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Active surveillance prostate

Carolyn K Kan, Muhammad M Qureshi, Apar Gupta, Ankit Agarwal, Gretchen A Gignac, B Nicolas Bloch, Nicholas Thoreson, Ariel E Hirsch
Objectives: Understanding the drivers of delays from diagnosis to treatment can elucidate how to reduce the time to treatment (TTT) in patients with prostate cancer. In addition, the available treatments depending on the stage of cancer can vary widely for many reasons. This study investigated the relationship of TTT and treatment choice with sociodemographic factors in patients with prostate cancer who underwent external beam radiation therapy (RT), radical prostatectomy (RP), androgen deprivation therapy (ADT), or active surveillance (AS) at a safety-net academic medical center...
April 2018: Advances in Radiation Oncology
Shengmeng Peng, Tao Du, Wanhua Wu, Xianju Chen, Yiming Lai, Dingjun Zhu, Qiong Wang, Xiaoming Ma, Chunhao Lin, Zean Li, Zhenghui Guo, Hai Huang
PURPOSE: The aim of this study was to investigate the associations of serine proteinase inhibitor family G1 (SERPING1) down-regulation with poor prognosis in patients with prostate cancer (PCa). Furthermore, we aim to find more novel and effective PCa molecular markers to provide an early screening of PCa, distinguish patients with aggressive PCa, predict the prognosis, or reduce the economic burden of PCa. METHODS: SERPING1 protein expression in both human PCa and normal prostate tissues was detected by immunohistochemical staining, which intensity was analyzed in association with clinical pathological parameters such Gleason score, pathological grade, clinical stage, tumor stage, lymph node metastasis, and distant metastasis...
June 11, 2018: Urologic Oncology
Sebastian Hoberück, Enrico Michler, Daniel Kaiser, Anne Röhnert, Klaus Zöphel, Jörg Kotzerke
A 79-year old man with prostate cancer under active surveillance for 5 years was referred for a PSMA-PET/MRI for re-evaluation because of a rising prostate-specific antigen value. PET/MRI revealed a ribbonlike tracer accumulation in a healing fracture of the distal radius. This case illustrates that PSMA expression may occur in healing bone fractures in the distal radius. It can be assumed that benign causes of tracer accumulations in the upper extremities are missed in PET/CT due to elevated position of the arms during image acquisition...
June 12, 2018: Clinical Nuclear Medicine
Karim Marzouk, Melissa Assel, Behfar Ehdaie, Andrew Vickers
PURPOSE: Active surveillance is the preferred management of men with low-risk prostate cancer. Cancer-specific anxiety during active surveillance remains understudied. We sought to report long-term anxiety for men on active surveillance to determine if interventions need to be tailored to improve adherence. MATERIALS AND METHODS: Four hundred and thirteen men enrolled in active surveillance at a single tertiary care center completed quality of life surveys as part of routine care...
June 7, 2018: Journal of Urology
Kittie Pang, Margaret Fitch, Veronique Ouellet, Simone Chevalier, Darrel E Drachenberg, Antonio Finelli, Jean-Baptiste Lattouf, Alan So, Simon Sutcliffe, Simon Tanguay, Fred Saad, Anne-Marie Mes-Masson
BACKGROUND: Over the last decade, active surveillance has proven to be a safe approach for patients with low-risk prostate cancer. Although active surveillance presents several advantages for both patients and the health care system, all eligible patients do not adopt this approach. Our goal was to evaluate the factors that influence physicians to recommend active surveillance and the barriers that impact adherence to this approach. METHODS: Focus groups (n = 5) were held with physicians who provided care for men with low-risk prostate cancer and had engaged in conversations with men and their families about active surveillance...
June 8, 2018: BMC Health Services Research
D Thurtle, L Starling, K Leonard, T Stone, V J Gnanapragasam
Objectives: The aim of this study was to pilot the use of a bespoke device (CAMPROBE, the CAMbridge PROstate Biopsy) to enable routine outpatient free-hand local anaesthetic (LA) transperineal prostate biopsies. Materials and methods: The CAMPROBE prototype was designed and built in our institution. Men on active surveillance due prostate resampling were invited to have a CAMPROBE biopsy as an alternative to repeat transrectal ultrasound-guided prostate biopsies (TRUSBx) as part of an approved trial (NCT02375035)...
May 2018: Journal of Clinical Urology
Lorena A Grondhuis Palacios, Esmée M Krouwel, Brenda L den Oudsten, Marjolein E M den Ouden, Gert Jan Kloens, Grethe van Duijn, Hein Putter, Rob C M Pelger, Henk W Elzevier
PURPOSE: To determine which health care provider and what timing is considered most suitable to discuss sexual and relational changes after prostate cancer treatment according to the point of view of men and their partners. METHODS: A cross-sectional survey was conducted among men diagnosed with prostate cancer or treated after active surveillance, who received laparoscopic radical prostatectomy, brachytherapy, intensity-modulated radiotherapy, and/or hormonal therapy...
June 7, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Viranda H Jayalath, Madhur Nayan, Antonio Finelli, Maria Komisarenki, Narhari Timilshina, Girish S Kulkarni, Neil E Fleshner, Bimal Bhindi, Andrew Evans, Alexandre R Zlotta, Robert J Hamilton
PURPOSE: Recent evidence suggests that statins may improve prostate cancer outcomes; however, their role in active surveillance (AS) is poorly characterized. We aimed to evaluate the association between statin use at diagnosis and time to progression on AS. MATERIALS AND METHODS: Data were obtained from a prospectively maintained cohort of men undergoing AS between 1995 and 2016 at our institution. All men satisfied the low-risk criteria: Gleason score <7, <4 positive cores, <50% involvement of any core, and prostate-specific antigen level <10...
June 6, 2018: Prostate Cancer and Prostatic Diseases
David A Woodrum, Krzysztof R Gorny, Lance A Mynderse
Prostate cancer is the most commonly diagnosed noncutaneous cancer and second leading cause of death in men. Many patients with clinically organ-confined prostate cancer undergo definitive treatment of the whole gland, including radical prostatectomy, radiation therapy, and cryosurgery. Active surveillance is a growing alternative option for patients with documented low-volume and low-grade prostate cancer. However, many patients are wanting a less morbid focal treatment alternative. With recent advances in software and hardware of magnetic resonance imaging (MRI), multiparametric MRI of the prostate has been shown to improve the accuracy in detecting and characterizing clinically significant prostate cancer...
June 2018: Topics in Magnetic Resonance Imaging: TMRI
L Weißbach, C Roloff
BACKGROUND: Treatment of localized low-risk prostate cancer (PCa) is undergoing a paradigm shift: Invasive treatments such as surgery and radiation therapy are being replaced by defensive strategies such as active surveillance (AS) and watchful waiting (WW). OBJECTIVE: The aim of this work is to evaluate the significance of current studies regarding defensive strategies (AS and WW). METHODS: The best-known AS studies are critically evaluated for their significance in terms of input criteria, follow-up criteria, and statistical significance...
June 5, 2018: Der Urologe. Ausg. A
Inderbir S Gill, Abdel-Rahmene Azzouzi, Mark Emberton, Jonathan A Coleman, Emmanuel Coeytaux, Avigdor Scherz, Peter T Scardino
INTRODUCTION: The prospective trial PCM301 randomized 413 men with low-risk prostate cancer to partial gland ablation with vascular-targeted photodynamic therapy (n=207) or active surveillance (n=206). Two-year outcomes were reported previously. Here we report four-year rates of intervention with radical therapy and further assess efficacy with biopsy results. MATERIALS & METHODS: Prostate biopsies were mandated at 12 and 24 months. Thereafter, patients were monitored for radical therapy, with periodic biopsies performed according to standard-of-care in each institution...
June 1, 2018: Journal of Urology
Peihe Liang, Jia Guo, Shadan Li, Qiunong Guan, Terry Vanderheyden, Alan So, Yuzhuo Wang, Tao Chen, Caigan Du
Low-risk prostate cancer (PCa) does not require immediate treatment, but PCa progression after years of active surveillance will need the treatment. This study was to test the efficacy of immunostimulant Deep Immune (DI) in controlling PCa progression. DI is an extract of eight different medicinal herbs. In vitro activity of DI was determined by phagocytosis activation using flow cytometric analysis of fluorescence-labeled latex bead uptake, expression of immune-modulating 84 genes using PCRarray, and tumor killing using coculturing with immune cells...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
A Raichi, G Marcq, J-C Fantoni, P Puech, A Villers, A Ouzzane
AIM: To evaluate the contribution of multiparametric MRI (MRI) and targeted biopsies (TB) in the selection and follow-up of patients under active surveillance (AS). METHODS: A single-center, retrospective cohort study on 131 patients in AS, with following criteria:≤cT2 stage, PSA≤15ng/mL, Gleason score≤6,≤3 positive biopsies and maximum tumor length≤5mm. Patients' selection and follow-up was performed by the combination of systemic biopsies (SB) and mpMRI±TB...
May 31, 2018: Progrès en Urologie
David P Smith, Gary A Wittert
No abstract text is available yet for this article.
June 4, 2018: Medical Journal of Australia
Jae Hung Jung, Michael C Risk, Robert Goldfarb, Balaji Reddy, Bernadette Coles, Philipp Dahm
BACKGROUND: Traditionally, radical prostatectomy and radiotherapy with or without androgen deprivation therapy have been the main treatment options to attempt to cure men with localised or locally advanced prostate cancer. Cryotherapy is an alternative option for treatment of prostate cancer that involves freezing of the whole prostate (whole gland therapy) or only the cancer (focal therapy), but it is unclear how effective this is in comparison to other treatments. OBJECTIVES: To assess the effects of cryotherapy (whole gland or focal) compared with other interventions for primary treatment of clinically localised (cT1-T2) or locally-advanced (cT3) non-metastatic prostate cancer...
May 30, 2018: Cochrane Database of Systematic Reviews
Feng Zhao, Jiayan Shen, Zuguo Yuan, Xiaokai Yu, Peng Jiang, Baishu Zhong, Jianjian Xiang, Guoping Ren, Liping Xie, Senxiang Yan
Objectives: A Patterns of Care Study (PCS) was performed in the largest regional medical center in Zhejiang Province, China. The hospital information system (HIS) was used to evaluate patient characteristics and changes in initial treatment patterns for prostate cancer and to determine recent predominant trends in treatment plans for prostate cancer (PCa) in China. Methods: Men who were newly diagnosed with localized or locally advanced PCa for 2010-2011 and 2016-2017 were identified in the HIS database. Patient characteristics and temporal trends in initial management were assessed, and differences between groups were evaluated for significance using Chi-square and Mann-Whitney U tests...
2018: Journal of Cancer
Evan Kovac, Emily A Vertosick, Daniel D Sjoberg, Andrew J Vickers, Andrew J Stephenson
OBJECTIVES: To determine if the presence of adverse pathologic features in patients eligible for active surveillance are prognostic of poor oncologic outcomes, independent of pretreatment risk. PATIENTS & METHODS: A retrospective analysis was performed on patients who underwent radical prostatectomy at two institutions (CCF, MSKCC) between 1987-2008 and who had subsequent follow-up. Rates of biochemical recurrence, metastasis and death from prostate cancer were compared among patients with adverse pathologic features (Gleason ≥7, ≥pT3, or lymph node invasion) based on D'Amico clinical risk (low vs...
May 26, 2018: BJU International
Joshua J Fenton, Meghan S Weyrich, Shauna Durbin, Yu Liu, Heejung Bang, Joy Melnikow
Importance: Prostate cancer is the second leading cause of cancer death among US men. Objective: To systematically review evidence on prostate-specific antigen (PSA)-based prostate cancer screening, treatments for localized prostate cancer, and prebiopsy risk calculators to inform the US Preventive Services Task Force. Data Sources: Searches of PubMed, EMBASE, Web of Science, and Cochrane Registries and Databases from July 1, 2011, through July 15, 2017, with a surveillance search on February 1, 2018...
May 8, 2018: JAMA: the Journal of the American Medical Association
Tyler R McClintock, Ye Wang, Alexander P Cole, Benjamin I Chung, Adam S Kibel, Steven L Chang, Quoc-Dien Trinh
Standard treatment of localized prostate cancer (PCa) includes active surveillance (AS), radical prostatectomy (RP), and radiation therapy with or without radiosensitizing androgen deprivation therapy. Though RP had been the most commonly performed treatment since the early 1980s, the landscape has changed significantly in the past 10-15 years. As evidence, 54% of Medicare patients with PCa in 1991 underwent RP, though this fraction dropped to 24% two decades later. This article is protected by copyright. All rights reserved...
May 24, 2018: BJU International
Melanie A Evans, Jeremy L Millar, Arul Earnest, Mark Frydenberg, Ian D Davis, Declan G Murphy, Paul Aidan Kearns, Sue M Evans
OBJECTIVE: To characterise the practice of active surveillance (AS) for men with low risk prostate cancer by examining the characteristics of those who commence AS, the rate of adherence to accepted AS follow-up protocols over 2 years, and factors associated with good adherence. Design, setting: Retrospective cohort study; analysis of data collected from 38 sites participating in the Prostate Cancer Outcomes Registry-Victoria. PARTICIPANTS: Men diagnosed with prostate cancer between August 2008 and December 2014 aged 75 years or less at diagnosis, managed by AS for at least 2 years, and with an ISUP grade group of 3 or less (Gleason score no worse than 4 + 3 = 7)...
June 4, 2018: Medical Journal of Australia
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