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MANAGEMENT OF PROSTATE CANCER Scott North, MD Medical Oncologist, CCI scottnor@cancerboard.ab.ca Pharm 589 November 17, 2003 Page 2 Overview • Normal prostate : anatomy, physiology, role of hormones • Prostate cancer : general overview • Treatment of prostate cancer – local and metastatic disease – role of hormonal therapy – role of chemotherapy • Summary Page 3 Normal Prostate • Small walnut sized gland situated beneath the bladder neck, anterior to the rectum • main function is to produce secretions that form part of seminal fluid • normal prostate is under hormonal influences with testosterone being the major androgen – 95% from testicles; 5% adrenal glands – conversion to 5 DHT inside prostate cells by 5 alpha reductase ...

1 A MARINE’S PROSTATE CANCER JOURNAL By John Van Nortwick I am posting this journal that records my experiences with prostate cancer in the hope that it will help one or more of the Marines or other Vietnam Vets out there. While it may be preaching to the choir for many whom have already been thru this, I feel that if I can help just one of you who is facing the same situation I did, then it will be well worth the effort. The possible relationship between Vietnam service, Agent Orange, and prostate cancer makes it even more important to post this. The increasing number of deaths of so many Popasmoke members from cancer in the recent past only reinforces this more. I do not pretend to say that we did the right things or the wrong things, just stating the things we did. I use the term “we” and “us” because my wife, Sonja, who many of you know, was beside me every step of the ...

The vision of our group is to bring together men who have prostate cancer plus their wives/partners and families to give support based on our own experiences. We will also work to raise the awareness of friends, neighbours and the community to the need for men to ask their doctor for a Prostate Specific Antigen (PSA) blood test to help rule out the likelihood of having prostate cancer . Our Golden Rule: We do not give medical advice—your GP, your Urologist and allied health professionals are the only people who are legally qualified to give you medical advice. WE GIVE YOU OUR WHOLEHEARTED SUPPORT . RESOURCES For more valuable information: The Prostate Cancer Foundation of Australia, PO Box 1332, Lane Cove, NSW, 1595 Tel: 1800 220 099 (toll free) Or (02) 9418 7942 Fax: (02) ...

We are here PROSTATE CANCER SUPPORT F O R Y O U and Your Family Onkaparinga Group South Australia An affiliate Member of the Prostate Cancer Foundation of Australia Mail us at: PO Box 627 Noarlunga Centre, SA 5168 Telephone: (08) 8382 6671 NEWSLETTER NOVEMBER 2003 Our meeting was held at Noarlunga Health Services Community Hospital on Wednesday 5 th November 2003, at 6.30 pm. Thank you to our Sponsors, Woodcroft Community Health Services, The Cancer Council S.A, and Port Noarlunga Christies Beach R & S. L, for helping with the Photocopying of our Newsletter. Chair: John Shields. Guest: Councillor Artie Ferguson. Present: 17. Apologies: Chris and Alice Conway, Trish Garraway, Ann Jones, Dolph and Ann ...

prostate cancer FAMILY HISTORY OF PROSTATE CANCER Men in the United States without any family history of prostate cancer have a one in eight chance of developing prostate cancer . Men that have one first degree relative (father or brother) with prostate cancer have twice the lifetime risk of contracting the disease (one out of four chance). Men with two affected first-degree relatives have five times the risk as men with out a family history (one out of two chance). Men with three affected first degree relatives are at eleven times greater risk of getting prostate cancer compared to men that have no family history. PROSTATE CANCER SCREENING The PSA level in the blood is very stable in healthy men without prostate cancer . PSA levels in men with cancer almost always tend to elevate. PSA blood test values in men without prostate cancer will generally be very stable ...

With a special focus on seed implantation ( Prostate Brachytherapy) Prostate Cancer Patient Information Page 2 Prostate Cancer Patient Information Page 3 3 Prostate Cancer Dear patient, Prostate cancer is the most common cancer amongst men. There is a high probability of cure if it is detected at an early stage. New developments facili- tate its treatment with a small invasion and minimal side effects. This brochure gives you a brief overview of the disease, the diagnostics and treatment options and puts a specific focus on seed implantation (brachy- therapy). This information does not replace the need for con- sulting the physician. Only the patient and the treating physi- cian can define the best treat- ...

PROSTATE CANCER WITH LARGE GLANDS TREATED WITH 3- DIMENSIONAL COMPUTERIZED TOMOGRAPHY GUIDED PARARECTAL BRACHYTHERAPY: UP TO 8 YEARS OF FOLLOWUP PANOS G. KOUTROUVELIS, NIKO LAILAS, STUART KATZ, JAMES SEHN, GUILLERMO GIL-MONTERO AND NABIL KHAWAND From the Uro-Radiology Prostate Institute, Vienna, Virginia ABSTRACT Purpose: We report post-brachytherapy results in patients with cancer in a large prostate . Materials and Methods: From June 1, 1994 to June 30, 2000, 331 consecutive patients with a large prostate of 50 to 180 cm. 3 (median 69) were treated with 3-dimensional computerized tomography guided brachytherapy. Patient age was 42 to 90 years (median 69). Of these patients 327 were available for followup for 2 to 8 years (median 4.5). Patients were stratified according to risk profile. The high risk group had 1 or more high risk factors ...

Treatment of Localized Prostate Cancer With Intermittent Triple Androgen Blockade: Preliminary Results in 110 Consecutive Patients R OBERT L. L EIBOWITZ , S TEVEN J. T UCKER Compassionate Oncology Medical Group, Los Angeles, California, USA Key Words. Prostate cancer · Triple androgen blockade A BSTRACT Objectives . To determine the effectiveness of triple androgen blockade as an alternative to watchful wait- ing, radical prostatectomy or radiation therapy in the management of patients with clinical stage T1 to T3 prostate cancer . Methods . The records of 110 consecutive patients were retrospectively evaluated. Patients were treated with a three-drug androgen blockade regimen, consisting of a luteinizing hormone-releasing hormone agonist (leuprolide ...

C onseil d’ É valuation des T echnologies de la S anté du Québec Report submitted to the Minister of Research, Science and Technology of Québec Conseil d’évaluation des technologies de la santé du Québec Report – January 2000 BRACHYTHERAPY AND PROSTATE CANCER (CETS 99-5 RE) Page 2 Information concerning this report or any other report published by the Conseil d'évaluation des technologies de la santé can be obtained by contacting the Conseil : Conseil d’évaluation des technologies de la santé 201, boulevard Crémazie est, Bureau 1.03 Montréal (Québec) H2M 1L2 Telephone: (514) 873-2563 Fax: (514) 873-1369 E-mail: cets@msss.gouv.qc.ca Web site address: http://www.msss.gouv.qc.ca/cets/ Legal deposit Bibliothèque nationale du Québec, ...

A Patient’s Guide An Educational Service of The Canadian Prostate Health Council Prostate Cancer Page 2 What do you know about prostate cancer ? Prostate cancer is the most common cancer diagnosed in Canadian men and the second most common cause of cancer deaths. Despite this, most men know very little about their prostate or prostate cancer . Can you answer the following questions? 1. The function of the prostate is to a) produce sperm b) store urine c) produce fluid in which sperm travel 2. Early prostate cancer usually causes a) no symptoms b) blood in the urine c) inability to urinate 3. The chance of a Canadian man developing prostate cancer in his lifetime is a) 1/100 b) 1/50 C) 1/8 4. Prostate cancer spreads to which ...

OUR VOICE FALL 2003 6 Dr. Neil Fleshner is Head of Urology at the University Health Network and of the Genitourinary Cancer Program at Princess Margaret Hospital, in Toronto. atively rare in other parts of the world — espe- cially the Far East. In countries such as Japan, China and Thailand, few men are diagnosed with, or die from, prostate cancer . Two possibilities exist to help explain this phenomenon. The first is that Asian populations may be protected by heredity from prostate can- cer, the second that elements in their environ- ment (food, culture, levels of pollution) work against the development of the condition. To sort out this issue of “genes versus environment,” Around the world Epidemiologic studies that attempt to uncover risks or protective factors associated with prostate cancer provide some telling hints about ...

Prostate Cancer Awareness Week 2003 Blood Test Information Sheet for Men At your PCAW screening you had a single tube of blood drawn in order to conduct the following tests: PSA This is a well known blood test used for prostate cancer screening where the level Prostate Specific Antigen (PSA) in the blood is measured. PSA is a protein produced by prostate cells. If you have an abnormal or high PSA level, you may have prostate cancer or other prostate disease. PSA results under 4 ng/ml are usually considered normal, values between 4-10 ng/ml are considered borderline and results over 10ng/ml strongly suggest prostate cancer . If your PSA result is over 4 ng/ml you should consult with your physician or urologist for further evaluation. cPSA The Complexed Prostate Specific Antigen (cPSA) is also used to aid in the detection of prostate cancer . cPSA measures ...

Facts About Prostate Cancer October 2003 What You Should Know Prostate cancer has been the most frequently diagnosed cancer in Michigan since 1991. 1 Prostate cancer was the second leading cause of cancer deaths among Michigan men during 2001. 2 In the time period between 1996 and 2000, Michigan ranked 20 th highest in the nation in prostate cancer mortality. 3 It’s not clear whether early detection of prostate cancer will improve a man’s chance of survival. Many doctors believe it will help, but not all doctors agree. Before deciding to be tested, every man should know what choices he has if prostate cancer is found. 4 Because treatment of prostate cancer may have serious adverse side effects (including urinary ...

Men's Health - Prostate Cancer Screening Age 50 and older and ever had a Prostate Specific Antigen (PSA) blood test? In the 2002 survey, 79 percent of men age 50+ responded that they had a Prostate Specific Antigen (PSA) blood test. Significantly higher percentages of men age 65+ reported having ever had a PSA blood test (age 65-74, 89 percent, and age 75+, 88 percent) compared to men age 50-64 (71 percent). Men age 50+ with some college education or a college degree had significantly higher percentages of ever having had a PSA blood test (82 and 83 respectively) compared to age 50+ men with less than a high school education (68 percent). The percentage of men age 50+ who had a PSA blood test increased significantly from 55 percent in 1995 to 79 percent in 2001 and 2002. The majority of this increase was seen between the result in the year of 1998 (57 percent) and the year 2000 ...

prostate cancer Identification of prostate cancer -specific genes strongly correlated with gleason score by whole genome expression profiling Pengbo Liu1, Andrew N. Young1, Qiqin Yin-Goen1, Noelani L. Anderson1, Lara Harik1, William Choi1, John Petros2, So Dug Lim1, Mahul Amin1 and Carlos S. Moreno1 1Department of Pathology & Laboratory Medicine and 2Urology Department, Emory University School of Medicine, Atlanta, GA 30322 We have performed whole genome expression profiling of 24 prostate cancer tissue samples and 12 matched normal adjacent tissues from 5 African-American patients and 19 Caucasian patients with Gleason scores ranging from 6-9. Using Affymetrix human U133 genome arrays representing approximately 39,000 transcripts, we have identified 200 probe sets corresponding to 185 unique genes that are highly discriminatory between tumor and normal prostate tissues. ...

13.1. INTRODUCTION AND SUMMARY Prostate cancer was the second commonest non-cutaneous cancer in men (Table 13.1). Men had a 5% risk of developing prostate cancer before age 75, and a 1.6% chance of dying before the same age. Prostate cancer incidence has increased since 1994, at an annual rate of 1.6%. Whether this is due to better case- finding, more incidental diagnoses or a true increase in incidence is unknown. Table 13.1. Summary of incidence and mortality statistics: prostate cancer INCIDENT CASES DEATHS All cancers (invasive, in situ and uncertain) (ICD-O-2 C61) 1997 cases 1133 536 % of all cancers (male) 10.7% 13.3% Incidence and mortality rates (per 100,000 persons per year) crude rate 62.6 29.6 World age-standardised rate 44.6 18.8 European age-standardised rate 71.3 32.9 cumulative ...

For Internal Use Only. Not For Use With The Public. This material is intended for insurance informational purposes only and is not personal medical advice for clients. Prudential Financial and the Rock logo are registered service marks of The Prudential Insurance Company of America and its affiliates. The Prudential Insurance Company of America 751 Broad Street, Newark, NJ 07102-3777 RX15 DOC IFS-A005231, Ed. 09/03, Exp. 03/05 Prostate Cancer The prostate is a walnut sized gland that surrounds the urethra at the base of the bladder. It is made up of five lobes: anterior, posterior, median , and two lateral lobes. Prostate cancer is the most common cancer in men. One out of 6 men will be diagnosed with prostate cancer in his lifetime. Risk increases with a family history and advancing age. Ninety-five percent of prostate cancers are adenocarcinomas. Another form of cancer ...

IGF-I and Prostate Cancer J une M. Chan et al . ( 1 ) report that plasma insulin-like growth factor–I (IGF-I) was as- sociated with the risk of prostate cancer in a prospective study that paired 152 men with prostate cancer with age-matched healthy men (controls), aged 40 to 82 years at the start of the study. They found that prostate cancer risk increased with concentrations of IGF-I; men with IGF-I values in the highest quartile had 2.4 times [95% confidence inter- vals (CIs) 1.2 to 4.7] the risk of men in the lowest quartile. We conducted a prospective study of IGF-I and several aging-related disorders including prostate cancer in a sample of 765 men, ages 60 to 91 years at the start of the study. The sample was randomly select- ed from 113,000 health plan members (all ages, both sexes) who had had a multipha- sic health ...

phate-buffered saline for 1 hour, then permeabilized with 0.1 % Triton X-100 for 3 min, and incubated for 1 hour with rhodamine-conjugated phalloidin (Mo- lecular Probes). The cells were photographed with a Zeiss Axiovert microscope. 21. F. Michiels et al ., J. Cell Biol. 137, 387 (1997). 22. Y. Zheng, D. Zangrilli, R. A. Cerione, E. Alessandra, J. Biol. Chem. 271, 19017 (1996). 23. R.-H. Chen, S. Corbalan-Garcia, D. Bar-Sagi, EMBO J. 16, 1351 (1997). 24. L. McCollam et al ., J. Biol. Chem. 270, 15954 (1995). 25. J. Zheng et al ., J. Cell Biol. 272, 30340 (1997). 26. S. Koshiba et al ., J. Mol. Biol. 269, 579 (1997). 27. T. Joneson, M. McDonough, D. Bar-Sagi, L. Van Aelst, Science 274, 1374 (1996). 28. P. Rodriguez-Viciana et al ., Cell 89, 457 (1997). 29. B. Yatsula and D. Bar-Sagi, unpublished observation. 30. M. A. White et al ., Cell ...

Page 2 In taking the lead on forming the Mayors’ Coalition for Prostate Cancer Awareness and Education, Denver Mayor Wellington E. Webb, USCM President 1999-2000, acted on the recommendation of the Conference’s Health and Human Services Standing Committee, chaired by Beaumont Mayor David W. Moore, who continued the prostate cancer work of the Committee’s former Chairman, Hempstead Mayor James A. Garner. The Mayors’ Coalition for Prostate Cancer Awareness and Education is dedicated to saving lives through informed decision making on screening and treatment. Launched in June 2000 by The United States Conference of Mayors, this new initiative addresses an old concern of the nation’s mayors. Here are the statistics that have compelled the mayors to act. A common cancer : Prostate cancer hits one man ...

EXPRESSION OF 3,582 GENES IN PC3-M CELL LINE TREATED WITH GENISTEIN: THE COMPLETE DATA SET AND VARIABILITY IN EXPRESSION INFORMATION LIST Borko D. Jovanovic, PhD 1,2,3 , Thomas M. McKibben II, PhD 2,3 , Raymond C. Bergan, MD 1,4 Robert H. Lurie Comprehensive Cancer Center (1) General Clinical Research Center (2) Department of Preventive Medicine (3) Department of Medicine, Division of Hematology/Oncology (4) Feinberg School of Medicine of Northwestern University Contact: borko@northwestern.edu Supported in part by grant M01 RR00048 from the NCRR/NIH P30 CA60553, from NCI, and by 1R21 CA99263-01, from NIH Version: May 20, 2003 Abstract We present a data set consisting of 3,582 gene expressions measured eleven times, and another data set consisting of coefficients of variation computed from it. Measurements ...

Ending the Threat of Prostate Cancer PROGRESS REPORT ON PROSTATE CANCER RESEARCH November 2002 Page 2 Ending the Threat of Prostate Cancer PROGRESS REPORT ON PROSTATE CANCER RESEARCH TABLE OF CONTENTS Part I Prostate Cancer : Ending the Threat Introduction 1 The Prostate and Prostate Cancer 1 Epidemiology 1 Symptoms 2 Risk Factors 3 Prevention 4 Early Detection 5 Treatment Options 6 Funding for Prostate Cancer Research 7 Research Funded by the Prostate Cancer 7 Research Foundation of Canada Part II Defeating Prostate Cancer : A Research Survey Introduction 11 Early Detection, Diagnosis and Prognosis 12 Biology, Progression and Metastasis 12 Genetic ...

From the Library of the Men’s Health Network www.menshealthlibrary.org For Immediate Release Office of the Press Secretary September 1, 2003 National Prostate Cancer Awareness Month, 2003 By the President of the United States A Proclamation Prostate cancer is the second most common form of cancer among men in the United States. This year alone, it is estimated that more than 220,000 new cases of prostate cancer will be diagnosed and that nearly 29,000 men will die from this disease. During National Prostate Cancer Awareness Month, we seek to increase understanding about the risk factors of prostate cancer , the importance of a healthy lifestyle, and the benefits of detecting the disease in its earliest stages, when it is most treatable. Although the exact cause of prostate cancer is unknown, several factors have been found to increase the ...

ACR PRACTICE GUIDELINE Brachytherapy of Prostate Cancer / 545 The American College of Radiology, with more than 30,000 members, is the principal organization of radiologists, radiation oncologists, and clinical medical physicists in the United States. The College is a nonprofit professional society whose primary purposes are to advance the science of radiology, improve radiologic services to the patient, study the socioeconomic aspects of the practice of radiology, and encourage continuing education for radiologists, radiation oncologists, medical physicists, and persons practicing in allied professional fields. The American College of Radiology will periodically define new practice guidelines and technical standards for radiologic practice to help advance the science of radiology and to improve the quality of service to patients throughout the United States. Existing practice guidelines and technical standards will ...

Nutrition & Prostate Cancer Natalie Ledesma, MS, RD Cancer Resource Center UCSF Comprehensive Cancer Center University of California, San Francisco Scientific evidence suggests that differences in diet and lifestyle may account in large part for the variability of prostate cancer rates in different countries (ACS). Good nutrition may reduce the incidence of prostate cancer and help reduce the risk of prostate cancer progression. There are many studies currently being conducted to help further understand how diet and prostate cancer are related. We do know, however, that improved nutrition reduces risk of heart disease, diabetes, and obesity, and usually improves overall quality of life. It is estimated that one-third of cancer deaths in the U.S. can be attributed to diet in adulthood, including diet’s effect on obesity. Additionally, a healthy ...

PROSTATE CANCER & ITS TREATMENT This document was written by the UCSF Medical Center Prostate Cancer Research Advocates GREETINGS! These guidelines are designed to help inform you about prostate cancer and to help you in your decision making. We know that fully understanding prostate cancer and making deci- sions about treatment can be difficult. We hope these guidelines will help you develop confi- dence in the course of treatment you choose. For some people, almost all of the information presented here is completely new. Others already may be well informed about prostate cancer and its treatment, and much of what is discussed will be familiar. Either way, don’t feel that this material has to be fully absorbed and understood in one reading. Reviewing portions of the material and discussing it with family, other men with prostate cancer ...

Cryoablation of Prostate Cancer Peter R. Carroll, M.D. Department of Urology University of California, San Francisco Introduction Cryosurgical ablation of the prostate using an open, perineal incision was started by Flocks and associates at the University of Iowa in 1969. 1 In this procedure, the posterior surface of the prostate , seminal vesicles and bladder base were exposed through a perineal incision. A cryoprobe was then inserted first into the prostate and/or adjacent tissues. The technique was monitored by visual and tactile inspection only. Such therapy resulted in coagulative necrosis of epithelial elements and replacement with fibrous stroma. Outcome (survival and recurrence) was related to stage and grade. Approximately 41% of patients eventually had evidence of persistent or recurrent disease. 2 Although the technique compared favorably ...

Brachytherapy for Prostate Cancer Mack Roach, III, MD; Katsuto Shinohara, MD; Joe Hsu, MD; and Peter R. Carroll, MD Departments of Radiation Oncology and Urology University of California, San Francisco Introduction Brachytherapy refers to a method of delivering radiation to cancers by placing radioactive sources either directly into the cancer or very close to it. Because the dose rate drops off rapidly as the distance increases from the source, brachytherapy has the advantage of delivering a high dose to the target volume and minimizing radiation to normal tissues adjacent to the cancer . Method For the management of prostate cancer , brachytherapy can be used as the primary treatment or in combination with external beam radiation or androgen deprivation. The most challenging aspects of brachytherapy are the identification of tumor volume and the accurate placement of the ...

S78 VOL. 5 SUPPL. 3 2003 REVIEWS IN UROLOGY A ndrogen ablation has proved to be an effective therapy for metastatic prostate cancer . Although rapid and dramatic regression of metastatic lesions often follows the achievement of castrate testosterone levels, this response generally lasts only 18 to 24 months. The majority of men eventually become refractory to androgen blockade, with a median survival time of 9 to 12 months. Cytotoxic chemotherapy for the treatment of hormone refractory Innovative Therapies for Prostate Cancer Treatment Samira Syed, MD, Anthony Tolcher, MD Institute for Drug Development, Cancer Therapy and Research Center, San Antonio, TX Androgen ablation is effective therapy for metastatic prostate cancer , but the majority of men eventually become refractory to this intervention. Cytotoxic chemotherapy offers palliation to ...

Prostate Cancer Prostate Cancer important information for you What is Prostate Cancer ? Prostate cancer is a disease that starts in the prostate . The prostate is a male sex gland about the size of a walnut. It is located just below the bladder. After skin cancer , prostate cancer is the most common cancer in men.The good news is that thousands of men across America have survived it. Am I at Risk for Prostate Cancer ? Anyone can get prostate cancer but there are reasons why some men are more likely to get it than others.These reasons are called risk factors. Risk factors for prostate cancer are: • Age. The risk for prostate cancer increases as you get older. • Family history. If you have a close relative, such as a father or brother, with prostate cancer , your risk for prostate cancer increases. ...