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And the Sunday prostate cancer news: November 2, 2008

Posted Dec 12 2008 3:41pm

In a separate post we have addressed the clinical significance of a finding of tertiary Gleason pattern 5 in a core (or cores) following prostate needle biopsy. Other reports, addressed below, deal with:

  • Genomic markers for prostate cancer risk stratification
  • Outcomes of men with “prevalent” as opposed to “incident” prostate cancer
  • Quality of life of men diagnosed with and treated for T3-4 disease
  • Testosterone replacement therapy and risk for prostatic disease

At the recent meeting of the AUA Western Section in Monterey, California, Collins discussed the current state of the development of knowledge about the potential use of genomic biomarkers to stratify risk for newly diagnosed prostate cancer patients and then to correlate this with treatment. His presentation was technical, and the best way to describe the “state of the art” is probably to say, “There is significant progress, but we ain’t there yet.” Collins concluded his presentation by saying that next-generation genetic sequencing will impact our knowledge about tumor behavior and have direct potential on our ability to turn scientific knowledge into practically applicable, clinical information.

Nguyen et al. have differentiated between men with prostate cancer diagnosed at initial screening ( prevalent cases) and men who are diagnosed at subsequent screenings ( incident cases) and, using a restrospective data analysis, demonstrated that men with prevalent disease are at greater risk for disease progression post-treatment than those with incident disease. There is a clear reasonableness about this outcome, and it probably should be used in discussions with newly diagnosed patients as guidance information. However, exactly how helpful it is likely to be in a discussion with a man who has just been diagnosed may be open to some question.

White et al. report on use of data from the CaPSURE registry to study quality of life in men diagnosed with and treated for locally advanced prostate cancer (clinical stages T3-4). The authors emphasize that this is an initial, exploratory analysis. Unsurprisisingly, they come to the conclusion that, “Treatment for locally advanced prostate adenocarcinoma is associated with a significant burden in patients, notably decrements in urinary and sexual function.” They go on to state that, “ Clinicians should consider the impact that treatment imparts on quality of life when counseling patients with locally advanced disease.”

Holyoak et al., in reviewing the available data on the use of testosterone replacement therapy (TRT) in the management of hypogonadal males, continue to reach the conclusion that all men receiving TRT should be closely monitored for any evidence of prostatic disease.

Filed under: Uncategorized | Tagged: genomic biomarkers, incident, prevalent, quality of life, testosterone replacement

In a separate post we have addressed the clinical significance of a finding of tertiary Gleason pattern 5 in a core (or cores) following prostate needle biopsy. Other reports, addressed below, deal with:

  • Genomic markers for prostate cancer risk stratification
  • Outcomes of men with “prevalent” as opposed to “incident” prostate cancer
  • Quality of life of men diagnosed with and treated for T3-4 disease
  • Testosterone replacement therapy and risk for prostatic disease

At the recent meeting of the AUA Western Section in Monterey, California, Collins discussed the current state of the development of knowledge about the potential use of genomic biomarkers to stratify risk for newly diagnosed prostate cancer patients and then to correlate this with treatment. His presentation was technical, and the best way to describe the “state of the art” is probably to say, “There is significant progress, but we ain’t there yet.” Collins concluded his presentation by saying that next-generation genetic sequencing will impact our knowledge about tumor behavior and have direct potential on our ability to turn scientific knowledge into practically applicable, clinical information.

Nguyen et al. have differentiated between men with prostate cancer diagnosed at initial screening ( prevalent cases) and men who are diagnosed at subsequent screenings ( incident cases) and, using a restrospective data analysis, demonstrated that men with prevalent disease are at greater risk for disease progression post-treatment than those with incident disease. There is a clear reasonableness about this outcome, and it probably should be used in discussions with newly diagnosed patients as guidance information. However, exactly how helpful it is likely to be in a discussion with a man who has just been diagnosed may be open to some question.

White et al. report on use of data from the CaPSURE registry to study quality of life in men diagnosed with and treated for locally advanced prostate cancer (clinical stages T3-4). The authors emphasize that this is an initial, exploratory analysis. Unsurprisisingly, they come to the conclusion that, “Treatment for locally advanced prostate adenocarcinoma is associated with a significant burden in patients, notably decrements in urinary and sexual function.” They go on to state that, “ Clinicians should consider the impact that treatment imparts on quality of life when counseling patients with locally advanced disease.”

Holyoak et al., in reviewing the available data on the use of testosterone replacement therapy (TRT) in the management of hypogonadal males, continue to reach the conclusion that all men receiving TRT should be closely monitored for any evidence of prostatic disease.

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