Prostate cancer news reports: March 17, 2010

In this news report we summarize studies dealing with:

  • Outcomes after RP in selected patients between 70 and 81 years of age
  • Management of men with prostate cancer recurrence after first-line EBRT
  • Innovative MRI-guided treatments as second- and third-line forms of management
  • Preclinical data on MAOA inhibition in prostate cancer

Pierorazio et al. have reported on the outcomes of a highly selected group of 386 patients with T1 and T2 prostate cancer aged between 70 and 81 years (median age 71 years) after surgical treatment for localized prostate cancer. Although the prostate cancer-specific survival rate for the selected patients was high (97.6, 94.0, and 90.2 percent at 5, 10 and 15 years, respectively), it is difficult to define the significance of these data based only on the information provided in the abstract of the paper. The great unknown is which of these patients actually needed treatment at all.

Cohen et al. have reported on the difficulties of appropriately managing the care of men with progressive prostate cancer after first-line treatment with external beam radiation therapy. Such patients tend to have a significant risk of persistent local disease, progression, and death from prostate cancer. Furthermore, an initial negative biopsy does not eliminate the potential for local recurrence. Early hormonal therapy may well be an option — but that doesn’t necessarily make it a good option.

Woodrum et al. have reported on the early use of MRI-guided laser thermal therapy and MRI-guided cryotherapy to treat men with progressive prostate cancer after first-line radical prostatectomy and after second-line radiation therapy. These treatments have only been applied to very small numbers of patients to date. According to the media release from the Mayo Clinic, one of the authors of this study stressed that this form of treatment “was in the formative stages,” and that “additional work is needed to see which patients will be best suited for the ablation procedure and to examine middle- and long-term results for efficacy.”

Flamand et al. have published data suggesting: (a) that the enzyme monoamine oxidase A (MAOA) appears to be expressed at high levels in high-grade primary prostate cancer and (b) that the MAOA inhibitor chlorgyline is able to inhibit the expression of factors associated with prostate cancer progression in  a mouse model. It is possible that MAOA inhibition offers opportunities for the treatment of high risk and/or progressive forms of prostate cancer, but a great deal more work will be needed to assess this possibility. MAOA inhibitors have been used historically in the treatment of depression and other neurological conditions.

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