THE “New” PROSTATE CANCER INFOLINK

According to an abstract of a presentation to be given at the American Society of Clincial Oncology (ASCO) annual meeting in a couple of weeks, Amgen Inc.’s experimental drug denosumab was more effective than zoledronate (Zometa) in preventing fractures in cancer patients — at least in early test results. … MORE

An article just published in the online version of Cancer suggests that:

• While many men are appropriate candidates for active surveillance (AS), in 2006 only about 10 percent of those eligible actually chose it (up from about 6 percent in 2000), and furthermore
• Of those that do initially choose AS, up to 50 percent will convert to active treatment later (either because of indicators of progression or for other reasons)

It would appear that anxiety is common in these men and may exceed grade or biopsy progression as a critical prompt for many men to switch to active treatment (or perhaps to avoid AS in the first place). … MORE

In a new analysis of the Prostate Cancer Prevention Trial (PCPT) trial data, published in Urology this month, Thompson et al. make the definitive recommendation that,

Finasteride significantly reduced prostate cancer risk regardless of the level of this risk, … this suggests that finasteride exerts both treatment and preventive effects. All men undergoing PSA screening should be informed of the potential for finasteride to reduce their risk of prostate cancer.

…MORE

A small but interesting study by Pinkawa et al. in Germany suggests that, as for return of potency after radical prostatectomy, patient age and pretreatment sexual function are the most important prognostic factors for the return of potency after external beam radiotherapy. The best predictor for preserving erections sufficient for sexual intercourse appears to be the occurrence of spontaneous erections in the morning or night, before treatment. Diabetic patients are not only predisposed for erectile dysfunction (ED) before radiotherapy, but also for post-radiotherapy-acquired ED. … MORE

Macdonald et al. have reported that, based on an analysis of data from the CaPSURE™ database, salvage radiotherapy (SRT) is optimal for patients with low pre-SRT PSA levels, long PSA doubling times, and favorable pathologic features. Patients who do not meet these criteria may benefit significantly less from SRT, particularly if the potential for complications and side effects is taken into account. … MORE

If one suffers from chronic belief in corporate media releases, the new ei·Nav/Artemis™ ultrasound imaging technology, approved by the US Food & Drug Administration last week, will utterly revolutionize the ability of urologists to carry out prostate biopsies. However, since we have yet to see any peer-reviewed, comparative data supporting the value of this new technology, we will withold judgment until such data is published. … MORE

A report by Hu et al. in the most recent issue of the Journal of Clinical Oncology has provided further evidence to substantiate a recurring theme of this web site: that outcomes to specific treatments for early stage disease are highly dependent on the skill and experience of the treating team and not the specific technique. In this case the candidate for study was minimally invasive radical (laparoscopic) prostatectomy (LRP). … MORE

Last week we were able to add content addressing the treatment of early stage prostate cancer with laparoscopic surgery and we are also pleased to note the contribution by Michael F. Sarosdy, MD entitled, “How to select your brachytherapist.”

The general prostate cancer news seems to be somewhat slow … probably because everyone is getting ready for presentations at the upcoming AUA meeting in Orlando, starting on May 17.

Two publications in a recent issue of Urology add to the available information about surgical management of low-risk prostate cancer, but offer little further guidance as to the decision-making process for newly diagnosed patients.

Hernandez et al., from Johns Hopkins, have demonstrated in a retrospective analysis of their series of 2,526 patients that men with prostate cancer who undergo radical prostatectomy and have pathologically organ-confined disease with a Gleason score 6 or less are very unlikely to experience disease recurrence. In addition, Loeb et al. have evaluated the outcomes and surgical complications of low-risk patients who underwent radical prostatectomy. … MORE

The potential role of PSA velocity in screening for prostate cancer has been unclear. However, recent data from the Rotterdam section of the European Randomized Study of Screening for Prostate Cancer  (ERSPC) appears to confirm earlier suggestions that PSA velocity (the rate of increase in PSA over time) is not an independent predictor of risk for clinically significant prostate cancer. … MORE