Prostate cancer news report: Sunday, January 24, 2010

In this weekend’s prostate cancer news reports, we have addressed recent publications on:

  • A SNP that may be specifically linked to risk for prostate cancer in African Americans
  • The need for extended biopsies in men with larger prostates who are considering focal treatment for prostate cancer
  • A possible association between diabetes, race, obesity, and risk for prostate cancer progression
  • Neoadjuvant hormone therapy, brachytherapy, and all cause mortality in older patients

Using peripheral blood DNA samples from 114 African-American men with prostate cancer, Whitman et al. have been able to identify a single nucleotide polymorphism or SNP (called Broad11934905) on a region of chromosome 8q24 that is specific for African ancestry, is associated with a significant increase in risk for non-organ-confined prostate cancer (pT3-4) at prostatectomy (by a factor of 4.5), and is associated with an increased frequency of and shorter time to biochemical recurrence after prostatectomy. However, we will need additional studies to be able to demonstrate whether this SNP is predictive for prostate cancer in African Americans.

Using data from 859 patients. Tsivian et al. have provided additional evidence of the value of extended biopsies (10-20 biopsy cores) in men with larger prostates (> 40 grams) compared with smaller ones when attempting to identify appropriate candidates for prostate hemiablation, i.e., patients who really do have prostate cancer that is confined to only one lobe of the prostate.

It is well known that diabetes is associated with a reduced risk for prostate cancer. Jayachandran et al. have now published data suggesting that the association between diabetes and prostate cancer aggressiveness may vary by race and obesity. According to their recent article, in a cohort of 1,262 patients treated by radical prostatectomy, diabetes was not associated with biochemical recurrence, but diabetes was associated with more aggressive disease in obese white men and less aggressive disease for all other subsets. Such an association needs independent validation.

Dosoretz et al. have shown that, in men of ≥ 73 years of age, the use of neoadjuvant hormone therapy (NHT) in combination with brachytherapy as first-line treatment for localized prostate cancer increases the patients’ overall risk of death from all causes by 25 percent. By comparison, in patients of < 73 years of age, there was no increase in all-cause mortality when NHT was combined with brachytherapy.

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