scholarly journals Prostate Cancer Management During the COVID-19 Pandemic

2020 ◽  
Vol 5 (S1) ◽  
pp. 231-233
Author(s):  
Kunhi Parambath Haresh ◽  
Yousra Izzudeen ◽  
Devangana Bora ◽  
Subhash Gupta ◽  
Goura Kishor Rath

The COVID-19 pandemic has derailed the management of many cancers. Prostate cancer although a disease known for good response to treatment has posed unique challenges in this pandemic in view of the co-morbidities associated with these elderly patients. A pandemic specific treatment approach following the RADS (Remote, Avoid, Defer, Shorten) principle is required while dealing with these patients. Very low, low and favourable intermediate risk cancers may be kept on active surveillance rather than active treatment. Unfavourable intermediate, high and very high risk cases may follow the ‘defer’ policy by initiating hormonal therapy for 6-8 months to defer radiotherapy. When radiation is planned for these patients extreme or moderate hypo fractionation may be used to follow the ‘shorten’ policy. Metastatic hormone sensitive cancers may be initiated on hormonal therapy avoiding antiandrogens like Abiraterone and chemotherapy upfront. In the castration resistant phase the antiandrogens like Abiraterone or Enzalutamide may be given preference over chemotherapy. In the post operative settings early salvage may be preferred over adjuvant that too, using hypofractionation. Symptomatic patients require prompt attention and radiation should not be delayed for palliation of impending spinal compression or fracture or for local symptoms. Aggressive histologies like small cell types also need prompt treatment. Other general measures like universal masking, hand hygiene, physical distancing, respiratory etiquettes, etc., must also be emphasised keeping in mind the vulnerability of these patients.

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaoyu Hou ◽  
Thomas W. Flaig

Prostate cancer is the most common cancer among men in the United States. For decades, the cornerstone of medical treatment for advanced prostate cancer has been hormonal therapy, intended to lower testosterone levels, known as Androgen Deprivation Therapy (ADT). The development of hormone-resistant prostate cancer (now termed castration-resistant prostate cancer:CRPC) remains the key roadblock in successful long-term management of prostate cancer. New advancements in medical therapy for prostate cancer have added to the hormonal therapy armamentarium. These new therapeutic agents not only provide a survival benefit but also show potential for reversing hormonal resistance in metastatic CRPC, and thus redefining hormonally sensitive disease.


1970 ◽  
Vol 16 (1) ◽  
Author(s):  
Endi Prilansa Mahadi ◽  
Suharto Widjanarko

Objective: To describe the prostate cancer management in Dr. Moewardi Hospital Surakarta on  January 2000 – December 2006. Materials & Methods: This study is a retrospective descriptive. The data was collected from Dr. Moewardi Hospital Surakarta’s medical record in seven years, from January 2000 to December 2006. Results: We found that thirty patients with prostate cancer with age above 50 years and mostly found on age 71 – 75 years (23,3%). The most common complain that can be found are LUTS (76,7%). Malignancies was found on digital rectal examination on 76,7% patients. About 28 patients with PSA level > 4ng. Most of the patients (20/66,7%) comes with T2 stadium and seven of them (23,3%) with metastize to the pelvic bone. All of the patient was administered with TUR-P, 7 patients with metastize administered to orchidectomy and hormonal therapy (23,3%), and only one of them continued with radiotheraphy. All of the prostate materials that analyze on pathyologic examination are adenocarcinoma of the prostate with 50% speciments are poorly differentiated. Conclusion: From thirty patients diagnozed with prostate cancer, most of them was found between 71 – 75 years old. The common complain are urinary retention, LUTS and pelvic bone metastize. The pathologic examination we shows all of the speciments are adenocarcinoma of the prostate and they are poorly differentiated.


2018 ◽  
Vol 18 (9) ◽  
pp. 869-876
Author(s):  
Samanta Salvi ◽  
Vincenza Conteduca ◽  
Cristian Lolli ◽  
Sara Testoni ◽  
Valentina Casadio ◽  
...  

Background: Adaptive upregulation of Androgen Receptor (AR) is the most common event involved in the progression from hormone sensitive to Castration-Resistant Prostate Cancer (CRPC). AR signaling remains the main target of new AR signalling-directed therapies such as abiraterone and enzalutamide in CRPC patients. Objective: In this review, we discuss general mechanisms of resistance to AR-targeted therapies, with a focus on the role of AR Copy Number (CN). We reported methods and clinical applications of AR CN evaluation in tissue and liquid biopsy, thus to have a complete information regarding its role as predictive and prognostic biomarker. Conclusion: Outcomes of CRPC patients are reported to be highly variable as the consequence of tumor heterogeneity. AR CN could contribute to patient selection and tumor monitoring in CRPC treated with new anti-cancer treatment as abiraterone and enzalutamide. Further studies to investigate AR CN effect to these agents and its potential combination with other prognostic or predictive clinical factors are necessary in the context of harmonized clinical trial design.


Sign in / Sign up

Export Citation Format

Share Document