Genitourinary Cancers

Over the past decade, interest has been growing in the quality of life of men with prostate cancer. Traditionally considered a group with few psychological complications, 10% to 20% of men with prostate cancer are found to have clinically significant levels of psychological distress. This article reviews the prevalence of psychiatric symptomatology among prostate cancer patients, the psychological challenges of coping with the disease, and general guidelines for treatment. [ONCOLOGY 16:1448-1467, 2002]

Pirl and Mello carefully review the current state of knowledge about the psychological complications of prostate cancer. Their discussion is worth reading, particularly by those who treat patients with the disease. To put this knowledge in context for the general reader, we should give some thought to what this review illustrates about all patients with a serious life-threatening illness.

African-American patients with advanced prostate cancer survived slightly longer than white patients, according to a multi-institutional study led by Dana-Farber Cancer Institute researchers. The findings, which were reported at the 38th annual

UPPSALA, Sweden-In a new study, radical prostatectomy reduced deaths due to prostate cancer but did not increase overall survival in men with newly diagnosed, early-stage disease. The Scandinavian Prostatic Cancer Study Group found that after a median 6.2 years of follow-up, there were no significant differences in overall survival, but patients randomized to radical prostatectomy were less likely to develop distant metastases than those randomized to watchful waiting.

ORLANDO-A new two-stage prostate cancer vaccine should be explored in a phase III study in metastatic prostate cancer patients, based on promising phase II results of an Eastern Cooperative Oncology Group trial (E7897). Howard L. Kaufman, MD, reported the results of the "prime/boost" vaccine trial at the 38th Annual Meeting of the American Society of Clinical Oncology (ASCO abstract 12).

SEATTLE-Dendreon Corporation has announced preliminary results from its analysis of its randomized, double-blind, placebo-controlled phase III study of Provenge (APC 8015) for the treatment of hormone-resistant prostate cancer. The trial of the cancer vaccine (D9901) involved 127 men with late-stage, metastatic, hormone-resistant prostate cancer, 82 of whom received Provenge, three vaccinations over a 4-week period.

The Bayer Corporation recently announced that it has teamed up with Us Too! International to offer Continuous Care, a program for advanced prostate cancer patients using the leuprolide acetate implant (Viadur). The program provides appointment reminders, education, support materials, and valuable health coupons.

ORLANDO-In clinical trials, black men with metastatic hormone-refractory prostate cancer have the same and possibly longer survival, compared with whites, according to a pooled analysis of nearly 1,000 patients in four separate randomized phase III Cancer and Leukemia Group B (CALGB) trials.

The bisphosphonate zoledronic acid (Zometa) is effective in the treatment of skeletal-related events from bone metastases in prostate cancer patients, according to data presented at the 97th annual meeting of the American Urological Association. Patients with advanced prostate cancer are at high risk for bone complications, including bone pain, pathologic fractures, need for radiation or surgery to bone, and spinal cord compression. This study marks the first time a bisphosphonate has demonstrated efficacy in the treatment of bone metastases in this patient population.

BETHESDA, Maryland-The National Cancer Institute’s Kidney/Bladder Cancer Progress Review Group has released 13 priority recommendations intended to serve as a national plan to guide research in the two diseases over the next 5 years. The recommendations cover basic and translational research, cancer control, and cancer treatment, and range from understanding the biologic mechanisms underlying the two diseases to developing innovative strategies to eradicate them.

With no clearly superior treatment for localized prostate cancer, physicians and patients would like to increase patient participation in the decision-making process. Unfortunately, physicians frequently have difficulty understanding patients’ preferences, and patients often do not have sufficient knowledge to make an informed treatment decision. Shared- decision-making tools, such as decision analyses, may increase patient participation and thereby improve physicians’ understanding of their patients’ views.

Normal and hyperplastic prostate glandular epithelium does not express somatostatin receptors. Neuroendocrine prostatic cells contain bioactive secretory products such as chromogranin A, serotonin, and neuron-specific enolase. The stromal smooth muscle cells around glandular epithelium and ganglion cells of the prostatic plexus are positive for somatostatin subtype 2 receptors (sst 2).[1] In prostate cancer, however, there is nonhomogeneous distribution of sst 1. In the peritumoral veins of prostate cancer, sst 2 receptors were found by Reubi et al in 14 of 27 samples.[2]

This second installment on prostate specific antigen (PSA) as a marker of disease activity and cancer cell viability in prostate cancer focuses on its role in monitoring the effects of a variety of therapies at different stages of the disease. In addition, the authors propose guidelines for studying the efficacy of new treatments in this setting.

As a tumor marker, prostate specific antigen (PSA) has revolutionized the detection and management of adenocarcinoma of the prostate. From its discovery in the early 1970s to its application in the 1980s and finally widespread use in the 1990s, PSA has profoundly affected the way in which we treat prostate cancer. Many researchers in basic science and clinical practice have helped to create the PSA story, and the authors of this manuscript have made major contributions to our understanding of PSA as a tumor marker.

Despite the impact of prostate-specific antigen (PSA) testing on the detection and management of prostate cancer, controversy about its usefulness as a marker of disease activity continues. This review, based on a

NEWTON, Mass-Matritech Inc. has received clearance from the US Food and Drug Administration to market NMP22 BladderChek for monitoring patients with a history of bladder cancer.

The patient, L.E., is a 72-year-old white male who has been under our care for 10 years. He initially presented to our clinic in 1992, with a diagnosis of localized prostate cancer.

ORLANDO-In patients with hormone-refractory, metastatic prostate cancer, an allogeneic vaccine delays progression of disease and prolongs survival, according to data presented at the 38th Annual Meeting of the American Society of Clinical Oncology (abstract 729).

The results of a phase III multicenter trial presented at the 38th annual meeting of the American Society of Clinical Oncology showed for the first time that chemotherapy can improve the survival of patients with advanced hormone-refractory prostate cancer. For the study, researchers compared the effects of vinblastine alone vs vinblastine combined with estramustine (Emcyt).

WASHINGTON-The incidence of testicular cancer, which predominantly targets young men aged 15 to 35, has nearly doubled in the past 70 years and continues to increase. Few in the vulnerable age group, however, are aware of the simple

The authors present an excellent review of prostate-specific antigen (PSA), bringing us up to date on the large body of information that has been collected since this marker came into clinical use in the mid-1980s. It is hard to believe that we have had this tool for nearly 20 years. Much has been learned.

This is a well-written and timely review of a topic that has recently become both complex to urologists and confusing to nonurologists. The authors discuss the physiology of prostate-specific antigen (PSA) and its role in a variety of clinical situations, highlighting the areas of proven utility and identifying areas of controversy.

Despite the impact of prostate-specific antigen (PSA) testing on the detection and management of prostate cancer, controversy about its usefulness as a marker of disease activity continues. This review, based on a

NEW YORK-Eligard 7.5 mg (leuprolide acetate for injectable suspension) is now commercially available for the palliative treatment of advanced prostate cancer, Sanofi-Synthelabo Inc. announced in a news release. The new formulation of the

PRINCETON, New Jersey-Cytogen Corporation’s ProstaScint (capromab pendetide) is being evaluated in a phase I/II clinical study for its utility in helping guide intensity modulated radiation therapy (IMRT) for prostate cancer.

Sanofi-Synthelabo announced the commercial availability of Eligard (leuprolide acetate, 7.5 mg) for the palliative treatment of advanced prostate cancer at the 2002 annual meeting of the American Urological Association. Recommended in the prostate

Prostate cancer represents the most common neoplasm and second leading cause of cancer mortality among men in the United States. There are 189,000 new cases of prostate cancer and 32,000 deaths resulting from prostate cancer expected in 2002.[1]

A study conducted by researchers at Duke University and Johns Hopkins Medical Centers and published in the journal Cancer (94:987-996) found that the use of indium-111-capromab pendetide (ProstaScint), a radiolabeled monoclonal antibody imaging agent, allowed identification of recurrent prostate cancer earlier than conventional imaging methods, such as the computed tomography (CT) scan. Prostate cancer recurs in nearly 40% of patients, and about 11% are at high risk for metastatic spread of the disease. Conventional imaging methods are often only able to detect a more advanced stage of prostate cancer.

NEW YORK-The final report of a phase II study suggests that the early addition of 13-cis-retinoic acid (isotretinoin, Acutane) to hormone therapy may enhance PSA responses in advanced androgen-dependent prostate cancer. Anna C. Ferrari, MD, of Mt. Sinai School of Medicine, New York, presented the results at the Chemotherapy Foundation Symposium XIX (abstract 58).

Docetaxel (Taxotere)-based regimens can be included among the most effective treatment options for the management of patients with advanced, androgen-independent prostate cancer. Results with docetaxel as a single agent and in combination regimens with estramustine (Emcyt) have consistently achieved a palliative response, reduced serum PSA levels by 50% or more, and produced objective responses in patients with measurable disease. In addition, encouraging survival data have been demonstrated in several phase II trials.