥ 8 from 21% to 30% (p = 0.0001). In the post-hoc analysis, median GS was significantly different between year 1 and year 3 (p < 0.0001) and year 2 to year 3 (p = 0.0004) but not year 1 to year 2 (p = 0.12). Conclusions: Our findings suggest a significant grade migration coincident with recommendations against PSA screening. While possibly desirable in the short term, should this trend continue we may miss the window of curability for many men.

scholarly journals Modalities for Imaging of Prostate Cancer

2009 ◽  
Vol 2009 ◽  
pp. 1-12 ◽  
Author(s):  
A. H. Hou ◽  
D. Swanson ◽  
A. B. Barqawi
Keyword(s):  
Prostate Cancer ◽  
Imaging Techniques ◽  
Specific Antigen ◽  
Rapid Evolution ◽  
Digital Rectal Examination ◽  
The United States ◽  
Molecular Data ◽  
Superparamagnetic Nanoparticles ◽  
Lower Grade ◽  
Radionuclide Scintigraphy

Prostate cancer is the second most common cause of cancer deaths among males in the United States. Prostate screening by digital rectal examination and prostate-specific antigen has shifted the diagnosis of prostate cancer to lower grade, organ confined disease, adding to overdetection and overtreatment of prostate cancer. The new challenge is in differentiating clinically relevant tumors from ones that may otherwise never have become evident if not for screening. The rapid evolution of imaging modalities and the synthesis of anatomic, functional, and molecular data allow for improved detection and characterization of prostate cancer. However, the appropriate use of imaging is difficult to define, as many controversial studies regarding each of the modalities and their utilities can be found in the literature. Clinical practice patterns have been slow to adopt many of these advances as a result. This review discusses the more established imaging techniques, including Ultrasonography, Magnetic Resonance Imaging, MR Spectroscopy, Computed Tomography, and Positron Emission Tomography. We also review several promising techniques on the horizon, including Dynamic Contrast-Enhanced MRI, Diffuse-Weighted Imaging, Superparamagnetic Nanoparticles, and Radionuclide Scintigraphy.

scholarly journals Prostate-specific Antigen Screening and Recent Increases in Advanced Prostate Cancer

2020 ◽  
Author(s):  
Yaw A Nyame ◽  
Roman Gulati ◽  
Alex Tsodikov ◽  
John L Gore ◽  
Ruth Etzioni
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Prostate Specific Antigen ◽  
Advanced Prostate Cancer ◽  
Metastatic Prostate Cancer ◽  
Specific Antigen ◽  
The United States ◽  
Models Of Disease ◽  
Screening And Diagnosis

Abstract Recent studies show decreasing prostate-specific antigen utilization and increasing incidence of metastatic prostate cancer in the United States after national recommendations against screening in 2012. Yet whether the increasing incidence of metastatic prostate cancer is consistent in magnitude with the expected impact of decreased screening is unknown. We compared observed incidence of metastatic prostate cancer from the Surveillance, Epidemiology, and End Results program and published effects of continued historical screening and discontinued screening starting in 2013 projected by two models of disease natural history, screening, and diagnosis. The observed rate of new metastatic prostate cancer cases in 2017 was 44%-60% of the projected increase under discontinued screening relative to continued screening. Thus, the observed increase in incident metastatic prostate cancer is consistent with the expected impact of reduced screening. Although this comparison does not establish a causal relationship, it highlights the plausible role of decreased screening in the observed trend.

scholarly journals Screening for prostate cancer: How to manage in 2006

2005 ◽  
Vol 52 (4) ◽  
pp. 19-21 ◽  
Author(s):  
B. Lobel
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Prostate Biopsy ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Rectal Biopsy ◽  
High Risk Population ◽  
Major Question ◽  
Prostate Cancer Prevention ◽  
History Of

National Societies usually recommend screening for Prostate Cancer (PC) with Serum Prostate Specific Antigen (PSA) and digital rectal examination annually beginning at age 50. In high risk population including men with a family history of PC or African population screening should start at age of 45 years. PSA has been widely used to detect PC despite the fact that PSA is not specific for PC. Over the years serum PSA level of greater than 4,0ng/ml was considered the threshold to perform prostate biopsy, searching for PC. In 2005 the Prostate Cancer Prevention Trial (PCPT) demonstrated that the cut-off of 4,0ng/ml for PSA is not anymore adapted1 due to the fact that this survey found in 15% of men with PSA < or = 4,0ng/ml a prostate cancer on sextant biopsies. Today the value of PSA and the cut-off for Prostate biopsy is questioned suggesting that PSA level higher than 2,6ng/ml must be the case to propose Prostate Biopsy. Catalona confirms that approximately 25% to 30% of men with PSA 2,6 to 4,0ng/ml have prostate cancer2. Schr?der and Gosselaar3 assert that screening for PC at low PSA levels (<4,0ng/ml) risks to detect clinically insignificant cancers which are no threat to man. So far in the year 2006 screening for PC demonstrates accumulating evidences of efficacy but persistent uncertainty4. The major question for an urologist at work when facing a young men searching early diagnosis of PC is: at which level of PSA do we have to perform rectal biopsy ?.

scholarly journals The Role and Significance of Bioumoral Markers in Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5932
Author(s):  
Traian Constantin ◽  
Diana Alexandra Savu ◽  
Ștefana Bucur ◽  
Gabriel Predoiu ◽  
Maria Magdalena Constantin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Blood Test ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The United States ◽  
Screening Tests ◽  
Internal Organs ◽  
Different Types ◽  
Oncology Treatment

The prostate is one of the most clinically accessible internal organs of the genitourinary tract in men. For decades, the only method of screening for prostate cancer (PCa) has been digital rectal examination of 1990s significantly increased the incidence and prevalence of PCa and consequently the morbidity and mortality associated with this disease. In addition, the different types of oncology treatment methods have been linked to specific complications and side effects, which would affect the patient’s quality of life. In the first two decades of the 21st century, over-detection and over-treatment of PCa patients has generated enormous costs for health systems, especially in Europe and the United States. The Prostate Specific Antigen (PSA) is still the most common and accessible screening blood test for PCa, but with low sensibility and specificity at lower values (<10 ng/mL). Therefore, in order to avoid unnecessary biopsies, several screening tests (blood, urine, or genetic) have been developed. This review analyzes the most used bioumoral markers for PCa screening and also those that could predict the evolution of metastases of patients diagnosed with PCa.

scholarly journals Clinically, Radiologically and Biochemically Metastatic Cancer Prostate: Could be Treated without Biopsy? A Clinical Case Study and Review of Literature

2019 ◽  
Vol 2 (1) ◽  
pp. 20-25
Author(s):  
A Abdelmaksoud Bader ◽  
◽  
G Alruwaily Fayez ◽  
Alalem Zaki ◽  
A Dafaallah Ahmad ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Metastatic Cancer ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Clinical Case Study ◽  
Nodal Size ◽  
Mass Size

Diagnosis of prostate cancer is suspected if there are abnormalities during digital rectal examination (DRE) and/or steady rising in levels of prostate specific antigen (PSA) and the confirmative diagnosis is established by histopathological confirmation of malignancy by biopsy from the prostate. A 87 years old male not diabetic nor hypertensive or other co-morbidities was well apart from mild lower back pain associated with mild irritative urinary symptoms, diagnosed clinically (DRE), radiologically and biochemically (markedly elevated PSA level) as a case of advanced prostate cancer and started treatment without biopsy by androgen deprivation therapy with other symptomatic support. After one month of treatment and then after, general conditions of the patient started to be significantly improved, the first follow-up CT showed considerable decrease of the mass size, then total non visualization of the previous prostatic mass, with marked decrease of the lymph nodal size in subsequent follow-up, PSA level decreased markedly, dropped from ≥700 ng/mL to 6.867 ng/mL, and then continued to decrease in subsequent monthly evaluations to reach 0.212 ng/mL at the last measurement after 8 months of treatment, that mean near complete radiologic and biochemical response. Treatment of advanced prostate cancer might be started without biopsy if there is high probabilities malignancy by DRE, imaging studies and significant rising in PSA levelin exceptional cases.

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