THE "NEW" PROSTATE CANCER INFOLINK

Today’s news report covers articles on:

• Prevention of prostate cancer and other prostate disorders
• Pelvic lymph node dissection
• Sexual activity at 15 years after radiation therapy
• Non-hormonal, non-surgical orchiectomy
• Another possible prostate cancer drug

Neill et al., in an article entitled “Strategies to preserve prostate health,” appear to suggest that at present we have none that are supported by good evidence, which contradicts the recent guidance on the appropriate use of 5α-receptor antagonists (e.g., finasteride and dutasteride) in selected men at risk for prostate cancer.

Burkhard and  Studer have provided a European perspective on the still controversial topic of who should be given a  pelvic lymph node dissection (PLND) and the extent of the dissection when it is performed. They recommend that, “PLND is indicated in all patients with a PSA value > 10 ng/ml and in those with a PSA < 10 ng/ml if the Gleason score is ≥ 7.” They go on to describe the extent of the PLND that they believe to be appropriate.

In their abstract, Fransson and Widmark unfortunately do not provide a key piece of information that would help to interpret the data they offer on the sexual activity of patients treated with external beam radiation at 15 years of follow-up: the age of the patients at the time of treatment. We assume that these data are in the actual paper. In this study, 29/181 surviving patients (originally treated between  1986 and 1989) and 34/141 untreated controls were asked about their sexual activity and capabilities using well validated surveys. Twenty-three of the patients (78 percent) and 13 controls (38 percent) were not sexually active. None of the patients and 14 controls had enough of an erection to perform intercourse. Patients with clinical progression who had received hormone treatment had decreased sexual desire. No significant differences were measured between patients without progression/hormone treatment and the controls. If we assume that the mean age of the patients at time of treatment was (say) 65 years, then their mean age at the time of this follow-up analysis would be 80.

Emir et al. have investigated the use of hypertonic saline injections as an alternative to surgical orchiectomy in an animal model. While we doubt that such a treatment would “catch on” in much of the developed world today, it may be a better option than surgical orchiectomy in regions of the world where the cost of LHRH agonists and other forms of hormone therapy is prohibitively high. However, human trials would be needed first.

Wang et al. report the development of a series of novel compounds known as “makaluvamines.” The most potent was one  currently called FBA-TPQ. The effects of FBA-TPQ have been evaluated on prostate cancer cells, andd the results support the further development of FBA-TPQ as a novel agent for prostate cancer.

Filed under: Drugs in development, Living with Prostate Cancer, Management, Prevention, Treatment | Tagged: FBA-TPQ, orchiectomy, pelvioc lymph node dissection, PLND, Prevention, radiation, sexual activity