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prostate cancer PATIENT REPORTED OUTCOMES IN PROSTATE CANCER Derek Raghavan MD PhD Cleveland Clinic Taussig Cancer Center Cleveland, OH. Rationale & Problems Difficulty of assessing response within “stable” disease category Use of patient reported symptom response widens the goalposts Contrast: symptoms of age symptoms of cancer side effects of therapy Dichotomy between objective vs. subjective vs. PSA response Optimal technology not defined Presentation of Advanced Prostate Cancer : Syndromes Bone pain Constitutional symptoms – the great mimic Urinary obstruction Slow stream, nocturia, frequency, hematuria Acute/chronic renal failure Bone marrow failure Unusual sites – liver, lungs, nodes, skin Urinary Obstruction ...

prostate cancer Prostate Cancer Specific Mortality – Clinical Issues in its Use in Validation of Surrogates Peter C. Albertsen, MD Farmington, CT Problem: Accurate assessment of cause of death is important for Determining clinical outcomes Calculating cause-specific survival rates Calculating population based mortality rates How is this done? Review of medical records Review of death certificate Interview family or other care givers How are Death Certificates Used? Information on death certificates is coded using ICD 9 - CM terminology How are Mortality Rates Calculated? A computer algorithm reviews the ICD 9 codes and determines the “official” cause of death The number of prostate cancer deaths is tabulated The total number of deaths is divided by the standard population ...

prostate cancer Hormone Sensitive Prostate Cancer Registration Trial Endpoints Donna J. Griebel, MD Division of Reproductive and Urologic Drug Products Outline Classes/Disease States Historic aspects Timing Endpoints Application to subsequent drugs in class Testosterone as a Surrogate Click to add title Advisory Committee Minutes : Dr. Messing “commented that there is now another lab marker that is considered to be a better estimate of prostate cancer volume PSA” Dr. _ “commented that he doesn’t think that PSA is the panacea that it is thought to be.” Classes of Approved Hormonal Therapies Diethylstibestrol - pre Food Drug and Cosmetics Act of 1962 GnRH analogs - agonists Leuprolide 1985 Non-Steroidal Anti-androgen Flutamide 1988 GnRH ...

Although the incidence of prostate cancer increased rapidly in the early 1990's due to increased public awareness of the disease and case finding due to de facto 'screening' with prostate specific antigen (PSA) testing, the incidence rate has reduced in the late 1990's. Overall incidence has increased between 1980- 82 and 1998-2000 by 93%. At the same time mortality has increased by about 33% up to 1989-91 and has remained stable since. Prostate cancer is the leading site for diagnosis of cancer amongst men. Background notes Prostate Cancer Page 2 Prostate Cancer - Incidence and Mortality* 1977-2000 All Ages Source - SA Cancer Registry Data 0 20 40 60 80 100 120 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 ...

The prostate The prostate is about the size of a walnut and is located just below the bladder. It surrounds the tube that carries urine from the bladder and out through the penis (the urethra). See the diagram, overleaf. Changes to the prostate Normally, cells grow and multiply only when the body needs them to. Cancer develops as a result of a breakdown in this process, leading to cells growing in an uncontrolled way. The mass of excess cells forms a tumour (growth), which may be benign or malignant. The tumour is described as malignant if it is able to invade other healthy tissue. The peripheral (outer) zone of the prostate is the area most susceptible to developing cancer . Risks and causes Prostate cancer is rare in men under 50 years old. However, the risk increases steadily with age and by the time they are 80, ...

A208: Prostate cancer tissues For research use only (formalin fixed) Specifications: • No. of cases: 40 • Tissue type: Prostate cancer tissues • No. of spots: 2 spots from each cancer case (80 spots) 4 non-neoplastic spots (4 spots) • Total spots: 84 • Corresponding normal tissues with cancers: Yes • Diameter: 1. 0 mm Documents : • Product specification: layout, summary of tissue spots • H&E stained images • Detailed pathological information Layout: Page 2 A208: Prostate cancer tissues For research use only (formalin fixed) Summary of tissue spots No. Age Key Word G V Size L Z TNM Stage Surgery 1 1, 2 52 Adenocarcinoma 4 5 0.8 r p II Prostatectomy ...

A223: Prostate cancer tissues - Stage III For research use only (formalin fixed) Specifications: • No. of cases: 45 • Tissue type: Prostate cancer tissues – Stage III • No. of spots: 2 spots from each cancer case (90 spots) 4 non-neoplastic spots (4 spots) • Total spots: 94 • Corresponding normal tissues with cancers: Yes • Diameter: 1. 0 mm Documents : • Product specification: layout, summary of tissue spots • H&E stained images • Detailed pathological information Layout: Page 2 A223: Prostate cancer tissues - Stage III For research use only (formalin fixed) Summary of tissue spots No. Age Key Word G V Size L Z Stage 1 1, 2 64 Adenocarcinoma 7 10 1.7 b ...

(formalin fixed) A302: Prostate cancer tissues with corresponding normal tissues For research use only Specifications: • No. of cases: 35 • Tissue type: Prostate cancer tissues with corresponding normal tissues • No. of spots: 2 spots from each cancer case (70 spots) 1 non-neoplastic spot from each corresponding tissue (35 spots) • Total spots: 105 • Corresponding normal tissues with cancers: Yes • Diameter: 1. 0 mm Documents : • Product specification: layout, summary of tissue spots • H&E stained images • Detailed pathological information Layout: Page 2 Summary of tissue spots (formalin fixed) A302: Prostate cancer tissues with corresponding normal tissues For research use only No Age Histological Diagnosis ...

May 2004 Newsletter # 42 (v. 5, 5) PCNG PROSTATE CANCER NETWORKING GROUP of Greater Cincinnati PCNG ( http://www.pcngcincinnati.org ) is a chapter of USToo Founder: Bob Kanter - Conveners Emeriti: Adrian Boie, Lou Stadler - Facilitators: 8/03: Stan Moczydlowski; 9/03: Steven Plymire; 10/03: Tom Young; 11/03: Steve Steiner; 1/04: Jerry Glenn; 2/04: Jack Ramsay; 5/04: Dick Fencl Newsletter (326 copies this issue) - Editors: Kees DeJong & Fran Stanton 779-0144 Adrian Boie: 1989, PSA 13, GS 9; RP, EBRT, IHT, HT 751-6888 Kees DeJong: 1996, PSA 24, GS 9; IHT, EBRT+Brachy, IHT 253-6768 John Hoffmann: 1997, PSA 5, GS 6; RP, EBRT TELEPHONE CONTACTS: 528-2769 Gordon Huntley: 1999, PSA 4, GS 9; RP and Orchiectomy 733-5745 Bill Riggs: 1995, PSA 33, GS 6; RP, EBRT, HT ...

www.datamonitor.com For details of all Datamonitor Healthcare Market Briefs, go to: A Datamonitor Market Brief Publication Date: Dec-03 Product Code: BFHC0640 thought-provoking Fresh opinions and out-of-the-box thinking Unique survey data and interview results Hundreds of hours of analyst time distilled into a few pages Reacting to the latest news breaking in your industry focused primary research timely On October 28th, news broke that AstraZeneca's Casodex 150mg was being withdrawn from its localized prostate cancer indication in many markets after new data from the IL0025 trail showed an increase in mortality for Casodex versus placebo. Datamonitor's Casodex Market Brief provides a timely overview of the impact of these events on AstraZeneca's drug and the prostate cancer market as a whole. Initial ...

— T HIRD E DITION — S E P T E M B E R 2 0 0 2 Published as a public service by Prostate Cancer Fund (A special program of Project Cure) P.O. Box 96673, Washington, D.C. 20090-6673 • 1-800-716-2152 Treatment of Prostate Cancer with Natural Therapeutics MT952-REP Page 2 2 Introduction: The prostate is a gland in the male reproductive system that helps produce semen, the thick fluid that carries sperm cells. The prostate is a walnut-sized structure located beneath the bladder of males. It surrounds the upper part of the urethra. The urethra is the tube that carries urine from the bladder. Prostate function is regulated by testosterone, the male sex hormone produced primarily in the testicles. Prostate cancer represents a significant number ...

Induction of Polyclonal Prostate Cancer -Specific CTL Using Dendritic Cells Transfected with Amplified Tumor RNA 1 Axel Heiser,* Margaret A. Maurice,* Donna R. Yancey,* Ning Z. Wu,* Philipp Dahm,* Scott K. Pruitt, † David Boczkowski, § Smita K. Nair, § Michael S. Ballo, ‡ Eli Gilboa, § and Johannes Vieweg 2 * Polyvalent cancer vaccines targeting the entire antigenic spectrum on tumor cells may represent a superior therapeutic strategy for cancer patients than vaccines solely directed against single Ags. In this study, we show that autologous dendritic cells (DC) transfected with RNA amplified from microdissected tumor cells are capable of stimulating CTL against a broad set of unidentified and critical prostate -specific Ags. Although the polyclonal CTL responses ...

Table of Contents Casodex 150mg BFHC0640 © Datamonitor (Published 12/2003) Page 13 This brief is a licensed product and is not to be photocopied TABLE OF CONTENTS ABOUT DATAMONITOR HEALTHCARE 2 About the oncology pharmaceutical analysis team 2 EXECUTIVE SUMMARY 3 Scope 3 Key findings for Casodex 150mg 4 Although there is no consensus amongst opinion leading physicians from the US and Europe on Casodex 150mg’s withdrawal in localized disease, many believe that regulatory authorities have over-reacted. As such, Datamonitor expects Casodex sales growth to be reduced, but overall sales to continue to increase 5 Casodex 150mg is likely to regain approval for the treatment of localized disease if AstraZeneca focuses on the benefits in patients with aggressive tumors, foregoing approval for the treatment ...

44 VOL. 6 NO. 1 2004 REVIEWS IN UROLOGY Nocturia continued desmopressin’s safety in this group of healthy Norwegians would translate to the ethically diverse US elderly popula- tion, with its multiple medical problems. In addition, acceptable sodium levels after 3 days of treatment does not guarantee that the drug is safe after 1 month or 1 year of administration. Several of my patients have presented to the emergency department with confusion and were subse- quently found to have sodium levels less than 125 mmol/L after taking stable does of desmopressin for weeks to months. Overall, I believe that desmopressin is a safe and effective drug, and I have had success with this treatment in adult neurogenic bladder patients. However, use of desmopressin in the elderly, even if apparently healthy, should be initi- ated with considerable caution. Erectile Function The ...

M ANAGEMENT U PDATE VOL. 6 NO. 1 2004 REVIEWS IN UROLOGY 1 Anemia in Men With Advanced Prostate Cancer : Incidence, Etiology, and Treatment Jeffrey G. Nalesnik, MD,* Angela G. Mysliwiec, MD, † Edith Canby-Hagino, MD* *Department of Urology, Wilford Hall Medical Center, Lackland Air Force Base, San Antonio, TX; † Hematology/Oncology Service, Brooke Army Medical Center, San Antonio, TX Anemia associated with advanced prostate cancer is a common occurrence. This article reviews the incidence and examines the various causes of this condition, including androgen deprivation, nutritional decline, bone marrow infiltration, treatment-related toxicity, and the chronic inflammatory state. Treatment of anemia in men with advanced prostate cancer is also discussed. In patients with limited bone marrow ...

March, 2004 PATIENT POWERline from the desk of Marie Savard, M.D. RE: Guidelines for Surviving Prostate Cancer Dear Friends, A friend and colleague, Dr. Roy Berger, has just published a new edition of his book - Updated Guidelines for Surviving Prostate Cancer by E. Roy Berger, M.D., F.A.C.P. and James Lewis Jr., PhD. Many of us have a family member or friend who has been diagnosed with prostate cancer and therefore it is an important topic. Dr. Berger has given me an excerpt from his book dealing with the latest research and findings on the treatment of prostate . Please share this information with anyone you know who could benefit from this most up-to-date information presented in a clear way. The information seemed too important to summarize in my usually small newsletter so I have attached the entire excerpt. Updated Guidelines for Surviving Prostate Cancer ...

• oncology/radiation therapy T HE I NTERNA TIONAL R EVIEW OF P ATIENT C ARE 32 Effective treatment of prostate cancer Advances in imaging technology provide increased knowledge of a tumour and its location, which has led to real-time planning and treatment techniques that improve the results and ef ficiency of radiotherapy. • U Lutz, F van Krieken, Nucletron BV B rachytherapy is increasingly becoming a successful and cost-ef fective method of treating prostate cancer . When contemplating brachytherapy, the physician has two choices: t r e a t i n g t h e c a n c e r w i t h r a d i o a c t i v e s e e d s , w h i c h a r e permanently implanted in the prostate , or using high-dose-rate brachytherapy (HDR), whereby a single, highly radioactive ...

November/December 2001, Vol. 8, No.6 496 Cancer Control Radical Prostatectomy in the Management of Clinically Localized Prostate Cancer Raviender Bukkapatnam, MD, and Julio M. Pow-Sang, MD Background: Several management options are available when prostate cancer is diagnosed at an early stage. However, the optimal treatment for localized prostate cancer is unknown, and reports in the literature are controversial regarding the best treatment modality for this early presentation. Methods: The authors review improvements in surgical technique that have decreased complications, and they address long-term outcomes of surgery related to cancer control. Results: Improvements in surgical techniques allow for decreased intraoperative complications. The incidence of long-term complications such as incontinence and impotency is also reduced. The 5- and 10-year progres- ...

Prostate cancer and use of nonsteroidal anti-inflammatory drugs: systematic review and meta-analysis S Mahmud* ,1,2,3,4 , E Franco 1,3 and A Aprikian 2 1 Department of Oncology, McGill University, Gerald Bronfman Centre, 546 Pine Avenue West, Montreal, Quebec, Canada H2W 1S6; 2 Department of Surgery (Urology) McGill University, Montreal, Quebec, Canada; 3 Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada Animal and laboratory studies suggest that regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce prostate cancer risk. To assess this association, we conducted a systematic review and meta-analysis of observational studies published before January 2003. We derived summary odds ratios (ORs) using both fixed and random effects models and performed subgroup analyses ...

Prostate Cancer is the most common cancer of men in the U.S. The Mayo Clinic states that "by age 50, up to one in four men have some cancerous cells in the prostate gland" and by age 80, one in two men do. Yet, having prostate cancer doesn't necessarily mean you will die of it. In fact, American men have only a 3% risk of dying of the disease, though a 30% risk of contracting it. What exactly is prostate cancer ? It means that a malignant (cancerous) tumor has grown within the prostate , a small muscular gland found in the male reproductive system. The prostate can be found at the "neck" of a man's bladder, in front of the lower part of the large intestine called the rectum, and around a portion of the urethra, the path that expels urine and semen from the body. There are four stages of prostate cancer . Stages T1 and T2 involve cancer of the prostate gland only, while Stage T3 ...

As we process data from a successful Prostate Cancer Awareness Week 2001, the Prostate Cancer Education Council has begun to make event plans for 2002. With the publications of many studies confirming the significant life-saving impact of prostate cancer screenings, we are working more diligently to reach more men with the life-saving information and services we have been providing now for well over a decade. Fundraising and awareness events make it possible to reach more men, provide better support services and ultimately, save more lives. The following events are being planed for 2002: Drive for Life 2002 The Prostate Cancer Education Council has embarked on one the most significant health promotions for men ever undertaken. We’re out to identify one million men prior to prostate cancer awareness week that we can send potentially life saving information to about prostate health ...

prostate cancer Advanced Prostate Cancer AUA 2002 Click to add sub-title Click to add title Can we define parameters important in prostate cancer progression? Abstract 696 (Kuefer et al) 21 patients with high grade or locally advanced PCa on androgen suppresion after RP Follow up of > 2 years 12 progressed, 9 stable Conventional retrospective analysis (Gleason score, stage , pretreatment PSA, node burden) did not discriminate between successes and failures of androgen suppression EZH-2 cDNA overexpression with immunohistochemical corroboration did Abstract 695 (Xin et al), Characterize the expression of genes in the prostates of 15 patients died from hormone resistant PCa harvested in warm autopsies cDNA expression analysis and immunohistochemistry in tissue microarrays ...

Making Prostate Cancer Making Prostate Cancer History In Virginia History In Virginia Carol Noggle Virginia Prostate Cancer Coalition 2 Prostate Cancer In Virginia Prostate Cancer In Virginia Too many Too many Virginians are Virginians are diagnosed with diagnosed with late late - - stage prostate stage prostate cancer with no cancer with no chance of a cure. chance of a cure. Page 2 3 Virginia Virginia PCa PCa Incidence Incidence Virginia, 145.4 U.S., 168.9 130 135 140 145 150 155 160 165 170 Incidence Source: American Cancer Society 2003 Facts and Figures for 1995-1999 ...

Prostate Cancer Thousands of men will be diagnosed with prostate cancer this year and if it’s caught early, it’s a highly treatable disease. If its already prevalent in your family, you may be undergoing routine screening, but if you don’t know much about prostate cancer , education is the first step. THE OLDER A MAN GETS, THE MORE FAMILIAR THIS ROOM WILL BECOME. NINETY-PERCENT OF ALL MEN 70 AND OLDER WILL BEGIN TO NOTICE SOME CHANGES IN THEIR URINARY FUNCTION. MOSTLY IT’S DUE TO THE PROSTATE , WHICH IS THE MALE SEX GLAND, THAT OVER TIME, CAN GROW AND PUSH AGAINST THE BLADDER. THIS CONDITION ON ITS OWN IS NOT LIFE THREATENING, BUT IT IS ONE OF THE FIRST OF MANY SYMPTOMS DOCTORS WILL LOOK FOR IN DETECTING PROSTATE CANCER . Dr. Primo Lara, medical oncologist, UC Davis Medical Center “ Prostate Cancer can present in different ways in an individual. He could have blood ...

Access to Prostate Cancer Treatment Prostate cancer is the most common type of cancer among men. It’s the second highest leading cause of cancer deaths in men behind lung cancer , but if it’s diagnosed early, it is treatable. Now in California there’s a new program that will ensure access to prostate cancer treatment for all California residents. PROFESSIONAL HORSEMAN WALT “BUBBA” COURTNEY HAD NO IDEA THAT HE HAD DEVELOPED PROSTATE CANCER . Walter Courtney “Last summer I was feeling tired, weak, run down, my legs were swelling. Not knowing, what or anything about the prostate cancer at the time, I just thought I was getting old.” FINALLY, HE DID GO TO A DOCTOR WHO GAVE HIM A BLOOD TEST FOR PROSTATE CANCER . THIS TEST, WHICH DETERMINES THE AMOUNT OF PSA OR PROSTATE SPECIFIC ANTIGEN IN THE BLOOD, IN WALTER’S CASE, YIELDED SHOCKING RESULTS. ...

R EVIEWING THE L ITERATURE Prostate Cancer Hereditary and Familial Prostate Cancer : Biologic Aggressiveness and Recurrence Steven R. Potter, MD, Alan W. Partin, MD, PhD The Brady Urological Institute, The Johns Hopkins Hospital Baltimore [ Rev Urol. 2000:2(1):35-36] A lthough all men are at increased risk for prostate cancer developing with increasing age, a family history of prostate cancer in a first-degree relative multiplies that risk approximately twofold. The terms “familial” and “hereditary” prostate cancer both imply increased risk but are not synonymous. Familial prostate cancer refers to a clustering of this disease within families. Hereditary prostate cancer (HPC) refers to a specific subtype of familial prostate cancer marked by a pattern consistent with ...

GEArray Q Series Mouse Androgen Signaling and Prostate Cancer Gene Array Cat. No. (Rad / Non-Rad) * Kit MM-031- 02 / MM-031N-02 2 Arrays MM-031- 04 / MM-031N-04 4 Arrays MM-031-12 / MM-031N-12 12 Arrays Description GEArray Q Series Androgen Signaling and Prostate Cancer Gene Array is designed to assess the role of 96 genes in androgen-regulated processes that are involved in malignant transformation of prostate gland. Androgen signaling plays an important role in the pathogenesis of prostate cancer , as exemplified by androgen ablation therapy for advanced prostate cancer . Activation of the PI3K/AKT/FRAP pathway has also been found to contribute to hormone resistant growth of recurrent prostate cancer . On the Androgen Signaling and Prostate Cancer Gene Array, ...

Draft Report of Workshop “Informatics Solutions for Prostate Cancer ” Sponsored by the Canadian Prostate Cancer Research Initiative Toronto, October 26-7, 2001 Organizing Committee: Brenda Gallie (Chair), Jack Boomer, Mary Gospodarowicz, Alex Jadad, Michael Jewett, Francis Lau, Charles Ludgate, Ron Heslegrave, Jim Till, Maryjane Salpeter The objective of the Informatics Solutions for Prostate Cancer Workshop was to inspire research and application of medical informatics to reduce the impact of prostate cancer on the health of Canadians. The discussions and ideas generated in the Workshop was to maximize the benefit of informatics research on many aspects of prostate cancer research, education, and implementation of new knowledge, in order to decreased suffering and impact of prostate cancer . The Workshop brought together recognized leaders in medical informatics ...

Robert Wood Johnson University Hospital Department of Public & Community Affairs (732) 937-8521 NEWS For Immediate Release Contact: Laurie Miller September, 24, 2001 (732) 937-8519 FOR COMMUNITY CALENDAR Free Prostate Cancer Screening Wednesday, October 3, 2001 WHAT: Since prostate cancer is the most commonly found cancer in men, and found at an even higher rate among African-American men, the Robert Wood Johnson University Hospital Community Health Promotion Program, in conjunction with the Cancer Institute of New Jersey, offers periodic free prostate cancer screening. Screening is open to all men 50 years and older with no history of prostate cancer in their family, or men over 40 years with a family history. This exam can identify early stage prostate cancer , which when detected early ...

PROJECT 4 –TRANSCRIPTOME & PROTEOME STRATIFICATION OF PROSTATE CANCER ADENOCARCINOMA PHENOTYPES Prostate cancer is a complex disease that presumably stratifies into different types of cancers with distinct progression rates, metastatic potentials and prognostic outcomes. We hypothesize that histologically similar primary prostate carcinomas can be stratified into distinct categories of clinical behavior based upon profiles of their expressed genes . We will determine the gene expression profiles of prostate carcinoma that correlate with clinical phenotype of progression or non-progression as determined by PSA-free survival at 5 years post-therapy. The expression profiles from the normal and neoplastic tissues of 100 individuals that have undergone radical prostatectomy will be determined. Outcomes will be measured by following serial PSA measurements for recurrent disease. Correlations ...