Cancer Research Lab

The addition of androgen suppression therapy to radiation therapy for treatment of prostate cancer fails to improve survival among men with serious co-existing illness, according to a study in the Journal of the American Medical Association for January 23.

Recent evidence suggests that androgen suppression therapy increases the risk of cardiovascular events in men of advanced age, lead author Dr. Anthony V. D’Amico of Brigham and Women’s Hospital in Boston and his associates note.

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Digital rectal examination (DRE) should not be excluded from prostate cancer screening protocols, according to a report in the December issue of Urology.

“To offer the patient a better evaluation of his prostate gland, the physician should perform the DRE as well as the PSA test,” Dr. William J. Catalona from Northwestern University Feinberg School of Medicine, Chicago, said.

Dr. Catalona and colleagues compared clinical variables and survival outcomes between patients diagnosed with prostate cancer by DRE alone versus those diagnosed by PSA level, regardless of DRE findings.

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The survival of patients with hormone-resistant prostate cancer is significantly longer after treatment with docetaxel every 3 weeks with prednisone (D3P) compared with other regimens, according to the follow-up of a major study.

The update of the TAX 327 study, which compared D3P to a weekly docetaxel treatment with prednisone (D1P) and with mitoxantrone plus prednisone (MP), was published in the January 10 issue of the Journal of Clinical Oncology.

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The level of a particular type of non-cancerous DNA fragment circulating in the sera of prostate cancer patients appears to be useful as a diagnostic and prognostic indicator, German researchers report in the January issue of the International Journal of Cancer.

“The detection of short circulating DNA fragments in patients’ serum allows distinguishing of prostate cancer patients and patients with benign prostate hyperplasia — including healthy controls — sensitively and specifically,” lead investigator Dr. Jorg Ellinger said.

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Dr. Hans Lilja and colleagues analyzed the long-term predictive power of tPSA, free PSA (fPSA) and human kallikrein 2 (hK2) levels measured between the ages of 44 and 50 years in 21,277 men enrolled in the Malmo (Sweden) Preventive Project between 1974 and 1986. The analysis focused on 462 participants who later developed prostate cancer and 1222 matched controls who did not.

The risk of prostate cancer in older age ranged from 1.0% to 7.5% if the mid-life tPSA was 0.5 ng/mL or lower, the investigators report in the February 1st issue of the Journal of Clinical Oncology.

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The results of a single total prostate-specific antigen test, done between the ages of 44 and 50, can reliably predict prostate cancer up to 25 years later, new research shows.

Dr. Hans Lilja, from Memorial Sloan-Kettering Cancer Center in New York, and colleagues analyzed the long-term predictive power of total PSA, free PSA, and human kallikrein 2 levels measured between the ages of 44 and 50 years in 21,277 men enrolled in the Malmo (Sweden) Preventive Project between 1974 and 1986. The analysis focused on the 498 patients who developed prostate cancer during follow-up through 1999, and on 1222 matched control patients who did not.

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A component of green tea combined with a low dose of a COX-2 inhibitor may act in concert to slow the spread of human prostate cancer.

In the journal Clinical Cancer Research, they report that low doses of the COX-2 inhibitor celecoxib (sold as Celebrex), given along with a green tea polyphenol slowed the growth of prostate cancer in cell cultures and in a mouse model of the disease.

“Celecoxib and green tea have a synergistic effect, each triggering cellular pathways, that, combined, are more powerful than either agent alone,” Dr. Hasan Mukhtar from the University of Wisconsin, Madison, said in a statement.

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Men with false-positive prostate cancer screening results report increased cancer-related worry and more problems with sexual function, despite having negative biopsy findings, according to researchers.

Because of this, lead investigator Dr. David A. Katz said, “the psychological consequences of screening are non-trivial and should be accounted for in evaluating the risks and benefits of screening in the general population.”

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Compared with conservative “watchful waiting,” which is often recommended for men with high-grade prostate cancer because of the difficulty of treating it, radiation therapy or radical prostatectomy can lead to a significant improvement in survival, New York-based researchers report.

“Patients with the most aggressive non-metastatic prostate cancers — Gleason scores 8-10 — if treated with prostatectomy or radiation, can expect to live more than 14 years,” lead investigator Dr. Ashutosh Tewari said. “Those treated conservatively will live, on average, less than 7 years.”

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Testosterone replacement therapy (TRT) appears safe for men who experience hypogonadal symptoms after brachytherapy for prostate cancer.

“Men who have undergone potentially curative treatment for prostate cancer but also suffer from severe effects of hypogonadism may benefit from a trial of testosterone replacement, with close monitoring of the PSA,” Dr. Michael F. Sarosdy from South Texas Urology and Urologic Oncology, San Antonio, said. “In our experience, most have done well.”

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