THE "NEW" PROSTATE CANCER INFOLINK

Today’s news reports address issues such as:

• Pro-PSA (a pecursor molecule to PSA itself)
• A review of development-stage markers for prostate cancer detection
• Understanding the pathology report
• A Phase I trial of high-dose testosterone in men with metatstatic CRPC

Hull et al. have reported on the expression of pro-PSA (the precursor of prostate-specific antigen), a distinct molecular form of serum-free PSA that includes normal and shortened forms, in benign tissue, in high-grade prostatic intraepithelial neoplasia (HG-PIN) and in prostatic adenocarcinoma.

Risk and Lin have reviewed current data on markers for the initial diagnosis of risk for prostate cancer. They comment that both serum and urine biomarkers are in various stages of development, that some of these seem to perform better than our current standards of diagnosis (PSA and DREs), and that some markers have suggested the capacity to predict stage and likelihood of recurrence. They express the opinion that the future of prostate cancer detection may lie in complex assays systems that can test for several markers at the same time and use the accumulated data to assess prostate cancer risk.

Hameed has commented on the importance of accurate understanding of the details in pathological reports in the diagnosis, prognosis, and subsequent decisions about treatment of prostate cancer. In particular, he points out that that atypia and other related terms (i.e., ASAP) are not specific diagnoses.

Morris et al. have studied the ability give high doses of testosterone, using testosterone patches, to a small number of men with metastatic castration-resistant prostate cancer (CRPC) who have been castrate for more than 1 year. They state that patients with metastatic CRPC can be safely treated with high-dose testosterone (at least in clinical trials using testosterone patches), and that future studies should employ strategies to maximize testosterone serum levels.