Articles addressed in this report deal with:
- The reactions of men to a diagnosis of prostate cancer
- Current and potential uses of dynamic, contrast-enhanced MRI in patient evaluation
- How much does benign prostatic tissue affect PSA levels after radical prostatectomy?
- The potential of sunitinib and vandetanib in treatment of CRPC
Hughes Halbert et al. have investigated how men react to being diagnosed with prostate cancer and attempted to identify factors that influence these responses. Participants were 70 African American and 124 white prostate cancer patients who completed a structured telephone interview. The authors report no racial differences in men’s reactions to being diagnosed with prostate cancer; however, greater perceptions of disease-specific stress, increasing levels of present temporal orientation, and more social constraints had significant positive effects on avoidant reactions. Greater perceptions of stress also had a significant positive effect on intrusive thoughts. The results of this study highlight the need for individualized approaches to help men address their thoughts and feelings about being diagnosed with prostate cancer.
McMahon et al. have reviewed the current and potential uses of dynamic, contrast-enhanced magnetic resonance imaging (MRI) in the evaluation of patients with prostate cancer.
Godoy et al. have studied the likelihood that benign prostatic tissue represents a source of measurable PSA after radical prostatectomy in patients with “extremely low-risk disease.” At 3 months to 6 years of follow-up (mean 36.2 months), 0.6 percent and 0.3 percent of patients had developed a measurable PSA level or biochemical recurrence, respectively. The single patient with biochemical recurrence responded to salvage radiotherapy, strongly suggesting a malignant etiology for the recurrence. Godoy and his colleagues concluded that a measurable PSA level or biochemical recurrence was an extraordinarily rare event in this group of patients. These results provide compelling evidence that retained benign prostatic elements are an unlikely source of elevated PSA levels in men who have undergone radical prostatectomy.
Articles by Horti et al. and by Dror Michaelson et al. have suggested that the potential of sunitinib (Sutent) and vandetanib (Zactima) in the treatment of castration-resistant prostate cancer (CRPC) — alone or in combination with docetaxel — is likely to be extremely limited. Whether either drug has potential earlier in the disease state is undetermined at this time.
Filed under: Diagnosis, Drugs in development, Living with Prostate Cancer, Management, Treatment Tagged: | CRPC, Diagnosis, MRI, PSA, radical prostatectomy, reaction, sunitinib, vandetanib
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Granted that since almost none of Godoy et al.’s patients developed a post-RP PSA, it is likely that the recurrence meant tumor. However, saying that the PSA became undetectable after RT means it came from tumor doesn’t make sense. Any residual prostate tissue would likely be destroyed by RT, tumor or not.