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Latest & greatest articles for prostate cancer
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Ejaculation frequency and subsequent risk of prostatecancer. Sexual activity has been hypothesized to play a role in the development of prostatecancer, but epidemiological data are virtually limited to case-control studies, which may be prone to bias because recall among individuals with prostatecancer could be distorted as a consequence of prostatemalignancy or ongoing therapy.To examine the association between ejaculation frequency, which includes sexual intercourse, nocturnal emission (...) the ages of 20 to 29 years, 40 to 49 years, and during the past year (1991).Incidence of total prostate cancer.During 222 426 person-years of follow-up, there were 1449 new cases of total prostatecancer, 953 organ-confined cases, and 147 advanced cases of prostatecancer. Most categories of ejaculation frequency were unrelated to risk of prostatecancer. However, high ejaculation frequency was related to decreased risk of total prostatecancer. The multivariate relative risks for men reporting 21
Salvage radiotherapy for recurrent prostatecancer after radical prostatectomy. Salvage radiotherapy may potentially cure patients with disease recurrence after radical prostatectomy, but previous evidence has suggested that it is ineffective in patients at the highest risk of metastatic disease progression.To delineate patients who may benefit from salvage radiotherapy for prostatecancer recurrence by identifying variables associated with a durable response.Retrospective review of a cohort (...) , or by the initiation of androgen deprivation therapy after treatment.Over a median follow-up of 45 months, 250 patients (50%) experienced disease progression after treatment, 49 (10%) developed distant metastases, 20 (4%) died from prostatecancer, and 21 (4%) died from other or unknown causes. The 4-year progression-free probability (PFP) was 45% (95% confidence interval [CI], 40%-50%). By multivariable analysis, predictors of progression were Gleason score of 8 to 10 (hazard ratio [HR], 2.6; 95% CI, 1.7-4.1; P
6-month androgen suppression plus radiation therapy vs radiation therapy alone for patients with clinically localized prostatecancer: a randomized controlled trial. Survival benefit in the management of high-grade clinically localized prostatecancer has been shown for 70 Gy radiation therapy combined with 3 years of androgen suppression therapy (AST), but long-term AST is associated with many adverse events.To assess the survival benefit of 3-dimensional conformal radiation therapy (3D-CRT (...) ) alone or in combination with 6 months of AST in patients with clinically localized prostate cancer.A prospective randomized controlled trial of 206 patients with clinically localized prostatecancer who were randomized to receive 70 Gy 3D-CRT alone (n = 104) or in combination with 6 months of AST (n = 102) from December 1, 1995, to April 15, 2001. Eligible patients included those with a prostate-specific antigen (PSA) of at least 10 ng/mL, a Gleason score of at least 7, or radiographic evidence
Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostatecancer. Mitoxantrone plus prednisone reduces pain and improves the quality of life in men with advanced, hormone-refractory prostatecancer, but it does not improve survival. We compared such treatment with docetaxel plus prednisone in men with this disease.From March 2000 through June 2002, 1006 men with metastatic hormone-refractory prostatecancer received 5 mg of prednisone twice daily and were randomly assigned (...) to receive 12 mg of mitoxantrone per square meter of body-surface area every three weeks, 75 mg of docetaxel per square meter every three weeks, or 30 mg of docetaxel per square meter weekly for five of every six weeks. The primary end point was overall survival. Secondary end points were pain, prostate-specific antigen (PSA) levels, and the quality of life. All statistical comparisons were against mitoxantrone.As compared with the men in the mitoxantrone group, men in the group given docetaxel every
Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostatecancer. Mitoxantrone-based chemotherapy palliates pain without extending survival in men with progressive androgen-independent prostatecancer. We compared docetaxel plus estramustine with mitoxantrone plus prednisone in men with metastatic, hormone-independent prostate cancer.We randomly assigned 770 men to one of two treatments, each given in 21-day cycles: 280 mg of estramustine three times (...) docetaxel and estramustine and 3.2 months in the group given mitoxantrone and prednisone (P<0.001 by the log-rank test). PSA declines of at least 50 percent occurred in 50 percent and 27 percent of patients, respectively (P<0.001), and objective tumor responses were observed in 17 percent and 11 percent of patients with bidimensionally measurable disease, respectively (P=0.30). Grade 3 or 4 neutropenic fevers (P=0.01), nausea and vomiting (P<0.001), and cardiovascular events (P=0.001) were more common
Prevalence of prostatecancer among men with a prostate-specific antigen level < or =4.0 ng per milliliter. The optimal upper limit of the normal range for prostate-specific antigen (PSA) is unknown. We investigated the prevalence of prostatecancer among men in the ProstateCancer Prevention Trial who had a PSA level of 4.0 ng per milliliter or less.Of 18,882 men enrolled in the prevention trial, 9459 were randomly assigned to receive placebo and had an annual measurement of PSA and a digital (...) rectal examination. Among these 9459 men, 2950 men never had a PSA level of more than 4.0 ng per milliliter or an abnormal digital rectal examination, had a final PSA determination, and underwent a prostate biopsy after being in the study for seven years.Among the 2950 men (age range, 62 to 91 years), prostatecancer was diagnosed in 449 (15.2 percent); 67 of these 449 cancers (14.9 percent) had a Gleason score of 7 or higher. The prevalence of prostatecancer was 6.6 percent among men with a PSA
Patients' preferences for the management of non-metastatic prostatecancer: discrete choice experiment. To establish which attributes of conservative treatments for prostatecancer are most important to men.Discrete choice experiment.Two London hospitals.129 men with non-metastatic prostatecancer, mean age 70 years; 69 of 118 (58%) with T stage 1 or 2 cancer at diagnosis.Men's preferences for, and trade-offs between, the attributes of diarrhoea, hot flushes, ability to maintain an erection (...) hot flushes (mean 0.6 months to move from a moderate to mild level or from mild to none).Men with prostatecancer are willing to participate in a relatively complex exercise that weighs up the advantages and disadvantages of various conservative treatments for their condition. They were willing to trade off some life expectancy to be relieved of the burden of troublesome side effects such as limitations in physical energy.
Satraplatin for second-line treatment of hormone-refractory prostatecancer - horizon scanning review Satraplatin for second-line treatment of hormone-refractory prostatecancer - horizon scanning review Satraplatin for second-line treatment of hormone-refractory prostatecancer - horizon scanning review NHSC Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA (...) database. Citation NHSC. Satraplatin for second-line treatment of hormone-refractory prostatecancer - horizon scanning review. Birmingham: National Horizon Scanning Centre (NHSC). 2004 Authors' objectives To summarise the currently available evidence on satraplatin for second-line treatment of hormone-refractory prostatecancer. Authors' conclusions Satraplatin, an orally-active platinum compound, is in phase III clinical trials as a second-line treatment for men with hormone-refractory prostate
Prostatecancer and use of nonsteroidal anti-inflammatory drugs: systematic review and meta-analysis Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Radiotherapy is a cost-effective palliative treatment for patients with bone metastasis from prostatecancer Radiotherapy is a cost-effective palliative treatment for patients with bone metastasis from prostatecancer Radiotherapy is a cost-effective palliative treatment for patients with bone metastasis from prostatecancer Konski A Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary (...) of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Several palliative treatments for patients with bone metastasis from prostatecancer were examined. These were pain medication only (best supportive care, BSC), chemotherapy consisting of mitoxantrone and prednisone, and single and multiple fractions (SFX and MFX, respectively) of external beam radiotherapy (EBRT). BSC consisted of 120 mg/day
Cost-effectiveness of zoledronic acid for the prevention of skeletal complications in patients with prostatecancer Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
and to contribute to a lower toxicity maintaining or increasing the therapeutic efficacy is still limited. There is still no information coming from controlled clinical trials with harder endpoints (mortality, disease-free survival, quality of life, acute and immediate toxicity) to be able to assess its relative efficacy and cost-effectiveness. Project page URL Indexing Status Subject indexing assigned by CRD MeSH Male; ProstaticNeoplasms /radiography; Radiotherapy, Computer-Assisted; Radiotherapy, Conformal (...) Intensity modulated radiotherapy (IMRT) for prostatecancer Intensity modulated radiotherapy (IMRT) for prostatecancer Intensity modulated radiotherapy (IMRT) for prostatecancer Pichon Riviere A, Augustovski F, Ferrante D, Regueiro A, Garcia Marti S Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Pichon Riviere A, Augustovski F
to screen for prostatecancer. Findings There are no completed randomized screening trials, although two are underway. Evidence from non-randomized studies suggests possible benefit, but these results may not be reliable due to bias or alternative explanations. The main areas of uncertainty are the natural history of the disease, which appears relatively benign in many cases, and appropriate treatment for positive screened cases. Policy considerations Mass screening should not be introduced (...) Should mass screening for prostatecancer be introduced at the national level? WHO/Europe | Should mass screening for prostatecancer be introduced at the national level? S Français Deutsch Pусский M search Databases Interactive atlases Evidence resources European health report Our flagship report maps health trends, charts progress towards achieving health goals and provides an advance base for health policy Resources Social media Events Organization Governance Partners Networks Jobs
Effect of verification bias on screening for prostatecancer by measurement of prostate-specific antigen. The sensitivity and specificity of a screening test are biased when disease status is not verified in all subjects and when the likelihood of confirmation depends on the test result itself. We assessed the screening characteristics of the prostate-specific antigen (PSA) measurement after correction for verification bias.Between 1995 and 2001, 6691 men underwent PSA-based screening (...) for prostatecancer. Of these men, 705 (11 percent) subsequently underwent biopsy of the prostate. Under the assumption that the chance of undergoing a biopsy depends only on the PSA-test result and other observed clinical variables, we used a mathematical model to estimate adjusted receiver-operating-characteristic (ROC) curves.Adjusting for verification bias significantly increased the area under the ROC curve (i.e., the overall diagnostic performance) of the PSA test, as compared with an unadjusted
Noninvasive detection of clinically occult lymph-node metastases in prostatecancer. Accurate detection of lymph-node metastases in prostatecancer is an essential component of the approach to treatment. We investigated whether highly lymphotropic superparamagnetic nanoparticles, which gain access to lymph nodes by means of interstitial-lymphatic fluid transport, could be used in conjunction with high-resolution magnetic resonance imaging (MRI) to reveal small nodal metastases.Eighty patients (...) with presurgical clinical stage T1, T2, or T3 prostatecancer who underwent surgical lymph-node resection or biopsy were enrolled. All patients were examined by MRI before and 24 hours after the intravenous administration of lymphotropic superparamagnetic nanoparticles (2.6 mg of iron per kilogram of body weight). The imaging results were correlated with histopathological findings.Of the 334 lymph nodes that underwent resection or biopsy, 63 (18.9 percent) from 33 patients (41 percent) had histopathologically
Screening for prostatecancer. Epidemiologically, screening is justified by the importance of the disease and the lack of prospects for primary prevention, but evidence from natural history is unhelpful since men are more likely to die with, rather than from, prostatecancer. The available screening tests do not always detect men whose lesions could result in future morbidity or mortality. Evidence is limited for the benefits of treatment for localised cancers detected through screening (...) , whereas the evidence for harm is clear. Observational evidence for the effect of population screening programmes is mixed, with no clear association between intensity of screening and reduced prostatecancer mortality. Screening for prostatecancer cannot be justified in low-risk populations, but the balance of benefit and harm will be more favourable after risk stratification. Prostatecancer screening can be justified only in research programmes designed to assess its effectiveness and help identify
Early prostatecancer: clinical decision-making. Prostatecancer is one of the most common malignantdiseases for which health-care intervention is sought worldwide, and in many developed countries it is the most common. Some patients with early-stage prostatecancer, especially those who are elderly and have comorbidities, can be observed without treatment. Surgery (radical prostatectomy) and radiotherapy (external-beam radiotherapy, brachytherapy, or both) are the most widely accepted (...) on many disease and patient factors. Here, we review the major treatment options, discuss their relative advantages and disadvantages, and provide a general approach to management of patients with early-stage prostatecancer.
and proven efficacy.To compare the prevalences of PSA and colorectal cancer screening among US men.The 2001 Behavioral Risk Factor Surveillance System, an annual population-based telephone survey of US adults conducted by the Centers for Disease Control and Prevention, was used to gather data on a representative sample of men aged 40 years or older from all 50 states and the District of Columbia (n = 49 315).Proportions of men ever screened and up to date on screening for prostatecancer (with PSA (...) Screening men for prostate and colorectal cancer in the United States: does practice reflect the evidence? The debate about the efficacy of prostate-specific antigen (PSA) screening for prostatecancer has received substantial attention in the medical literature and the media, but the extent to which men are actually screened is unknown. If practice were evidence-based, PSA screening would be less common among men than colorectal cancer screening, a preventive service of broad acceptance
Pathological and molecular aspects of prostatecancer. This review focuses on new findings and controversial issues in the the pathology and molecular biology of adenocarcinoma of the prostate. Since management of high-grade prostatic intraepithelial neoplasia on needle biopsy--the most common precursor lesion to prostatecancer--is the crucial issue with this lesion, we discuss the risk of cancer subsequent to this histological diagnosis and the issue of whether such neoplasia should (...) be regarded as carcinoma-in-situ. We also look at prostatecancer itself, starting with its diagnosis, reporting on needle biopsy, and reviewing how the most frequently used grading system, the Gleason grading system, affects treatment. The molecular basis of prostatecancer includes inheritable and somatic genetic changes (tumour suppressor genes, loss of heterozygosity, gene targets and regions of chromosomal gain, CpG island promoter methylation, invasion and metastasis suppressor genes, telomere
Prostatecancer epidemiology. Because more and more men are being diagnosed with prostatecancer worldwide, knowledge about and prevention of this disease is important. Epidemiological studies have provided some insight about the cause of prostatecancer in terms of diet and genetic factors. However, compared with other common cancers such as breast and lung cancer, the causes remain poorly understood. Several important issues could help in our understanding of this disease-the variation (...) in incidence of prostatecancer between ethnic populations and the factors leading to familial clustering of the diseases.