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Prostate Cancer
NIH - Medical Encyclopedia Prostate cancer
"The cause of prostate cancer is unknown, although some studies have shown a relationship between high dietary fat intake and increased testosterone levels. … Prostate cancer is the third most common cause of death from cancer in men of all ages and is the most common cause of death from cancer in men over 75 years old. Prostate cancer is rarely found in men younger than 40. … Men at higher risk include black men older than 60, farmers, tire plant workers, painters, and men exposed to cadmium. The lowest incidence occurs in Japanese men and vegetarians. Prostate cancers are classified or staged based on their aggressiveness and how different they are from the surrounding prostate tissue. There are several different ways to stage tumors, a common one being the A-B-C-D staging system, also known as the Whitmore-Jewett system: A: Tumor is not palpable (not felt on physical examination), and is usually detected by accident after prostate surgery done for other reasons. B: Tumor is confined to the prostate and usually detected by physical examination or PSA testing. C: Tumor extends beyond the prostate capsule without spread to lymph nodes. D: Cancer has spread (metastasized) to regional lymph nodes or other parts of the body (bone and lungs, for example)."
Highlighted ArticleMeat Consumption among Black and White Men and Risk of Prostate Cancer in the Cancer Prevention Study II Nutrition Cohort (Cancer Epidemiol Biomarkers Prev 2006)
"No measure of meat consumption was associated with risk of prostate cancer among White men. Among Black men, total red meat intake (processed plus unprocessed red meat) was associated with higher risk of prostate cancer … this increase in risk was mainly due to risk associated with consumption of cooked processed meats (sausages, bacon, and hot dogs … This study suggests that high consumption of cooked processed meats may contribute to prostate cancer risk among Black men in the United States."
Prostate Cancer
Diagnosis, Imaging, and Screening
NEWS:
Baldness drug could mask prostate cancer marker "A popular baldness drug taken by more than 4 million men worldwide can mask an important marker used in screening tests to detect prostate cancer, scientists said on Monday. Finasteride, which is made by Merck & Co Inc. and sold under the trade name Propecia, is a leading drug to treat male-pattern baldness. But researchers have discovered it artificially lowers a protein called prostate specific antigen (PSA). High levels of PSA in the blood can signal prostate cancer or other problems."
Complexed PSA May Be Thriftier Prostate Cancer Test
Health Tip: Symptoms of Prostate Cancer
New Test Detects Hidden Lymph Node Metastases in Prostate Cancer
Newer Approach Urged in Screening for Aggressive Prostate Cancer "Researchers at the Johns Hopkins University School of Medicine say that how fast the amount of prostate-specific antigen (PSA) in a man's blood increases is an accurate gauge of tumor aggression and danger, even when PSA levels are so low as to not warrant a biopsy."
'PSA Bounce' After Prostate Cancer Treatment Doesn't Affect Survival "For men with prostate cancer, a rise in PSA levels after radiation therapy -- called PSA bounce -- is not clinically relevant and doesn't affect survival, researchers from Fox Chase Cancer Center report. In addition, another study by other Fox Chase researchers shows that a rapidly rising PSA level before treatment is a sign that the cancer has most likely spread beyond the prostate and that hormone therapy, in addition to radiation, is called for."
PSA Screening May Not Be Warranted in Elderly Men With Limited Life Expectancy
Older men may not need prostate cancer screening "The findings of a new study provide further evidence that screening older men for prostate cancer is not worthwhile and may actually do harm. Aggressive treatment of prostate cancers detected in patients in this age group has a minimal effect on survival, but markedly impairs quality of life, according to the study."
The PSA test for prostate cancer
ARTICLES:
Assessing Risk: Does This Patient Have Prostate Cancer?
Prostate Cancer Screening and Mortality: An Expert Interview With David F. Penson, MD, MPH
JOURNAL ARTICLES:
A Meta-Analysis of The Performance Characteristics of The Free Prostate-Specific Antigen Test. (Urology. 2006)
[Advancement of PET and PET/CT in prostate carcinoma.] (Urologe A. 2006)
Being Screened for Prostate Cancer: A Simple Blood Test or a Commitment to Treatment? (Cancer Nurs. 2006)
Conventional MRI capabilities in the diagnosis of prostate cancer in the transition zone. (AJR Am J Roentgenol. 2006)
Does PSA Velocity Predict Prostate Cancer in Pre-Screened Populations? (Eur Urol. 2006)
Effect of finasteride on the sensitivity of PSA for detecting prostate cancer. (J Natl Cancer Inst. 2006)
Free/total PSA ratio can help in the prediction of high gleason score prostate cancer in men with total serum prostate specific antigen (PSA) of 3-10 ng/ml. (Int Urol Nephrol. 2006)
How Good Is MRI at Detecting and Characterising Cancer within the Prostate? (Eur Urol. 2006) "CONCLUSIONS: The sensitivity of MRI has improved to the point that it has potential in several new areas: targeting of biopsies, monitoring of disease burden both during active surveillance and after focal therapy, and exclusion of cancer in patients with a raised prostate-specific antigen level."
How well does the Gleason score predict prostate cancer death? A 20-year followup of a population based cohort in sweden. (J Urol. 2006)
Impact of age, benign prostatic hyperplasia, and cancer on prostate-specific antigen level. (Cancer. 2006) "RESULTS: Among men with cancer and the absence of benign prostatic hyperplasia, mean PSA values were 2.05 ng/mL and 2.66 ng/mL for younger (<60 yr) and older (>/=60 yrs) men, respectively. These estimates were 2.56 ng/mL and 3.90 ng/mL in the presence of benign prostatic hyperplasia for younger and older men, respectively. For men without prostate carcinoma, these values were 0.78 ng/mL and 1.23 ng/mL for younger and older men, respectively, among those without benign prostatic hyperplasia, and 0.97 ng/mL and 1.75 ng/mL for younger and older men, respectively, among those with benign prostatic hyperplasia. CONCLUSIONS: Accurate estimates of the mean and variance of PSA values for men with or without cancer may provide PSA thresholds for biopsy that are specific for age and prostate size as assessed by digital rectal exam. Therefore, the current threshold of 4.0 ng/mL should not be applied indiscriminately."
Lower urinary tract symptoms and risk of prostate cancer in Japanese men. (Int J Urol. 2006) " . prostate volume was the dominant predictor for the detection of prostate cancer, followed by PSA level . "
Making sense of prostate specific antigen: improving its predictive value in patients undergoing prostate biopsy. (J Urol. 2006)
[MR techniques for noninvasive diagnosis of prostate cancer.] (Urologe A. 2006)
[MRI and staging evaluation of prostate cancer.] (J Radiol. 2006)
Pathological characteristics of prostate cancer detected through prostate specific antigen based screening. (J Urol. 2006)
Performance of tPSA and f/tPSA for prostate cancer in Chinese. A systematic review and meta-analysis. (Prostate Cancer Prostatic Dis. 2006)
[PET and PET/CT in relapsing prostate carcinoma.] (Urologe A. 2006)
Prediction of Pathological Stage is Inaccurate in Men with PSA Values above 20ng/mL. (Eur Urol. 2006) "CONCLUSIONS: The ability to predict pathological stage in patients with PSA values in excess of 20ng/mL significantly decreased, compared to patients with lower PSA values. Therefore, accurate staging of these patients may require alternative markers or staging schemes."
Prostate cancer progression in the presence of undetectable or low serum prostate-specific antigen level. (Cancer. 2006) "CONCLUSIONS.: Progression of PC may occur despite undetectable or low PSA levels. Complete physical evaluation and imaging studies may be indicated in the surveillance of patients with high-grade, locally advanced tumors, especially when atypical histologic variants are present."
Prostate specific-antigen distribution in asymptomatic Canadian men with no clinical evidence of prostate cancer. (BJU Int. 2006)
Prostate volume and prostate-specific antigen levels in men enrolled in a large screening trial. (Urology. 2006)
Prostate-specific antigen-based serial screening may decrease prostate cancer-specific mortality. (Urology. 2006)
[PSA in early detection of prostate cancer and course of disease] (Ther Umsch. 2006)
PSA Screening Among Elderly Men With Limited Life Expectancies (JAMA. 2006) "Conclusions Prostate-specific antigen screening rates among elderly veterans with limited life expectancies should be much lower than current practice given the known harms of screening. More attention to prognosis is needed when making screening PSA recommendations to elderly men."
PSA velocity and PSA slope. (Prostate Cancer Prostatic Dis. 2006)
Screening for prostate cancer. (Cochrane Database Syst Rev. 2006) "AUTHORS' CONCLUSIONS: Given that only two randomised controlled trials were included, and the high risk of bias of both trials, there is insufficient evidence to either support or refute the routine use of mass, selective or opportunistic screening compared to no screening for reducing prostate cancer mortality. Currently, no robust evidence from randomised controlled trials is available regarding the impact of screening on quality of life, harms of screening, or its economic value. Results from two ongoing large scale multicentre randomised controlled trials that will be available in the next several years are required to make evidence-based decisions regarding prostate cancer screening."
Should Men with Serum Prostate-Specific Antigen (Oncology. 2006)
Staging for prostate cancer: time to incorporate pretreatment prostate-specific antigen and Gleason score? (Cancer. 2006) "CONCLUSIONS.: The current AJCC staging system does not divide contemporary patients with prostate cancer into prognostic subgroups and does not identify patients who have comparable biochemical control and survival. The AJCC staging system for prostate cancer should be changed to incorporate pPSA, GS, and risk stratification."
The Effectiveness of Screening for Prostate Cancer (Arch Intern Med. 2006)
[Transrectal ultrasound and biopsy of the prostate.] (J Radiol. 2006)
Value of (11)C-choline PET and PET/CT in patients with suspected prostate cancer. (Eur J Nucl Med Mol Imaging. 2006) "CONCLUSION: Based on our findings, differentiation between benign prostatic changes, such as benign prostatic hyperplasia or prostatitis, and prostate cancer is feasible in the majority of cases when image interpretation is primarily based on qualitative characteristics."
Viewpoint: expanding prostate cancer screening. (Ann Intern Med. 2006) "The authors argue, on the basis of evidence published since 2000, that data supporting the efficacy of PSA screening are convincing. They recommend screening for risk assessment for average-risk men beginning at age 40 years, screening selected healthy men older than age 70 years, and lowering the PSA threshold for considering biopsy to 2.5 ng/mL for all men."
Viewpoint: limiting prostate cancer screening. (Ann Intern Med. 2006) "The author recommends that screening should not be expanded to include average-risk men younger than age 50 years or older than age 75 years and that a PSA threshold below 4.0 ng/mL should not be used to trigger biopsy referral."
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