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Latest & greatest articles for prostate cancer
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and Care Excellence (NICE) guideline Prostatecancer: diagnosis and management [ ]. Radical treatments What is radical prostatectomy, and when is it appropriate treatment for prostatecancer? The aim of radical prostatectomy is to remove the entire prostate gland and eradicate the disease. It can be performed by open, laparoscopic, or robot-assisted surgery. Risks associated with radical prostatectomy include urinary incontinence, erectile dysfunction, and incomplete resection of the tumour. Complete (...) tumour removal is not always achieved, and approximately 20% of men develop biochemical or clinical recurrence of prostatecancer. Radical prostatectomy is an appropriate treatment option for: Localized prostatecancer — it can be considered in men at low prognostic risk, and is a preferred option for men at intermediate risk and those at high risk who have a realistic chance of gaining long-term control of the disease. It is not common to offer it to men older than 70 years of age. Biochemical
common types of cancer that affects men. In the United States, the lifetime risk of being diagnosed with prostatecancer is approximately 11%, and the lifetime risk of dying of prostatecancer is 2.5%. Many men with prostatecancer never experience symptoms and, without screening, would never know they have the disease. In autopsy studies of men who died of other causes, more than 20% of men aged 50 to 59 years and more than 33% of men aged 70 to 79 years were found to have prostatecancer. In some (...) . The CAP trial was a cluster-randomized trial of a single invitation to PSA-based screening in the United Kingdom among 415,357 men. Overall, 34% of invited men received a valid PSA screening test. After a median follow-up of 10 years, there was no significant difference in prostatecancer mortality between the invited group and the control group (absolute risk, 0.30 per 1000 person-years vs 0.31 per 1000 person-years, respectively). Based on clinical stage, tumor grade, and PSA level, prostatecancer
) until disease progression, unacceptable toxicity, or the completion of ten treatment cycles. Randomisation was stratified by use of opioids for prostatecancer-related pain at screening, disease progression following first-line docetaxel treatment established by radiographic evidence, and previous treatment with abiraterone or enzalutamide. The co-primary endpoints were overall survival in all randomly assigned patients and in a poor-prognosis subgroup. All analyses were intention to treat (...) Custirsen (OGX-011) combined with cabazitaxel and prednisone versus cabazitaxel and prednisone alone in patients with metastatic castration-resistant prostatecancer previously treated with docetaxel (AFFINITY): a randomised, open-label, international, ph Docetaxel and cabazitaxel improve overall survival compared with mitoxantrone in patients with metastatic castration-resistant prostatecancer. Custirsen (OGX011) is a second generation highly specific antisense oligonucleotide that inhibits
has published a white paper to provide some guidance regarding periprocedural prophylaxis. Since prostate biopsies are also an important part of some active surveillance programs, understanding these risks and communicating them to patients is not only integral to informed consent for prostatecancer screening but also for consideration of treatment options. Once diagnosed with prostatecancer, a man is faced with the risk of overtreatment of indolent disease due to the assumption that diagnosis (...) with a malignancy must necessarily result in treatment of this malignancy. Estimates of overdiagnosis vary widely from less than 5% to more than 75% depending upon the population used with lead times of 5 to 15 years. Although prostatecancer specific mortality and the need for related palliative care is decreased by screening, quality of life may be impaired as a result due to lasting impairment in urinary, bowel, and sexual function. There is considerable distress involved in the decision making process
5-year survival rate is around 100% for local- and regional-stage prostatecancer, and around 30% for distant-stage prostatecancer (based on data from 2007 to 2013). Definition A malignanttumour of glandular origin, situated in the prostate. It is most commonly seen in older men; between 2011 and 2015 the median age at diagnosis in the US was 66 years. National Cancer Institute; Surveillance, Epidemiology, and End Results program (SEER). SEER stat fact sheets: prostatecancer. 2018 [internet (...) is the principal investigator of an R-21 NIH research grant investigating the tumour-mediated immune responses in African-American men with prostatecancer. Professor Department of Radiation Oncology University of Texas MD Anderson Cancer Center Houston TX Disclosures MSA declares that he has no competing interests. Peer reviewers Clinical Oncology Registrar St Luke's Cancer Centre Royal Surrey Hospital Guildford Surrey UK Disclosures EA has received consultation fees from the following organisations during
Prostatecancer that has not been treated with ADT or that is responding to ADT is called “castration sensitive”. Over time, most cancers that were castration sensitive become castration resistant. Castration-resistant prostatecancer (CRPC) is defined as prostatecancer that progresses clinically, radiographically, or biochemically despite ADT that has achieved low (castrate) levels of serum testosterone. 6 Patients with metastatic disease by conventional imaging (e.g., CT, bone scan, MRI) who (...) inhibitors that bind to the ligand-binding domain of the androgen receptor. 10,11 Apalutamide is not FDA-approved for metastatic CRPC (mCRPC). The management of patients without metastatic disease by conventional imaging who progress on ADT (nonmetastatic castration-resistant prostatecancer; nmCRPC) has been less clear; progression typically involves increases in the biochemical marker prostate specific antigen (PSA). Until recently, such patients were most often managed with continued ADT
Post-treatment impact and needs of prostatecancer survivors in Malaysia; a qualitative study There are limited studies conducted on the needs of cancer survivors in developing countries like Malaysia. This qualitative study aimed at exploring the post-treatment impact and needs of prostatecancer survivors.A qualitative study design was used. One in-depth interview and four focus group discussions were conducted with 24 prostatecancer survivors (age range: 58-79 years) from government (...) and private hospitals in Malaysia in 2013. Trained researchers used a topic guide to guide the interviews, which were audio-recorded, transcribed verbatim, checked and managed with Nvivo 10 software. A thematic approach was used to analyse the data.Three main themes emerged from the analysis: (a) impact of prostatecancer on the survivors, (b) support needed for coping and (c) information needs. Prostatecancer has an important impact on the survivors' lifestyle after treatment. Some of them have to live
Outcomes and toxicity from a prospective study of moderately hypofractionated radiation therapy for prostatecancer The purpose of this study is to report the long-term outcomes and toxicity results of a prospective trial of moderately hypofractionated, image guided radiation therapy (RT) for localized prostate cancer.Patients were enrolled between December 2006 and February 2012. Patients in group 1 were stage T1-T2b, had a Gleason score (GS) of 2 to 6 or 7 (3 + 4) with only 1 lobe involved (...) , and had prostate-specific antigen levels ≤10 ng/mL. Group 2 patients were stage ≥T2c, had a GS ≥7 (4 + 3), a GS 7 (3 + 4) involving both lobes, or a PSA >10 ng/mL and ≤30 ng/mL. All patients underwent transrectal ultrasound guided fiducial (Visicoil) placement prior to computed tomography/magnetic resonance imaging simulation. Daily cone beam computed tomography with online correction was used. The prescribed dose was 64 Gy in 20 fractions. The primary endpoint was acute and late toxicity
Destroying the androgen receptor (AR)-potential strategy to treat advanced prostatecancer 29344555 2018 11 13 2331-4737 4 11-12 2017 Nov Oncoscience Oncoscience Destroying the androgen receptor (AR)-potential strategy to treat advanced prostatecancer. 175-177 10.18632/oncoscience.389 Narayanan Ramesh R University of Tennessee Health Science Center, Memphis, TN, USA. Ponnusamy Suriyan S University of Tennessee Health Science Center, Memphis, TN, USA. Miller Duane D DD University of Tennessee (...) Health Science Center, Memphis, TN, USA. eng Editorial 2017 12 28 United States Oncoscience 101636666 2331-4737 androgen receptor castration-resistant prostatecancer (CRPC) selective androgen receptor degraders (SARDs) ubiquitin proteasome pathway CONFLICTS OF INTEREST Ramesh Narayanan is a consultant of GTx, Inc. 2017 11 16 2017 11 16 2018 1 19 6 0 2018 1 19 6 0 2018 1 19 6 1 epublish 29344555 10.18632/oncoscience.389 389 PMC5769981 Elife. 2013 Apr 09;2:e00499 23580326 Science. 2009 May 8;324(5928
Superior metastasis-free survival for patients with high-risk prostatecancer treated with definitive radiation therapy compared to radical prostatectomy: A propensity score-matched analysis For high-risk prostatecancer (HR-PCa) in men with a life expectancy of at least 10 years, the National Comprehensive Cancer Network recommends radiation therapy (RT) plus androgen deprivation therapy (ADT) with category 1 evidence or radical prostatectomy (RP) as an acceptable initial therapy. Randomized (...) evidence regarding which therapy is optimal for disease control is lacking for men with HR-PCa. We performed a propensity-score-matched comparison of outcomes for men with localized HR-PCa treated with primary RT or RP.The medical records of patients with localized HR-PCa who were treated at our institution between 2002 and 2011 were reviewed. Patient and disease characteristics, treatment details, and outcomes were collected. A combination of nearest-neighbor propensity score matching on age, Adult
Risk factors involved in treatment delays and differences in treatment type for patients with prostatecancer by risk category in an academic safety net hospital Understanding the drivers of delays from diagnosis to treatment can elucidate how to reduce the time to treatment (TTT) in patients with prostatecancer. In addition, the available treatments depending on the stage of cancer can vary widely for many reasons. This study investigated the relationship of TTT and treatment choice (...) with sociodemographic factors in patients with prostatecancer who underwent external beam radiation therapy (RT), radical prostatectomy (RP), androgen deprivation therapy (ADT), or active surveillance (AS) at a safety-net academic medical center.A retrospective review was performed on 1088 patients who were diagnosed with nonmetastatic prostatecancer between January 2005 and December 2013. Demographic data as well as data on TTT, initial treatment choice, American Joint Committee on Cancer stage, and National
Risk of Cardiovascular Ischemic Events After Surgical Castration and Gonadotropin-Releasing Hormone Agonist Therapy for ProstateCancer: A Nationwide Cohort Study Purpose Our aim was to determine whether cardiovascular (CV) risk in patients with prostatecancer (PCa) differs between those who receive androgen-deprivation therapy by surgical castration and those who receive gonadotropin-releasing hormone agonist (GnRHa) therapy. Patients and Methods By using the Taiwan National Health Insurance (...) of age, had hypertension, had a Charlson comorbidity index score ≥ 3, and had a previous history of MI, IS, or coronary heart disease. Conclusion Compared with bilateral orchiectomy, use of GnRHa does not increase the risk of CV ischemic events in patients with PCa. Nonetheless, orchiectomy is associated with higher rates of CV ischemic events in older patients and those with a history of CV comorbidities within 1.5 years of initiating androgen-deprivation therapy. These findings can help clinicians
Effect of Comorbidity on ProstateCancer-Specific Mortality: A Prospective Observational Study Purpose To determine the effect of comorbidity on prostatecancer (PCa)-specific mortality across treatment types. Patients and Methods These are the results of a population-based observational study in Sweden from 1998 to 2012 of 118,543 men who were diagnosed with PCa with a median follow-up of 8.3 years (interquartile range, 5.2 to 11.5 years) until death from PCa or other causes. Patients were (...) categorized by patient characteristics (marital status, educational level) and tumor characteristics (serum prostate-specific antigen, tumor grade and clinical stage) and by treatment type (radical prostatectomy, radical radiotherapy, androgen deprivation therapy, and watchful waiting). Data were stratified by Charlson comorbidity index (0, 1, 2, or ≥ 3). Mortality from PCa and other causes and after stabilized inverse probability weighting adjustments for clinical patient and tumor characteristics
the Committee, issued a positive opinion for granting a marketing authorisation to Tookad on 14 September 2017. 2. Scientific discussion 2.1. Problem statement 2.1.1. Disease or condition Tookad is indicated as monotherapy for adult patients with previously untreated, unilateral, low-risk, adenocarcinoma of the prostate with a life expectancy = 10 years and: - Clinical stage T1c or T2a, - Gleason Score = 6, based on high-resolution biopsy strategies, - PSA = 10 ng/mL, - 3 positive cancer cores (...) Padeliporfin (Tookad) - prostatecancer / ProstaticNeoplasms 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact 14 September 2017 EMA/644309/2017 Committee for Medicinal Products for Human Use (CHMP) Assessment report TOOKAD International non-proprietary name: padeliporfin Procedure No. EMEA/H/C/004182/0000 Note Assessment report
Guideline for Optimization of Surgical and Pathological Quality Performance for Radical Prostatectomy in ProstateCancer Management | Cancer Care Ontario Google Tag Manager You are using an outdated browser. We suggest you update your browser for a better experience. for update. Browse Guidelines Browse Pathway Maps Sort by You are here / / Guideline for Optimization of Surgical and Pathological Quality Performance for Radical Prostatectomy in ProstateCancer Management Guidelines & Advice (...) Guideline for Optimization of Surgical and Pathological Quality Performance for Radical Prostatectomy in ProstateCancer Management english Version: 2 ID: 17-3 Oct 2017 Type of Content: Guidelines & Advice, Clinical Document Status: Current Authors: J. Chin, J. Srigley, L.A. Mayhew, R.B. Rumble, C. Crossley, A. Hunter, N. Fleshner, B. Bora, R. McLeod, S. McNair, B. Langer, A. Evans, ProstateCancer Surgery and Pathology Expert Panel Guideline Objective The objective of this document is to provide
Comparative Analysis of Biopsy Upgrading in Four ProstateCancer Active Surveillance Cohorts. Active surveillance (AS) is increasingly accepted for managing low-risk prostatecancer, yet there is no consensus about implementation. This lack of consensus is due in part to uncertainty about risks for disease progression, which have not been systematically compared or integrated across AS studies with variable surveillance protocols and dropout to active treatment.To compare risks for upgrading (...) .2576 men aged 40 to 80 years with a GS between 2 and 6 and clinical stage T1 or T2 prostatecancer enrolled between 1995 and 2014.PSA levels and biopsy GSs.After variable surveillance intervals and competing treatments were accounted for, estimated risks for biopsy upgrading were similar in the PASS and UT studies but higher in UCSF and lower in JHU studies. All cohorts had a delay of 3 to 5 months in detecting upgrading with biennial biopsies starting after a first confirmatory biopsy versus
Health-related quality of life for immediate versus delayed androgen-deprivation therapy in patients with asymptomatic, non-curable prostatecancer (TROG 03.06 and VCOG PR 01-03 [TOAD]): a randomised, multicentre, non-blinded, phase 3 trial Androgen-deprivation therapy in patients with prostatecancer who have relapsed with rising prostate-specific antigen concentration only (PSA-only relapse), or with non-curable but asymptomatic disease at diagnosis, could adversely affect quality of life (...) at a time when the disease itself does not. We aimed to compare the effect of immediate versus delayed androgen-deprivation therapy on health-related quality of life over 5 years in men enrolled in the TOAD (Timing of Androgen Deprivation) trial.This randomised, multicentre, open-label, phase 3 trial done in 29 public and private cancer centres across Australia, New Zealand, and Canada compared immediate with delayed androgen-deprivation therapy in men with PSA-only relapse after definitive treatment
Risk of Alzheimer's Disease Among Senior Medicare Beneficiaries Treated With Androgen Deprivation Therapy for ProstateCancer Purpose To assess the relative risk of Alzheimer's disease (AD) among patients with prostatecancer who received androgen deprivation therapy (ADT), after adjustment for other cancer therapies. Methods Data from demographics, survival, diagnoses codes, procedure codes, and other information about beneficiaries age 67 years or older in the Medicare claims database (...) was assessed to determine the unadjusted and adjusted risks of AD and of dementia from ADT. The prespecified survival analysis method was competing risk regression. Results Of the 1.2 million fee-for-service Medicare beneficiaries who developed prostatecancer in 2001 to 2014, 35% received ADT. Of these, 109,815 (8.9%) and 223,765 (18.8%) developed AD and dementia, respectively, and 26% to 33% died without either outcome. Unadjusted rates of AD and all-cause mortality per 1,000 patient-years were higher
Phase III Study Comparing a Reduced Dose of Cabazitaxel (20 mg/m2) and the Currently Approved Dose (25 mg/m2) in Postdocetaxel Patients With Metastatic Castration-Resistant ProstateCancer-PROSELICA Purpose Cabazitaxel 25 mg/m2 (C25) significantly improved overall survival (OS) versus mitoxantrone ( P < .001) in postdocetaxel patients with metastatic castration-resistant prostatecancer (mCRPC) in the phase III TROPIC study. The phase III PROSELICA study ( ClinicalTrials.gov identifier (...) : NCT01308580) assessed the noninferiority of cabazitaxel 20 mg/m2 (C20) versus C25 in postdocetaxel patients with mCRPC. Methods Patients were stratified by Eastern Cooperative Oncology Group performance status, measurability of disease per Response Evaluation Criteria in Solid Tumors (RECIST), and region, and randomly assigned to receive C20 or C25. To claim noninferiority of C20 (maintenance of ≥ 50% of the OS benefit of C25 v mitoxantrone in TROPIC) with 95% confidence level, the upper boundary
Adherence to Report and Patient Perception of an Interactive App for Managing Symptoms During Radiotherapy for ProstateCancer: Descriptive Study of Logged and Interview Data Patients undergoing radiotherapy for prostatecancer experience symptoms related to both the cancer itself and its treatment, and it is evident that patients with prostatecancer have unmet supportive care needs related to their disease. Over the past decade, there has been an increase in the amount of research within (...) and not particularly time-consuming to send a daily report, and many described it as becoming a routine. Reporting symptoms facilitated reflection on their symptoms and gave them a sense of security. Few technological problems were reported.The use of Interaktor increased patients' sense of security and their reflections on their own well-being and thereby served as a supportive tool for the self-management of symptoms during treatment of prostatecancer. Some further development of the app's content might