THE "NEW" PROSTATE CANCER INFOLINK

In todayas news reports we deal with items about:

• Celecoxib therapy prior to radical prostatectomy for cT1-2 disease
• Sentinel lymph node dissection (again)
• Surgical decompression and spinal reconstruction in man with spinal metastasis

Sooriakumaran et al. have published data from a small, randomized clinical trial of the selective cyclooxygenase-2 (COX-2) inhibitor celecoxib (Celebrex) 400 mg twice a day in treatment patients with  cT1-2 prostate cancer compared to no treatment for 4 weeks prior to radical prostatectomy. The authors report that, in this small pilot study,”a 4 week regimen of celecoxib resulted in measurable biological effects in prostate cancer tissue.” However, there are insufficient data from this study to make any determination of the clinical value of Celebrex as a form of pre-surgical treatment for localized prostate cancer.

Following the report by Holl et al. (posted just last week), a report from Veermeeren et al. provides additional information on the potential utility of sentinel lymph node evaluation as a methid to assess risk for micrometastatic prostate cancer in men with intermediate or high risk for progressive disease.

Williams et al. have published a retrospective analysis of data from their institution on the use of surgical intervention to manage spinal metastases occurring as a complication of advanced prostate cancer. Based on the data they present, they conclude that, “In selected patients with prostate cancer metastases to the spine, aggressive surgical decompression and spinal reconstruction is a useful treatment option. … Gleason score, metastatic burden, and degree of spinal canal compression may be associated with survival following surgery, and thus should be considered carefully prior to opting for surgical management.” This is not exactly a new observation, but the present paper does add to our knowledge of which patients may gain the most significant benefit from this type of surgical intervention.

Filed under: Diagnosis, Drugs in development, Living with Prostate Cancer, Management, Risk, Treatment | Tagged: cedlecoxib, Celebrax, decompression, dissection, lymph node, sentinel, spinal metastases, surgery |