THE "NEW" PROSTATE CANCER INFOLINK

Today’s news reports address items on:

• Outcomes from different types of radical prostatectomy
• Radiation therapy in patients > 80 years of age
• Paclitaxel-based, second-line chemotherapy
• Prostate and other cancers in transplant patients

Drouin et al. have offered yet another report suggesting the there are minimal differences in outcomes between patients undergoing open, laparoscopic, and robot-assisted laparoscopic forms of radical prostatectomy (always assuming that the surgeons involved had comparable levels of skill using their selected techniques).

Nguyen et al. have published a retrospective analysis of data from 65 patients > 80 years of age treated at 12 different institutions for localized prostate cancer using external beam radiation therapy. They conclude that  “Radiation therapy given with curative intent is well tolerated in this selected group of patients aged over 80 years with localized prostate cancer. Results in terms of survival do not suggest a deleterious impact of this treatment.” The “New” Prostate Cancer InfoLink would merely observe that the potential risk for adverse effects of treatment in such patients is highly likely to outweigh any conceivable treatment benefit. We would hope that in the majority of such patients, clinicians would make a determined and collaborative effort to suggest that the patient consider an active surveillance protocol rather than invasive treatment.

Sella et al. have reported on the use of a combination of paclitaxel + estramustine + carboplatin as a form of second-line chemotherapy for patients who have failed docetaxel-based chemotherapy. This was a small study, and while some patients did demonstrate responses to therapy, the authors conclude that “This regimen is too toxic for palliative therapy. Careful patient selection is needed when this regimen is considered” for treatment of patients who are no longer responding to docetaxel-based regimens. One of the 15 patients in this study died of a brain hemorrhage.

In an analysis of data on new cancers in transplant recipients, Miao et al. have shown — perhaps unsurprisingly — that for prostate and other common cancers, transplant patients experience worse outcomes than the general population. Their data also suggest that cancers in transplant recipients are more aggressive biologically at the time of diagnosis.

Filed under: Diagnosis, Living with Prostate Cancer, Management, Treatment Tagged: | age, chemotherapy, external beam radiotherapy, outcomes, radical prostatectomy, second-line, transplant