1/354. Novel concept of antisurvival factor (ASF) therapy produces an objective clinical response in four patients with hormone-refractory prostate cancer: case report.BACKGROUND: osteoblasts and osteoblast-derived survival growth factors, such as insulin-like growth factor i (IGF I), inhibit chemotherapy apoptosis of prostate cancer cells, thereby producing cytotoxic drug-resistant tumor growth, in vitro. methods: We tested a novel therapeutic approach, referred to as antisurvival factor (AFS) therapy, that aimed at reduction of osteoblast-derived IGFs, using dexamethasone (4 mg per os, qD) and growth hormone (GH)-dependent liver-derived IGFs, using a somatostatin-analog (lanreotide, 30 mg, intramuscularly (i.m.), q14D) in combination with triptorelin (3.75 mg, intramuscularly, q28D) to produce a clinical response in 4 patients with progressing hormone-refractory prostate cancer. RESULTS: The patients given ASF therapy exhibited an excellent improvement of clinical performance and a decline of prostate-specific antigen (PSA) within 2 months of ASF therapy. One of them experienced excellent clinical response (normalization of PSA), two experienced good clinical response (decline of PSA of more than 50%), and one experienced stabilization (decline of PSA of less than 50%). CONCLUSIONS: We conclude that this novel concept of combination therapy, using ASF with hormone ablation, is a promising salvage therapy that should be further assessed with a randomized clinical trial.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/354. Interstitial microwave thermoablation for localized prostate cancer.The conventional treatment for localized prostate cancer can be associated with significant morbidity and cost. Interstitial microwave thermoablation is a minimally invasive procedure used experimentally to treat selected patients with failed radiation therapy of prostate cancer at our institution. Preliminary results in these patients suggest that this treatment might be a useful alternative in selected patients with previously untreated localized prostate cancer. In this report we describe the first use of percutaneous transperineal interstitial microwave thermoablation to treat a case of primary prostate cancer. There were no treatment complications. At 18 months the patient's serum prostate-specific antigen remains undetectable, and his prostate biopsy shows no evidence of malignancy. These very preliminary but exciting results in this single patient suggest that this experimental technique should be explored further.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
3/354. Progressive prostate cancer associated with use of megestrol acetate administered for control of hot flashes.Low doses of megestrol acetate are frequently used for treatment of hot flashes in men having androgen ablation for prostate cancer. We report a case in which megestrol acetate (20 mg bid) was administered for symptomatic control of hot flashes in a medically castrated patient with prostate cancer. The patient was subsequently noted to have a rising prostate-specific antigen (PSA) level. megestrol acetate administration was discontinued, and the PSA level declined. These data indicate that even the low doses of megestrol acetate used for control of hot flashes can be associated with PSA increases in some patients with prostate cancer.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
4/354. Adenosquamous carcinoma of the prostate.We present an unusual variant of prostatic adenocarcinoma with obvious squamous differentiation. The squamous component is represented by cells that contain vesicular or hyperchromatic nuclei and large acidophilic cytoplasm. We could demonstrate immunohistochemically the presence of prostate specific antigen (PSA) and glial fibrillary acidic protein (GFAP) in these tumour cells. Either in adenocarcinomatous or malignant squamous components, the prostatic epithelial cells showed the two markers, namely PSA, GFAP, which may reflect the multidirectional differentiation of these cells from a pluripotent origin.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/354. Mucin-producing carcinoma of the prostate: review of 88 cases.OBJECTIVES: To report on a case of mucinous carcinoma of the prostate and discuss the clinical and histopathologic features of the mucin-producing carcinoma of the prostate from a review of published reports. methods: Our case and 87 other previously reported cases were evaluated clinically and histologically. RESULTS: We encountered a case of mucinous carcinoma of the prostate, Stage C, which was treated by radical prostatectomy. After reviewing it and the 87 other cases, we believe that these cases of mucin-producing carcinomas can be divided into three groups: 60 cases of mucinous carcinoma, 17 cases of primary signet-ring cell carcinoma, and 11 cases of mucinous carcinoma with signet-ring cells. Mucinous carcinoma is a variant of high-grade adenocarcinoma of the prostate, wherein there is a 77.8% rate of prostate-specific antigen elevation and a similar rate (77.8%) of response to endocrine therapy. Fifty percent of patients survived 3 years and 25%, 5 years. In contrast, primary signet-ring cell carcinoma conveys one of the worst prognoses among patients with prostate cancer. There are no reliable tumor markers, and there was no response to endocrine therapy. patients with primary signet-ring cell carcinoma had a 27.3% 3-year survival rate; none survived to 5 years. The clinical features of mucinous carcinoma with signet-ring cells are very similar to primary signet-ring cell carcinoma; again, there was no response to endocrine therapy and the 3-year survival rate was 16.7%. CONCLUSIONS: Although it has been suggested that mucinous carcinoma is a variant of high-grade adenocarcinoma of the prostate, signet-ring cell carcinoma and mucinous carcinoma with signet-ring cells are other variants of carcinoma that develop in the prostate, and their prognoses are very poor.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
6/354. Prostatic signet-ring cell carcinoma: case report and literature review.Signet-ring cell carcinoma (SRCC) of the prostate is a very rare neoplasm and there have been only 38 cases reported to date. Here the 39th case of prostatic SRCC containing a small amount of neutral mucin, prostatic specific antigen (PSA) and prostatic specific acid phosphatase (PSAP) in the signet-ring cells is reported. It was also found that some intracytoplasmic lumina were derived from the shallow or deep invagination of luminal membranes of cancer cells that formed the neoplastic glands. Using immunohistochemistry, a combination of monoclonal antibodies against cytokeratins 7 and 20 as well as PSA and PSAP may be useful in differentiating prostatic primary SRCC from metastatic SRCC originating in the gastrointestinal tract.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
7/354. Use of PC-SPES, a commercially available supplement for prostate cancer, in a patient with hormone-naive disease.OBJECTIVES: PC-SPES, an over-the-counter supplement, is actually a combination of eight different herbs. It is being used by patients to treat cancer of the prostate at different stages of the disease and has been commercially available since November 1996. It has been observed to dramatically decrease prostate-specific antigen (PSA) values in several patients; however, its out-of-pocket cost ($162 to $486/mo) and potential side effects must be weighed against its potential objective benefits. We reviewed its use in 1 patient. methods: A patient with clinically localized prostate cancer (T1c) with a PSA of 8.8 ng/mL, who decided to delay any conventional treatment, began treatment with 9 PC-SPES capsules/day. RESULTS: After 3 weeks, his PSA dropped to 1.4 ng/mL and after a total of 8 weeks, his PSA was less than 0.1 ng/mL (undetectable). He has continued on a maintenance dose of 6 capsules per day, decreasing to 4 capsules per day, with a continuing undetectable PSA. During this time the patient also experienced a number of strong estrogenic effects: loss of libido, erectile dysfunction, extreme breast enlargement and tenderness, reduction in overall body hair, pitting edema, and a significant drop in his lipoprotein (a) level (from 46 to 11 mg/dL). CONCLUSIONS: PC-SPES may provide additive advantages (or disadvantages) over prescribed hormonal treatments but must be compared with other hormonal and nonhormonal treatments in clinical trials with hormone-sensitive and -insensitive patients with prostate cancer to determine its future use or nonuse.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
8/354. Immunoreactivity of prostate-specific antigen in male breast carcinomas: two examples of a diagnostic pitfall in discriminating a primary breast cancer from metastatic prostate carcinoma.Prostatic-specific antigen (PSA) is regarded as a specific marker secreted by normal and neoplastic acinar epithelial cells of the prostate gland; its detection by immunocytochemistry has been accepted as an indication of metastatic prostate cancer. This is ascribed to the commonly held belief that PSA is not found in extraprostatic tissues. However, this concept has recently been challenged, based on the observations that certain nonprostatic tissues and their neoplasms can also secrete PSA. Such a questionable belief could result in a diagnostic pitfall when using immunostaining for PSA on fine-needle aspiration (FNAC) cytology samples to differentiate metastatic prostate cancer from a primary carcinoma of an extraprostatic organ. In this communication, two cases of primary carcinomas of the male breast are reported in which PSA immunopositivity on FNAC led to the suggestion of a diagnosis of metastatic carcinoma of the prostate. Diagn. Cytopathol. 1999;21:167-169.- - - - - - - - - - ranking = 5keywords = antigen (Clic here for more details about this article) |
9/354. Primary care screening for prostate cancer.Prostate cancer is second only to lung cancer among killers of men in the United States. Researchers continue to develop tests that are more sensitive for diagnosing prostate cancer. At present, primary care assessment and evaluation of the disease are determined by physical evidence that may not be apparent and by laboratory values that may not be truly reflective of the underlying disease process. men over the age of 40 need an annual evaluation for increased prostate-specific antigen (PSA) along with a digital rectal examination. Some data suggest that the digital rectal exam and PSA levels may be insensitive indicators of prostate cancer in men with low total or free testosterone levels. The synergistic effect of testosterone on PSA could mask indicators for evaluation of prostate cancer.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
10/354. Cushing's syndrome in prostate cancer. An aggressive course of prostatic malignancy.We report a case with an initial diagnosis of adenocarcinoma of the prostate in whom Cushing's syndrome developed. The disease did not respond to estrogen treatment and the patient died of severe septicemia. Histopathologic examination of the autopsy specimens revealed a small cell carcinoma intermingled with a moderately differentiated adenocarcinoma in the prostate and widespread metastases of small cell carcinoma. Immunoreactivity for neuroendocrine differentiation was found only in the small cell carcinoma. Determination of different tumor markers in plasma samples showed markedly elevated levels of prostate-specific antigen as well as carcinoembryonic antigen prior to treatment, with no significant changes after treatment. The concentration of the neuroendocrine marker chromogranin a was initially within the normal range, but increased during estrogen treatment, whilst neuron-specific enolase was moderately elevated throughout the observation period. copyright copyright 1999 S. Karger AG, Basel- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
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