The Tuesday news update: March 10, 2009

Today’s news reports include items on:

  • Risk for prostate cancer
  • Patient decisions about sexual functionality and prostate cancer treatment
  • Whole gland and focal cryotherapy
  • Testosterone replacement after prostate cancer therapy

and other items.

Patel and Klein have published a new review on risk for prostate cancer that starts by stating categorically that, “The incidence of prostate cancer continues to increase in the US.” This is a somewhat odd statement when one considers that SEER and ACS data suggest that the number of newly diagnosed prostate cancer patients has actually remained relatively stable at about 200,000 new cases a year since the year 2000. The variations in that number, which have ranged from a low of 180,400 in 2000 to  a high of 234, 460 in 2006, appear to have more to do with the statistical methods used to compute the number than “reality.” What the authors note that is certainly true is that “the causes of prostate cancer remain poorly understood” and that many of the known risk factors do not seem to have any easily identified association with actual and consistently understandable development of prostate cancer.

Knight and Latini have reviewed the complex decision processes that men face in making the trade off between effective prostate cancer treatment and the risks for impact on sexual functionality associated with such treatment. They state that, based on their research and their review of the available literature, “among men diagnosed with prostate cancer sexual function is less important to men than concerns about survival, but is more highly valued than other side effects and treatment characteristics.” However, they also point out the existence of evidence that “concerns about sexuality are not in proportion with the associated risk for sexual problems with prostate cancer treatment and men acknowledge unmet needs for information about sexuality in making prostate cancer treatment decisions.” It is high time that we started to ensure appropriate education of men and their spouses or partners about the real risks for sexual and other side effects associated with prostate cancer treatments of all types.

Ritch and Katz have reviewed the currently available data on whole gland and focal cryotherapy and made a good case for the use of these techniques in appropriately selected patients. The application of focal cryotherapy in relatively low risk patients is still a “work in progress,” but an increasing number of high quality centers are investigating the potential of this procedure, as exemplified by the Phase II trial in development at Memorial Sloan-Kettering Cancer Center.

Khera has joined other voices making the case for the use of testosterone replacement therapy (TRT) in the preservation of sexual function in men who have received treatment for prostate cancer. This remains  a controversial issue because of the known relationship between testosterone levels and prostate cancer development and progression. While arguing the potential of TRT, Khera clearly makes the point that, “further studies are needed to assess the true safety of TRT following RP.”

Harris et al. have reviewed current understanding of the mechanisms of development of androgen resistance and related issues such as the development of abiraterone acetate and analogous compounds.

InnerCool Therapies, Inc. has issued a media release regarding the use of the company’s UroCool Catheter System in  association with robot-assisted laparoscopic prostatectomy, and Paladin Labs, Inc. has announced that it has filed a new drug submission for Trelstar® 22.5 mg (triptorelin pamoate for injectable suspension) — a 6-monthly formulation of this LHRH agonist — in Canada.

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