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 Screening for Prostate Cancer: To Screen or Not To Screen? A Review of The State-of-The Art

2019 ◽  
pp. 19-24
Author(s):  
Lajos Döbrőssy
Keyword(s):  
Prostate Cancer ◽  
State Of The Art ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Conclusive Evidence ◽  
Screening Tests ◽  
Health Concern ◽  
Average Risk ◽  
Randomized Controlled ◽  
Sensitivity Specificity

Prostate cancer is a major public health concern, particularly in the welfare countries, for this reason, screening should be considered to reduce the number of deaths. Screening tests are available, i.e. digital rectal examination; trans-rectal ultrasonography and prostate specific antigen, nevertheless their sensitivity, specificity and positive predictive value are far from being perfect. Evidences from randomized screening trials are still indebted for conclusive evidence. The screening might cause more harm than good due to over diagnosis and over-treatment as a result of limited specificity of the screening tests. According to our point a view, opportunistic screening as part of diagnostics of patients having suspicion for uncertain symptoms of prostatic disorder is fully justified but mass screening of the population of average risk should not be introduced until supportive evidence from randomized controlled trials would be available.

Retrospective mathematical analysis of serial prostate specific antigen (PSA) measurements for patients with M0 prostate cancer treated with intermittent androgen suppression (IAS).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15201-e15201
Author(s):  
Celestia S. Higano ◽  
Yoshito Hirata ◽  
Koichiro Akakura ◽  
Nicholas Bruchovsky ◽  
Kazuyuki Aihara
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
The United States ◽  
Phase Iii ◽  
Similar Distribution ◽  
Castration Resistance ◽  
Group I ◽  
Intermittent Androgen Suppression ◽  
The Individual

e15201 Background: Recently a phase III trial demonstrated that IAS was non-inferior to continuous AS in men with M0 disease after primary or salvage radiation and quality of life was better in the intermittent arm (Crook ASCO 2011). In that trial, men were treated with 8 months of AS followed by a variable time off AS driven by the absolute PSA value. The Hirata mathematical model describes the dynamics of prostate cancer treated with IAS (Hirata et al, J of Theoretical Biol 2010). In the model, there are three classes of cancer cells: a class of androgen dependent (AD) cells and two classes of androgen independent (AI:X1 and AI:X2) cells. During AS, AD cells will change to the two AI classes, and during the off treatment period, AI:X1 cells will revert to AD cells whereas AI:X2 cells cannot revert to either AD or AI:X1 cells. Methods: After IRB approval, we applied the Hirata model using serial monthly PSAs from men with M0 disease treated with IAS from Japan, Canada, and the United States. The proportions of men from each country who fell into the 3 categories of patients previously defined by the Hirata model were compared. Results: Serial PSAs from 26 men from Japan, 72 from Canada, and 79 from US were put into the model. The 3 categories of patients from the model include: (i) those with disease that will remain androgen sensitive and will respond to IAS without development of castration resistance (CRPC) (ii) those who will benefit from IAS but will develop CRPC sooner than those in group (i), (iii) those for whom continuous AS is superior to IAS. The datasets from each country show a similar distribution among the categories, and overall there were 42%, 51%, and 7% falling into groups i, ii, and iii respectively. Conclusions: This retrospective analysis shows that men with M0 disease treated with IAS fall into the 3 categories predicted by the Hirata model in similar proportions, regardless of country of origin. The ability to apply this model to the individual patient in the clinic is currently under development. The model may ultimately be able to optimize both the on and off treatment durations of IAS and to predict those patients who will most benefit from this approach.

Associations between uncertainty, anxiety, and quality of life in men with favorable-risk prostate cancer on active surveillance: Two-and-a-half years' follow-up.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 135-135
Author(s):  
Patricia A. Parker ◽  
John W. Davis ◽  
David Latini ◽  
George Baum ◽  
Xuemei Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Active Surveillance ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Study Entry ◽  
Illness Uncertainty ◽  
Disease Specific

135 Background: Active surveillance (AS) has emerged as a viable option for many men with early stage prostate cancer (PC). This approach of careful monitoring with prostate-specific antigen (PSA) level, digital rectal examination, and prostate biopsy may allow men to avoid or delay the potentially debilitating side effects of such aggressive treatments as surgery or radiation; however, AS may create uncertainty and anxiety for men with PC. We examined the associations between illness uncertainty and anxiety and general and PC-specific quality of life (QOL) of 191 men with favorable-risk PC participating in the AS program at MD Anderson Cancer Center. Methods: Men completed measures of uncertainty (Mishel Uncertainty in Illness Scale), anxiety (State-Trait Anxiety Inventory), and general (SF-12, Physical Health [PCS] and Mental Health Component Score [MCS]) and disease-specific (Expanded Prostate Index Composite [EPIC]) QOL questionnaires upon study entry and every 6 months. These results are through a 2.5 year follow-up. Results: Men were primarily (86%) white and an average age of 67.2 (SD=8.9). Average baseline PSA was 3.3 ng/mL (SD=1.6), 98% had a Gleason score of 6, and 85% had cT1c disease. Both general and PC-specific QOL were relatively unchanged across the 2.5 year study period, except for statistically significant declines in the EPIC Sexual score (p<0.05). Controlling for demographic (age, ethnicity) and clinical characteristics (study entry PSA, PSA density, testosterone, BMI, baseline number of biopsies, family history of cancer, whether patients were taking a 5-alpha-reductase inhibitor, and whether the tumor was reclassified during the study), illness uncertainty was a significant predictor of all EPIC summary scores, PCS, and MCS (all, p<0.05). Anxiety was also a significant predictor of all EPIC summary scores and MCS (all, p<0.05), but not PCS (p=0.08). Conclusions: Both increased anxiety and increased illness uncertainty were associated with poorer general and disease specific QOL. Interventions that focus on reducing uncertainty and anxiety may enhance the QOL of men on AS for PC.

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.

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.

Evaluation of prostatic specific antigen and digital rectal examination as screening tests for prostate cancer

The Prostate ◽  
2000 ◽  
Vol 45 (1) ◽  
pp. 19-35 ◽  
Author(s):  
Bernard Candas ◽  
Lionel Cusan ◽  
Jose-Luis Gomez ◽  
Pierre Diamond ◽  
Raul E. Suburu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Screening Tests ◽  
Prostatic Specific Antigen ◽  
Rectal Examination

scholarly journals Prostate Cancer Screening and Determining the Appropriate Prostate-Specific Antigen Cutoff Values

2010 ◽  
Vol 8 (2) ◽  
pp. 265-270 ◽  
Author(s):  
William J. Catalona ◽  
Stacy Loeb
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Prostate Cancer Screening ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
The United States ◽  
Screening Programs ◽  
Psa Screening ◽  
Specific Mortality ◽  
Derivatives Of

Prostate-specific antigen (PSA) in combination with digital rectal examination forms the basis for current prostate cancer (CaP) screening programs. Although PSA screening was recently shown to reduce CaP-specific mortality in the European randomized trial, its limitations include the risk for unnecessary prostate biopsy and the diagnosis and treatment of some CaP that might never have caused suffering or death. A potential way to minimize these pitfalls is through the use of derivatives of PSA, particularly PSA kinetics, to increase the specificity for clinically relevant CaP. CaP is the second-leading cause of cancer death in men in the United States and many other westernized countries; accordingly, judicious screening of healthy men allows for diagnosis sufficiently early that all options (i.e., treatment or surveillance) are still available in most cases.

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