The Thursday news reports: February 27, 2009

In news from sources other than the Genitourinary Cancer Symposium today, we have six reports on:

  • Oxidative stress and the development of prostate cancer
  • A review of PSA kinetics in the diagnosis, prognosis, and monitoring of prstate cancer
  • Focal therapy in general and focal cryoablation specifically
  • The relevance of elevated chondroitin sulphate levels and androgen receptor levels to prostate cancer progression

Khandrika et al. have reviewed data on how, as changes in reactive oxygen species (ROS) become more common with aging, ROS signaling may play an important role in the development and progression of prostate cancer.

Fitzpatrick et al. have published a thorough, useful, and current review on the application of PSA kinetics in the diagnosis, prognosis, and monitoring of patients with prostate cancer. They come down on the side of Vickers and his colleagues in agreeing that PSA velocity adds nothing to the analysis of risk for prostate cancer in an undiagnosed patient. They also note that the value of PSA velocity in prognosis of outcome in response to curative therapy is (at best) controversial at this time. This entire article can be downloaded from the UroToday web site.

Mouraviev and Madden have looked at the issue of patient selection for focal therapy from a pathologist’s point of view. They suggest that, “Even for moderately selective protocols such as hemiablation, … appropriate patient selection will be challenging.” They conclude that sophisticated biopsy protocols under imaging guidance may be required for treatment planning and that further research is needed to ensure that we can optimize patient selection and treatment using focal therapy.

Polascik et al. have evaluated available data on the rationale for, candidate selection in, and outcomes of the early clinical studies of focal cryoablation as a possible alternative to whole gland treatment. They conclude that minimally-invasive, parenchyma-preserving cryoablation is a potential feasible option for the treatment of early stage, localized prostate cancer in appropriately selected candidates with low volume and low or low-moderate risk prostate cancer.

Ricciardelli et al. have demonstrated that, although peritumoral chondroitin sulfate (CS) levels and Gleason score are strong predictors of relapse-free survival in early stage prostate cancer patients, neither peritumoral CS levels nor Gleason score can predict survival outcome in patients with advanced disease.

In laboratory analyses, Wikström et al. have shown that the aggressiveness of prostate cancer and the effectiveness of surgical castration therapy are associated with androgen receptor (AR) levels in the tumor itself and importantly with AR levels in the surrounding normal prostate tissue.

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