THE "NEW" PROSTATE CANCER INFOLINK

We have reported separately on a small, Phase II trial of neoadjuvant chemotherapy prior to radical prostatectomy in men with locally advanced, high risk prostate cancer. Other reports today address:

• Prostate cancer detection and treatment in China
• The effectiveness of preoperative nomograms in men diagnosed with PSA levels < 2.5 ng/ml
• Body mass index and treatment outcomes in Dutch men
• The TGFβ signaling pathway and its role in prostate cancer development
• Tumor hypoxia, androgen ablation, and effective hormone therapy

Peyromaure et al. have provided an interesting comparative analysis on the current state of prostate cancer detection and treatment in China and France. They note that, in China, most patients subjected to prostate biopsy suffer from urinary symptoms and have elevated PSA levels; the lack of widespread screening for prostate cancer results in a high rate of advanced tumors with nodal involvement and/or metastases; radical prostatectomy is rarely performed in Chinese hospitals; and castration represents the usual treatment of prostate cancer. This situation is similar to that still found in a very large proportion of the world with less sophisticated and less widely available health services.

Berglund et al. have evaluated whether patients diagnosed with a PSA level < 2.5 ng/ml had post-surgical outcomes different than those predicted by a validated preoperative nomogram. A total of 399/6,130 patients in a two-institution database met the criterion for inclusion in this analysis. The authors found that: (a) Patients with a  PSA < 2.5 ng/ml comprise a small proportion of those treated, and most have palpable disease. (b) Patients with especially low PSA values (≤ 0.5 ng/ml) have a high rate of non-organ-confined disease. (c) There was no evidence that patients with low PSA levels have worse outcomes, after their stage and grade were taken into account.

In a study of data from 1,302 men with clinically localized prostate cancer undergoing radical prostatectomy at two academic medical centers in the Netherlands, van Roermund et al. have reported that body mass index (BMI) appears to have no prognostic significance on biochemical recurrence with a median follow-up of nearly 6 years. Studies in the USA have previously suggested that BMI may have prognostic impact on biochemical recurrence in similar patients.

Jones et al. have discussed the theoretical potential of targeting the TGFβ signaling pathway as a means to prevent the early development and later progression of  prostate cancer.

Rudolfsson and Bergh have reviewed the relationship between tumor hypoxia (low levels of oxygen in tumor tissues and cells), the impact of androgen ablation on tumor hypoxia, and the ability to use levels of androgen ablation to optimally manage tumor hypoxia in order to optimize therapetic outcomes.

Filed under: Diagnosis, Drugs in development, Living with Prostate Cancer, Management, Risk, Treatment