to -15.4) and active surveillance (-12.7 points; 95% CI, -16.0 to -9.3) but was associated with better urinary irritative symptoms than active surveillance (5.2 points; 95% CI, 3.2 to 7.2). No clinically significant differences for bowel or hormone function were noted beyond 12 months. No differences in health-related quality of life or disease-specific survival (3 deaths) were noted (99.7%-100%).In this cohort of men with localized prostate cancer, radical prostatectomy was associated with a greater (...) Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years. Understanding the adverse effects of contemporary approaches to localized prostate cancer treatment could inform shared decision making.To compare functional outcomes and adverse effects associated with radical prostatectomy, external beam radiation therapy (EBRT), and active surveillance.Prospective, population-based, cohort study involving 2550 men (≤80

Prostate Cancer in Southern Africa: Does Africa Hold Untapped Potential to Add Value to the Current Understanding of a Common Disease? 30241160 2019 03 04 2378-9506 4 2018 Sep Journal of global oncology J Glob Oncol Prostate Cancer in Southern Africa: Does Africa Hold Untapped Potential to Add Value to the Current Understanding of a Common Disease? 1-7 10.1200/JGO.2016.008862 Hayes Vanessa M VM Vanessa M. Hayes, University of Sydney, University of New South Wales, and Garvan Institute (...) 17176219 BJU Int. 2010 Aug;106(3):405-11 19849691 Lancet Glob Health. 2016 Sep;4(9):e609-16 27470177 BJU Int. 2005 Jul;96(1):29-33 15963115 Rural Remote Health. 2014;14:2378 24815856 BMC Urol. 2013 Dec 29;13:74 24373635 Nat Genet. 2013 Apr;45(4):385-91, 391e1-2 23535732 Am J Epidemiol. 2011 Jun 1;173(11):1280-8 21447478 PLoS One. 2011 Jan 06;6(1):e14495 21253579 Prostate Cancer. 2011;2011:947870 22111004 Nat Genet. 2016 Jan;48(1):30-5 26569126 Hum Genet. 2014 May;133(5):509-21 24185611 Transcult

ACR Appropriateness Criteria for external beam radiation therapy treatment planning for clinically localized prostate cancer, part II of II To present the most updated American College of Radiology (ACR) Appropriateness Criteria formed by an expert panel on the appropriate delivery of external beam radiation to manage stage T1 and T2 prostate cancer (in the definitive setting and post-prostatectomy) and to provide clinical variants with expert recommendations based on accompanying (...) , including (1) a standard case and cases with (2) a distended rectum, (3) a large-volume prostate, (4) bilateral hip implants, (5) inflammatory bowel disease, (6) prior prostatectomy, and (7) a pannus extending into the radiation field. Each case outlines the appropriate techniques for simulation, treatment planning, image guidance, dose, and fractionation. Numerical rating and commentary is given for each treatment approach in each variant.External beam radiation is a key component of the curative

Lutetium 177 PSMA radionuclide therapy for men with prostate cancer: a review of the current literature and discussion of practical aspects of therapy Prostate-specific membrane antigen (PSMA) is a receptor on the surface of prostate cancer cells that is revolutionising the way we image and treat men with prostate cancer. New small molecule peptides with high-binding affinity for the PSMA receptor have allowed high quality, highly specific PET imaging, in addition to the development of targeted (...) radionuclide therapy for men with prostate cancer. This targeted therapy for prostate cancer has, to date, predominately used Lutetium 177 (Lu) labelled PSMA peptides. Early clinical studies evaluating the safety and efficacy of Lu PSMA therapy have demonstrated promising results with a significant proportion of men with metastatic prostate cancer, who have already failed other therapies, responding clinically to Lu PSMA. This review discusses the practical issues of administering Lu PSMA, and gives

First Australian experience of treating localised prostate cancer patients with CyberKnife stereotactic radiotherapy: early PSA response, acute toxicity and quality of life This study is to evaluate biochemical response, acute toxicity and health-related quality-of-life (QOL) outcomes among prostate cancer patients following stereotactic body radiation therapy (SBRT) in the first Australian CyberKnife facility.Forty-five consecutive patients with clinically localised prostate cancer were (...) treated with SBRT using CyberKnife technology and enrolled in this study. Protocol treatment consisted of 36.25 Gy in five fractions. PSA and acute toxicity was assessed at each follow-up visit and QOL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Global Health Status (GHS) C30 and PR25 questionnaires and the Karnofsky Performance Status (KPS). Distance of travel for treatment was recorded.The median prostate-specific antigen (PSA) level declined from

DESNT: a Poor Prognosis Category of Human Prostate Cancer A critical problem in the clinical management of prostate cancer is that it is highly heterogeneous. Accurate prediction of individual cancer behaviour is therefore not achievable at the time of diagnosis leading to substantial overtreatment. It remains an enigma that, in contrast to breast cancer, unsupervised analyses of global expression profiles have not currently defined robust categories of prostate cancer with distinct clinical (...) outcomes.To devise a novel classification framework for human prostate cancer based on unsupervised mathematical approaches.Our analyses are based on the hypothesis that previous attempts to classify prostate cancer have been unsuccessful because individual samples of prostate cancer frequently have heterogeneous compositions. To address this issue, we applied an unsupervised Bayesian procedure called Latent Process Decomposition to four independent prostate cancer transcriptome datasets obtained using

Initial experience with intra‐fraction motion monitoring using Calypso guided volumetric modulated arc therapy for definitive prostate cancer treatment Accurate delivery of radiation while reducing dose to organs at risk is essential in prostate treatment. The Calypso motion management system detects and corrects both inter- and intra-fraction motion which offers potential benefits over standard alignment to fiducial markers. The aims of this study were to implement Calypso with Dynamic Edge™ (...) gating and to assess both the motion seen, and interventions required.An implementation group was formed which assessed changes needed to standard workflows. Three patients had Calypso beacons inserted into their prostate. All patients were treated using volumetric modulated arc therapy to a dose of 80 Gy in 40 fractions. Standard inter-fraction motion correction using either kilovoltage (kV) orthogonal paired imaging or cone beam computed tomography (CBCT) image-guided radiotherapy techniques, were

Randomized, Double-Blind, Phase III Trial of Ipilimumab Versus Placebo in Asymptomatic or Minimally Symptomatic Patients With Metastatic Chemotherapy-Naive Castration-Resistant Prostate Cancer Purpose Ipilimumab increases antitumor T-cell responses by binding to cytotoxic T-lymphocyte antigen 4. We evaluated treatment with ipilimumab in asymptomatic or minimally symptomatic patients with chemotherapy-naive metastatic castration-resistant prostate cancer without visceral metastases. Patients (...) event (AE) reported in ≥ 10% of ipilimumab-treated patients. Nine (2%) deaths occurred in the ipilimumab arm due to treatment-related AEs; no deaths occurred in the placebo arm. Immune-related grade 3 to 4 AEs occurred in 31% and 2% of patients, respectively. Conclusion Ipilimumab did not improve OS in patients with metastatic castration-resistant prostate cancer. The observed increases in progression-free survival and prostate-specific antigen response rates suggest antitumor activity in a patient

Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: Correlation with tumor cell density and percentage Gleason pattern on whole mount pathology To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with apparent diffusion coefficient (ADC) values on corresponding TROIs outlined on pre-operative MRI.Men with biopsy-proven prostate adenocarcinoma undergoing (...) included in this study. ADCmean values for TROIs were 944.8 ± 327.4 vs. 1329.9 ± 201.6 mm2/s for adjacent non-neoplastic prostate tissue (p < 0.001). ADCmean, ADC10th percentile, and ADCratio values for higher grade tumors were lower than those of lower grade tumors (mean 809.71 and 1176.34 mm2/s, p = 0.014; 10th percentile 613.83 and 1018.14 mm2/s, p = 0.009; ratio 0.60 and 0.94, p = 0.005). TCD and ADCmean (ρ = -0.61, p = 0.005) and TCD and ADC10th percentile (ρ = -0.56, p = 0.01) were negatively

Pretreatment prostate specific antigen doubling time as prognostic factor in prostate cancer patients Despite the prostate-specific antigen (PSA) serum level commonly uses as tumor marker in diagnosis of prostate cancer, it seems that PSA doubling time (PSADT) could be more useful indicator of tumor behavior and of prognosis for patients. The results of hormone and radiation therapy were evaluated for 912 prostate cancer having at least 2 PSA tests before the treatment was started. Clustering (...) procedure (selection of homogenous group) was performed by using PSADT as the classification marker. The rate of PSADT was estimated for different dissemination rate, age, Gleasons's score and education level. PSADT index inversely correlated with the rate of prostate cancer dissemination, Gleason's score and the level of education were directly correlated with the age of patients. Survival time was longer and PSADT index was higher in "slow" tumor growing subgroups in local, local-advanced

Switching from an LHRH Antagonist to an LHRH Agonist: A Case Report of 10 Finnish Patients with Advanced Prostate Cancer Luteinizing hormone-releasing hormone (LHRH) analogues are widely used for the treatment of advanced hormone-dependent prostate cancer. However, there are currently no clinical guidelines for switching between LHRH analogues. It has been reported that there may be clinical benefits for patients switching between different formulations of LHRH agonists, as well as from an LHRH (...) agonist to LHRH antagonist, but there are no published data on switching from an LHRH antagonist to an LHRH agonist. In this paper, we summarize the clinical notes of 10 patients with hormone-sensitive advanced prostate cancer who switched from an LHRH antagonist to an LHRH agonist.Patients with T3N0M0-T4N1M1 prostate cancer experiencing injection site reactions, such as pain and swelling, with monthly degarelix (Firmagon®) subcutaneous injections were switched to the 3-monthly leuprorelin acetate

through 2003, we assigned 760 eligible patients who had undergone prostatectomy with a lymphadenectomy and had disease, as assessed on pathological testing, with a tumor stage of T2 (confined to the prostate but with a positive surgical margin) or T3 (with histologic extension beyond the prostatic capsule), no nodal involvement, and a detectable PSA level of 0.2 to 4.0 ng per milliliter to undergo radiation therapy and receive either antiandrogen therapy (24 months of bicalutamide at a dose of 150 mg (...) Radiation with or without Antiandrogen Therapy in Recurrent Prostate Cancer. Salvage radiation therapy is often necessary in men who have undergone radical prostatectomy and have evidence of prostate-cancer recurrence signaled by a persistently or recurrently elevated prostate-specific antigen (PSA) level. Whether antiandrogen therapy with radiation therapy will further improve cancer control and prolong overall survival is unknown.In a double-blind, placebo-controlled trial conducted from 1998

Androgen Deprivation Therapy and the Risk of Dementia in Patients With Prostate Cancer Purpose Recent observational studies have associated the use of androgen deprivation therapy (ADT) with an increased risk of dementia and Alzheimer's disease, but these studies had limitations. The objective of this study was to determine whether the use of ADT is associated with an increased risk of dementia, including Alzheimer's disease, in patients with prostate cancer. Patients and Methods Using (...) the United Kingdom's Clinical Practice Research Datalink, we assembled a cohort of 30,903 men newly diagnosed with nonmetastatic prostate cancer between April 1, 1988 and April 30, 2015, and observed them until April 30, 2016. Time-dependent Cox proportional hazards models were used to estimate adjusted hazard ratios with 95% CIs of dementia associated with the use of ADT compared with nonuse. ADT exposure was lagged by 1 year to account for delays associated with the diagnosis of dementia

in this health technology assessment includes treatment-naïve men with stage I-II localized prostate cancer who undergo definitive monotherapy with CyberKnife SBRT. Clinical Alternatives: Prostate cancer treatment is guided by the initial disease risk category. Options include active surveillance or watchful waiting, radical prostatectomy, external beam radiation therapy using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy; high-dose-rate brachytherapy; high-intensity-focused (...) Stereotactic body radiation therapy with CyberKnife Robotic Radiosurgery System (Accuray Inc.) monotherapy of primary localized prostate cancer Stereotactic body radiation therapy with CyberKnife Robotic Radiosurgery System (Accuray Inc.) monotherapy of primary localized prostate cancer Stereotactic body radiation therapy with CyberKnife Robotic Radiosurgery System (Accuray Inc.) monotherapy of primary localized prostate cancer HAYES, Inc Record Status This is a bibliographic record

180,890 new cases with a projected 26,120 deaths. In contrast to patients with lower-risk disease, those with locally confined high-risk prostate cancer and those with intermediate-risk disease with 2 or more risk factors typically have poorer prognoses requiring more intensified treatment. High-dose-rate (HDR) brachytherapy is commonly used as a "boost" to conventionally fractionated external beam radiation therapy (EBRT) in this setting, but is highly invasive and resource-intensive. Extreme (...) CyberKnife SBRT boost. Clinical Alternatives: Prostate cancer treatment is guided by the initial disease risk category. Options can include active surveillance or watchful waiting; radical prostatectomy; EBRT using 3-dimensional conformal radiation therapy or intensitymodulated radiotherapy; HDR brachytherapy; high-intensity-focused ultrasound; hormonal therapy; cryosurgery; or combinations thereof. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD

. HIFU may also lead to overtreatment of indolent prostate cancers in patients for whom active surveillance would lead to a good outcome. Relevant Questions: Does HIFU provide effective local tumor control and acceptable rates of remission and long-term disease-free survival in patients with localized prostate cancer? Does HIFU provide acceptable outcomes with regard to urinary function, prostate outcomes, and sexual function? How does HIFU compare with other primary treatment options for localized (...) . Citation HAYES, Inc.. Ultrasound-guided high-intensity focused ultrasound for primary treatment of localized prostate cancer. Lansdale: HAYES, Inc.. Directory Publication. 2016 Authors' objectives High-intensity focused ultrasound (HIFU) is a minimally invasive (transrectal) treatment that generates heat through sound energy to destroy tumor tissue. Sound waves produced by an ultrasonic transducer mounted on an endorectal probe penetrate the rectal wall and ablate the entire prostate gland or focal

Clinical and dosimetric predictors of late rectal bleeding of prostate cancer after TomoTherapy intensity modulated radiation therapy Rectal bleeding after radiotherapy impacts the quality of life of long-term surviving prostate cancer patients. We sought to identify factors associated with late rectal bleeding following intensity modulated radiation therapy (IMRT) using TomoTherapy for prostate cancer.We retrospectively analysed 82 patients with localised prostate cancer treated

Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Men with high serum prostate specific antigen usually undergo transrectal ultrasound-guided prostate biopsy (TRUS-biopsy). TRUS-biopsy can cause side-effects including bleeding, pain, and infection. Multi-parametric magnetic resonance imaging (MP-MRI) used as a triage test might allow men to avoid unnecessary TRUS-biopsy and improve diagnostic accuracy.We did (...) this multicentre, paired-cohort, confirmatory study to test diagnostic accuracy of MP-MRI and TRUS-biopsy against a reference test (template prostate mapping biopsy [TPM-biopsy]). Men with prostate-specific antigen concentrations up to 15 ng/mL, with no previous biopsy, underwent 1·5 Tesla MP-MRI followed by both TRUS-biopsy and TPM-biopsy. The conduct and reporting of each test was done blind to other test results. Clinically significant cancer was defined as Gleason score ≥4 + 3 or a maximum cancer core

Sociodemographic disparities in the utilization of proton therapy for prostate cancer at an urban academic center Despite increasing use, proton therapy (PT) remains a relatively limited resource. The purpose of this study was to assess clinical and demographic differences in PT use for prostate cancer compared to intensity modulated radiation therapy (IMRT) at a single institution.All patients with low- and intermediate-risk prostate cancer (N = 633) who underwent definitive radiation therapy (...) ), black (51% vs. 75%), and living in poverty or close to the facility (mean distance between residence and facility, 90 vs. 21 miles; P < .05). Prostate-specific antigen, prostate volume, and International Index of Erectile Function were significantly higher in the IMRT cohort (P < .05), but insurance type, risk group, tumor stage, Gleason score, and patient-reported urinary and bowel scores did not differ significantly (P > .05). Patients who underwent PT were more likely to receive hypofractionated

In vitro antioxidant and anticancer activity of Leea indica leaf extracts on human prostate cancer cell lines To determine the phytochemical constituents, antioxidant, and anticancer activities of Leea indica leaf extracts on DU-145 and PC-3 human prostate cancer cell lines.Leaf sample was subjected to Soxhlet extraction method with increasing polarity of solvents, namely, chloroform, ethyl acetate, methanol, ethanol, and aqueous. Phytochemical screening was done using different biochemical (...) tests. Quantitative analysis for phenol was determined by Folin-Ciocalteu reagent method. The antioxidant activity was tested using 2,2-diphenyl-1-picrylhydrazyl, ferric ion reducing power assay, and phosphomolybdenum assay. In vitro anticancer activity on DU-145 and PC-3 human prostate cancer cell lines was evaluated by (3-(4, 5-dimethyl thiazole-2yl)-2, 5-diphenyl tetrazolium bromide) MTT assay.Phytochemical screening confirmed the presence of phyto-constituents like alkaloids, flavonoids