THE "NEW" PROSTATE CANCER INFOLINK

In today’s (slightly belated) news reports, we comment on studies dealing with:

• A possible association between hypertension and later diagnosis of prostate cancer
• Appropriate selection of high-risk patients for RALP
• Optimization of the appropriate use of docetaxel + prednisone in  treatment of CRPC

Based on an analysis of data from 336,159 patients in a Swedish construction workers health database, Stocks et al. have reported the possibility of an association between high blood pressure (hypertension) and subsequent decreased risk for incident (i.e., localized, non-aggressive) prostate cancer. However, they also state that they have no clinical or scientific explanation for this possible association. Hypertension did not appear to predict a decreased risk for aggressive forms of prostate cancer in this analysis. This study also provided support for an association between a high body mass index (BMI) and risk for fatal prostate cancer.

Uberoi et al. have attempted to expand our understanding of the appropriate selection of high-risk patients for treatment with robot-assisted laparoscopic prostatectomy (RALP). Their study is based on a retrospective analysis of data from patients with PSA levels ≥ 10 ng/dl, high volume disease, or a Gleason score ≥ 8 who underwent RALP at their institution between December 2004 and September 2008. They report that patients with lower PSA levels, lower PSA densities, and a lower percentage of positive cores were more likely to have favorable pathology at the time of surgery. The presence of bilateral disease and/or high-grade prostatic intraepithelial neoplasia (HG-PIN) was not statistically significant

Armstrong and George have published a review of available information related to optimization of the use of docetaxel + prednisone in the treatment of castration-resistant prostate cancer (CRPC). Although other agents are advanced stages of in clinical development, this regimen is the approved first-line treatment for CRPC. Their paper focuses on “understanding the practical and often subtle issues of docetaxel initiation, duration of therapy, cessation of therapy and treatment holidays.”

Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: CRPC, docetaxel, high-risk patients, hypertension, prednisone, RALP, risk, robot-assisted laparoscopic prostatectomy