THE "NEW" PROSTATE CANCER INFOLINK

In today’s other news reports there are items on:

• Mistrust between patients and their doctors regarding prostate cancer issues
• Use of a new, 3D transrectal ultrasound-guided biopsy system
• Pelvic lymph node dissection and its extent in prostate cancer staging and outcome
• Negative result of oblimersen sodium prior to docetaxel in castration-resistant prostate cancer

Halbert et al. have  investigated the degree of mistrust between patients and their doctors by conducting an observational study among 71 African-Americans and 125 Caucasians who were newly diagnosed with prostate cancer during 2003 through 2007. They found that race, education, healthcare experiences, and cultural factors had significant effects on mistrust. They suggest that efforts to enhance trust among men who are diagnosed with prostate cancer should target African-American men, men with fewer socioeconomic resources, and men with lower perceptions of interdependence. Reasons for deterioration in trust associated with greater experience with specialty providers should be explored along with the effects of interventions that are designed to address the concerns of individuals who have greater mistrust.

Chen et al. have reported on the utility of a new 3D transrectal ultrasound (TRUS)-guided prostate biopsy system that allows precise needle placement in a 12-core template fashion. They evaluated its performance in the detection of prostate cancer by conducting a retrospective analysis of data from 68 patients biopsied prospectively with this system between April 2006 and November 2007. The indication for prostate biopsy was a PSA ≥ 4.0 ng/ml in 47 patients (69 percent), an abnormal DRE in 17 patients (25 percent), and atypia on previous biopsy in 4 patients (6 percent). Prostate cancer was detected in 18 patients (26.5 percent) and 7 (10.3 percent) had atypical small acinar proliferation (ASAP). The highest frequency of detection of cancer (55 percent) occurred when the 3D TRUS-guided biopsy system was used to conduct initial biopsies. A media release about this study has been issued the manufacturer of this particular piece of equipment.

Briganti et al. have published a systematic review of the literature on pelvic lymph node dissection (PLND) and its extent in prostate cancer staging and outcome. On the basis of current data, the authors suggest that if a PLND is indicated, then it should be extended. Conversely, they also state that, in view of the low rate of lymph node invasion among patients with low-risk prostate cancer, an extended staging PLND is avoidable in this patient category. Whether this approach is also safe from oncologic perspectives is still unknown. Patients with low-volume nodal metastases have a good long-term prognosis; to what extent this prognosis is the result of a positive impact of PLND on prostate cancer outcomes is still to be determined.

Sternberg et al. have reported that treatment of men with castration-resistant prostate cancer with the investigational drug oblimersen sodium prior to docetaxel (Taxotere) therapy had a negative effect on patient outcomes compared to the use of docetaxel alone, including a lower clinical response rate and a higher incidence of clinically significant adverse events.

Filed under: Diagnosis, Drugs in development, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: biopsy, docetaxel, mistrust, oblimersen, pelvic lymph node dissection, PLND, three-dimensional, transrectal, ultrasound-guided