The Tuesday news reports: February 24, 2009

We have dealt separately with an article on the way in which surgical technique appears to affect the likelihood of positive surgical margins after robot-assisted laparoscopic prostatectomy (RALP). Other reports today cover:

  • Whether multifocal tumors are “riskier” that single prostate cancer tumors
  • The role of n-3 fatty acids in prevention of selected cancers (including prostate cancer)
  • Lycopene in prevention and treatment of prostate cancer
  • Serum cholesterol levels and prostate cancer
  • Different forms of imaging for prostate cancer localization during EBRT
  • Carboplatin + etopside chemotherapy in late-stage metastatic disease

Stamatiou et al. have studied whether multifocal prostate cancer tumors place patients at higher risk than single (unifocal) tumors. Their data sucggest that this is not the case, but this is likely to remain a controversial issue among basic scientists for some time.

Pauwels and Kairemo have reviewed information on the methods by which n-3 fatty acids (most commonly found in fish) may affect and prevent the process of carcinogenesis. The review focuses on the effects of n-3 fatty acid intake on risk for breast, prostate, and colorectal cancers.

Similarly, Ellinger et al. have reviewed current data on the potential roles of lycopene in prevention and treatment of prostatic diseases. They conclude that lycopene has no preventive effect in prostate cancer, but may have some value in treatment — an effect that still needs to be validated in clinical trials.

Solomon et al. have studied the effects of ezetimide (Zetia, a cholesterol-lowering agent) on prostate cancer in mice in the laboratory. The conclude that, “Our results … suggest that” having high serum cholesterol levels (hypercholesterolemia) “directly accelerates the growth of prostate carcinomas, and that the pharmacological reduction of serum cholesterol levels may retard prostate cancer growth by inhibiting tumor angiogenesis.”

Peng et al. have compared the potential value of mega-volt CT imaging (MVCT) and ultasound imaging as methods for the day-to-day localization of the prostate among 140 patients undergoing external beam radiotherapy (EBRT) for prostate cancer. The authors also address the impact of this localization on dosimetric accuracy. The conclude that the MVCT technique results in smaller variations in daily shifts than ultrasound imaging, indicating that MVCT is a more reliable and precise method for prostate localization. They suggest that utrasound-based localization may overestimate the daily prostate motion and thus negatively impact prostate dose coverage and rectal sparing.

Loriot et al. have reported on the use of a combination of carboplatin and etopside in chemotherapy of patients with castration-resistant prostate cancer who have progressive disease after prior docetaxel-based chemotherapy. While this combination of agents did produce significant PSA responses in 9/40 patients and reduction in the pain of 15/28 evaluable patients, it would not appear that this combination has significant clinical impact on disease progression (at least based on these data). The authors state that adverse events to this form of chemotherapy were “tolerable.”

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