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Prostate cancer treatment in HIV-positive men

Posted Dec 12 2008 3:39pm

There are limited data available as yet on the treatment of prostate cancer in HIV-positive men. However, we can expect the need for such treatment to expand over the next 10-15 years.

A paper just published by Ng et al. in Urology reports on the authors’ experience in treatment of localized prostate cancer in 14 males with a prior diagnosis of HIV infection. All patients were treated with external beam radiation, brachytherapy or both.

All the patients had PSA levels, CD4 counts, and viral loads assessed immediately prior to radiation treatment and at the time of their most recent follow-up. In addition, 13/14 patients completed a quality of life survey and were examined by their radiation oncologist to assess the complications after treatment.

The results of this retrospective analysis are as follows:

  • At the most recent follow-up, only 1/14 patients had a PSA level > 1.1 ng/mL.
  • The patients’ mean CD4 counts remained generally stable, increasing from 523 to 577 cells/mm 3, with the lowest final count at 200 cells/mm 3.
  • Viral load increased in only 2/14 patients.
  • There were no unusual rectal, urinary, or sexual complications, and no infections related to treatment.

Based on changes in viral load and CD4 count, the authors conclude that radiotherapy does not appear to have any significant long-term negative effect on the immune system. Treatment complications are consistent with those seen in HIV-negative patients, giving no evidence that the subset of HIV-positive patients should be treated differently from prostate cancer patients without HIV when considering radiation therapy.

The authors note that more investigation will be necessary before reliable prostate cancer mortality and morbidity data can be assessed for HIV-positive patients.

Filed under: Uncategorized | Tagged: HIV-positive, radiotherapy

There are limited data available as yet on the treatment of prostate cancer in HIV-positive men. However, we can expect the need for such treatment to expand over the next 10-15 years.

A paper just published by Ng et al. in Urology reports on the authors’ experience in treatment of localized prostate cancer in 14 males with a prior diagnosis of HIV infection. All patients were treated with external beam radiation, brachytherapy or both.

All the patients had PSA levels, CD4 counts, and viral loads assessed immediately prior to radiation treatment and at the time of their most recent follow-up. In addition, 13/14 patients completed a quality of life survey and were examined by their radiation oncologist to assess the complications after treatment.

The results of this retrospective analysis are as follows:

  • At the most recent follow-up, only 1/14 patients had a PSA level > 1.1 ng/mL.
  • The patients’ mean CD4 counts remained generally stable, increasing from 523 to 577 cells/mm 3, with the lowest final count at 200 cells/mm 3.
  • Viral load increased in only 2/14 patients.
  • There were no unusual rectal, urinary, or sexual complications, and no infections related to treatment.

Based on changes in viral load and CD4 count, the authors conclude that radiotherapy does not appear to have any significant long-term negative effect on the immune system. Treatment complications are consistent with those seen in HIV-negative patients, giving no evidence that the subset of HIV-positive patients should be treated differently from prostate cancer patients without HIV when considering radiation therapy.

The authors note that more investigation will be necessary before reliable prostate cancer mortality and morbidity data can be assessed for HIV-positive patients.

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